The Bi-Borough Short Breaks Team have 1.5 Occupational Therapists (OT’s) and 0.5 Occupational Therapy Assistants (OTA’s) dedicated to the Borough of Westminster. The OT’s and OTA’s support children and young people with disabilities in their home environment. The aim of the service is to support a child / young person and their carers to manage everyday tasks through:
- provision of specialist equipment
- provision of advice and teaching alternative ways of doing things to increase independence
- recommendations for adaptation to their homes
- referral to appropriate agencies when necessary
How the service is provided
Referrals are made directly to the Westminster (Bi-Borough Short Breaks Service) OT Team and can be made by anyone who knows the child / young person / family and who has their consent. Once full referral information is received, the service aims to respond to all referrals within 5 working days. The service operates a priority system where the children in most need are seen first. Following a referral being accepted, an assessment for a new child /young person will be carried out within 6 weeks or sooner, subject to the availability of the family.
What happens at an assessment
An OT / OTA will conduct a home assessment. The aim of this is to establish the child / young person’s abilities in all activities of daily living (ADL). This will include observing / discussion how the child / young person:
- gets in and out of the home
- gets in and out of their bed / bath
- sits on a chair for mealtime / play
- gets dressed
- eats / drinks / participates in meal preparation
- remains safe in their home
During assessment consideration will be given to any transport requirements and any assistance required to support safe transfer.
From the information obtained at the assessment, the OT will propose outcomes and ways of overcoming problems that have been raised, with the child and parents/carers
Adapting the home
OT’s will recommend adaptations when they are assessed as ‘necessary and appropriate’ and ‘reasonable and practicable’. Adaptations are only carried out with the permission of the landlord or property owner and funding for adaptations is dependent on the owner of the property. Funding an adaptation may require an application to Westminster Council for a Disabled Facilities Grant (DFG).
Adaptations are usually provided so that the child can have:
- access to the building
- access to facilities for washing (this could be a bath or a shower)
- access to a room that can be used as a bedroom
- access to a room with a toilet
- safety in the home for the disabled person and other people living in the building
- access to the principal family room
- access to a room for cooking/ a wash hand basin
Loan of specialist equipment
Sometimes specialist furniture or equipment is needed to manage every day activities. This is provided via an OT recommendation and is on loan to an individual for as long as it’s needed and are living in the borough. If something is designed to “grow” with a child/ is likely to need replacement for growth or requires ongoing review, the OT’s will review the child / young person’s needs every 6-12 months, or as parents / carers alert them to change.
Other OT and therapy services
There are other OT’s in the borough who are employed by the NHS (CYPOT Service) and the Special Educational Needs department, to work with children with additional needs in their nursery or school to support inclusion. CYPOT also give developmental support to pre-nursery infants.
Social care OT’s work closely with the other OT’s working with a child, and with parents’ permission, share our assessments and follow up each other’s work to avoid asking the same questions. We also work closely with other members of Child Development Teams, in particular the Physiotherapists, who will often be involved in orthopaedic management, postural care and the provision of mobility equipment (i.e. walkers and standing frames).
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