In January my LA will be asking social workers to provide and fit basic equipment (pick up sticks, toilet seats, bath boards, grab rails). This will include undertaking a functional assessment, the main assessment tool that O.T's undertake. This is meant to be part of 'reablement'. I was just wondering weather other LAs will be (or have been) doing this? And what anyones feeling on this is? We as a team are not happy about doing this, and do not feel comfortable taking on a role that O.T's train for 3 years to do.
LEEDSLEEDSLEEDS: In January my LA will be asking social workers to provide and fit basic equipment (pick up sticks, toilet seats, bath boards, grab rails). This will include undertaking a functional assessment, the main assessment tool that O.T's undertake. This is meant to be part of 'reablement'. I was just wondering weather other LAs will be (or have been) doing this? And what anyones feeling on this is? We as a team are not happy about doing this, and do not feel comfortable taking on a role that O.T's train for 3 years to do.
My LA have been doing this for years. To be honest, you don't need an OT qualification for very minor aids and adaptations, just decent training and mentoring (we have a 12 week programme) and access to qualified colleagues if in any doubt. Plus experience and practice, as with many things, will count for a lot as time goes on. It frees up the OTs for more complex work and brings the waiting lists down. Personally, I've not seen any problems arising yet (touch wood).
I quite enjoy getting my tape measure out. Mind you , I caught myself mentally measuring up my mum's bath for a bath board at the weekend...
Ideally it would be preferable for any Aids & Adaptations assessment of a person with a disability to be signed off by an OT - that is their area of expertise and they may spot something than an unqualified person may well have missed.
What is the view of the local OT's?
In my LA we have Generic workers - used to be called sw assistants or OT assistants - and they combine both OT and SW elements. They have had some training where as a SW I have not. I would worry as a NQSW if i allocated a bath board or toilet seat and the S/U then had an accident - where would that leave me legally, I have not had any OT style training.
I am a first year social worker student and I have already learnt social work has no categorical definition of what role they have. But I am certain it's not the role of an OT. Social Work in Scotland is a generic profession and I feel expanding our knowledge on care needs and services is pertinent in delivering high quality of care.
However, social workers are constantly under pressure and giving social workers more jobs to do may adversely impact on them helping service users. OT assessments should be carried out by OT's as they are the qualified professional to do so. I agree with one of the other comments that social workers may not recognise what care or aid is needed in terms of OT to assist the service user.
For instance, if a service user requires a specific wheelchair, the social worker may not have the skills to provide this. Finally, maybe the OT's would benefit more with liaising with Physio's as they too work in 'reablement'.
Mandi: For instance, if a service user requires a specific wheelchair, the social worker may not have the skills to provide this. Finally, maybe the OT's would benefit more with liaising with Physio's as they too work in 'reablement'.
No-one's suggesting doing wheelchair assessments or anything like that level of sophistication. Social workers and SW assistants, properly trained, are quite capable of assessing for things like grab rails, trollies, reacher sticks, extra bannisters, small kitchen aids and offering advice like taking up loose rugs and reorgansing one's space and routine to make things easier.
We used to have people waiting for months to see an OT because they were so taken up with trivia.
Mandi : ''Social Work in Scotland is a generic profession'' Eh?! Since when? I am a social worker working in Scotland and I can assure you the role certainly isn't a generic role!
With regards to the initial post I think I too would be uncomfortable with completing OT assessments as I believe that should be a protected part of the OT role. I work in a multi-disciplinary setting alongside several OTs and whilst due to the setting (community care) and the roles we undertake (case management) there are lots of overlaps in terms of initial assessments etc, when it comes to more specialist OT assessments, kitchen assessments and so on, the OT would take the lead or if there were adult protection issues the social workers would be more likely to take the lead. I believe this is what makes a multi-disciplinary team work...if each discipline is clear about what their role is and their 'protected' responsibilities but also work within a larger framework or approach; recovery model for example.
Just my rambling thoughts for this evening!
I understand what you are saying, but one thing may lead to another and before you know it your carrying out assessments for wheelchairs etc.
Is it within the SW remit to take on these trivial task's to free up the time of OT's, and will this not increase the workload of SW?
Do you provide training for carers to carry out these task's?
I just started doing my social work programme this year! So im just a learner and find it interesting as to why you say it is not a generic profession. As I am being told in university that it is.
Can you explain if you can in more detail?
It is a generic profession - that is, however, different from practitioners working generically as used to be the case in the 1970's and 80's especially. Specialisation has now become far more accepted and the split between Adults and Children's Services especially very much began that process.
This is nothing new as I was being asked to do it in my first NQSW post with Cleveland county council in 1989! My social work course had nothing in it about 'aids and adaptations' and we were given no training on the job other than a brief informal chat with experienced colleagues! We had to go out and do the initial assesment and refer it to the OT if it required anything more than bath/toliet aids such as a ramp. There was such a long waiting list for the OT that clients just could not wait a year or more for a toilet seat or grab rail. We had to initially assess for major renovations such as downstairs toliets etc but this would always require a final OT report before approval.It seems things have come round full circle!
This is nothing new. I trained as a social worker only to find they wanted me to be a typist.
Hi! I think Rupert is right - as the OTs what they think. Interesting that someone has said social workers are doing these trivial jobs to save OT time. Wouldn't our time be better spent as trained professionals ourselves in doing social work? Many social workers no longer receive car allowances so we are surely under no obligation to ferry bits of equipment around in our own vehicles. Raised Toilet Seat on the bus, anybody?
BAOT/COT the professional body for OT in the UK published a guide for housing associations which may be of interest to those on this thread. It is available as a free download here http://www.cot.co.uk/publication/books-z-listing/minor-adaptations-without-delay
12 week programme? Is this the same social work "profession" which was aghast and apoplectic when it was suggested that teachers and lawyers be fast tracked into social work? No wonder we are thought to be up ourselves.
Shirack: This is nothing new. I trained as a social worker only to find they wanted me to be a typist.
Came in handy though, or we would never have heard of you in here!
Where I work, OTs do their own assessments as well as setting small packages of care, MOWs, Telecare etc, It has not yet been introduced for SWs to conduct OT assessment, even at a basic level, however, it has been heard int he pipeline that quite soon, SWs will be conducing financial assessments as well as our own work.
This again goes back to the issue of the SW role. GSCC have tried on numerous occasions to define the role of a social work with adults, but these list of tasks always appear to become blurred or merged at some point. Its unfortunate but it is likely this will only continue as budgets get smaller a well as teams within the Local Authorities and the tasks of a social worker will continue to murged and blurred further.
hehehe
Look, you don't need to be an OT to provide someone with a grab rail or a banister. Thousands and millions of houses across the countries have been fitted with banisters without any OT going near them. And the worst that can happen if a grab rail is in the wrong place is the client can't reach it and you have to put one in the right place.
But, the problem with the approach as outlined in the first post is that people assume that because equipment is simple, the assessment process behind it must be simple too. Sometimes you don't want to provide someone with a raised toilet seat, you want them to work on their quadriceps exercises and be able to get up from the toilet independently. Social workers could learn the basics of simple equipment easily enough, but that's not the difficult bit - the bit that really matters is the assessment process that gets you to the providing the equipment bit, and that's a different matter altogether.
Kirst: Look, you don't need to be an OT to provide someone with a grab rail or a banister. Thousands and millions of houses across the countries have been fitted with banisters without any OT going near them. And the worst that can happen if a grab rail is in the wrong place is the client can't reach it and you have to put one in the right place. But, the problem with the approach as outlined in the first post is that people assume that because equipment is simple, the assessment process behind it must be simple too. Sometimes you don't want to provide someone with a raised toilet seat, you want them to work on their quadriceps exercises and be able to get up from the toilet independently. Social workers could learn the basics of simple equipment easily enough, but that's not the difficult bit - the bit that really matters is the assessment process that gets you to the providing the equipment bit, and that's a different matter altogether.
the worst thing that can happen is not only that the client cant reach the grab rail - they could fall , injure themselves and others assisting them, idont feel that i could be knowledgable enough to asses and provide grab rails , although prob could assist a client to get a replacement aid if there was no change in need.
i agree with the aspect of assesments being the most crucial part of the process.
i also think we all need to be careful and think about the proffessional training and experiences we each have and respect those of O.T s , physios, speech and language therapists etc.. as there will be people out there as well that believe the whole role of social workers can be done by anyone, without any proffessional training as its straightforward to fill in an assesment form , protect a child, support a family etc .. before we know it no need for proffesionals at all , big society??
You'd have to be spectacularly stupid to put a grab rail where someone couldn't reach it. And even if you did, the person would be no worse off than they were when they had no grab rail at all.
Kirst: You'd have to be spectacularly stupid to put a grab rail where someone couldn't reach it. And even if you did, the person would be no worse off than they were when they had no grab rail at all.
god forbid the LA that employ me ask SWs to take on OT role: I am that spectacularly bad/stupid person at diy around the home...there is a reason I'm not an OT, or a joiner/decorator/tradesperson, and that's for the safety of others and myself lol... joking aside, the erosion of professional boundaries is worrying. And even more so considering social work's forthcoming absorption into the HPC. I value the work and input of OTs in my work and i would hate to think either profession is to become a jack of all trades and master of none. Or is it the modern thing to tie a brush up the backside of any public sector professional and make them take on several different trades, in the name of efficiency savings
I'd like to see them try the same thing with GPs - oh Dr Kildare, whilst you're out doing home visits, would you mind just measuring up for that grab rail / additional step at the door? Hmm, can't quite see that. But then the way the medical profession is treated is very different to that of allied health professionals, social workers etc, at least in government eyes.
The more time I spend as a qualified SW in front of a computer screen doing the work that admin used to do and how that impacts on the time available to see real people in a social work capacity, to then think I'd be assessing and arranging OT aids and adaptations on top of that... frightening. There's not even the time to fulfill the SW role as it is with caseloads on the up, compulsory redundancies and staff sickness. Or is that the general plan, for social workers to cease having time to social work? Just a thought...
You should see my DIY 'Kirst' - you'd be 'spectacularly stupid' to even let me near a piece of wood and a hammer!!!
suesy q: Kirst: Look, you don't need to be an OT to provide someone with a grab rail or a banister. Thousands and millions of houses across the countries have been fitted with banisters without any OT going near them. And the worst that can happen if a grab rail is in the wrong place is the client can't reach it and you have to put one in the right place. But, the problem with the approach as outlined in the first post is that people assume that because equipment is simple, the assessment process behind it must be simple too. Sometimes you don't want to provide someone with a raised toilet seat, you want them to work on their quadriceps exercises and be able to get up from the toilet independently. Social workers could learn the basics of simple equipment easily enough, but that's not the difficult bit - the bit that really matters is the assessment process that gets you to the providing the equipment bit, and that's a different matter altogether. the worst thing that can happen is not only that the client cant reach the grab rail - they could fall , injure themselves and others assisting them, idont feel that i could be knowledgable enough to asses and provide grab rails , although prob could assist a client to get a replacement aid if there was no change in need. i agree with the aspect of assesments being the most crucial part of the process. i also think we all need to be careful and think about the proffessional training and experiences we each have and respect those of O.T s , physios, speech and language therapists etc.. as there will be people out there as well that believe the whole role of social workers can be done by anyone, without any proffessional training as its straightforward to fill in an assesment form , protect a child, support a family etc .. before we know it no need for proffesionals at all , big society??
With regards to that last sentence is that not happening and even happened already? In my old team the unqualified staff vastly outnumbered the qualified staff with UQ often taking on adult protection work. To be honest Im not sure once theyve done it a few times there was really any difference in the quality of work either - it is after all how qualified staff learn the majority their trade (ie on placement rather than in the classroom). That and your real learning takes place in post anyway.....
Connexions and sure start andf family support have all taken away roles from childrens social workers - often with the same specific brief - and whe i did childrens placement it was hard to tell the difference between unqualified and qualified roles - particularly if the qualified had only been in post a few years.
Often though that as a brand social work (and its aim of supporting peple) is tainted irreversibly for professionals, service users and the general public and as a company there would either be a huge million pound rebranding exercise - or it would be declared bankrupt and restarted under another name....
Rupert M: You should see my DIY 'Kirst' - you'd be 'spectacularly stupid' to even let me near a piece of wood and a hammer!!!
You do realise that the OTs don't fit the rails themselves? Neither do they remove baths and create wet floor shower areas themselves? Any kind of construction work, from fitting a 12" plastic grab rail to building an extension is done by qualified tradespeople.
Kirst: Rupert M: You should see my DIY 'Kirst' - you'd be 'spectacularly stupid' to even let me near a piece of wood and a hammer!!! You do realise that the OTs don't fit the rails themselves? Neither do they remove baths and create wet floor shower areas themselves? Any kind of construction work, from fitting a 12" plastic grab rail to building an extension is done by qualified tradespeople.
Just checking
I have been a Btec trusted assessor for OT equipment - move with the times ! whats the big deal ?
How strange, I came back to the earth to be a Social Worker and the earthlings now what me to be an IT expert - agile working, smart pens, Blackberry, Note book and all that tec....
OTs look out here I come - what challange is it to assess for a grab rails, bath seat, commode, perching stool, RTS, chair raiser, helping hand. I did the Btec trusted assessor in 4 weeks, well worth it, why would I want a client to be on a 9 month waiting list !
Has anyone thought what a terrible waste of all that expensive social work training going to waste because it is not being used properly?
Our role is quite clear, to help people achieve positive change in their lives and fight for social justice. There is an international definition of social work that describes that process. You can access guidance from Scottish Government on the role of the social worker - based on that definition - and pulled together in a very helpful booklet that you can download from the website called - Practice Governance Framework: Responsibility and Accountability in Social Work Practice March 2011 www.scotland.gov.uk
Ruth Stark: Has anyone thought what a terrible waste of all that expensive social work training going to waste because it is not being used properly? Our role is quite clear, to help people achieve positive change in their lives and fight for social justice. There is an international definition of social work that describes that process. You can access guidance from Scottish Government on the role of the social worker - based on that definition - and pulled together in a very helpful booklet that you can download from the website called - Practice Governance Framework: Responsibility and Accountability in Social Work Practice March 2011 www.scotland.gov.uk
i agree with the first bit - i dont see a lot being done about it tho
Just a thought, who is insuring the unqualified person carrying out a task that takes an O/T three years to qualify for? And are the people giving the insurance cover aware that unqualified people are carrying out these task's?
All workers are insured by their employer to do anything their employer has asked them to do as long as they're doing it in the manner they've been taught to do it. And I would remind you that it does not take 3 years to learn where to put a grab rail or a banister - builders and joiners do it every day without any OT training.
The issue isn't grab rails, banisters or equipment. The issue is knowing what you're hoping to achieve by providing something, can that aim be achieved by something else, what the outcomes are likely to be and what the outcomes would be if you didn't do it. OTs don't walk into houses, say oh, you can't get off your toilet, have a grab rail - there's a complex assessment process going on in the OT's head, even if they don't articulate it.
If I arranged for an electrician to come and fix something in my house and a joiner turned up instead I would be very annoyed. Both skilled people the joiner and the electrician would say that they are there to help people. All that the Social Workers are suggesting is that we use the people with the right skills, knowldge and expertise for the right jobs. It will give you the SU the better service and will be a better use of scarce resources.
Surely, all you need is knowledge of what is available and ears to listen to the client.
There will be exceptions I know but most will be able to articulate problems pre and post change.
Why do we have to make things so farting complicated.
A Service User with a physical disability needs an OT Assessment which may well highlight other than the 'presenting' need - Ruth is correct in stating that the right people should carry out assessments / work.
Shirack: Surely, all you need is knowledge of what is available and ears to listen to the client. There will be exceptions I know but most will be able to articulate problems pre and post change. Why do we have to make things so farting complicated.
No, there's a bit more to it than that. You need to know what the client's medical condition is, what treatment they have had, what the likely prognosis is, what they would like their functional outcomes to be, the structure of the house, their cognitive state, their motivation and a whole lot more. And if you think that sounds over the top, that's because you're not an OT, you haven't had the training and you don't know, for example, that if someone is having trouble getting up from the toilet after heart surgery, you never give them a frame with arms to push up from, you always give them either a higher seat or a rail on the wall in front to pull on. Or that someone after knee replacement surgery should be encouraged to bend their knee, someone after certain types of hip surgery should be discouraged from bending the hip. It's not as simple as "they can't do that so we'll give them that" - knowing what not to do is just as important.
Good points Kirst. As you say I'm not an OT and you have enlightened me. Thanks.
And for those who jump in without thinking first who knows they too may end up needing an OT assessment!!!
Excellent and informative posting Kirst.