A day in the life of a social care occupational therapist

Claire Wright is an advanced practitioner occupational therapist (OT) working in adult social care. She describes a typical Thursday working from home. 

08:30 – It is a beautiful sunny day and today is a work from home day so, after a relaxed start with coffee on the patio, I ‘commute’ to my desk and log on to check and respond to emails.

09:00 – My first task is supervision; part of my role is to provide clinical supervision for other OTs and OT assistants. Today I am supervising a colleague, Kate*, who has been supporting a resident with a physical health condition. Kate describes the challenges of supporting a resident with rapidly declining mobility and no formal care in place who wants to remain safe in their own home.

We discuss what this means for the resident, concluding that it is the loss of independence with personal care tasks, such as washing and dressing, which was causing the most challenge. Throughout our conversation, Kate identifies a range of strategies to enable the resident to live in congruence with their personal values and without the perceived intrusion of formal support services.

Kate reports feeling confident to support the resident with maintaining their independence while minimising risk. We then discuss upcoming changes to practice and training opportunities and then explore Kate’s plans for her future personal development.

We look at the Royal College of Occupational Therapy career development framework together and Kate suggests mapping her experience to the four pillars of practice – evidence, research and development, facilitation of learning, professional practice and leadership.

I leave the meeting feeling that our supervision was a valuable conversation that allowed us both the space to reflect on the ongoing development of our practice. I commit to completing the same mapping exercise myself.

10:00 – I make some coffee and do a quick write-up of my supervision notes, which are then sent to Kate.

Promoting independence

10:30 – Time to leave for my first visit of the day. As part of my role, I visit residents in their own homes to assess their functional ability and provide advice, referrals and equipment to support them to remain there, living as independently as possible.

I cover the whole county so travel can be a large part of my day. Today, it took 45 minutes to reach Tim, who lives with his partner, Jane, in a beautiful, rural part of the county. Tim has motor neurone disease and we’ve been working together to help him live independently for two years.

He has a razor-sharp sense of humour and a clear understanding of what he needs from professionals and what he wants to achieve in his life.

Recently, he has been experiencing increasing challenges with his toilet transfers and this has led to a decline in his wellbeing, independence, and dignity.

The standard approach in this case would be to move to a passive transfer method, such as a hoist and slings. However, this would lead to increased transfer times, a higher likelihood of accidents of urinary continence and potential additional costs in formal care. This is not what Tim wants, so we have been investigating potential solutions.

The freedom to innovate

Today, we  investigate a new piece of equipment, called the Kera sit2sit, that Tim was keen to trial as it would enable a non-weight bearing transfer without the need for a hoist and sling. He would be able to use it supported by Jane without the need for an additional carer.

Having the professional freedom to explore innovative equipment to support a resident in meeting their occupational needs feels amazing. Tim and Jane felt that the Kera met their needs so they won’t be needing additional support.

12:15 – Back in the car for the 45-minute journey home and time while driving to reflect on the visit.

13:00 – I arrive home and go straight out to walk the dogs with my partner. I really value being able to manage my diary and support my work-life balance by scheduling breaks when they are most beneficial to me.

14:00 – I grab a quick bite to eat and then switch on focus time to write up the case notes from my visit. I complete a justification and risk assessment for Tim’s piece of equipment, place the requisition and write up the assessment.

15:00 – I usually take on a task that can be interrupted at this time of day as my teenage twins get home from school and like to stop by my home office to tell me about their day and to inquire about food. Today, I am reviewing and authorising colleagues’ recommendations for disabled facilities grants, which help disabled people make changes in their homes.

I examine whether what has been recommended is necessary and appropriate and will meet the needs of the resident, both now and for the foreseeable future.

Supporting others’ practice

16:00 – My next task is an audit. Each month I audit one of my colleagues’ occupational therapy assessments. I look for evidence of best practice and any areas for improvement.

Once complete, I arrange a meeting with the therapist to provide feedback on the examples of great practice I observed and discuss any areas they can be supported with through practical guidance or training.

This month, I had the pleasure of auditing a truly person-centred assessment where I could hear the voice of the resident throughout. I noted that this resident had received advice and signposting, as well as onward referral to other services and a prescription of equipment to maintain their independence in their own home.

I highlighted areas where we could refer to the Care Act 2014 to further support our professional reasoning and where changes to our own recording systems would more effectively capture best practice.

17:15 – I quick review my plans for tomorrow and my email inbox and finish for the day.

*all names have been replaced with pseudonyms