In 2021, following a comprehensive assessment by the Adult Learning Disability (ALD) Occupational Therapy (OT) service, the first OT recommendation was made for a dedicated regulation space aiming to:
- Enhance participation in occupations
- Ensure access to essential facilities within the home for autistic adults with a learning disability
- Reduce levels of dysregulation and improve quality of life
An involvement project was designed to evidence and evaluate the impact of housing adaptations for adults with a learning disability who present with access issues that are not related to physical disability – challenging the status quo re: who can access this funding. Ensuring that all types of disability have the right to live their best lives in the community.
Actions taken:
- Collaborative assessment process and design re: regulation space to meet individualised needs based on valid, reliable and standardised assessments, along with clinical observations and carer and service user involvement was central
- OT and a carer co-designed The Housing Adaptation Impact Survey as an outcome measure to capture this new development and shift in perspective/OT practice.
- Pre-recorded carer interview sessions x2 were made with WHSCT OT staff and CEC AHP staff to measure and share the impact of carers using their own words”
The outcome measure developed assesses the impact on the client and carers’ pre and post housing adaptations – this has been adapted for use within WHSCT ALD OT services and shared regionally across ALD OT services
- The outcome measure collates quantitative data regarding the impact on the client such as levels of distress/anxiety, engagement in activities, interactions with family etc. The impact on the carers in terms of stress, ability to supervise and maintain safety etc are also examined. Quantitative data is collated and compared using a 5 point Likert scale and ‘free text’ comments are encouraged to collect more qualitative/lived experience data regarding the impact on everyday life
- Change in practice re: how OT appraise and assess for housing adaptation in a more inclusive way
- Sharing or changes within Trust e.g. OT paediatrics and regionally across ALD OT services
- Sharing initial results via interagency collaboration e.g. NIHE/DoH Health and Housing Liaison Officer
Results/Impact (outcome measure) noted to date
Quantitative
Summary of the impact on client:
- Reduced frequency and intensity of distress
- Increased engagement and interactions
- Improved quality of life
Summary of the impact on carers:
- Reduced frequency and intensity of carer stress
- Enhanced supervision and ease of maintaining safety etc
- Improved quality of life
Qualitative
Carer shared their lived ‘rich’ experience in their own words re: impact of housing adaptations at a Regional ALD OT workshop event in Belfast in February 24 – feedback was extremely positive for carer input
What has been learned
The emotive and rich lived experience is much more powerful when articulated by a carer/service user as opposed to a health professional speaking on their behalf – their own words bring the impact to ‘life.’ Working in partnership is key to meetings needs and developing trusting and therapeutic relationships
Abstract has been accepted for presentation at Allied Health Professionals (AHP) Innovation and Research Conference in September 2024 – the presentation will be co-produced with carer(s) – sharing their views and insights
WHSCT AHP Quality Improvement day – Nov 2024 – plans to have a service user involved in this project – present their lived experience directly to a wide audience.
