The COVID-19 pandemic is affecting all aspects of the world of neurorehabilitation, with people and businesses working within the sector turning to innovative new ways of working to protect and support clients.
Here, in the first of a series of insights brought to you by the neurotrauma team at Sintons, Jules Leahy, development director at STEPS Rehabilitation, a dedicated rehab facility in Sheffield, shares how the centre is achieving many positives from the most difficult of times.
Protecting our clients is always our priority, but keeping them safe during these current times is the overriding concern. For some of our clients, due to the nature of their injuries and conditions, they could have a survival chance of less than 50% if they contracted COVID-19, so we addressed the risks in this area at the earliest opportunity.
We have been planning for the onset of Coronavirus since the end of January and introduced lockdown in mid-March, a week ahead of the official Government instruction.
A swift redesign of our centre layout followed and we moved our most vulnerable clients – those who have a tracheostomy – to the top floor, in an area of the building that can be closed off by doors normally left open. We relocated our games room and created a mini gym just for their use, so they could have some time outside of their rooms In the last week we have also introduced rehab sessions in our garden for certain clients to attend, one at a time, and with extensive cleaning of our lift and equipment between each patient’s use.
We have gone to great efforts to give all our clients as much normality as possible in these far from normal times. Not having regular visits from family and friends is enormously challenging so we have created folders for every client with a record of things they like, compiled in association with their loved ones, so we can be sure we are doing something with them they enjoy.
Everyone has access to an iPad, we have invested in 15 more so we have enough within the centre, so they can video call family and friends, as well as each other. We have had afternoon teas and we are doing a quiz every week for all of our clients, as communication and social interaction is so important, even if that can’t be achieved in person. We realise being in their rooms for such a long period of time each day is very challenging for our clients and their mental health, but we ensure they have one-to-one time with a rehab assistant or wellbeing co-ordinator for some time for an activity they enjoy, be that playing a game, potting plants, having a hand massage, or anything else they enjoy.
We have discovered a number of new ways of working and of delivering rehabilitation, which benefit us greatly, one of the main ones being that some of our therapy sessions and medical assessments are now being delivered by video. Our neurologic music therapy sessions, which are hugely popular, are now held via Zoom, with an assistant on-hand in person to assist if needed with any movement.
Recently Dr Liz Iveson, a wonderful consultant we work with, diagnosed a problem via video which could have led to this particular client losing their sight had it remained untreated. We have always worked in an interdisciplinary way, but currently that is even more useful to us. For example, instead of nurses having to put on their full PPE to enter clients’ rooms to do a temperature check, if a physiotherapist is already there, they can do that instead.
A number of new staff members have joined us, who are fantastic, and we adopted a new way of recruiting which may well become more widely used. We couldn’t hold our usual recruitment days so held telephone interviews and then offered on-site experience to see how they took to the roles and interacted with our clients. We have found several really excellent new team members – some are students who are not able to go to university in the current climate, some are self-employed people who cannot do their usual jobs, and we have some brilliant physiotherapists with us who are ordinarily university lecturers with private practices – we have been able to build relationships with them we are confident will last well beyond the COVID-19 lockdown.
Our team have responded to the situation in the most superb way and we are genuinely all in this together. Everyone has stepped up and goes well above and beyond what is asked of them, working extra hours to ensure our clients are safe, well and happy. A really strong community has emerged among our staff as we all work to keep morale up. We are now a stronger team than we ever have been.
While we have discovered many new positives from this unprecedented situation, we have also had to deal with significant challenges. In early April, one of our clients became poorly and was taken into hospital with suspected COVID-19. The hospital wanted to send the patient back to us, and the family was desperate for them to be discharged, but we insisted this could not happen until the client was tested for COVID-19, so we could make proper provision in case of a positive diagnosis. The client was confirmed as having COVID-19 so we had to make some further rapid changes within the centre. We created a totally segregated section for this client, so they would not come into contact with any other clients, and a limited number of staff, all in the appropriate PPE, visit this area only.
As with other healthcare organisations across the country, we have struggled to obtain PPE. We were initially offered 300 surgical masks by PHE but that was nowhere near enough – we have clients with tracheostomies, we need full PPE to keep them and our staff safe. It has almost been a full-time job in finding this equipment ourselves. We have had to source overalls from a local decorating shop, as medical PPE has been so challenging to source – we have ordered 1,000 pairs. At one point we also had bin bags ready to turn into aprons – luckily some aprons arrived and we didn’t have to use them.
For a small business like ours, we have had to make huge investment into buying equipment, implementing new processes and taking on new staff, but this is what we will continue to do to ensure everyone stays safe. We have seen an amazing team effort from our staff and clients alike, the way everyone has pulled together during these very difficult times has been incredible, and I couldn’t be prouder of what we have done.
