“The power of being at home should never be underestimated” – Laura Wood, Home First

The power of being at home in familiar surroundings should never be underestimated, according to Laura Wood, the Occupational Therapist who led the Home First year-long pilot in Orkney.

With support and guidance from Ruth Lea, the Occupational Therapy Lead – Adult Services, Laura and the Home First team ​have been able to transform people’s lives, ensuring the right care, at the right time is in place relevant to each person’s needs.

The Home First team, who work in tandem with social care, Care at Home staff and physiotherapists have supported patient’s home, and in some cases prevented people from going into residential care.

The patients we spoke to stressed that home is the place they want to be for as long as is safely possible and Laura firmly agrees.

“The power of being at home should never be underestimated and we have been seeing the results for ourselves; the improvements in patients, even those ​who are deemed to be severely frail are quite remarkable. With familiar surroundings and an environment, they love, you tend to see people do more for themselves, which, in turn, I believe actually prolongs their life. Home is a great place for rehabilitation as people tend to be more focused and driven to participate in daily activities and  do things for themselves. Lying in a hospital bed when you don’t need to be there can often lead to low mood and quite rapid deterioration which is what we all want to try and avoid.

“The Home First experience really has surpassed all my expectations in terms of how good the occupational outcome performance improvements for patients have been. This isn’t just lifechanging for the person themselves but also for their families and carers.”

Home First is a new care model which supports people home from hospital and aims to help people establish their care and support needs in their own home environment. The team helps support people to be as independent as possible within their home and focuses on working towards any goals they may have.

The Home First team is to be permanently established and will be ultimately linked with Intermediate Community Therapy and the Mobile Responder Green Team to form an intermediate care hub with a single point of access.

Laura, who trained in Edinburgh and worked in various hospitals throughout Glasgow as an OT and stroke specialist, says she took a gamble by moving back to Orkney two and a half years ago to a temporary post within NHS Orkney.

“That gamble has definitely paid off. After securing the Home First role, I can honestly say that it has been the most exciting project I have worked on in my career to date. ”

Hospital patients who may benefit from Home First support are referred to Laura and the team. She will typically ​meet and assess the person within hospital, then ​accompany them home for the first time.

“Assessments will be carried out with ​the person, and we will also look at their home environment. We aim to involve not only the person, but their families and carers too when that is appropriate. We can offer assistance not just in terms of physical, cognitive and psychological support, but also practically with equipment and personal aids. We also make onward ​referrals for more major pieces of work that may be required such as wheelchair ramps, wet rooms etc. We are also able to signpost people to other agencies such as Age Scotland Orkney, Befrienders or Crossroads, ensuring their needs are being met in the community as best as possible.”

“This is also about joined up working with all teams. I work closely with the Home Care staff, and they are the experts in so many ways - I have learned so much from them in this last year. By working ​together on a daily basis, we can best assess how to ensure a person can live safely at home and what kind of support they may need to allow that to happen. We also find that often a person’s support needs during their time within Home First has reduced, as they become more independent and gain confidence in their own abilities at home.

“This is not about taking care away from people, this is about enabling people at home – I have found that people typically want to be within their own home and to be as independent as possible. We listen and work towards their personal goals – which may be washing your own face, or brushing your own teeth, making a cup of tea to managing to move around your home independently or getting out and about. When people achieve personal goals, it tends to spur them on to think of the next goal they wish to achieve. We are giving people a voice to express their goals and wishes at home.

“It can often be a daunting thought for patients when discussing the transition from hospital to home, especially after a long hospital stay or when for those who have never required assistance at home before are faced with others coming into their home to help. People can have anxieties about that loss of independence and change in their routine.”

Laura would typically visit a person weekly for around six weeks, however that varies depending on the individual.

“The job satisfaction I get is tremendous. Watching people’s confidence and independence grow as they make their own personal achievements and enabling them to live safely at home for as long as possible is such a pleasure to be involved with. We are all delighted that Home First is now permanent and will hopefully assist many more people.”