In this article (written 15th April 2020), Director, Jules Leahy, explains some of the operational changes that have been made to the delivery of rehabilitation therapies and medical treatment, as well as the daily lives of the clients in their care since the outbreak of COVID-19.
Prior to the COVID-19 pandemic, STEPS delivered rehabilitation throughout the day and evenings, and pretty much everything we did was about rehabilitation. That hasn’t really changed, but what has changed (for the time being) is the way we are doing it.
Normally, the start of the day is focused on supporting all clients to get up, dressed and out of their bedroom suites to undertake their planned rehabilitation sessions with specialist therapists and rehabilitation assistants. Clients are ordinarily in the therapy gym anytime between 8am and 6pm with therapists and into the evening up until 10pm with rehabilitation assistants, long after the therapists have gone home!
Getting showered and dressed to come down to gym, rather than having therapy in bedrooms has always been important psychologically for clients. Clients, relatives and staff also eat together in the café area, and activities and rehabilitation take place all over the building, as well as outside. Therapy sessions were planned for the week and clients’ timetables were emailed to them so they knew what they were doing for the week (which they could share with their family if they wished).
How does it look now?
Due to the Covid-19 pandemic, we have had to look at how we deliver our therapy sessions as clients are now mostly confined to their bedrooms. Each day the Occupational therapists start at 8am to do washing and dressing sessions. The therapy team meet together at 9am and plan the therapy to be delivered for that day. Because we have staff who need to self isolate, we never quite know who will be able to work, which means we have to work flexibly.
Despite this uncertainty, the new system is working really well and we are, in the most part, still managing to deliver the same amount of therapy to each client as in pre Covid-19 times.
To allow us to deliver the same quantity and standard of therapy we have recruited 3 new physios, 3 therapy assistants and 1 occupational therapist in the last 3 weeks. Our new team members join us from various clinical practices in Sheffield that are now not operating due to the current lock down rules.
For the last few weeks therapy sessions have all been delivered in clients’ bedrooms until the last few days, when we have trialled bringing clients downstairs one at a time and into the garden for one session a day. This is quite an operational feat, as we must maintain the highest levels of infection control, however we felt it was imperative for client wellbeing. The therapy sessions are planned very carefully to allow time to get the equipment needed into the client’s room, get dressed in the correct personal protective equipment (PPE) and then clean the equipment at the end of the session.
We have moved a lot of the gym equipment upstairs to the bedrooms; one client has the rowing machine; one the punch bag; two share the standing frame and two share the bike (which are all cleaned between clients of course).
When we designed our building a key requirement was that all the bedrooms had to be very large. As a result they can be used to practice walking and they all have a full-length mirror, which can be used for therapy; also the Wetrooms are all large enough to carry out sessions.
Therapists, therapy assistants and rehabilitation assistants have continued to deliver sessions throughout the day and into the evening. Rehabilitation assistants are able to support the clients with stretches, sensory programmes, neuro-stim, FES and exercise programmes.
All of the STEPS team work in a interdisciplinary way which makes working in this current way a lot less challenging than it would in another setting where this isn’t a normal way of working.
Virtual Sessions
We have been unable to have external professionals visit STEPS, so we are facilitating sessions such as psychology on Zoom. Our usual weekly consultant and GP visits are also now happening by Zoom. We have purchased enough new iPads to allow one iPad per bedroom to facilitate effective infection control.
Our Chroma Neurologic music sessions are another therapy session that we have had to temporarily rethink how we deliver. They are now happening over Zoom with our music therapist, Rebekah, delivering the sessions from her home, and one of our Physio students, Josh, supporting the session from STEPS.
We now have 2 team members working on supporting client wellbeing and they are providing invaluable support to our clients. This ranges from collecting shopping, toiletries, sweets etc. to a quiz on Zoom, potting plants, art, music, massage, relaxation and board games or just company and a good chat.
It is down to the ingenuity, enthusiasm and dedication of our wonderful team at STEPS that things are still functioning so smoothly and to such a high standard during these unprecedented times.
Take a look at our fly-on-the-wall video diary here.