Rachel Russell, Senior Advisor at Foundations image
Rachel Russell, Senior Advisor at Foundations

In this exclusive guest article for AT Today, Rachel Russell, Senior Advisor at Foundations, explores the development of Foundations’ new Adaptations Triage Tool, which formally launched on 22 March 2022. Rachel starts by answering the question: “Why develop a triage tool?”

The triage tool was developed in response to ‘Adaptations without delay’, published by the Royal College of Occupational Therapists (RCOT) in 2019. Waits for an assessment by an occupational therapist in social care can be lengthy and can be seen as a delay in the DFG process.

‘Adaptations without delay’ makes the case that trusted assessors could effectively manage more straightforward cases if supported by appropriate operational and procedural mechanisms, such as a triage tool. This would allow occupational therapists to focus on the complex cases where their skills and knowledge are most effective in assessing and supporting the design of the adaptation.

Following the publication of ‘Adaptations without delay’, there was an appetite from both occupational therapy teams and adaptations services for Foundations to develop a triage tool, so work began on a tool in 2019.

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We have used an iterative process to develop the tool that continues today, as we gather further user feedback.

The first stage involved a desktop review of relevant legislation, good practice guidance, research, and other literature related to complexity and the occupational therapist’s role in the adaptation process. From this, we developed the initial triage tool, and we held a focus group with stakeholders to get feedback, which indicated it needed to be shorter.

Finally, we have worked with the University of Salford and their students to refine the triage questions and pilot them with several local authorities.

The triage tool now only has four questions (initially, it had nine). However, there are initial screening questions that ensure the person can participate in the triage process and adaptions are the right intervention pathway.

Despite only asking four questions, they focus on the critical factors that make an assessment of what adaptations are ‘necessary and appropriate, complex or straightforward’. Below is a brief explanation of what each question explores.

Question 1: Considers the complexity of the person’s current and future condition, and the implications on the individual’s long-term health and social care needs.

Question 2: Considers complexity of the activity(s) the person is struggling to perform and where those activities take place in the home environment

Question 3: Considers the complexity of the care needs of the individual and any current or future equipment that may be required when using the adaptation.

Question 4: Considers the complexity of the impact the potential adaptation could have on others living and using the property.

Over the last six months, several local authorities have been piloting the tool. Salley Holley, an occupational therapy manager from Leicestershire, gives her thoughts and views on the triage tool in an interview about the pilot that can be seen in our webinar recording from 22/03/2022.

Another senior practitioner who piloted the tool reported that although they only triaged a small number of cases, the tool had guided the questions to the customer and ensured they were getting a complete picture of the difficulties they are having and any potential changes in the near future. They also could see that the tool would be useful to be used more widely within their duty team, especially with customers they had previous involvement with.

A copy of the triage tool can be downloaded here.

If you would like to discuss how the triage tool could be used in your local authority, then contact Rachel Russell, Senior Regional Advisor for Foundations, via rachelr@foundations.uk.com, or your Foundations Regional Advisor, details of which can be found here.

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