Occupational therapists are now treated as appropriate trained professionals, thanks to lobbying by the College of Occupational Therapists (COT). This means they can undertake complex assessments alongside social workers and other professionals and consequently, they must have a good working knowledge of the Care Act.
Here are four essential things that occupational therapists need to know about the act.
Wellbeing
The act states that any care and support should help people achieve outcomes which matter in their own lives, and that local authorities must promote people’s wellbeing when carrying out their care and support duties. The cornerstone of occupational therapy is the promotion of health and wellbeing through everyday activities. Supporting people to improve their wellbeing might include changes to physical environments, helping participation in work, education, training, or adapting daily routines.
Prevention
The ambition within the prevention part of the act is to move to proactive, rather than a reactive, care and support service. The act also points toward the vital part carers play in care and support, and states that the local authority have a duty to prevent, delay or reduce carers’ needs alongside those they care for.
Occupational therapists can, for example, support carers in self-management techniques for healthy eating, anxiety, fatigue and back care management.
For those in need of care, occupational therapists also have a leading role to play in reablement services based in local authorities, supporting people to learn or re-learn the skills for daily living following illness or disability. They also complete environmental adaptation, equipment provision and moving and handling interventions, which can be a contributing factors in limiting and/or delaying people’s needs for care and support.
Within the act, there are a number of factors that highlight the importance housing plays in meeting the needs of people and their carers. One definition of wellbeing focuses on the suitability of an individual’s living accommodation; this could include adaptation to property and information and advice on more suitable housing options, including the care homes.
There is also a duty on local authorities to carry out their responsibilities for care and support in a more integrated way with the NHS and other health-related services, which also includes housing organisations.
A particular initiative championed by the act is the Better Care Fund, which pools clinical commissioning groups and local authority funds to meet shared objectives around preventative care and support services in the community.
An important element is the disabled facilities grants. Recommendation for adaptive work, which aims to maximise a person’s independence and/or ability to remain in their own home, funded by these grants, is often carried out by occupational therapists. This work addresses people’s wellbeing needs and contributes to preventing further escalation of needs.
Safeguarding
Occupational therapists within social care participate in all areas of safeguarding, and their particular skills are often used in complex moving and handling cases to ensure risks are managed in a client-centred way.
For the first time, the act sets out clear legal guidelines on safeguarding duties related to adults. It details the responsibilities for local authorities which include:
- Making enquires if abuse or neglect is suspected.
- The establishment of local safeguarding adults boards and carrying out safeguarding adults reviews.
- Arranging independent advocacy where appropriate.
- And requirements that all relevant partners cooperate with the local authority.
Alerting the local authority when there is a safeguarding concern is the responsibility of everyone regardless of position or service.
The addition of self-neglect as a category of abuse presents a real challenge, however in recent guidance on self-neglect (pdf), occupational therapists are accredited as being effective professionals to work in this area due to their client-centred and holistic approach.
Prisons (custodial settings)
Finally, the act places a duty on local authorities to assess and meet eligible care and support needs for prisoners who are in their local area. The legislation provides welcome clarity, as previously provision of services was unclear, leaving prisoners with unrecognised or ineffectively met needs.
With an increasing number of older people in prisons, the responsibilities within the act have come at an opportune time. Although people in prisons benefit from most of the rights and responsibilities under the act, there are notable exceptions. Prisoners are not eligible for direct payments, and their choices about care and support are limited.
In addition: investigation of safeguarding incidents is not the responsibility of adult social care teams; preference of accommodation can only be expressed when leaving prison; and local authorities are not responsible for protecting the property of adults in prisons.
Occupational therapists’ skills are increasingly recognised within prisons and a number of local authorities have set up teams to meet prisoners’ needs which include occupational therapists as key members.
COT has published a series of guides to the Care Act which have been endorsed by the Association of Directors of Adult Social Services to support practitioners to understand and deliver its key concepts and their duties.
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