The past four months have seen inordinate change for the people with disabilities and families who use the services of St. Michael’s House. Widespread closure of schools, adult day and training services and respite have placed huge pressures on individuals and families.
Clinical supports have been altered or ceased. Routines have been disturbed, much needed programmes suspended and contacts with familiar staff and peers restricted and in many cases, stopped altogether.
For the children and adults with intellectual disabilities who we work with, the reasons for these changes are not always understood. This has led to confusing and perplexing times for many.
For those living in our residential houses, the lack of contact with family and friends has brought particular sadness and challenges. For some, it hasn’t been easy to spend so much extra time with housemates when they usually all have other outlets outside the home.
Others are enjoying the extra time in their homes and as providers of day services, this gives us cause to pause and reflect on what these individuals are telling us and whether day service models may need to change into the future.
For the Organisation, keeping our core residential services running has involved reorganising our services and locations, managing the challenges of physical distancing restrictions in our small disperse facilities and being flexible and responsive to the changing needs of those we support, as well as to the impact of Covid-19 on our staff teams.
Staff and management have worked hard to be flexible and have tried to respond to the needs of those we support and their families. However, there have been limitations in terms of what we have been able to achieve and certainly in the level of contact and supports we have been able to maintain for those who normally use our schools and day services.
Many staff have taken on new roles and we have been called on to develop new procedures and services within tight timescales. Some of our main focuses have been:
- Supporting our frontline staff in their crucial 24/7 work in our residential houses, keeping them and the people who use our services safe and well
- Facilitating people to understand and ask questions about the changes in their lives – by preparing easy read information, social stories and other communication supports
- Preparing guidance for staff regarding ethical decision-making during the pandemic. People with disabilities are being asked to have swabs, to self-isolate, to cocoon and accept other restrictions on their daily lives. All of these require our staff to carefully reflect on what we are asking people to do, what their will and preferences are and what other options may be available to them and us
- Maintaining contact with individuals and families who are at home without day services and schools, through a system of key contacts
- Ensuring teamwork continues and is enhanced across clinical services, frontline services and management
- Piloting the provision of single discipline and team-based clinical supports in new ways whilst preserving physical distance e.g. telepractice, online training portals, virtual team meetings and even garden/window visits
- Supporting staff to take on new roles with appropriate training and induction – swabbing team, clinicians’ residential relief panel, day to residential frontline staff re-deployment, Covid-19 treatment and rehabilitation roles etc.
- Upgrading our ICT systems to enable safe and effective remote-working
- Procuring and managing a stock of appropriate PPE to enable our staff to work safely with the people we support
- Establishment of an appropriate environment, systems and contingency plans for isolation, treatment and rehabilitation of those we support who contract Covid-19
- Developing an in-house Covid-19 testing service for those in our residential houses
- Working with HSE to ensure all our frontline staff are tested and with occupational health regarding contact tracing and managing self-isolation and cocooning requirements for those staff who need to.
This Blog was written by Eilín de Paor, Clinical Manager for Adult Services & Caroline Howorth, Speech and Language Therapy Manager, St. Michael’s House, Dublin
E-mail: eilin.depaor@smh.ie & caroline.howorth@smh.ie
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