RIBU one year in

27 November 2023

“The team is really cemented and comfortable with each other. It’s just day to day now because we are one big family.”

The Turn Furlong Recovering Independence Bed Unit team recently celebrated their first birthday having had a busy yet incredibly successful year working as one team with NHFT providing clinical staff and West Northamptonshire Council providing social care staff at the Northampton site.

The residential rehabilitation centre was formally a specialist care centre and delivers short-term care for people who are not quite ready to return home after a hospital stay.

Combining WNC social care and NHFT clinical teams as a joint workforce was a new concept but has been fully embraced by both teams and the 51-bed unit is continuously occupied with patients, with 336 admissions between Nov 22 to Oct 23 and 328 discharges.

Turn Furlong’s joint leadership team had a vision to build a great overall team culture. This has been achieved with the team now working incredibly well together and even hosting social events including a summer fete and having meals out together.

Because of the unique staffing model, an MDT meeting takes place once a week, which is a holistic discussion with health and social care teams all in one room. This way of working is incredibly effective and allows individual care plans to be looked at and reviewed. In addition, the changes has enabled a supported discharge of people back into the community with Reablement WEST, where they benefit from further rehabilitation from the team and therapists in their own familiar surroundings.

An important team development activity that has taken place over the past year is staff training. Training that teams are taking part in has included wound and pressure care, stoma care, mental capacity act (MCA), delirium, and falls training. The team of reablement support workers from WNC have been upskilled as well.

All the training that the team has undertaken has meant that as well as the day-to-day efficiencies and camaraderie, when there have been emergencies in the unit – the team has handled them well through working and learning from each other. Friendships have formed and there is a sense that you can ask anyone anything.

“We adapt, and we are good at embracing change, and keeping this going with the enthusiasm to improve.”

A great example of how the RIBU provides the right care at the right time was recently with a patient who had a recent dementia diagnosis. They had been discharged, but after they returned home it became apparent that being at home was not going to be sustainable as they needed more support.

The patient was assessed and then referred to the RIBU where an individualised care plan was promptly arranged.

The RIBU provides rehabilitation with a personalised care plan that is goal-led for individuals. For this patient, their main goal was to get home and be able to use the stairs safely. With this in mind, and having on-site therapy team members, daily physio was introduced as well as carrying out stairs assessments and focussing on functional activities with the Occupational Therapist. Ensuring the patient walked to get breakfast and lunch and to sit in the lounge and walk around the garden were other everyday activities that were carried out as part of the rehabilitation plan.

As a result of the quick assessment and the subsequent rehabilitation plan, the patient progressed from being immobile to walking with a walking stick in less than 35 days.

If the patient had not been able to have the personalised rehabilitation care that the RIBU offered, the alternative would have been a care package at home which would have taken longer to achieve the patient’s goals and there would have been no rehabilitation input.

Recent implementations and innovations

• The team has been working with local GPs to look at Venous thrombosis assessment and the team is looking at what they can do in terms of VTE assessment and protocol to prevent this from happening.
• What patients eat and drink is also being continuously reviewed and working with the kitchen to develop menus with more protein to encourage tissue healing in them is one such innovation. There has also been a hydration drive – with hydration stations set up to keep this at the top of the staff members’ minds.
• New mattresses have been introduced to help with pressure ulcers and wooden floors have replaced carpets in patients’ bedrooms which are much more efficient to clean. There is also lots of new equipment on site such as, floor beds and falls alarms, lifting equipment. Both teams have worked together to identify what is needed and to train each other on how to use it when it arrives.
• Running a 51-bedroom facility is busy, and so volunteers from NHFT have been introduced to help with capacity and further help patients with dementia by reminiscing about their lives and walking in the garden. These activities make a huge difference to patients and using volunteers helps the team a great deal.
• Champions have been introduced in specific areas such as end of life and Infection Prevention Control - with staff taking on an extra responsibility by volunteering to do this.
• There has also been engagement and fundraising with the local Northamptonshire Health Charity and plans to connect with local schools.