Community Rehabilitation Service

Rhona Smyth

Assistant Manager

Background

Started in 1998 Jointly funded by health and social work Early supported discharge Reduction in hospital bed days Reduce the need for large care packages All adults over 16 years City of Edinburgh

Staffing Assistant Manager 3( WTE) Occupational Therapists 3 ( WTE) Physiotherapists ( Senior II

Vacancy) 12.5 ( WTE)Community Rehab Support

Workers Clerical

Referral Process MDT decision - OT/PT Referral Meeting criteria AMT 5 + or MMSE 16+ Motivation Client and family agreeable Rehab potential - goal setting

Diagnosis 05/06

Diagnosis

29%

25%14%

10%

9%

7%6% Orthopaedics

Stroke

Falls

Neurological

Resp/Cardiac

Surgical

Other

Assessment Joint OT and PT assessment of day of

discharge Clients own goals established Programme of visits agreed Provision of equipment /CAS Weekly Review

Range of Activities Self Care Meal planning and preparation Mobility and exercise Progression from equipment Community Mobility/bus practice Leisure Activities

Medication Supervision /monitoring Dosette boxes and refills arranged Orientation

On discharge from CRS Referrals made for Home Help ( 12%

April - Sept 06) Discharge letter sent to GP and copy to

referring therapist and Hospital Consultant