Quality requirement 5: Community rehabilitation and support

The Disabled Adults Resource Team (DART), Bristol, S.Gloucestershire and N. Somerset

DART consists of 3 teams, one for each of the areas above, total population approx 880,000. The service was commissioned in 1999 to begin to address the acknowledged local gaps in health service provision for disabled adults of working age. Whilst the service works with adults aged 16-65 with continuing primarily physical impairments, the majority of clients have neurological conditions.

DART aims 'to support disabled people in the community in aspects of their lives which they consider most relevant in order to contribute to the enhancement of their overall quality of life'. The philosophy of service delivery is based on disability equality principles. The teams have produced a poster to explain some ways of working from a social model in NHS settings, as well as several examples of information for clients, standards and documentation informed by disability equality principles.

The multi-professional teams are committed to inter-disciplinary working in the community, and collaborate and often work jointly with local authority colleagues, primary and secondary care staff, and the voluntary and private sectors to support individual clients. An open referral system is in place, and goal-focused periods of intervention are agreed with each individual. Service users are routinely involved in service evaluation and planning.

The teams have carried out and published results of pilot projects into short-term counselling interventions for disabled people, and speech and language therapy needs. They have developed a number of resources, all informed by disability equality principles,  which they are willing to share including:

• Standards of practice for rehabilitation assistants and for therapists
• Referral and closure standards
• Protocols for specific interventions eg splinting, posture management, fatigue management, general outcome measurement, working with very distressed and / or suicidal clients
• Information sheets for clients eg partnership working, working with different professionals, how to contact the teams, passive stretches, fatigue management
• Client file documentation