History review

As wife of the then Governor General, Laura Fergusson was deeply concerned o witness so many young faces in geriatric wards during her official visits to hospitals throughout the country. She encouraged a meeting to be held at Government House in 1967 and as a result, a National Trust was formed. Over the next ten years, Trust Homes were built in Auckland, Wellington and Christchurch to accommodate young people with congenital or trauma induced impairments. Lady Fergusson became Patron of the Trust and injected a great deal of enthusiasm into the work of the women’s auxiliaries. She was an inspiration to all those associated with the Homes for she not only lent her name to the Trust but gave her real self to a cause in which she believed wholeheartedly.

Her tragic death in 1979 was a great loss. Earlier that year she and Lord Ballantrae had made the journey from Scotland to officially open the Christchurch Home.

Today, the Laura Fergusson Trust (LFT) (a not for profit organisation) provides a range of rehabilitation, training, care and accommodation services that enable people with impairments to achieve maximum independence and quality of life.

Individually tailored rehabilitation programmes are offered, and these are based on multidisciplinary assessments from both LFT staff and independent professionals. The client, their family and the multi-disciplinary team (including occupational therapists, speech language therapists, physiotherapists, clinical psychologists and social workers and nurses) set all programme goals and these are achieved with the help of rehabilitation coaches. All types of impairment are catered for; congenital, acquired and traumatic. Staff specialise in functional recovery work within a trans-disciplinary model, while carefully considering the pre-accident lifestyle. While each branch of the LFT operates independently of the others, the organisation as a whole has focussed on developing a strong public profile. This has been achieved by a variety of means, including staff representation on policy and operational groups both locally and nationally.

The Canterbury home owes a great deal to the tireless efforts of its esteemed Patron, Mrs Noelene McIlroy. Her involvement in the Trust began in 1974 when she was elected President of the recently formed Women’s Auxiliary, replacing its founder, the Mayoress of Christchurch. Fund raising for the home began immediately and resulted in the home opening, debt-free in 1979. Despite ending her Presidency in the same year, Mrs McIlroy continued to be involved in both the Women’s Auxiliary, the Trust Board and the running of the home until 1995 at which time her amazing contribution was acknowledged and she was made Patron. Today, Mrs McIlroy remains a passionate supporter of LFT Canterbury.

 

MISSION STATEMENT

At the end of March 2008, the Christchurch home has completed a new series of strategic plans with a new mission:

“To facilitate autonomy, inclusion, involvement and independence for people with impairments and their families/whanau.”


LFT in Canterbury

The Canterbury Home is located at 279 Ilam Rd, a tranquil, yet convenient location neighbouring the Jellie Park Aqualand Pool and Fitness Centre. The home is within walking distance of the Fendalton Shopping Centre, Library and

Orbiter/City bus stops. A variety of housing facilities are provided for 24 long term and 16 rehabilitation residents (16 years of age and over), amid beautiful gardens, within easy access of public transportation. The majority of residents enjoy single rooms within the main building. These rooms include an ensuite with level access toilet and shower, phone, TV and easy access to the surrounding gardens. A cottage facility exists on the grounds and this is shared by up to four residents at any one time. This facility is designed to simulate a “flat” situation and is used to promote group living under the LFT Canterbury framework of “ordinary life opportunities”. Six self-contained units also provide accommodation for those who are more independent or in transition to supported living within the community. Three beds are provided for carer respite purposes, enabling families of high needs individuals to take a break from day-to-day care. In addition to the rooms, the complex includes two laundries, a fully equipped training kitchen, large dining room and barbecue area, lounge room (complete with TV, DVD and pool table), a small gym, conservatory, and computer room (the Trust subcontracts a computer tutor to provide information technology support and instruction). The Home is modern and well equipped due to strong, consistent growth over the last five years as new contracts were obtained.

Rehabilitation LFT Canterbury provides slow stream rehabilitation for residents who are under a specific contract with ACC or a Rehabilitation contract with the MOH. The therapy team includes an occupational therapist, speech language therapist, physiotherapist, clinical psychologist. These disciplines have input as required with residents and the day-to-day programme is carried out by rehabilitation coaches.

Use of local community facilities (i.e. Jellie Park gym and pool, the University of Canterbury, and local shopping centres) is seen as an integral part of rehabilitation and is incorporated as necessary into residents’ programmes.

Residents receiving rehabilitation input may be at LFT Canterbury either on a long term basis or for a shorter length of time with a view to discharge. Rehabilitation services are provided in partnership with Insight Ltd (www.insightteam.co.nz).

In July 2006, LFT Canterbury completed work on a state of the art rehabilitation kitchen. This facility (arguably the best in the South Island) is used by residents who often bake or prepare shared meals together. Residents who are developing skills in order to integrate back into the community also use the kitchen to increase their skill level and confidence with cooking. This kitchen features a kitchen surface - complete with sink and hob - that can move up and down at the touch of a button. Those who have experienced life-changing trauma and require modifications to be made to their home can experiment in the LFT Canterbury kitchen, identifying the features and settings that best suit their needs.

This is just one example of the pioneering work regularly undertaken at LFT

Canterbury. New projects are undertaken with a view to constant growth and advancement in the provision of services to those who need them, as well as ensuring that staffs are provided with opportunities for professional development. By definition, rehabilitation includes all aspects of self care. Each resident is therefore required to take as much responsibility as they can for their own domestic work (i.e. laundry, cooking and cleaning). Coaches provide consistent support in developing relevant skills and increasing the level of self reliance. Where people are not able to undertake these tasks they become part of the service provided.



PHILOSOPHY OF CARE

The Theory

LFT Canterbury operates in accordance with the NZ Disability Strategy, which

focuses on creating an inclusive and enabling, rather than disabling society.

Specifically, the Strategy envisages:

“A society that highly values our lives and continually enhances our full participation.”

Achieving this vision will involve ensuring that disabled people have a meaningful partnership with Government, communities and support agencies, based on respect and equality. Disabled people will be integrated into community life on their own terms, their abilities will be valued, their diversity and interdependence will be recognised, and their human rights will be protected.

These are encapsulated in The Code of Health and Disability Services Consumers’ Rights, which details 10 fundamental principles at the heart of respectful and empowering care practices. A holistic approach underpins all care provided by LFT Canterbury. This is based on Maslow’s Hierarchy of Needs – a model which describes the relationship between various aspects of human motivation. Maslow argued that we are driven to meet the basic needs first, then, as this is accomplished our focus shifts to the next level and the next:

 

The Practice

Consistent with the enabling model described above, LFT Canterbury’s primary function is the facilitation of skills associated with self-care and the expression of individuality – unintrusively supporting people in managing their own wellness. This is perhaps best illustrated by those residents receiving rehabilitation services following traumatic brain injury (although long-term residents are also actively managed). The first priority for the staff when working with a new resident is to get to know the individual as much as possible, particularly in reference to their life and identity prior to the accident. Often much of this information is collected from friends and family who are asked for a detailed account of the resident’s lifestyle, hobbies, likes and dislikes etc. While physiotherapy is a strong component of the care each resident receives, recovery of all physical functions is not necessarily a primary goal. More important is the individual’s adjustment to their changed circumstances and the opportunity to rebuild their identity, taking into account the limiting factors. Staffs therefore seek to identify the characteristics, traits or beliefs which are central to each individual’s sense of who they are. These self-images are then actively promoted and expressed through activities which encourage skill development in the relevant areas.

One long-term resident for example, was a motorbike and dog enthusiast prior to the accident which left him with permanent brain injuries. He therefore enjoys visits to the dog kennels and was elated when the motorbike of his dreams showed up at the home. Just sitting on the machine was enough!

While the Trust offers a very wide range of activities on site, residents are also encouraged to participate in community groups catering for a range of arts and crafts which include gardening, woodworking and music (among many others!). One resident is also a longstanding member of Toast Masters

The process of rehabilitation is, by its nature, often slow and uncertain. While some residents may come to LFT before returning to their home, for others, discharge from the

Trust is not a realistic option and is not therefore set as a goal for either residents or staff. Instead, success is measured In relation to the day to day goals of each individual, e.g. dressing themselves or cooking a meal for someone else. Often, the individual’s shortened attention and memory span prevents them from fully recognising their own progress. In practise, this means that if asked, a resident may not be able to identify the gains made over years of rehabilitation.

Nevertheless, the achievement of clear cut goals is undeniable.

This functional, long-term approach is fundamental to everything we do at the Laura Fergusson Trust. Residents are encouraged to plan for all aspects of their daily living for which they can reasonably be expected to take responsibility. Unexpected gains are often made when an individual’s confidence is raised through the achievement of relatively small goals.




THE STAFF

LFT Canterbury, as an Equal Opportunities Employer, boasts a stable team of over 50 staff from many countries and employees who themselves have impairments. A flat management structure ensures that each staff member’s views are heard and valued, allowing great scope for creativity and innovation.

While the salaries offered are consistent with DHB scales, the hours worked are significantly better, particularly as they don’t include shift work. A family-like environment is fostered within the Home and this extends to staff whose children freely visit them at work. A wide variety of formal opportunities are provided for professional development including conference attendance and participation in working parties. Recent topics of focus include family involvement, sexuality, behaviour management, organisational audit and strategic development. Staff are also encouraged and actively supported in undertaking relevant qualifications. The inclusive team environment serves to create spontaneous learning opportunities on a daily basis. LFT Canterbury has adopted an exciting team approach to care – enrolling the participation of everyone, from kitchen staff to gardeners. While expertise and experience is valued, each staff member’s skills and contributions are valued equally, regardless of their qualifications or “status” according to the standard medical model, and they are invited to explain their opinion to all others concerned. For example, if kitchen staff notices that a particular resident has significantly changed their eating behaviour, they will bring this to the attention of others. This information will then be used to ascertain what has happened (e.g. the development of mouth ulcers or a stomach upset), and what – if anything - should be done. As this is not a medical environment, the hierarchies present in such facilities do not exist.

Decisions are made in consultation with others, and no-one is expected to give or follow orders. The flat management structure provides little room for egos and hierarchies. All staff members are open to being challenged on their views, recognizing that residents’ support takes priority over their personal or professional pride. This requires a mature and open-minded approach, which results in continuous learning opportunities for everyone.

The work itself is often challenging. Behavioural issues often arise, particularly from residents who have experienced traumatic brain injury.

Strong people skills are therefore always in demand, as are those related to alcohol and drug abuse. All staff must consistently maintain a non-judgemental attitude, regardless of their personal views or beliefs. This may be challenging as they encounter issues such as lifestyle choice, sexuality and substance use. Each resident’s well being is supported on their own terms and, as balancing the needs of the individual with the desires of their family can be tricky, the personal values of staff members can not be allowed to muddy the waters. Ongoing training and supervision is provided to help staff deal with these issues as they arise.