It is widely recognised that monitoring changes to a person and being able to spot the signs and symptoms of conditions such as sepsis early can save your life. But what if you felt unwell, but couldn't always describe why, or displayed pain through behaviour that others dismissed? For many people who have a learning disability, this is a reality.
To help our teams to identify symptoms among people we support, MacIntyre introduced the Anticipatory Care Calendar (ACC) in 2017, included within this was the necessity to complete a Baseline Health Assessment, to capture and evidence what is normal for a person. This means that we can then closely monitor and track changes and patterns for each person using the ACC, which has been fundamental to helping many people we support to gain a more accurate and timely diagnosis.
What is a Baseline Health Assessment?
A Baseline Health Assessment captures and evidences what is “normal” for the person, recording important information about a person’s health and wellbeing. It records and captures a person's current health status and what is normal for that person.
Normal may include how a person usually expresses how they are feeling well, their usual bowel patterns, and how the person may usually express they are in pain.
Once it is completed, it’s never to be archived or lost. It should remain with the person wherever they go (even if this is to another organisation or provider). This means that in years to come, we can accurately evidence to Health Professionals that the changes we are noticing in people supported, isn’t normal for them and use the Baseline Health Assessment to evidence what was considered normal.
This document must be completed with the person, as well as their circles of support (including families), and anyone who knows the person really well; so that a full picture of that person’s health is recorded and is accurate and detailed.
Jo and Jess' Story
Jess has a learning disability, as well as some impaired sight and physical disabilities and has been supported by MacIntyre for seven years. Jo is Jess' mother.
Jo and Jess' dad have been there for every milestone in Jess' life, which has included several health challenges.
With a wealth of information between them about Jess and her experiences, including Jess' early life, they know Jess incredibly well and what works for her. This information can be crucial during trying to evidence changes noticed to relevant professionals, when a person may be displaying changing behaviour that may be easily dismissed by medical professionals, it is these sometimes subtle changes that can be key to spotting health deterioration or that something just isn’t quite right.
Like many parents, Jo was concerned about what a future for Jess would look like when she and Jess' father are no longer present and what this would mean for Jess's wellbeing.
Jo and Jess are no strangers to discussing loss. Although a difficult topic for many, Jo was keen to ensure that Jess understood she and Jess' dad would not always be in her life. Jo wanted to prepare her and plan for this eventuality together. After developing a will and power of attorney for Jess, Jo learned about the Baseline Health Assessment used within MacIntyre.
Jess' Baseline Health Assessment
Jo realised that she had never fully reflected on Jess' health and medical history and recorded it all in one place. The Baseline Health Assessment was an opportunity to record every detail of Jess' life and health journey so that it might be useful in many years to come.
"It is incredibly important that if Jess's dad and I are not here and something goes wrong for Jess, that everything about her health history and what is normal for Jess is recorded. This is important not only for MacIntyre to have this information documented but also for my son too, who will be there for Jess when we can't be."
For Jo, the Baseline Health Assessment was another layer of security and something she wants to encourage other family members of someone with a learning disability to support in completing.
"It gives me peace of mind,"
Speaking about the value of the Baseline Health Assessment, Sarah Ormston, MacIntyre's Health, Dementia and Wellbeing Manager said:
“The Baseline Health Assessment has been instrumental to how we record accurately what is normal for a person. This has meant that our staff have been equipped with a tool to evidence to Health Professionals the changes they are noticing, and how this is not usual. We use it alongside the Anticipatory Care Calendar, which then tracks and records and changes from the Baseline Health Assessment. It is really through and has led to positive health outcomes for people, for example we were able to quickly identify sepsis symptoms for a person using the calendar.
We review the Baseline Health Assessment a minimum of annually or if something significant changes to a person, and these changes are recorded on the Monitoring Health Assessment. It is absolutely key to ensure when we first fill out a Baseline Health Assessment, that we include all the relevant stakeholders important to a person, as well as the person themselves if we are to truly capture the detail required.”