What is the therapeutic care team?
Therapeutic care is a substantive team, grown and nurtured
to provide one to one enhanced observation to patients across The James Cook University Hospital.
Therapeutic care was introduced to improve the management of patients that present with challenging and escalating behaviour. These patients are assessed and may require one to one enhanced observation.
Therapeutic care support workers (TCSWs) are substantive members of staff within
James Cook. The team provides an invaluable therapeutic service to patients requiring one to one support during their hospital stay.
The team provide non-clinical intervention to support patients with challenging behaviours.
What are enhanced observations?
The South Tees Hospital NHS Foundation Trust is committed to providing a safe, secure and supportive environment for all patients.
When a patient exhibits changes in their behaviour, this may manifest itself in a way which increases risk to themselves and others. Thus, meaning that an increased level of observation may be required to effectively support the patient.
This increased level of supportive observation is implemented with the aim of minimising the risk of the patient harming themselves or others, and to ensure that the behaviour does not have a negative impact on the patient’s recovery from illness and their quality of life.
General ward level observation:
Staff are expected to be aware of the whereabouts of the patient in their care. Staff on the ward will follow Trust Agreed practice of bay nursing.
Continuous eyesight observations:
Patient is high risk and should be observed at close proximity and in the direct eye line of the observer. Actual distance will be determined by the patient’s behaviour. It is anticipated that continuous observation will only be used for a limited time and assessed daily. DoLS is required if patient is on these observations.
(If the patient is an absconding risk or the patient is showing signs of violence and aggression, security are to be informed of the need for a possible rapid response).
Patients who present with mild to moderate behavioural changes and risks, such as agitation and disorientation, are to have their safety visually confirmed at intermittent periods. This confirmation must be documented within the enhanced observation assessment record.
Depending on risk and the presentation of behaviours that are challenging, the patient can be on one of the following levels of intermittent observations; every 15, 30 or 60 minutes. Intermittent observations lends itself to the Trust Agreed practice of bay nursing and patients on this level of observation will not require extra staffing support from the therapeutic care team.
Senior therapeutic care support worker (STCSW) role
- They identify, assess and document the one to one and enhanced observation needs of patients to ensure that the appropriate level of care is provided by the therapeutic care team
- They are the first point of contact for ward staff regarding enhanced observation levels for patients and they will support staff with the plan of care for patients requiring enhanced observation
- They support training of staff on the CG47 Enhanced Observation Guidance
- The seniors work in a supportive role within therapeutic care and oversee the allocation of therapeutic care support workers across the James Cook site
- They are able to communicate effectively and professionally with a wide rage of people, recognising and managing barriers to communication.
- They understand the importance of early identification of changes in patient behaviour and instigate a plan of care. This information is collated and inputted to allow for safe and effective allocation of staff.
- They recognise and respect patient confidentiality.
Therapeutic care support worker (TCSW) role
- They provide a full range of therapeutic care and interaction with patients whilst maintaining respect for the individuality, confidentiality and dignity of our patients. The role is underpinned by the Chief Nursing Officer’s 6Cs.
- They provide one to one enhanced observation for patients assessed and cared for under CG47 level 3 observations.
- They demonstrate a range of nursing skills, under appropriate supervision, to meet the needs of the patient in a safe, caring environment that promotes dignity, privacy and respect.
- They are able to communicate effectively and professionally with a wide range of people, recognising and managing barriers to communication.
- They understand the importance of early identification of changes in patient behaviour and instigate a plan of care.
- They will recognise and respect patient confidentiality.
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital In Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.