Service Description

The Community SLT team, consists of Speech & Language Therapists and Assistant Practitioners, working across Nottingham, seeing a wide variety of adult clients, in their own homes, community settings and care homes. We work closely with other community health and social care teams, including GP surgeries, Supportive & Palliative Care Service, Integrated Care Homes teams, social care and the voluntary sector.

Our clients present with a wide range of aetiologies, including stroke, dementia, progressive neurology, respiratory conditions and stammering.

We aim to triage daily and prioritise patients for urgent or routine assessments which may be face to face or remote (telephone) depending on needs.

The main indicators we use for urgent referrals are as follows:

  • Drastic weight loss
  • Chest infections (severe or recurrent)
  • Client or carer distress levels
  • Choking episodes
  • If someone is palliative/end of life:
  • Admission avoidance

Exclusion criteria

  • People under the age of 18.
  • People with developmental communication/swallowing needs (other than stammering).
  • People whose communication/swallowing needs relate to a learning disability.
  • People who are being seen by SLT in the Community Stroke Team, Community Neurology Service, ENT SLT or MHSOP (Mental Health Service for Older People).

Referral Pathway

To talk to us about our service contact a team member on 0115 8834707

To make a referral:

  • Call Nottingham Health & Care Point on 0300 131 0300, option 1 then option 4.
  • Refer via SystmOne F12 function.
  • Also accesstoservices.citycare.org.uk

Dysphagia

A large part of our work involves assessing and managing swallowing difficulties. The main aim of this is to reduce complications related to aspiration and choking risk and enable clients to eat and drink safely.

The symptoms of dysphagia can include:

  • Drooling.
  • Inability to control secretions.
  • Food/drink remaining in mouth after swallowing.
  • Food/drink coming out of the nose during or after swallowing.
  • Coughing immediately before, during, or soon after swallowing (eating or drinking).
  • Clearing throat immediately before, during, or soon after swallowing (eating or drinking).
  • Developing a wet, gurgly, voice during or soon after eating or drinking.
  • Swallowing numerous times for one bite/sip.
  • Taking a long time to swallow or not swallowing at all.
  • Chest infections - especially recurrent chest infections.
  • Shortness of breath when swallowing.
  • Unexplained weight loss.

If you observe any of the above, please consider referring to Speech and Language Therapy. 

Capacity assessments

Another important part of our role involves facilitating capacity assessments for people with communication disorders. We work closely with colleagues in social care to empower patients to understand information and communicate their decisions regarding important life choices. (This can include but is not limited to decisions about having modified diet and fluids or alternative feeding).

Communication input could include:

  • Comprehensive assessment.
  • One to one impairment-based therapy.
  • Optimising the environment.
  • Providing AAC/communication books
  • Promoting choice making and supporting clients to express basic needs and wishes.
  • Supporting and educating care staff about the nature of the difficulty and how effectively communicate with clients.
  • We run a variety of groups for different client groups such as for people who have a stammer, aphasia and for people with Parkinson’s disease voice changes.

Our role in end of life care

Provide consultation to patients, families and the care team re:

  • Communication.
  • Swallowing.
  • Develop strategies in area of communication skills to support the patient’s role in decision making, maintain social closeness and assist patient in achieving fulfilment of end-of-life goals.
  • Assist in optimising function related to dysphagia symptoms to improve patient comfort and satisfaction. Promote positive feeding interactions with formal and informal carers.

Safeguarding

Any concerns are escalated within the home initially (where relevant), and incident reports completed as appropriate, we would refer onto the safeguarding team where indicated.

Whilst we can support with non-compliance issues, once we have made recommendations it is ultimately the responsibility of the care home to implement these.

Care home training

Care home training is not currently available we are working with parties to develop this.  Please contact us on 0115 8834707 if you would like more information.