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Community Independence and Wellbeing team

We support people to retain or regain optimal independence and wellbeing. Also, our team supports people to develop their ability to manage their disability and/or illness.

People who we work with

We work with adults aged 18 onwards with:

  • complex and long term life limiting illnesses
  • chronic, progressive or improving health conditions
  • sudden onset impairment due to trauma
  • physical needs

This also applies if any of the above have an immediate, substantial and adverse effect on daily life.

Examples of people supported

Examples of people supported include:

  • people whose condition has deteriorated and their ability to live in the community has reduced, but they could regain key skills
  • people who need multi-disciplinary, community based rehabilitation
  • people who have family or carers who need advice or assistance for their caring role
  • people whose function is decreasing due to degenerative conditions and need new coping strategies to keep them out of hospital
  • people whose function is decreasing due to degenerative conditions and need new coping strategies to support timely discharge back into their homes
  • people who need interventions so they can maintain or access their choice of work, learning and leisure

Ethos

We use the social model of disability, which positively promotes choice, control, dignity, equity, opportunity and participation.

We are a multi-disciplinary health and social care team, which is community based. Working in an integrated way, we take a holistic approach that considers:

  • medical conditions
  • related health issues
  • wellbeing
  • personal and social factors such as isolation, confidence, community life 
  • family and formal care services

Aims

We aim to:

  • foster independence, reducing reliance on acute responses
  • provide a person centred, multi-disciplinary response
  • deliver the right level of response whilst recognising that people’s needs fluctuate

Our service does this by:

  • engaging with families and carers to support them in their roles
  • allowing people to be partners in decisions about their health and wellbeing
  • working with key community and third sector partners to ensure a person centred approach while getting the most from all resources

This approach allows a more co-ordinated, integrated way of working. Also, it builds on existing core services such as primary care, homecare and district nursing.

The service we provide

We enable people, families and carers to live as well as possible with their conditions by:

  • exploring the issues and problems affecting their daily health and wellbeing, with regard to the Wellbeing Outcomes Framework
  • understanding their experiences
  • giving people more awareness of their condition
  • developing people’s practical skills to manage their condition’s effect on day to day life
  • encouraging self-confidence and the ability for self-management by supporting and providing access to resources and advice

The team’s composition

  • Team Manager (registered professional)
  • Senior Social Work Practitioner
  • Disability Social Workers
  • Disability Social Work Assistant
  • Occupational Therapist
  • Physiotherapist
  • Speech and Language Therapist
  • Specialist Nurse
  • Independent Living Coordinators

Contact

Telephone: 01656 815888
Address: Trem y Mor, Bettws Road, Bettws, CF32 8UN.

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