Case Study - the impact of high quality staff

Staffing Case Study: Enhancing Service Delivery for Individuals with Aphasia and other Communication Disabilities

This case study presents the need to increase staff time and resources to improve the service Say Aphasia provides to individuals with aphasia. By increasing staff time (from 2 WTE to 4 WTE), we will enhance the training and support provided to our volunteers and therefore deliver higher-quality and more effective support to our members. This report describes how.

This case study has been chosen to highlight the unique challenges faced by our organisation in meeting the needs of service users who are most severely affected by their communication disability. 

By focusing on our charity’s frontline experience, we aim to illustrate the vital role that properly trained and adequately supported volunteers play in delivering effective, compassionate support and to demonstrate how funding a full- time service manager, full-time Assistant Service Manager, part time Training Lead, and a full-time Charity Co-ordinator will enable our organisation to effectively recruit, train and support our volunteers, as well as reach more people with aphasia.

 

Background:

Our charity provides essential support to individuals living with aphasia—an acquired language disorder caused by brain injury, e.g. stroke, head trauma or dementia. Aphasia significantly affects a person’s ability to communicate, creating challenges in speaking, understanding language, reading, and writing.

Many of our service users also face complex physical and emotional challenges as a result of their brain injury. Many people talk about the sudden, traumatic and life-changing moment their communication difficulties started, following a stroke or head injury.

These challenges make the process of social re-integration difficult, affecting both the individual with the communication disability and the volunteers supporting them. 

We run free, regular drop-in groups which provide a safe and supportive environment where individuals with aphasia communicate with others facing similar life changes, regain their confidence, and as result become less isolated. These groups are vital for improving quality of life and social connectedness, but their success heavily relies on the skill, experience, and emotional resilience of our volunteers.

 

The Need for Funding:

While our current volunteer team is dedicated and compassionate, they are often under-resourced (insufficient numbers in some groups) and lack specialised training. To truly meet the needs of our diverse service users (and particularly those who communicate via non-verbal means), we need to expand the team and enhance the training provided to our volunteers. 

Currently, communication within the groups between the volunteers and the group members is frequently challenging, and emotionally draining for all concerned. This is particularly true when working with individuals who may have accompanying mental health needs either caused by their brain injury or resulting from it, due to the changes in their personal circumstances eg loss of friendships and roles, due to communication struggles. 

Here is an example of a group member who regularly attends his local group. This example demonstrates the emotions typically experienced by many of our members and the skills needed by the volunteers :

“He couldn't speak, or read, and became very emotional. He became frustrated and cried about 4 or 5 times in the 2 hours. He also kept having little episodes of something. His wife said the Dr said it wasn't mini seizures.... but it was like it had little episodes of being tearful, then zoning out and becoming sort of non responsive / staring down for a minute.”

The complexities of aphasia and brain injury require that our volunteers not only have the ability to communicate clearly and empathetically, but also understand the varied needs of individuals with brain injury, which may include emotional regulation challenges.

If specialist communication training is not provided to our volunteers then the volunteers may inadvertently exacerbate the communication difficulties of our group members, leading to frustration, reduced engagement, and a lower quality of support. Furthermore, for the volunteers this may result in the volunteers feeling responsible for the communication breakdowns that occur, dissatisfied in their role, inadequately supported and therefore leaving the organisation leaving the group unsustainable.

Here is another example to illustrate how what would seem the simplest of tasks in another charity are incredibly labour intensive in the context of working with an individual who has a communication disability, especially as the volunteer in this instance had not received training in how to adapt her communication:

A volunteer sits with a new group member to complete a new member form, for context, the information on the new member form is needed so that the charity can contact the member by their preferred method of communication to let them know of group changes and to find out their emergency contact details.

The volunteer asks the member the questions slowly and verbally repeats the information on the digital form. The volunteer shows the group member the form so he can read it. The group member is unable to answer the questions. Due to severe word finding difficulties and co-ordination difficulties affecting his ability to form the words the group member can not give their name or the name of the person they would like to be contacted in an emergency. The member is only able to say yes and no and a few social phrases. The group member looks despondent. The member is given a form to take home to show his family.

If the volunteer had received communication training they would be aware of how to adapt their communication further to enable the group member to express themselves e.g. using pen and paper to write or draw, or by asking the member if the emergency contact is written on a card in their wallet or stored on their phone. Thinking out of the box for alternative ways to retrieve information doesn’t always come naturally to volunteers. Hence why specific training is needed.

 

Project Objectives:

To address these challenges, we aim to expand our volunteer program by increasing the number of volunteers and by offering enhanced, regular training and supervision sessions. 

This be will achieved by:

1. Increasing Staffing Levels: Increase the hours and number of paid staff, which will enable us to: 
   • Expand the number of drop in groups by 4 per year, whilst ensuring sufficient oversight, and coordination.
   • Enhance the support provided to the peer leaders of the drop in groups.
   • Improve the overall efficiency and quality of the service. 
   • Increase the number of volunteers who support the drop in groups (both existing and new groups) to a minimum of 3 per group and ensure that all volunteers recruited meet our selection criteria via our short-listing and interview processes.
   • Provide effective, bespoke support and supervision to the peer leaders and volunteers.

2. Enhance Volunteer Training: We plan to introduce a comprehensive training program for volunteers, which will focus on:
   • Understanding aphasia and the emotional impact of brain injury.
   • Learning specific communication strategies and techniques (specifically the supported communication approach) * Supported communication is an approach used where the person adapts their communication often using non-verbal means of communication to support the person with the communication disability to understand the message or to express their message.
   • Recognising and managing difficult situations, including difficult emotions or inappropriate behaviours , including how to sign-post to other services.
   • Building confidence and emotional resilience to work with people who may have limited verbal communication.

By offering this in-depth training, volunteers will feel better equipped to support the group members and will experience greater role satisfaction and emotional resilience, while improving retention rates.

3. Improve Group Facilitation: With more trained volunteers and additional staff support, we will be able to offer more personalised support to each participant, ensuring that their individual needs are met. This will also allow for better group dynamics, ensuring that group members can participate at their own pace and with tailored support e.g. volunteers will feel more skilled in the use of communication tools such as personalised communication books and communication apps on the group tablets.

 

Impact:

The expanded service will have a significant impact on both the volunteers and the individuals attending the drop-in groups. Service users will experience:

• Improved Communication Opportunities: With more trained volunteers, participants will have more chances to engage in meaningful conversation and practice their verbal and non-verbal communication skills.
• Increased Emotional Support: Volunteers will be better equipped to offer emotional support, reducing frustration and anxiety among group members who often feel isolated and misunderstood due to their communication difficulties.
• Enhanced Quality of Life: Improved communication will improve social interactions, reducing the risk of depression and isolation, which are common among people with aphasia and resulting in members reintegrating into their communities.

For volunteers, the benefits of increased training and support will include:

• Greater Confidence and Competence: Volunteers will feel more confident in their ability to communicate effectively with people with complex needs, leading to a more rewarding and fulfilling volunteering experience.
• Reduced Burnout: With better training, support from paid staff, and a more manageable group size (increased volunteer to member ratio), volunteers will be less likely to experience dissatisfaction, stress and burnout, ensuring the sustainability of our volunteer program and our drop-in groups.

 

Conclusion:

The need for funding is critical to the continued success and growth of our aphasia support services. By increasing staffing levels to enable us to provide comprehensive, ongoing training to our volunteers, we will ensure that individuals with aphasia and other communication disabilities receive the specialised, compassionate support they need to maintain and build on their communication skills, rebuild confidence, and adapt to live life successfully with their communication disability.

Funding support will allow us to create a sustainable, high-quality service that addresses the complex needs of our community, reduces isolation, and provides hope for those who may otherwise feel forgotten or misunderstood.

 

 

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