Wellbeing

Introduction

These resources are for staff delivering wellbeing support remotely to students with SEND in their own homes during the COVID-19 pandemic. They should help you monitor the quality of that support, regardless of the means by which it is provided.

This resource pack includes:

  • characteristics of high-quality wellbeing support for students at home which can be downloaded and used as a self-assessment tool
  • some emerging evidence of the effects of confinement on wellbeing
  • effective practice guidelines for assessment
  • issues to consider when preparing and delivering wellbeing support
  • key principles that underpin wellbeing support at home
  • suggested activities to support wellbeing in lockdown including resources developed by staff working in Natspec colleges
  • a case study on providing peer support sessions as part of wellbeing support
  • a short report sharing some lessons learnt from setting up online peer group support
  • a selection of further useful resources

The pack has been developed by Natspec, working with a group of colleagues from a range of member colleges. Contributors include:

  • Andrew Aspinall, Lead Nurse, Bridge College
  • Dr Rachel Cole, Lead Psychologist, Young Epilepsy
  • Gillian Leno, PSHE Lead/Safeguarding, Queen Alexandra College
  • Sasha Narey, Provision Manager, National Star Hereford
  • Sarbjit Singh, Health Wellbeing and Pastoral Lead, Glasshouse and Argent College

We are very grateful to them for sharing their expertise.


Characteristics of high-quality wellbeing support for students in their own homes

The following characteristics can be used by individual staff to help them assess the quality of the support they are providing and by senior managers in colleges to help set and monitor standards for wellbeing support provision at a whole-organisational level.

High quality wellbeing support should

  1. be specific to the times we are in rather than just providing general information and activities about recognising and improving mental health and wellbeing
  2. take into account the welfare of care givers in the isolation setting
  3. be consensual so that the student, family and lead member of staff are in agreement about the support to be provided
  4. be safe for the student and those supporting them
  5. be part of a holistic package of learning and support for the student
  6. be individualised, linked to the student’s own targets and goals, which may have been revised as a result of the current situation
  7. be easy to understand for those supporting the student at home and, as far as possible, for the students themselves
  8. be consistent with previous practice in college as far as possible to provide continuity for the student
  9. be realistic and achievable, given the home circumstances (constraints, conflicting demands on families etc) and not overwhelming for either student or family/supporter
  10. fit into the daily lives of the student and those supporting them, as easily as possible, e.g. through embedding into daily tasks and routines in the home or being delivered at a time to suit the student/family
  11. remain consistent with professional standards and be evidence-based
  12. be consistent with any organisational policies and procedures for the provision of wellbeing support, including those relating to safeguarding, confidentiality and any specific to the COVID-19 pandemic

You can download the Wellbeing Checklist including a RAG rating for use in your organisation.


Emerging evidence of the effects of confinement on wellbeing

It is yet unknown what the long-term effects of isolation/confinement will be on wellbeing. What is known is based on general advice from early Chinese data, and data from other pandemics.  This is from studies of the general population.

There are some early findings from research mainly on neurotypical children, carried out during the Covid 19 period.  Emerging evidence has found:

  • being inside for long periods / online can have negative effects on sleep: Wang et al., 2020
  • longer screen time is not good for mental wellbeing (Wang et al., 2020)
  • people feel socially isolated: Sprang & Silman, 2013; Cowan 2020
  • confinement can exacerbate existing mental health difficulties: Holmes et al., 2020
  • confinement can negatively affect family relationships: Cowan 2020

Evidenced based, high quality wellbeing support to young people with SEND at home therefore, has to be based on existing knowledge, expertise and ‘best fit’ judgments and Cowan’s current research shows that the following help people to maintain their wellbeing:

  • staying connected
  • keeping busy
  • physical activity
  • staying calm
  • managing information intake
  • maintaining routine.

Effective practice guidelines: assessment

  •  A holistic needs assessment should be completed within a multi-disciplinary (MDT) meeting
  • The student voice should be the basis of all decision-making during the assessment process
  • If the student and family cannot be directly involved in the process, members of staff who know the student best should have discussed wellbeing with them and advocate for them throughout, in order to maintain realistic expectations of the student and the family’s ability to carry out assigned work or tasks
  • Prior wellbeing concerns should have been addressed first, in order to discuss concerns that may arise from social isolation, beginning with an assessment of any safeguarding concerns.

The designated safeguarding (DSL) lead is paramount to an assessment process for wellbeing support as they will have access to information regarding existing or prior safeguarding concerns.  The DSL will need to decide which of any of this information should be shared in the best interests of the student. If social isolation will place the young person in unsafe or extremely vulnerable circumstances, this should be shared with social services as soon as possible, with the DSL acting as main point of contact with social services or other authorities.

The questions below form a set of useful prompts for the MDT when planning effective delivery of wellbeing support.

Issues to consider when preparing and delivering wellbeing support

  1. Are there any prior wellbeing concerns?
  2. What is the student’s current wellbeing status?
  3. What factors, other than social isolation, are most likely to affect wellbeing e.g., medical concerns affecting wellbeing, access to medicines, further supplies, ability of carer to assess for problems, peer groups?
  4. Is the student able to access services required, such as GP, physio and other specialist appointments?
  5. Which professionals are involved with the student? Are they aware of the student’s current situation? What can they add to the assessment process or how can they be involved in supporting wellbeing?
  6. How will contact take place? Who will be the main contact for the student/family? How will avoid overwhelming the student/family with too much contact?
  7. How does the student communicate? What support can OT and SALT offer to provision of wellbeing support?
  8. Are expectations of delivery or work being carried out by the student or contribution from the family realistic?
  9. What is the housing situation? Who lives at home? Are any of them key workers? How might the size or location of the house, number of family members, or access to outdoor areas/nearby parks impact wellbeing?
  10. How safe will it be to recommend physical activities? Is there a history of falls? Is the student at risk of running away?
  11. What is the best format for tasks, e.g. hard copy information posted to home or video instructions?
  12. Where will contact be recorded? How will contacts be monitored and by whom? Is there a simple flow chart to escalate concerns in line with policy?
  13. How will progress be monitored, taking into account how the students felt about it, what worked well, what could have been done differently?

A note on safeguarding

Young people will benefit from having a safe, private space to engage with wellbeing support, particularly if the information being shared is of a sensitive nature. Parental reluctance to allow the learner confidential support should be documented, particularly where that young person has the capacity to understand and ask for privacy.


Key principles that underpin effective wellbeing support at home

Effective wellbeing support helps students continue to feel valued and secure while enriching the learning experience.  Although colleges should take a holistic approach to offering wellbeing support, it can be helpful to think about wellbeing in the following categories:

  • physical wellbeing
  • mental wellbeing
  • spiritual and emotional wellbeing
  • e-safety wellbeing
  • domestic wellbeing (self-care)
  • nutritional wellbeing
  • parent/carer wellbeing.

Physical wellbeing

The biological and health benefits of being physically active are widely known. Home learning is likely to be more sedentary which can give rise to a whole host of other wellbeing issues. Being physically active also gives us a better chance of having a deeper and more restful sleep at night.

Physical activity can be designed to encourage the students to think. This ‘primal movements’ video made by Sarbjit Singh at Glasshouse College, part of the Ruskin Mill Trust, has been sent to students at home. The aim of the video is for the young person to have some fun whilst exercising and to think about how animals move.  This type of activity can be tailored to different student cohorts:

“For lower level learners, just leaping like a frog or crawling in some shape or form can be fun, stimulating and a confidence builder. For mid-higher level learners, not rustling the grass, keeping focus on prey can be added.  This invokes things in the imagination as well as stimulating them physically. This type of activity does not require high functioning cognitive ability but where physical mobility acts as a barrier, adjustments can be made.”

Mental wellbeing

Effective support for mental wellbeing needs to be more specific to the times. For instance, you could send end information specific to being in isolation, rather than just give general information and activities about recognising and improving mental health.

This example of an ‘isolation reframing’ activity from Glasshouse College is designed to help the student consider the potential positives of being in isolation if they are struggling with the restrictions of the situation.

Spiritual and emotional wellbeing

Movement is not just restricted to physical activities, sport and exercise. Beyond physical movement, there is internal movement. Students who can move their body – even if it is just a fraction – and be mindful of doing it can be taught the benefits and techniques of moving emotions. Work can then be done on which emotions or feelings are hard to move.

Creating activities that encourage mindfulness such as the activity of creating a ‘calm down jar’ can remind students of the importance to take their time, slow their thoughts when they are racing.

E-safety/wellbeing

With more time being spent at home and online, being digitally safe is crucial.  This guide to Keeping safe online guide for people with learning difficulties from Care Management Group may be helpful.

Domestic wellbeing (self-care)

The home learning context is a good for developing domestic skills such as cooking and cleaning. Stressing the importance of personal hygiene along with cleanliness around the home is important, particularly with the current pandemic. This guide to mobile phone hygiene produced by Glasshouse College may interest students. An accessible, easy-read daily, weekly and monthly chore checklist using symbols and photos can be helpful and give structure for carrying out chores.

As part of domestic wellbeing, students can be supported to understand the importance of nutrition. A balanced diet is key to staying healthy and not suffering any major symptoms or complications if infection were to occur. Being at home also allows boredom to set in which can increase the chances of binge-eating and snacking on nutritionally deficit foods.

You could create a guide using the traffic light approach to help students be aware of good and poor food choices. Creating recipe cards can be a fun and interactive way for students to learn new skills and recipes. It can also be integrated into other aspects of learning, e.g. by exploring the history and geography of the dish.

Parent / carer wellbeing

The long period of isolation will be taking its toll on many. A stressed or anxious parent will be in less of a position to support learning or provide a healthy environment for their child. Glasshouse College has designed a guide to making light of isolation to help parents start supportive conversations with their young person. The contents of Glasshouse College’s ‘E- safety for parents’ documents could be adapted for different ages and cohorts of students. Ruskin Mill are also developing a welfare guide during isolation for parents. It contains top tips to help parents “…cope and thrive in this new world we find ourselves in” and give tips and suggestion for parents on: mental wellbeing, diet, sleep, exercise, self-care, restricting media intake, getting out to green spaces if possible, creating a structure to the week and setting goals.


Wellbeing and Peer support

Young people benefit enormously from being able to keep in touch with their peers. This peer support case study describes the process of setting peer support sessions up at National Star College, Hereford and early learning from this experience.

This report on the provision of online group support sessions produced by National Star College and Queen Alexandra College discusses lessons learnt from setting up online peer group support for students at home. It looks at safeguarding and inclusion issues arising from the provision of online group support sessions and suggests some solutions.


Useful resources

Guidance for parents and carers on supporting children and young people’s mental health and wellbeing during the coronavirus (COVID-19) pandemic: general guidance from Public Health England

Looking After your Feelings and Body: a simple, illustrated description of we look after our physical and emotional wellbeing

BILD Resources to support families / carers of people with learning disabilities through the Coronavirus restrictions including helpful strategies for carers.

MENCAP resources: for people with a learning disability, their carers, and professionals supporting them.

Wellbeing resources from National Autistic Society