reasonable adjustments

Breaking Down Barriers – there’s an app for that!

When healthcare information is accessible and understandable for all, it can literally save lives.

Alix Lewer, Founder and CEO of Include and The Include Champions helped to develop an accessible version of the CardMedic app…a tool that breaks down barriers to good communication in healthcare.

It’s a partnership that we are really honoured to be part of. We wanted to know a bit more about what the people at CardMedic thought, so we asked!

Rachael Grimaldi – Co-Founder and CEO of CardMedic

What is CardMedic’s mission?

At the point of care, the inability to communicate is the largest single contributor to health inequalities, and patients with additional communication needs make up nearly 50% of the population.

CardMedic’s mission is to break down communication barriers between healthcare staff and patients by making healthcare information accessible and understandable for all.

We’re committed to inclusive communication and believe in acknowledging and accommodating everybody, regardless of their communication needs. Our aim is to provide intuitive and cost-effective technology that empowers clinicians and patients to communicate quickly and efficiently across any barrier, enabling more effective delivery of care, reducing health inequalities, and improving patient outcomes.

Why did CardMedic want to work with Include?

We were really keen to work with Include because we share their mission to break down barriers and create a more inclusive world. At CardMedic, we recognise that accessible information is vital for ensuring equitable care delivery, so we couldn’t imagine a better partner.

Alix Lewer’s expertise as a Speech and Language Therapist, as well as Founder and CEO of Include, made it a no-brainer. She and her amazing team have been invaluable in helping us improve communication in healthcare and increase our understanding of the challenges people can face.

Together, we’ve been able to develop innovative solutions and resources that empower us to think differently about how we communicate. Particularly in a healthcare setting, we’ve learnt how to effectively communicate with patients with diverse communication needs and improve health outcomes for underserved populations.

Our shared vision of inclusivity and accessibility made us confident that partnering with Include would help us work towards a more equitable healthcare system for all.

How did the partnership help your project?

Alix is incredibly knowledgeable in the accessible information space and about the Mental Capacity Act (2005). She understands that inclusive communication means recognising and respecting all forms of communication–not just the written and spoken word.

Drawing on her knowledge of inclusive practice in health and social care, having worked as a Speech and Language Therapist in the NHS, Alix contributed to the initial development of an accessible version of the CardMedic app. Include’s lived experience Champions Group also continues to work with us to review our content regularly and provide feedback about accessibility.

Our partnership with Include has helped us refine our content to ensure that it’s as accessible as possible to individuals with diverse needs, including those with learning differences, visual and hearing impairments, and language barriers.

Alix’s expertise has helped us convert our library of scripts covering a vast array of clinical specialties and sub-specialties into Easy Read, at a reading age of 6 or under. This essentially means it is accessible to many more people than traditional information would be, both children and adults.

What would you say to others thinking of partnering with Include?

For anyone working in the accessibility, language, and communication space, they would be remiss not to reach out to Include! Include promotes inclusion and wellbeing, empowers people with additional communication needs, and ensures that they have equal access to services, facilities, and opportunities. They do a fantastic job of collaborating with businesses, educational institutions, and other organisations to help raise awareness of accessibility and provide practical solutions for inclusivity.

Include also offers brilliant training and consultancy services to help organisations improve their practices by making them more accessible. By partnering with Include, you’ll gain valuable insights, guidance, and resources to enable you to create a more inclusive environment.

The team are so friendly, and their expertise will help you address communication barriers and send out a powerful message about your commitment to inclusivity. All in all, we’d highly recommend partnering with Include!

Get in touch with Include, please email : info@include.org

More information : https://www.cardmedic.com/

(She won’t tell you herself, but while we are here and talking about healthcare…Alix won a Royal College of Speech & Language Therapists’ Giving Voice Award for voluntary work with The Mental Capacity Act Clinical Excellence Network – Raising Awareness of Supported Decision Making at End of Life.)

Penny Sims
Communications and Partnerships Manager

Adjusting for Sensory Needs

Free Easy Read

This week is National Inclusion Week which celebrates inclusion and encourages taking action to create inclusive workplaces.

One of the ways that employers can be more inclusive is to think about the sensory experiences of their employees. We found an interesting article on LinkedIn which talks about things like lighting adjustments, sensory break spaces and noise control.

Of course, sensory considerations are not unique to the office environment. People who experience their senses such as smell, noise, or textures in heightened or muted ways may need reasonable adjustments to be made wherever they are.

Many theatres are now good at taking sensory needs into account. For example, The Lyceum has a scene-by-scene Sensory Synopsis of The Lion King available on its website. In addition, during relaxed performances the theatre turns off noisy hand-dryers in the toilets and provides alternative ways to dry hands.

Being in a healthcare setting can lead to heightened experiences – so it’s important that healthcare staff and those designing healthcare settings take sensory needs into consideration and act on requests for reasonable adjustments.

We had the founder of The Sensory Projects www.thesensoryprojects.co.uk Joanna Grace as a special guest at one of our Champions sessions. She talked with us about the reasonable adjustments that autistic people may need to help communication in a healthcare setting.

Many thanks to Jo for kindly sharing her own personal insights of how her autism affected her experience of healthcare during pregnancy and birth.

The NHS’s Sensory Friendly Resource Pack (Free here: NHS England » Sensory-friendly resource pack) describes 3 types of sensory experiences that people with autism may experience:

hyper-sensitivity:
- extreme over-reactivity to sensory input
hypo-sensitivity:
- extreme under-reactivity to sensory input
sensory-seeking:
- unusual interest in aspects of the sensory environment.

The Include Champions have produced a new FREE Easy Read document to share about reasonable adjustments for sensory needs.

Download it free here:

Sensory Needs Reasonable Adjustments FREE EASY READ Download

Listen to it on SoundCloud

Penny Sims
Communications and Partnerships Manager

Meet Beth

Everyone is welcome

When I talk to people about Include, I always say how much it has made a huge, positive impact in my life and improved my quality of life, given me a purpose and that it is the BEST charity I have ever come across where EVERYONE is included, everyone is welcome.

I want the world to know that there is no place anywhere that makes you feel so included, safe, comfortable, happy and purposeful as Include does.

How it started

I first found out about Include by research. I moved back down to Surrey from Coventry, and wanted to find out if there were any Makaton groups nearby and that’s how I came across Include. I messaged Alix and it all went from there.

I wanted to get involved because I was very lonely and I enjoy Makaton so much, and use it a lot personally.

At first, I was very anxious, only because I always am when facing new places, people and situations BUT this didn’t last long! Soon I was comfortable and felt ‘included’ and part of an amazing community and surrounded by lovely, genuine people.

When I first went to Include, I started off just joining in the choir every Wednesday evening in Redhill.

Growing in confidence

It wasn’t long before I wanted to volunteer, make a difference and help others.

I also started to attend some of the Stroll and Sign walks on Saturdays, going to performances, and helping to design the new ‘Star of the month’ certificate and another certificate.

I am also now part of the Champions Group which I really enjoy and feel we all make a difference by working on and designing Easy Reads for people and giving examples and explaining things like ‘reasonable adjustments’ etc.

Since being part of Include, I have gained confidence, made friends and have something to really look forward to each week; helping others, having fun, being included and having a purpose.

Signs of Change

Although I already knew most Makaton signs before I came across include, I have gained more skills from The Include Choir and the Champions Group. These include improved speaking and listening skills, trusting people because I feel comfortable with the people I’m surrounded by and learnt a couple more skills on my computer.

The things I do with Include really help me day to day and help my support workers, family and others around me to understand and communicate with me, and others in a better or different ways.

When I struggle, I can become non-verbal, so for support workers and family to know basic Makaton signs is very important and helpful. I am now able to feel confident to teach them the important basic signs that are useful so that they can best support me.

I think it is important for people in all sorts of jobs to know basic Makaton e.g. hospital staff, doctors, teachers in schools, dentists and other professionals that might come across people who may use a different form of communication like Makaton.

We are all different…

My favourite quote is ‘we are all different, but all equal’ and I feel everyone at Include is treated equally no matter what their needs are and this makes me very proud to be a part of such an amazing group.

The next step in my Include story is to do volunteering more and make more of a difference, help people more, improve more skills and gain more confidence.

I have a goal and that is to do a solo Makaton song at Christmas, I hope I can get enough confidence in time.

Discovering Include is the BEST thing that’s happened and I am very grateful for all that everyone does to make it such a lovely, enjoyable group.

Penny Sims
Communications and Partnerships Manager

Reasonable Adjustments

At Include, we work hard to ensure that communication needs or disabilities are not a barrier to access or inclusion in our projects.

We proactively make reasonable adjustments – and we keep listening and checking what else we can do to ensure people have equal access.

We admit that we can always improve in this area.

Probably most services, charities and businesses can do more to enable genuine equality of access. We don’t just mean how easy a building is to access if you have a mobility issue. But the whole experience – how people interact and communicate, how we experience an environment or service from a sensory point of view etc.

A graphic representation of a ramp - explaining the things that support Communication access. 1 Raise Awareness of Communication Needs. 2 Increase Understanding of Inclusive Communication 3 Build confidence and self-advocacy in people with Communication needs 4 Train people to be inclusive communication partners.

Focussing on improvements that help individuals and getting it right tends to enhance things for everyone, with or without an additional need.

FREE Easy Read download about Reasonable Adjustments Download

As well as coproducing a FREE Easy Read on Reasonable Adjustments, our lived experience consultancy team The Include Champions are reviewing some of the things we do within Include and helping to fine-tune them.

By sharing this FREE Easy Read we hope more people with communication needs and disabilities will have better experiences when they go to work, interact with services or are customers in shops and restaurants.

Email

We recently talked about our emails.

We already use accessible fonts and Easy Read format – with a picture to reinforce each point.

But our members suggested that we use shorter and simpler links, and make the writing bigger.

Website

Image of a young man pointing at the colour red on a board which has two colours on it - red and blue

We’re becoming even more aware of the importance of colour contrast in terms of how easy, or not, it is to read and have started to use a new resource to check this: https://colourcontrast.cc

Furthermore, we are going to be working harder to make best use of alternative (Alt) Text to describe the images we use on our website and elsewhere. Thanks to Colin Grist from Few and Far for his recent free talk and tips on website accessibility.

A screen shot of a calendar of things Include.org is doing on 15th 18th and 19th of July. Which are Stroll and Sign on 15th at 11am, Epsom Include Choir on 18th at 6pm and Redhill Include Choir on 19th at 7.30pm

Our website provides project information in a calendar format so members can check at any time what projects are running, where and when. One of our Champions, Hannah is encouraging everyone to use it – it means you don’t have to wait for the emails!

Visuals

A photo of the list of songs that Include Choir members have put together on a board. Includes songs Any Dream Will Do, Three Little Birds, This is M, Sweet Caroline, I have a Dream, Fly a Kite, Don't Worry Be Happy, Shotgun and Wonderful World

Consultation and co-production are central to the way we do things, so naturally Include Choir members help to write lyrics and choose which songs we learn to sing and sign.

Visual and tactile prompts help people with communication needs. So, we make a physical list of song names with visuals using Velcro. Members choose from a whole table full of song options to decide which songs we perform at certain events.

Recently Hannah, one of our members has suggested that our song polls on Facebook also have an image to represent each song option to enhance understanding.

We also have a photo board at the choir sessions – this is for people to add themselves (sign in – without needing a pen) as they arrive and so everyone can see from the photos who is there that day.

Recently we have had feedback to say that we should make the signing in board a bit more organised so that volunteers are shown in a board along with an idea of their role that day.

Objects

Hattie the hat stand is never far from Choir Director Alix’s side! There is a very good reason for that. We have Hattie because it carries all our props or objects of reference. We use physical props because some people find objects helpful to enhance understanding – because communication is more than signs or words.

Champion Beth feels the props are good as we have some visually impaired members – props can enhance their experience too. Member Philip loves the hat stand and Josh reminds us to include Hattie in some of our photos!

Location

A photo of 5 people walking down a path in the countryside chatting and using hand gestures while talking

Many of the adjustments we make are not to do with literal access ramps (often the first thing that comes to mind when people consider disability access). That said, when we run projects like our Stroll and Sign wellbeing walks, or perform as a choir in new locations we always risk assess beforehand.

An important element of that is assessing accessibility and working out what adjustments we may need to make. For example, regarding lighting in a car park, suitability for wheelchair users or access to a stage. And if we need to, we do feedback to venues about any issues to try to improve things.

If you would like some guidance on inclusive communication, or access to a lived experience a focus group to look at this topic for your organisation please get in touch: info@include.org

Penny Sims
Communications and Partnerships Manager