What we’re working on: Small Things

Published in October 2019

Northcott customer smiling and looking at her hand that has a ring on itSmall Things is a project we’re working on for our parent company, Northcott. We were asked to look at ways to create more opportunities for choice in the daily lives of Northcott’s accommodation customers, by improving the interactions between customers and staff. Northcott has a lot of accommodation sites – 106 – so improving something as individualised and nuanced as communication or interaction is not an easy task. So we tried something different.

The project places two speech therapy university students in their final year into a supported living home for a concentrated period of time: around 4 weeks, for 4 days a week. The students were asked to observe customers and then identify and trial small things that staff could do to provide more opportunities for choice, independence and communication. These small things could range from techniques such as offering customers a choice in what they wear, to identifying opportunities for assistive technology solutions, both high and low tech.

So far we’ve trialled this in two houses, with positive results. Our primary aim was not to build the capability of customers, but to provide direct care staff, or disability support workers, with examples of practices that could enhance the experience of customers. What we found though was customer capacity has been built, alongside some other interesting outcomes that we hope we can build on.

Customer communication capabilities

Across both houses there have been amazing changes in the communication skills and abilities of customers. Two  non-verbal customers have developed new communication skills over the 4 week period. One customer can now use a simple voice output device, to request Greek music when he would like to listen to it. The device, called a Big Mack, is a hand sized button that will speak a single pre-recorded message when pressed. The other customer can now communicate about her food choices using a Go Talk. A Go Talk is a simple battery powered communication device that can be programmed to say a set number of messages. We also have several customers who are now learning to use picture based communication boards to convey their wants and needs. One customer has made great progress, significantly increasing her engagement with staff, and revealed an emerging love of YouTube.


The two trials have also provided an insight into how a novel approach such as this can provide positive outcomes for all involved. The peer-modelling role played by students has been welcomed by staff. Support workers in accommodation sites sometimes work with customers for many years; they know their customers very well. Staff have welcomed the ‘fresh eyes’ students can provide on a day-to-day basis. They appreciate the extended period of time students have spent with customers, getting to know them. This is in contrast to most formal therapy opportunities, which are more consultative in nature, taking place over short periods of time or separated by weeks.

Students experience working with people with disability

The constraints of a speech pathology university degree do not allow for any in-depth work with people with disability. This placement has provided students with knowledge and experience they would not have gained, had they pursued a more ‘usual’ clinical placement. The students acknowledged how useful this will be when they work in ‘mainstream’ practice.

A whole-of-house approach to communication strategies: an individualised approach, within a broader context

The project has brought to light the potential of a whole-of-house approach to interaction strategies for customers and staff. Working with customers in the context of their own homes, alongside everyone else who lives in the home, has meant strategies can be adapted to things like the daily routines of the house and the different needs of the customers.

Communication design

In both homes the students produced videos of each customer, introducing them and their interaction / communication styles, detailing some of their likes and dislikes. We’re hoping these will be useful for new and casual/temporary staff.  The students have also developed a number of different communication devices – specific to their area of expertise – but the project has also shed light on the potential for more design opportunities. For instance, the students developed an A4 information sheet about the communication of each customer, with the aim of attaching it to their wheelchair so they could carry it with them. The content of each of these is fantastic, but we need to do some work on the way in which it is visually presented and how it could work with customers’ chairs in a way that is noticeable but discreet, allowing for dignity and privacy. Communication from within the house to customers’ families and to the house from the wider organisation are also areas of opportunity.

If you would like to know more about the project feel free to get in touch:

Sam Frain
email us