Speech and Language Therapy

Who are we?

Adult Community Speech and Language Therapists work with people who have problems with their swallowing, speech, language or voice. We work with a wide variety of clients, including people who have had strokes, acquired brain injuries, progressive neurological conditions, head and neck cancer, stammering, voice impairment and degenerative disease such as dementia.

Adult Community SLT services are provided by NHS Lothian within each Health and Social Care Partnership.

Manual for Mealtimes

This comprehensive resource for Speech and Language Therapy Guidance for Problems with Eating, Drinking and Swallowing and has been developed by NHS Lothian in conjunction with the Care Inspectorate, Scottish Care, Alzheimer Scotland and the Royal College of Speech and Language Therapists.

For contact details of the SLT Teams please see the Referral Pathway pages

Recording what you have noticed

Care home staff should go through the protocol in the Manual before requesting Speech and Language Therapy for other reasons, and we ask for your support with this. Some problems will not require SLT intervention, and only the more severe or persistent swallowing difficulties will need an immediate referral.

Staff can use the guidance in the Manual to problem solve the less severe difficulties, and have approval to use the documentation provided as evidence for the Care Inspectorate. Only one Eating and Drinking Problem Chart and one Eating and Drinking Trial of changes Record needs to be completed for each person. The Trial of Changes Record can be added to on different days.

If self management strategies are not successful, and a referral is indicated, copies of the documentation should be sent with a completed referral form from the Manual so that the SLT service can see what has been tried.

You can promote the Manual for Mealtimes in your care home using this poster and summary.

Who should I refer?

Anyone can request Speech and Language Therapy including the individual concerned.

You can refer individuals to Speech and Language therapy for:

Communication issues

where there has been a change, for example

if someone expresses concerns about their communication
if someone experiences difficulties understanding what is being said to them
if someone experiences difficulties expressing themselves or interacting with others
to gain practical advice and support for people with communication needs to enable their decision making capacity

Swallowing issues

There is a specific pathway for swallowing assessments in care homes, using the Manual for Mealtimes, which is now available in all care homes in Lothian. There is also a narrated training presentation to guide staff in the use of the manual.

Refer to Speech and Language Therapy immediately if:

The resident has had several recent chest infections and you think there is a connection with eating and drinking
OR
The resident has frequent signs of aspiration (food or drink going into the airway) when eating or drinking i.e. one or more of the following: