What is “Single Handed Care”?
For many years, it has been established standard practice for people who need to be hoisted or cared for in bed to have a double staffed care package. In the last few years, there has been research carried out into this area, and there have been innovations in equipment and manual handling techniques. It has been shown that in many cases, a single carer can provide care safely on their own.
Why is single handed care necessary?
- Put very simply, the introduction of single handed care is undoubtedly going to be required in order to meet the demands placed on health and social care services in the future
- Double staffed care packages are expensive, difficult to rota, and can therefore take a long time to arrange, and often leave few choices to the service user about their care.
- We need to free up capacity in our domiciliary care services – every care package that can safely be provided by one person means another carer is available to care for someone else
- Service users who have a single carer often report they have more independence, choice and control, a better relationship with their carer, and that they feel they have more dignity and privacy
- For many service users, it also means being “handled” less, better comfort and positioning when sitting in their chair or wheelchair, and less danger of damage to their skin, for example when hoist slings are fitted and removed
- For many people, it will mean they can have the choice to be cared for a by a relative for longer, and to do so safely
Does it work?
It doesn’t work for everyone, and we will only implement single handed care when it is safe and appropriate to do so. Experience from other projects around the UK have shown that single handed care can be successfully delivered in between 25-48 % of cases who would ordinarily need a double handed care package.
We are working closely with local authorities across England and Wales who are also on their way to implementing single handed care, and we are sharing knowledge and experience with them.
We also maintain close links with professional bodies such as National Back Exchange to ensure that what we do is in line with recommended good practice. Each case will be carefully risk assessed on an individual basis, and any decision to provide single handed care will be based on shared multidisciplinary decision making.
What about the cost of the new equipment?
Experience in other areas has shown that an average of £725 is spent per person on putting equipment in place to enable single handed care to be implemented. This may seem a lot, but the cost of equipment is quickly offset by savings in care costs, and over time there are savings of many thousands of pounds to be made for each person.
How single handed care should be implemented
This will be achieved through:
- A programme of information, education and training for all professional groups involved in the assessment for, commissioning of, and provision of domiciliary care to older people in. Some of this will be awareness raising only, and some of it will give hands on practical skills to deliver single handed care safely and with confidence
- Revising some existing policies and working procedures, and writing some new ones, so that Health and Social Services staff can work closely together in a seamless and integrated way to implement single handed care
- Working closely with our providers of domiciliary care to support a transition to single handed care at a pace which is safe and sustainable
- Aiming to be ready to introduce as standard practice single handed care right from the start of someone needing hoisting or care in bed for the first time, at a time agreed internally
- Assessing a selection of existing service users, where it is felt there is potential for single handed care to be successful. This will give the staff involved an opportunity to gain experience, skills and confidence to build on, and will produce savings and quality outcomes to service users straight away
Personal Care Consultants – Risk Assessment Service
Personal Care Consultants offers a Risk Assessment and Manual Handling Risk Assessment service in the North West of England and North Wales. Our Risk Management Team is made up of Occupational Therapists and Nurses. This varied background gives our team a solutions focused approach being able to offer clients, carers and staff alike advice, training and suggestions in how to assist clients most effectively while retaining dignity and choice.
Personal Care Consultants prides itself on the up to date knowledge of our assessors who are members of both the Local and National Back Exchange and keep themselves up to speed with new developments and equipment within the field.
Our team of Manual Handling Risk Assessors can offer a swift response to urgent referrals, particularly for clients awaiting discharge from hospital. Our expertise also means that our assessors can assist in the most complex and challenging situations and find safe, practical and client focused solutions to manual handling issues.
Once a service user has been identified as a potential suitable candidate for single handed care, a specific single handed care risk assessment can be carried out. This can take place at hospital, respite care or the client’s own home and will facilitate the safe provision of single handed care by:
- A person centered initial risk assessment visit will be completed by the risk assessor with the service user in the presence of their families or formal carer’s if required. Here the assessor will take a detailed history of the service users past medical history and complete a functional assessment of the service users physical and cognitive ability
- During the risk assessment process the service use will have the opportunity to trial any recommended pieces of equipment that may enable single handed care
- Formal recommendations will be made by the risk assessor regarding any particular techniques or equipment that will facilitate single handed care.
- Any recommended items of standard stock equipment will be formally requested by the risk assessor from the Community Equipment Service
- Written quotations will be obtained for any required non-stock items of equipment not held by the Community Equipment Service and a special request for the equipment will be placed with justification of the costs.
- Following delivery of any recommended equipment a follow up visit will be completed by the assessor in order to review the safe and efficient use of the equipment and provide family member and /or formal care staff client specific training and supervision to ensure correct use of the recommended equipment.
- A client specific and detailed written single handed care risk assessment report will be produced by the risk assessor and sent out to the referrer. This will contain the service user’s personal details, the diagnosis and presenting problem, a formal manual handing risk assessment to indicate an initial risk rating. This risk assessment rating is based on the All Wales NHS / Local Government Manual Handling Training Passport and Information Scheme. The risk associated with each task is assessed against the likelihood of an incident occurring and should it happen, the severity of the consequences. In undertaking this assessment cognisance is taken of the appropriate legislation:
Health and Safety at Work Act 1974
Management of Health and Safety at Work Regulations 1999
Manual Handling Operations Regulations 1992 (2002 as amended)
Provision and Use of Work Equipment Regulations 1998
Lifting Operations and Lifting Equipment Regulations 1998
Human Rights Act 1998
Mental Capacity Act 2005
Deprivation of Liberty Safeguards
- A manual handing plan will also be produced detailing what specific techniques and/or equipment should be used by the service user to facilitate single handed care safely and how this should be used and/or carried out.