Occupational Therapy News OTnews November 2019 | Page 17

MANUAL HANDLING FEATURE
managed. In all likelihood, early identification of the issues with
these clients avoided escalation or break down in the provision of
the care package.
A further three clients were identified as needing further in-
depth assessment by the Thurrock Council team, due to the
complexity of their cases; two clients were assessed, but sadly
passed away before the recommendations for reduction in their
care packages could be actioned.
The remaining 61 clients reviewed did not require additional
intervention, however the review constituted their annual care
package review, releasing other social services staff from the need
to undertake a further review with these clients.
The reductions achieved equated to a total of 214.75 hours per
week in reductions in care hours.
When completing the EQ-5D outcome measure after their
review, and comparing responses to those given at the original
assessment, 91 per cent of clients indicated that they felt an
improvement in their health state, 44 per cent of clients indicated
of the review and report on
the SROI. The evaluation
process included identification
of and engagement with
key stakeholders identified
from care providers (both
private organisations and
Thurrock’s provider services),
occupational therapists, the
project lead, the Thurrock
occupational therapy service,
Thurrock commissioning service and the social work review
team.
It was agreed that the Inclusion.me team would complete
an outcome measure with each client, before and after the
occupational therapy intervention, and the EQ-5D outcome
measure – a National Institute for Health and Care-preferred
standardised instrument that measures health-related quality of
life – was chosen.
Clients were invited to participate in completing the
questionnaire prior to their review and then at a follow up visit, and
70 of the 96 clients whose care packages were reviewed, their
families or carers, provided responses.
Under the project, 128 clients were referred to Inclusion.me for
review and assessment; 96 cases were assessed, while 32 clients
were not assessed as they had moved from the area, moved into
care, passed away, or their package of care had already been
reduced.
Of the 96 clients who were reviewed, 27 were identified as
needing a reduction or change of care and equipment provision
(28 per cent), with the reduction in care hours ranging from 1.5
hours a week to 33.5 hours a week.
In addition, one client had a planned increase in care avoided
through provision of equipment, and two clients were identified
as having potential safeguarding issues, which were reported and that they had experienced an improvement in their feelings of
anxiety and depression, and 24 per cent indicated that there had
been an improvement in the levels of pain and discomfort that
they were experiencing.
The use of new and up-to-date equipment, along with the
upskilling of carers to use new equipment and techniques, should
contribute significantly to improvements in comfort for clients and
consequently a reduction in the levels of pain that they experience.
A number of outcomes were identified through stakeholder
interviews and client feedback.
The occupational therapists
were also asked to produce a
detailed manual handling risk
assessment, with the provision
of additional manual handling
plans, pictorial guidance sheets
and training support for each
client.
The organisation was
also asked to provide a
report on the Social Return
on Investment (SROI)
demonstrated by these
interventions.
An evaluator, Linda Agnew,
an independent occupational
therapist, was commissioned
to assist with the development
The occupational outcomes included:
• promotion and maximisation of independence;
• reduced stress on family and informal carers;
• provision of increased support for formal and informal carers;
and
• more flexibility of when care visits can take place, resulting in
formal care service being more able to meet individual client
needs.
The health and wellbeing outcomes included:
• less time in hospital;
• reduced risk to carers;
• reduced risk to individuals;
• sustainability of care at home, reducing the need for 24 hour
care; and
• use of new equipment and improved techniques to improve
the health and wellbeing of carers and individuals.
The quality of care outcomes identified included:
• equipment is based on the person’s individual needs and care
is more person focused;
• there were benefits to an individual’s personal dignity through
having only one carer carry out intimate personal care;
• having more personalised care with a smaller group of carers
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