needs . Our service aims to support these individuals , however access to specialist seating and funding was challenging and often a very lengthy process .
Due to the length of time it would take from initial referral to receipt of a chair , the client ’ s needs would change and it was found that the equipment ordered would no longer be appropriate .
Because of the high numbers of chairs going through a special authorisation panel and the issues identified , Rotherham Council made the decision to commission a stock , configurable specialist chair .
Funding was also secured through the Rotherham NHS Foundation Trust in order to provide our team with a number of sleep system cushions , which would be loaned to care home residents who may have contractures and postural needs .
Following the introduction of a specialist chair within our equipment service , we have further developed our seating and posture provision and assessment . The number of referrals we receive for seating has significantly increased and this is one of the three main reasons that we receive referrals into our team .
We currently work very closely with care homes and their staff to provide education around seating and posture and support carers to identify when a resident may require further assessment to ensure early intervention .
The team is further developing formal training sessions for carers , alongside Rotherham Council , to improve knowledge and understanding of seating and posture within the wider community .
Overall , access to a stock chair and sleep system has significantly reduced waiting times for specialist equipment and increased the quality of care we are able to provide to our care home residents , to ensure earlier intervention and prevention of contractures and postural seating issues .”
Referrals and assessment
Following receipt of a referral , we aim to review the resident for an initial postural assessment within a two-week timeframe . This aspect of our service is predominantly provided by the three part-time occupational therapists within our team and we complete a comprehensive holistic assessment of the resident in their care home .
Within our assessment , we collect subjective information regarding the reason for referral and issues identified , previous medical history and medications , and the resident ’ s current seating .
Assessment is completed within supine and sitting , reviewing pelvic and leg positioning , trunk position and head and neck control . Consideration is given to a resident ’ s pressure care needs , diet and nutrition , and the overall benefits of our intervention . Detailed assessment allows us to identify patient specific goals and outcomes , which we aim to achieve following our intervention .
The current chair available to our service allows us to support clients with complex seating needs . The chair is adjustable , in order to enable us to adapt the seat width , height and depth . The tilt in space function and medium to high pressure relief ensure we are able to provide improved postural support and reduce the risk of developing pressure areas within the seating .
Highlighting the positive impact we ’ re having
We have completed a number of case examples to highlight the positive impact of our interventions for care home residents . One of the occupational therapists within our team , Rebekah Delap , received a referral due to poor positioning within the bed and associated swallowing problems .
The goals for seating and positioning in this case were identified as :
• Improving posture for eating and drinking and to help prevent chest infections .
• Improving posture to prevent the development of pressure associated damage .
• Improving the resident ’ s comfort and reducing joint pain , to enable access to alternative environments and socialisation and to reduce carer burden through improved positioning .
Numerous assessments were completed and the resident was provided with the stock specialist chair and a sleep system .
The occupational therapist was able to work closely with the wider multidisciplinary team , in order to change anti-spasticity medications and also provide education to carers on how to
46 OTnews February 2023