methodical planning , which can lead to over-prescription of care .
It is argued that , in part , this is related to therapists ’ attitudes towards risk and discharge decision making ( Newman et al 2022 ). Staff need to have confidence in the onward discharge plans to support their risk taking .
Once a patient is discharged with double handed care ( or more ), it can be incredibly challenging to reduce care , as patients feel that they require two people for their safety , which exacerbates the challenges seen within the community , with increased pressures and demands on an already strained social care system .
To alleviate these challenges , these patients need to be supported at the start of their journey into hospital , with reduced carer handling in mind from the point of admission .
As a way to support the demand in community services , a proposal was made to provide a whole systems approach to upskilling allied health professionals , therapy assistants , enablers and community care providers from across the system , including the acute trust , inpatient community beds , intermediate care , local authority adult social care and local care providers .
The government ’ s 2021 White Paper , Integration and innovation : working together to improve health and social care for all , recommends that barriers to integrated working need to be removed to enable improvements to be seen across health and social care systems .
With this in mind , the proposal in the Medway system recognised the value of starting the change model within the acute trust and the importance of extending offers of upskilling to colleagues within the acute trust .
What happened next ?
A successful grant application was made to Health Education England , to increase the capacity and capability of our community rehabilitation workforce .
In total , 45 participants ( 19 occupational therapists , five physiotherapists and 18 care providers / enablers ) – were invited to receive training in an advanced Level 4 RoSPA qualification in single-handed care .
A pre-test- post-test questionnaire was completed by each delegate on the final day , to ascertain levels of confidence and competence prior to the course starting and at the end of the course , as it was anticipated that although all staff were previously trained in moving and handling , they may not be aware of potential limitations to their knowledge until presented with specific singlehanded care training .
Evaluation and emergent themes
The data we collected showed delegates ’ perceptions of both their competence and confidence in reducing and providing single-handed care before and at the end of the training .
We could see that 78 % of the delegates scored three or below on the Likert scales initially ( one being least confident and five being extremely confident ). After the course , all delegates felt that their competence had improved , with only one participant reporting their confidence had not improved .
All delegates were directly involved in assessment , recommendations and / or delivery of single-handed care , with only
July 2023 OTnews 31
© FredFroese via Getty Images