Single-handed care
Single-handed care
The overarching theme identified in this question were the benefits of collaborative and integrated working , including improved communication , appreciation , sharing knowledge and experience , standardisation of ways of working and changes to culture and mindset .
Furthermore , delegates identified other benefits of collaborative and integrated working through efficiency savings , reductions in care , increased confidence and innovation .
Another theme to emerge was perception of the law , with sub themes around the importance of health and safety for both patients and service users and care givers , better understanding of the law and the importance of risk assessments .
Misconceptions exist that moving and handling of a person requires two people and the fear of litigation , with a number of high-profile cases whereby care has been reduced being presented to the courts ( Mandelstam 2020 ).
Mandelstam ( 2020 ) argues the importance of a thorough risk assessment and the skill , confidence and competence of those providing care ; a further argument towards provision of specialist training and a systems approach with reduced carer handling being the default position .
The final part of the evaluation was to explore what delegates felt that they needed to embed the training into practice , where three overarching themes were identified :
• Ongoing training and support , including regular refreshers , peer support , including champions , and a review of local policies .
• Equipment , which included equipment familiarity , availability , and a review of manual handling plans and assessment tools .
• Engagement from care agencies , including handovers to agencies , engagement from other professional groups and training to be made available to carers .
Next steps
A task and finish group , consisting of system partners , was set up to explore ways to address the gaps identified and from this the following has since been achieved :
• An agreed core stock required to deliver singlehanded care from point of discharge .
• Local authority framework care providers participated in carer engagement days , whereby they also achieved a single-handed care qualification and access to an online accessible resource .
• Manual handing leads in each organisation attended specialist single-handed care training , so that single-handed care is embedded across the system in annual statutory and mandatory moving and handling training .
• Train the trainer for some participants who had attended the initial training , so that a cascade model of training can be utilised across the system moving forward .
In summary the work highlighted the importance and benefits of system wide singlehanded care and highlighted the gap in both confidence and competence of practitioners who prescribe and / or deliver care support to patients upon discharge from hospital .
It has further emphasised what is needed to ensure successful implementation of change of practice and culture that is needed to ensure its success .
Department of Health and Social Care ( 2021 ) Integration and innovation : working together to improve health and social care for all . Available online bit . ly / 3XCCtaN [ accessed 3 July 2023 ].
Flinders S and Scobie S ( 2022 ) Hospitals at capacity : understanding delays in patient discharge ? Quality Watch : Nuffield Trust and Health Foundation . Available at bit . ly / 46vXTKQ [ accessed 3 July 2023 ].
Harrison D ( 2017 ) Single-handed care , is it a vision or a reality ? Part one . Column , 29 ( 4 ): 14-18 .
Mandelstam M ( 2020 ) Manual handling , singlehanded care , occupational therapy and the law : 2020 and beyond ; a discussion paper . Inclusion Me .
Newman C , Whitehead P , Thomson M ( 2022 ) Investigating the effect strength of positive risktaking barriers on discharge decisions in occupational therapy intermediate care : A factorial survey . British Journal of Occupational Therapy , 86 ( 4 ): 293 – 301 . doi : 10.1177 / 030802262211413 20 .
Words DIANE LANE , Head of Service Intermediate Care , Medway Community Healthcare and SAM DAWSON , Therapy Clinical Lead , Medway Community Healthcare , diane . lane3 @ nhs . net or sam . dawson4 @ nhs . net
July 2023 OTnews 33