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“A double-edge sword: Single-handed care from a national perspective”

Deborah Harrison

Research into single-handed care Exploring Barriers and Solutions

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Who is A1 Risk Solutions?

Our passion is ensuring workforces handle the person safely with dignity and respect, creating caring and competent workforces

We know from experience the difficulties and barriers you are or will experience with single handed care

We deliver Level 4 and 3 manual handling training packages tailored to meet your needs-all qualifications are quality assured by RoSPA and

Ofqual

We have developed an online system with you in mind

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The only online system with a research and evidence

base that demonstrates it significantly reduces risks

Presentation Aims• Gain a holistic perspective on single-handed care.

• Consider whether it can have a positive impact on both the lack of care staff as well as service users

• Learn about the new evidence base surrounding single handed care. Share latest evidence

• Explore the key themes

• Evaluate some of the barriers to single-handed care

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Single handed Care-What is it?

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Are we at the 11th hour?

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State of Play

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Kings fund Report

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Perfect Care Company

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Reducing NHS capacity

• Where will the extra patients go?

• Bed blocking

• 1 in 10 delayed discharges

• Current spend on delayed discharge

will fund 15,000,000 hours

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Scotland, Wales, Cumbria Yorkshire and Devon…. Beautiful

What have they all got in common?

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Bed management and the bed blocking process

BLOCK

Delays on Hospital discharge costing NHS £900m a year

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What does this mean in real terms ?

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Poor Quality care across health and

social care

Poor quality careIncreased mortality

Blocking of ICU beds

Cancelled operations

Hospital diversions

Poor emergency

interventions

Lack of care for vulnerable

Poor quality

care

Care is often undignified and

rushed

People admitted to care homes instead of staying at home

Invasive lots of different staff

Lack of personalised care

Health Social care

What does everyone say?

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A National Strategy is required

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Integration of Health & social services

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ServiceNumber of reviews

What % of the reviews resulted in reductions

Actual or projected

savings

Equipment spend

Cambridgeshire CC 2016/2017 135 so far

44% reduction projected £840K

£10K pm

Gwent CCSeptember 2015 figures

2015 In the pilot166 reviews

38% reduction 9.5% (avoided costs)

Projected £172K

£130K

Somerset CouncilH Bagatelas and N Pluckrose ‘Somerset’s reduction of care review’ (2016)

April 2016-Nov 2016 143 reviews

44% reduction £258K £7.5K

Cardiff CC 2015/2016227 reviews

30% care packages were either reduced or prevented

£395K

Tower Hamlets started pilot 2016

Projected £170K

Reading Council 2016 100 reviews 20% reduction £150K

London Borough of Havering

142 reviews 42% were suitable for a reduction

Devon CCHague C, Charlton C, Billing R, Bone L, Cambridge S (2015) Double Handling project in Devon

3862015

42.5% suitable for reduction (147 cases)

£414 K

Tameside CC 2005 Harrison

2005 107 in 3 months

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Results of a survey

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International Survey

• A series of 23 questions

• Across 15 groups of staff

• Established demographics

• Answer options: strongly agree to strongly disagree

• Three open ended questions gave us rich qualitative data

List positives for single carer handling

List concerns for single carer handling

Any suggestions regarding single handed care

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Demographics

A total of 4575 responses

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48% were Occupational therapists

34% were Moving and handling professionals

Single handed care is against the law?

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OT’s & MH 4.6% Agency managers 7.6% Care staff 42.9%

It should always be two to hoist?

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Gantry or over head hoist

17%

Mobile hoist

32%

Do you have the confidence to assess and implement SHC packages?

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17%

27%

37%

57%47% 67%

77%

87%

9%

OT & MH professional

• I am expected to carry out complex assessments and demonstrate to care staff-When am unsure myself around SHC

OT and MH

• I am concerned that we have no meaningful training to do this

Manager of services

• I am concerned about my team do they have the skills

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MH and OT professionalsWe need a list of simple guidelines around assessment for SHC

Lack of assessment skills

Lack of training of MH’s, OT’s and care staff

Only attended an equipment demo before-forgot most of it

I don’t know the answers to all the objections

Extra time required by the assessor

The whole process is intimidating and scary

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Care Agency ManagersMy staff do not know what they are doing and are not competent

Who is going to train them-cost

Lack of training of senior managers and risk assessors

How am I going to get staff new to care to do SHC?

Dealing with the client with fluctuating needs

We do not have the skills to risk assess for SHC

The staff will hold us at ransom point

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Care staffI do not know what I am doing

The service user will not like it

The family will not like it

It is unsafe

Why change now we have always done it with two

It was unsafe last week for one person to do SHC so why is it okay now?

I am sure its against the law

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What are the themes

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Collaboration

Red Dress Day

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Local authority Provides services

using public money

Often two carers

One carer One carer

Agency care Direct Payments

Informal care

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Number of deaths in hoisting

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Education and Training

I feel confident in my knowledge of the equipment

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62% Felt confident

38% Did not

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After training we need lots of

support as we easily forget

Do you think you will remember the training or product demo?

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74% Struggle to

remember new skills

Why is Single Handed Care (SHC) advantageous

Taking a person centred holistic approach

1. Service users

2. Families

3. Care staff

4. Care agency

5. Social services SW allocating of care

6. Hospital discharge team

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Person Centred Approach

Person

Empowering

Improved

Communication

Able to remain

in own home

Improved

flexibility in

routineLess invasive

Improved

dignity

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Enabling

Can save the client money

Better quality of

careLonger time and better relationship

with carer

The person feels they

are part of their care

Self fulfilling prophecy

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