Deborah Harrison of A1 Risk Solutions, explores the many benefits that arise from the implementation of Single-Handed Care, the barriers, and busting those myths with creative solutions
What is Single-Handed Care?
It is a means of creating capacity across a whole system. By carrying out a person-centred assessment of the individuals needs, we are ensuring care is proportionate to meet the needs of the individual and is received at the right time and in the right environment.
BENEFITS
Service User in the community:
· Able to remain in their home as care packages are now available
· Able to have a timely hospital discharge into their home
· Person-centred and safe means of Moving and Handling the individual
· The service user feels less isolated and reports an improved communication
· Improved dignity and trust with the staff
Patients in a hospital acute/Community Hospital setting:
· Length of stay reduction 9.1 days compared to those awaiting a Doubled Handed Care package
· It can be used as part of a rehabilitation programme
· It can be used for end-of-life care
· Frailty score after hospital discharge remains the same
· The patients after discharge mainly stay on the SHC pathway
All staff (Including therapists, nurses and HCA’S)
· Improved skills in Moving and Handling risk assessment, problem solving and achieving creative solutions.
· The care providers are less stretched and able to manage the unrelentless workload
ORGANISATIONS WITHIN THE SYSTEM
Working together using a system’s approach organisations have been able to demonstrate they have had a positive impact with hospital discharge processes and waiting lists for care in the community. Examples have been Southampton and IOW ICB (Foxley, 2024), Medway and Reading.
Southampton and IOW ICB
They have carried out discharge assessments across a variety of wards
· A reduction in the length of stay by 9.1 days compared to those awaiting DHC
· The number of bed days saved were 1103 in the first 24 weeks
· 98% of patients on the SHC pathway were discharged to their preferred places of care
· Over 51% reviewed were deemed suitable, of the 312 reviewed, 161 patients were suitable for SHC
· 80% of patients six weeks post discharge were still on the SHC pathway or even requiring no care
· The frailty score was 7 and remained at 7 post discharge
So, what does this mean in real terms?
An additional 81 care packages were created instead of awaiting a DHC package and deconditioning in a hospital setting.
BUSTING MYTHS
Sometimes you will come across resistance in many forms. Below are a few of the myths we have challenged.
It’s against the law:
Moving and handling should always be based around avoiding or reducing the level of risk to the most reasonable level practicable (MHOR, 1992). The risk assessment should consider the person’s needs, the number of handlers, competency, the environment and any equipment or process required. No matter how many carers are required, demonstrating you have followed a process and have a robust risk assessment is essential.
Our insurance will not cover us to carryout SHC:
There is no evidence of this within insurance policies
Plus Size (Bariatric patients) - we will still need four people:
We can often reduce the care package with this client group to two carers, imagine how undignified it is to have that many sets of hands and eyes on you.
The individual is dying - surely we need two people?:
Often the individual can be managed with one person with the right equipment in a quiet, dignified and gentle manner.
The individual’s condition and mobility are variable
We will give you a variable handling plan that will ensure it meets the needs of the person, enabling the individual to remain as independent as possible.
Deborah Harrison the founder and Clinical Director of A1 Risk Solutions has produced an evidence base alongside the University of Salford and Jo Webb. Copies of these studies are available for those attending our courses.
Next Steps
If you’re interested in introducing SHC into your organisation register your interest by emailing: Admin@A1RiskSolutions.co.uk or call 0161 327 2195.