Equipment and adaptations: guidance on provision - executive summary
Guidance outlining the responsibilities of NHS Scotland, Local Authorities, Integration Authorities, and their Housing and Education partners for the provision of equipment and adaptations, with the aim of supporting partnerships, across Scotland, to deliver a more equitable and accessible service.
Moving & Handling
Equipment plays a critical role in supporting the effective moving & handling of people who are frail or unable to transfer independently.
The assessment process to determine appropriate equipment provision, needs to clearly evidence the views of the person who requires to be moved and handled and a person-centred approach should be promoted.
Risk assessments should promote the ethos of 'minimum intervention, maximum independence with the aim of fully utilising the persons functional abilities at all times and avoids practice which over prescribes equipment requirements, and 'disables' the person, impacting negatively on their potential wellbeing.
The Health & Safety Executive (HSE) are clear in their guidance that blanket solutions should not be applied, and their helpful guide Getting to Grips with Hoisting provides information which highlights the importance of the individual assessment in determining the appropriate number of carers required to safely move and handle the person.
A wide range of professionals including physiotherapists, nurses, occupational therapists, and social care staff, should be able to assess for and provide moving and handling equipment as required, as part of the service they are providing, and health and social care services should ensure that they avoid arrangements which encourage duplication in the assessment pathways and inappropriate onward referrals.
The publication of the Scottish Manual Handling Passport, in 2016, has highlighted the importance of a strategic, partnership approach to the effective provision of manual handling interventions, ensuring safety, and competence, in the workforce, whilst ensuring the promotion of person-centered approaches which maximise independence and choice.
- Assessments should evidence the views of the person who requires to be moved and handled and a person-centred, and risk-enabled approach should be promoted.
- Services should apply a minimum intervention ethos, which aims to maximise a person's ability to utilise functional performance and avoids practice which 'disables' the person and impacts negatively on their potential wellbeing.
- For 'end of life' ensure that services act in line with good practice/policy for those with palliative needs and ensure the service users wishes are central to the decision making, avoiding unnecessary equipment provision.
- Ensure that a wide range of professionals are able to assess for and provide moving and handling equipment as required, either to support hospital discharge and/or as part of the service they are providing.
- Services must ensure robust training and refresher training, is in place to support the effective assessment (including positive risk-taking), and use of the equipment.
- Services should ensure they avoid arrangements which encourage duplication in the assessment pathways and inappropriate onward referrals.
- Blanket solutions to moving and handling should not be applied and individual assessment is used to determine the number of care workers required to safely move and handle the person, encouraging the use of single-handed care where appropriate.
- Partnerships should review arrangements to encourage good practice recommendations from the Scottish Manual Handling Passport which aim to help standardise good practice across Scotland.
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