All too often these days we only hear about our service users’ experiences of local authorities and PCTs when the system fails them and they make formal complaints. It’s not unusual in these circumstances that, often desperate, people contact their “local rag” to report how badly they have been treated by their public sector health or social care organisation, and MPs are called in to put further pressure on, what some people may describe, as an already overstretched system.
It is for this reason that I wanted to highlight a particular assessment that I found myself involved in when the system worked particularly well for my client. All the client’s outcomes were achieved in a time frame that may have been unheard of in some local authorities
As an independent Consultant Practitioner, working as an associate on behalf of Personal Care Consultants, I was asked to carry out a complex manual handling risk assessment for a lady who lived alone in the community. As this assessment was being completed on behalf of Halton Social Services, who are based in the North West of England, I was able to be extremely responsive (as always) and respond to the initial referral on the day that I received it.
The initial referral has been anonimised for obvious reasons but read “an urgent manual handling risk assessment is required for Mrs X. Mrs X has a past medical history of spinal nerve compression in her cervical spine, hiatus hernia, ischemic heart disease, a previous stroke and a recent diagnosis of Motor Neurones Disease”.
Motor Neurones Disease is a progressive illness that is caused by the breakdown of the nerve cells in the brain that control the muscles. As a result Mrs X had experienced a rapid deterioration in her functional ability and was now unable to mobilise or transfer independently.
It turned out that Mrs X lives in a small one bed roomed warden controlled bungalow owned by Halton Housing Trust. Mrs X is cared for by formal home carers who had reported experiencing significant difficulties when assisting Mrs X with standing transfers.
In order to demonstrate the sequence of events following the initial receipt of the referral I have taken exerts from my electronic activity dairy. This computerised system is used to enable me to record all interventions in each case that I am involved with. This is then presented to our customers at the point of invoice to show what intervention has taken place with each client and when.
Thursday 8th April 2010 – Referral received from Halton Social Services requesting an urgent manual handling risk assessment. Admin to process referral together with outgoing telephone calls to the client and her family, the private care agency and the client’s Care Manager. A joint visit was arranged for following day.
Friday 9th April 2010 (11AM) – Initial manual handling risk assessment was completed with Mrs X in the presence of her formal carers and son who were able to contribute towards the assessment verbally. Following the completion of an Oxford scale assessment (to assess the client’s range of movement and the amount of power she had in her limbs) it was possible to observe Mrs X attempt to carry out an assisted standing transfer with the assistance of two carers. This was unfortunately carried out in an unstable and unsafe manner due to the client displaying reduced weight bearing ability and difficulties in stepping and placing her feet.
Recommendations were made for the client to use a hoist and sling to facilitate all transfers. This was suggested instead of a stand aid hoist as it was reported that Mrs X often not only had reduced weight bearing ability, but was unable to weight bear at all. As she has a degenerative condition this was only likely to get worse until eventually she would be unable to weight bear at all.
As Mrs X’s home was extremely small, it was identified that a mobile hoist could not be used due to insufficient floor space and turning circles. A ceiling track hoist was therefore recommended.
Outgoing telephone call to representative from AA Moving Solutions Ltd (an independent company who supply and install ceiling track hoists and other manual handling and community equipment). A request was placed to arrange a further joint visit with Mrs X to obtain quotation and to survey the property for the provision of a ceiling track hoist in the client’s bedroom. Rep working in area so able to fit in a visit early this afternoon.
Friday 9th April 2010 (1PM) – Joint visit with rep as arranged this morning followed by incoming email from AA Moving Solutions later in the day with drawings and written quotation for the provision of ceiling track hoist. Advised by company that, due to the urgency of Mrs X situation, they would be able to install early next week if order placed quickly by local authority.
Outgoing phone call to Principle Officer of Independent Living Team (Halton Social Services) requesting the urgent provision of ceiling track hoist. I outlined context of assessment and I advise that the suppliers of the ceiling track hoist had a window of opportunity and could install early next week if order received. In view of urgency, the Principle Officer agreed to place order today and accept written recommendations with clinical reasoning and justification retrospectively.
Monday 12th April 2010 – Manual handling risk assessment document completed. Ceiling track to be installed today. AA Moving Solutions to telephone assessor near completion of installation. Assessor attended to complete review of equipment and special sling assessment.
Special equipment request placed with Halton Independent Living Team for the provision of a special sling. Handling plan completed with full detailed account of risk assessment process and full recommendations. Administration to send risk assessment report to Halton Social Services.
So there you go. Did you think it was humanly possible to get such a quick result when dealing with a local authority? Four days from receiving the referral to the installation, provision and review of recommended equipment in situation is fantastic. It just goes to show that with a bit of luck and like minded individuals who just want to get the job done effectively and efficiently miracles can happen! As you can imagine the client was delighted with my input and is now able to complete safe transfers in order to carry out her activities of daily living with ease.
Gareth Pennell – Consultant Nurse Practitioner
It is for this reason that I wanted to highlight a particular assessment that I found myself involved in when the system worked particularly well for my client. All the client’s outcomes were achieved in a time frame that may have been unheard of in some local authorities
As an independent Consultant Practitioner, working as an associate on behalf of Personal Care Consultants, I was asked to carry out a complex manual handling risk assessment for a lady who lived alone in the community. As this assessment was being completed on behalf of Halton Social Services, who are based in the North West of England, I was able to be extremely responsive (as always) and respond to the initial referral on the day that I received it.
The initial referral has been anonimised for obvious reasons but read “an urgent manual handling risk assessment is required for Mrs X. Mrs X has a past medical history of spinal nerve compression in her cervical spine, hiatus hernia, ischemic heart disease, a previous stroke and a recent diagnosis of Motor Neurones Disease”.
Motor Neurones Disease is a progressive illness that is caused by the breakdown of the nerve cells in the brain that control the muscles. As a result Mrs X had experienced a rapid deterioration in her functional ability and was now unable to mobilise or transfer independently.
It turned out that Mrs X lives in a small one bed roomed warden controlled bungalow owned by Halton Housing Trust. Mrs X is cared for by formal home carers who had reported experiencing significant difficulties when assisting Mrs X with standing transfers.
In order to demonstrate the sequence of events following the initial receipt of the referral I have taken exerts from my electronic activity dairy. This computerised system is used to enable me to record all interventions in each case that I am involved with. This is then presented to our customers at the point of invoice to show what intervention has taken place with each client and when.
Thursday 8th April 2010 – Referral received from Halton Social Services requesting an urgent manual handling risk assessment. Admin to process referral together with outgoing telephone calls to the client and her family, the private care agency and the client’s Care Manager. A joint visit was arranged for following day.
Friday 9th April 2010 (11AM) – Initial manual handling risk assessment was completed with Mrs X in the presence of her formal carers and son who were able to contribute towards the assessment verbally. Following the completion of an Oxford scale assessment (to assess the client’s range of movement and the amount of power she had in her limbs) it was possible to observe Mrs X attempt to carry out an assisted standing transfer with the assistance of two carers. This was unfortunately carried out in an unstable and unsafe manner due to the client displaying reduced weight bearing ability and difficulties in stepping and placing her feet.
Recommendations were made for the client to use a hoist and sling to facilitate all transfers. This was suggested instead of a stand aid hoist as it was reported that Mrs X often not only had reduced weight bearing ability, but was unable to weight bear at all. As she has a degenerative condition this was only likely to get worse until eventually she would be unable to weight bear at all.
As Mrs X’s home was extremely small, it was identified that a mobile hoist could not be used due to insufficient floor space and turning circles. A ceiling track hoist was therefore recommended.
Outgoing telephone call to representative from AA Moving Solutions Ltd (an independent company who supply and install ceiling track hoists and other manual handling and community equipment). A request was placed to arrange a further joint visit with Mrs X to obtain quotation and to survey the property for the provision of a ceiling track hoist in the client’s bedroom. Rep working in area so able to fit in a visit early this afternoon.
Friday 9th April 2010 (1PM) – Joint visit with rep as arranged this morning followed by incoming email from AA Moving Solutions later in the day with drawings and written quotation for the provision of ceiling track hoist. Advised by company that, due to the urgency of Mrs X situation, they would be able to install early next week if order placed quickly by local authority.
Outgoing phone call to Principle Officer of Independent Living Team (Halton Social Services) requesting the urgent provision of ceiling track hoist. I outlined context of assessment and I advise that the suppliers of the ceiling track hoist had a window of opportunity and could install early next week if order received. In view of urgency, the Principle Officer agreed to place order today and accept written recommendations with clinical reasoning and justification retrospectively.
Monday 12th April 2010 – Manual handling risk assessment document completed. Ceiling track to be installed today. AA Moving Solutions to telephone assessor near completion of installation. Assessor attended to complete review of equipment and special sling assessment.
Special equipment request placed with Halton Independent Living Team for the provision of a special sling. Handling plan completed with full detailed account of risk assessment process and full recommendations. Administration to send risk assessment report to Halton Social Services.
So there you go. Did you think it was humanly possible to get such a quick result when dealing with a local authority? Four days from receiving the referral to the installation, provision and review of recommended equipment in situation is fantastic. It just goes to show that with a bit of luck and like minded individuals who just want to get the job done effectively and efficiently miracles can happen! As you can imagine the client was delighted with my input and is now able to complete safe transfers in order to carry out her activities of daily living with ease.
Gareth Pennell – Consultant Nurse Practitioner
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