community equipment provision policy€¦ · equipment service. community equipment provision will...

1

PROVISION OF

COMMUNITY

EQUIPMENT

BURY

Criteria Guidance

July 2017 Version 10.0

2

Contents Page

Community Equipment Provision 5

Equipment eligibility and Service Access Arrangements

Responsibilities

Equipment Panel 10 Terms of Reference

Standing Financial Guidance – Health / Social Care

Protocols 13 Risk Assessment

Ordering Combinations of Equipment Stock Items Provision

Non stock items provision Duplicate ordering

Combinations of equipment Assessment of people in residential and nursing homes

Private Practitioners Out of area requests for equipment

Respite and shared care

Transfer of equipment Exchange of equipment

Emergencies and Equipment Failure 16

Satellite Stores 17

Equipment Locations

Opening hours

Equipment Maintenance 18 Portable Electrical Appliance Safety

Lifting equipment LOLER

Training & Competencies 23

Driver Delivery and Fitting Arrangements 24

Delivery Times & KPI’s Urgent/non urgent

End of Life Support of hospital discharge

Orders Procedure 26

Stock Items and Non Stock Items

3

The Care Act 28

Equipment Collection Procedure 32 Data Collection 33

Guidelines for the Selection of Bathing/Showering Equipment 34

Paediatric Equipment for Toileting

Criteria for Bath Seat Criteria for Bath/Shower Board

Paediatric Bathing Criteria for Bath Step

Criteria for Bath Lifter Criteria for Shower Chair

Criteria for Shower Stool Criteria for Swivel Bather

Guidelines for the Selection of Bed Equipment 49

Criteria for Back Rest Criteria for Bed Grab Rails (lever)

Criteria for Cot Sides Criteria for Bed raisers

Criteria for Electric Profiling Bed Hospital Beds for Children

Pressure Redistribution Equipment (Mattresses)

Criteria for Mattress Variator Criteria for Pillow Lifter

Guidelines for the Selection of Walking Equipment 74

Criteria for Walking Frame Criteria for Walking Frame with Wheels

Criteria for 3 Wheeled Walker Criteria for 4 Wheeled Walker

Criteria for Adjustable height Walking Stick Criteria for Fischer Stick

Guidelines for the Selection of Seating Solutions 82

Criteria for Chair raisers Criteria for High Seat Chair

Children’s Chairs

Criteria for Perching Stool Criteria for Riser /Recliner

Guidelines for the Selection of Access Solutions 90

Door Intercom

Guidelines for the Selection of Toileting Solutions 92 Criteria for Commode

Criteria for Raised Toilet Seat Criteria for Toilet Frame

4

Criteria for Combi-Loo

Guidelines for the Selection of Transfer/

Manual Handling Solutions 98 Criteria for Handling Belt

Criteria for Hoist & Slings

Children’s Postural Management Criteria for Leg Lifter

Criteria for Slide Sheet Criteria for Transfer Board

Criteria for Stand & Pivot Aid Criteria for Standaid

Appendices

Appendix One – Forms 109

5

Community Equipment Provision

Equipment refers to specialist disability equipment, which are not readily available

for use by able bodied persons, e.g. bath mats. Minor adaptations are rails, banisters, and minor works up to the value of £1000. These items are specialist and

not exhaustive.

Equipment is for use in individuals’ only or main residence, but only a small range of equipment is provided in residential and nursing homes.

All prescribers must be trained in use and assessment of the equipment they are

recommending. Training, Clinical Supervision and Competency in the assessment and provision of equipment is the responsibility of the individual requesting the aid.

Funding

Provision of community equipment is funded via the community equipment service.

Minor adaptations are funded from a small budget held within the Home Improvement Agency for public sector housing and by the store for private sector

housing.

Introduction

The Community Equipment Service operates to provide an equipment provisions

service to meet a range of needs for the residents of Bury supporting their independence and care in the community. The Service is funded by contributions

from Bury Council, and Pennine Care NHS Foundation Trust. Organisations have a responsibility to deliver a high quality, integrated Community Equipment Service for

Bury. Integrated equipment provision must take account of the following:

The range of needs of the community The range of equipment solutions available to meet those needs

Nationally recognised guidelines and evidence based practice indicators for equipment selection

Risk management strategy

Sound procurement principles that allow greatest opportunities for purchasing flexibility and cost effective provision.

Equipment Eligibility and Service Access Arrangements

There are a range of organisations who may have access to the Community Equipment Service. Community equipment provision will be governed by the

following: Customer must be resident in Bury, and be registered with a GP.

6

Specific procedures will apply to Community Equipment Service provision in

circumstances of the following : Customers who are moving from Bury

Combinations of equipment Complex and continuing care needs

Duplications of equipment

Emergency arrangements - equipment failure Equipment maintenance protocol

Funded registered nursing care and nursing homes Private health care referrals

Referral from out of area Residential care

Respite and shared care Transfer of equipment between customers

Protocol for the exchange of equipment An assessment of customer need must be conducted by designated

competent Professional. Equipment solution selection is the responsibility of the designated competent

Professional. There is a range of equipment available for supply.

Equipment specific eligibility criteria must be adhered to by the designated Professional

Completion of the appropriate requisitioning documentation and its progress

to the Community Equipment Service is the responsibility of the designated Professional

The Community Equipment Service will ensure that the equipment provided is fit for purpose

Equipment provision will take account of the seven working day delivery performance indicator

When equipment is no longer required it must be returned to the Community Equipment Store. Some equipment is designated as disposable and non

returnable.

Responsibilities

Project Board:

Determining the strategic direction of the Community Equipment Service

Commissioning Community Equipment for the whole of Bury. Overseeing and monitoring the use of the budget

Monitoring Community Equipment Service performance activity

Service Managers are responsible for:

Ensuring that their staff are aware of Community Equipment Service provision protocols and procedures

Ensuring that their staff are suitably trained and are competent to assess and provide equipment as appropriate

7

Monitoring compliance with the protocols and procedures

Monitoring the prescription of bespoke and special equipment activity related to Community Equipment Service provision

Monitoring performance activity data Responding to risk management issues that are Community Equipment

Service generated

Supporting the Strategic Steering Group in the provision of a high quality Community Equipment Service

8

Professionals are responsible for

Carrying out an assessment of customer need

Applying equipment eligibility criteria to requisitioning activity Identifying appropriate equipment solutions to meet the assessed

need

Complying with Community Equipment Service protocols and procedures

Identifying and communicating appropriately any risk issues associated with the provision of the equipment

Participating in relevant training initiatives related to Community Equipment Service activity

Community Equipment Store Manager is responsible for

Co-ordinating the purchase of stock and non stock equipment ensuring

quality and value for money Managing equipment stock levels

Generating performance activity data Supporting Project Board in the provision of a high quality integrated

Community Equipment Service Providing an efficient and effective equipment delivery and collection service

as designated by procedure.

Maintaining efficient systems detailing customer, equipment provision and referrer information

Providing the customer with equipment specific information Providing the customer with Community Equipment Service contact details

Ensuring equipment issued and on loan is fit for purpose and appropriately maintained

Providing and monitoring emergency/out of hours arrangements for specified equipment items

Ensuring health and safety and infection control procedures are applied to the management of equipment resources

Ensuring recycling opportunities are maximised according to procedures Ensuring staff have the skills and training to carry out their duties efficiently

and effectively

Community Equipment Service Staff are responsible for

Ensuring equipment ordering procedures are followed appropriately

Maintaining accurate records of equipment provision Ensuring equipment maintenance procedures are followed appropriately

Complying with infection control procedures regarding the management and care of equipment

Complying with health and safety responsibilities associated with the provision of equipment

Participating in training activities relevant to their contribution to their role Delivery of high quality customer care

9

Quality Management Responsibilities

All staff have a responsibility to report any service quality concerns to the

Equipment Service Manager and their own line manager.

Medicines & Healthcare Products Regulatory Agency (MHRA)

The Community Equipment Service Manager will respond to relevant notices and

information received from the MHRA via Bury PCT’s Health and Safety Advisor as the responsible MHRA Liaison Officer. The Community Equipment Service Manager

will co-ordinate action to be taken and will respond as required and appropriate.

Opening Hours

The administration office is open between 8.45am and 5pm Monday to Friday.

The Stores operate between 8.00am and 4.30pm.

Should you wish to access the store for emergency purposes, please telephone in advance and we will try as far as possible to deal with your request.

10

EQUIPMENT PANEL

TERMS OF REFERENCE and PROCESS

Core Panel Members Out of Hospital Senior Manager / Service Lead Community Equipment Manager Disability Services / OT Manager (Adult Care) OT Lead (PCFT) Adult & Children’s Physio Lead (PCFT) Adult & Children’s Nursing Lead Children’s Nursing Lead Commissioner

Panel Meetings Each Panel member will identify a designated representative should they be unable to attend. The full Panel must meet, however, in cases of sickness, annual leave or emergency, the following group can process cases; Adult Care OT Team Manager Out of Hospital Manager Nursing Lead

1. The Panel will meet each week. 2. The meeting will be chaired by Out of Hospital Senior Manager / or Service Lead 3. Cases will be presented by the Lead clinician who will have checked that the referral is

appropriate and screened (if required) for Continuing Health Care funding. 4. Cases to be considered will include:-

- Non-standard items of adult equipment - referrals for which there is no clear pathway - equipment that costs in excess of xxxx - border issues

5. Specials orders should be fully supported by a ‘statement of case’ with detailed quotations within ‘standing financial instruction’ guidelines

6. It is the panels remit to document outcomes and for these records to be held for audit purposes.

7. It is the Panel’s remit to consider the appropriate funding source for the case. Where the case falls outside of the criteria for ICES the Commissioning representative will inform the relevant Commissioning Director (CCG/CF&W).

8. The panel is to make recommendations where the referral is either not considered to meet the service criteria OR whereby the request is potentially inappropriate to be funded by this service budget under any SLA agreed OR where the person or family have personal responsibility to provide.

9. It is the prescribers responsibility to feedback any outcome to the patient / client. 10. It is the panel’s duty to escalate any cases to the Integrated Community Equipment

Board for consideration/decision whereby a decision has not been reached by the panel

11

or the person has appealed against the decision. The appropriate Commissioning Manager will process these cases to the Board.

11. It is the panels remit to communicate in writing to the referrer (clinician) whereby a decision has been made NOT to proceed with the referral request. This will be processed and recorded by the OSRC Administrator. It is the referrer’s responsibility to discuss outcomes with the service user/patient.

12. It is the panel’s remit to consider Right to Control request for items outside of the standard list (see below).

13. It is the panel’s remit to seek cost effective and innovative ways to provide alternative service if possible.

14. Outcomes of panel decisions will fall into the following categories; Not Approved (alternative option provided) Not Approved Deferred (for additional case or finance information to be obtained) Approved

15. It is the panels remit to review those adaptations and complex equipment referrals which are submitted to the service and agree outcomes on a case by case basis whereby:-

- the case is FACS substantial/moderate borderline - possible responsibility of a Housing Association - hospital discharge is affected - falls into Nursing criteria for panel :

a) Low Air loss systems b) Bariatric c) Double mattresses d) Equipment not under contract

- Costs over £,1000 - Special Order / bespoke item - Is an adaptation refit (hoist / stair lift) - Ramps - Repairs - No clear funding stream - Is considered exceptional circumstance

Items not required to be considered at panel include; Grab rails Handrails Stair Rails Key safes Half steps Floor to wall rails Newel Post rails Scandia Frames Bed raisers Bed infills Porch infills Bed/chair/Settee raise x 1 Widening doorways for wheelchair access Fixing of shower stools

12

Contract Procedure Rules Guidance

Contracts procedure rules require a full tender process for all contracts valued above £75,000 (contract not annual value)

The table below sets out, for different contract values, the procurement procedure

that must be followed to procure contracts, the minimum number of tenders that must be invited and how invitations to quote or tender must be publicised.

Contract procedures for different contract values

Value (£) Procurement procedure

Minimum number of tenders

Tender publication

0-999 An agreed price Minimum of one price

The Chest if appropriate or as

described in the

Procurement Guidance

1,000-4,999 Competitive prices Minimum of two prices


described in the Procurement

Guidance

5,000-24,999 Competitive written quotations based

upon a request to quote

Minimum of three written quotations


described in the Procurement

Guidance

25,000-74,999 Competitive written

quotations based upon a full

Quotation Process

Minimum of three

written quotations

The Chest

75,000 up to EU threshold

Full tender process Minimum of four tenders

The Chest and Specialist

publication if appropriate

EU threshold and

above

Full tender process EU minimum

number

The Chest, OJEU

Contract Notice and Specialist

publication if appropriate

13

Protocol for Risk Assessment

TBC

14

Protocol for Ordering Specific Combinations of Equipment from the

Community Equipment Service

This protocol deals with the circumstances and arrangements relating to the supply of specific combinations of items of equipment from the Community Equipment &

Resource Service.

The following combinations of equipment should not be prescribed for loan at the

same time

Equipment for use in a bath and equipment for use in a shower (cubicle/walk-in)

Pillow lifter and dynamic pressure re-distributing mattress Wedge and dynamic pressure re-distributing mattress

Hoist and Stand aid equipment Handling belt and stand and pivot transfer aid

Where possible ordering activity should not generate the above equipment combinations.

Community Equipment Service Catalogue Stock Items Provision

The customer must be assessed by a Community Equipment Service

designated Professional. If the assessed need can be addressed by the provision of a ‘stock item’ from the Community Equipment Service

Catalogue, the Professional must follow Stock Ordering Procedure.

Community Equipment Service Catalogue Non Stock Items Provision

Where the customer is assessed and requires an item of community equipment that

is designated a ‘non stock item’, i.e. equipment required is a variation of a stock item available in the Community Equipment Service Catalogue, the Professional

must follow the Specials Ordering Procedure. The Specials Order Form must be completed fully and accurately by the Professional. Forms must be sent to the line

manager for authorisation. Following authorisation, the documentation should be e mailed to the Community Equipment Service for action and processing. These

requisitions may have an overview from a Senior Professional.

Protocol for Ordering Duplicate Equipment from the Community Equipment Service

This protocol deals with the circumstances and arrangements relating to the supply

of duplicate items of community equipment from the Community Equipment & Resource Service.

15

Duplicate items of equipment can be defined as either:

more than one item of the same piece of equipment or more than one item of equipment that provides a similar function.

Examples would include two raised toilet seats (same item duplicated) and a high

seat chair and chair raisers (items with a similar function).

Where the Professional determines that duplicate equipment may be required the

following conditions must be applied The customer’s assessment of need

The availability and capability of carers Environmental factors

Equipment provision will meet the customer's minimum requirements to support care and independence

Where the conditions are met Professionals can order duplicate items of equipment

from the range stated below by following the Equipment Ordering Procedure toileting equipment

mobility equipment perching stools

In all other circumstances where duplicate equipment is required the Professional

must discuss customers' needs with their manager. If there is agreement that the

equipment is required then the Equipment Ordering Procedure must be followed and the order must be authorised by their Manager/Senior Clinician.

Children’s Equipment

In the case of children requiring duplicate none stock equipment where there is shared custody by estranged parents, this can only be ordered on the express

authorisation of the relevant Social Services Budget Manager, and a request should be put to them in writing. It would be expected that any safely transportable

equipment would not be requested in duplicate. Equipment should be provided in main residence only.

16

Emergency Arrangements - Equipment Failure

Introduction

The Community Equipment Service has a number of measures in place to ensure that customers are provided with high quality, reliable and safe equipment. As part

of these arrangements all customers are given written information advising them to

contact the Community Equipment Service immediately by telephone in the unlikely event of equipment failure.

All requests for assistance in the event of equipment failure must be managed via

the Community Equipment Service using the arrangements detailed below. Equipment failure during the hours when the Store is open

During the Community Equipment Service opening hours telephone calls from

customers (or representatives acting on their behalf) will be handled by a member of the staff at the Community Equipment Service and the necessary steps will be

taken to support the customer, arrange for the repair/exchange of the equipment and ensure the safety of the customer and carers affected by the equipment failure.

The process will be managed and monitored by the Community Equipment staff ensuring satisfactory resolution of the event. If the customer has not been

assessed for some time, it is considered good practice to reassess their needs, to ensure their safety.

Appropriate incident reporting procedures will be followed.

Equipment failure during the hours when the store is closed

The contract for hoists is with Prism Medical. If a hoist breaks down out of hours

the client should ring the emergency duty team on (0161) 253 6606 who should then ring Prism Medical. The client may also contact Prism Medical will attend and

carry out repairs if possible. Prism Medical will inform the admin office to complete the appropriate paperwork.

17

Satellite Stores – TBC

Satellite Stores that are located in Bury carry a core range of equipment that is available for issue when the Community Equipment Service is closed and there is

an identified need to: facilitate emergency discharges from hospital

prevent emergency admission to hospital

support replacement of existing equipment in the event of breakdown/failure support equipment provision associated with an unplanned care situation

Access to these stores is strictly controlled. Entry to the Out of Hours Stores is

restricted to designated Community Nurses, Occupational Therapists and Physiotherapists.

Staff must complete the necessary documentation and follow the equipment ordering procedure for any equipment that is issued from the Out of Hours Stores.

The stock will then be replenished on a regular basis. Satellite Stores will continue to be based across Fairfield Hospital, The Bury Living Well Centre and Killelea.

18

Equipment Maintenance Protocol

Equipment provided by the Community Equipment Service is subject to a range of

checks to ensure it remains in a safe condition and is fit for purpose. These checks are carried out at regular intervals by competent maintenance staff and are co-

ordinated by the Community Equipment Service, and appropriate contractors.

Routine maintenance and repair of equipment may be undertaken in the customer’s home or in the Community Equipment Service as appropriate.

Portable Electrical Appliance Safety

Electrical equipment supplied by the Community Equipment Service is subject to

routine maintenance and electrical safety testing at regular intervals. This is undertaken by competent trained technicians and is organised by the Community

Equipment Service. All electrical equipment supplied by the Store carries a label confirming it has been checked and serviced and it details when the next service is

scheduled.

However, as part of equipment safety and risk management, it must be considered good practice to undertake a simple visual inspection of any electrical equipment

prior to using it. This promotes safety for all and can identify indicators that the equipment may require attention from maintenance staff at any time during the

interval between services. Using the checklist below the integrity of the equipment

can be monitored and when a concern is identified the Community Equipment Service should be contacted immediately for advice. The equipment should not be

used if there is any concern about its condition.

Electrical Equipment Visual Inspection Checklist Is there damage (apart from light scuffing) to the cable sheath? Is the plug damaged (e.g. the casing cracked or pins bent)?

Has the cable been joined together at any point along its length or repaired with tape or other material?

Is the coloured insulation of internal cable cores showing where they enter the plug or at any other place along its length?

Does the appliance appear to have been subjected to conditions for which it is not suitable (e.g. is it wet or excessively contaminated)?

Is there damage to the external casing of the equipment or are there loose

screws or parts etc.? Is there evidence of overheating (e.g. burn marks or discoloration)?

Is the main on/off switch damaged, does it operate incorrectly?

Maintenance of ‘Lifting’ Equipment (LOLER Regulations)

Where the primary function of the community equipment item is to lift the customer e.g. a hoist and its slings, such equipment must be routinely checked at

6-monthly intervals to ensure that it is safe and fit for purpose. These checks are co-ordinated by the Community Equipment Service and are conducted by

competent assessors.

19

However, as part of equipment safety and risk management, users must alert the

Community Equipment Service if there is any suspected fault, breakdown or other concern about any equipment provided by the Service. In the event that the

Community Equipment Service are unable to service and maintain equipment for any reason (e.g. unable to gain access to customer’s premises); the Professional

will be contacted where necessary.

Assessment of people in residential and nursing homes

Regulation 10(e) of the Residential Care Home Regulation 1984 makes clear; it is

for the proprietors of such homes to arrange for the provision of adaptations and facilities necessary to make their homes suitable for residents with disabilities.

However this does not preclude the local authority from supplying to residents, equipment such as walking frames, where they are supplied specifically for the

resident’s personal use. Admission into a care home will be subject to a community care assessment and

admission would normally take place when a person is no longer able to live independently or with cares in their own home.

To be fit for purpose a care home must supply appropriate equipment for the type of people likely to be resident there. Therefore it is expected the standard needs of

occupants will be met by the home.

The proprietors of Nursing Homes registered under the Act are expected to provide

such personal equipment for their patients.

Where Residential Care Homes require moving and handling equipment in order to meet their health and safety obligations to their staff who are supporting residents,

it will be the Residential Care Homes’ responsibility to provide the necessary equipment to comply with this statutory obligation.

In circumstances where Community Nursing Staff need moving and handling

equipment to provide regular treatment to an individual resident and the Residential Care Homes’ equipment does not meet their requirements, then

Community Nursing Staff only can order manual handling equipment to support the delivery of treatment they are providing. Community Nurses must withdraw this

community equipment when they discharge the resident from their care.

Protocol for the Provision of Community Equipment Service for Referrals from Private Practitioners

The Community Equipment Service will not provide equipment to customers who

are referred to the Community Equipment Service by private Nursing, Occupational Therapy and Physiotherapy practitioners except in the following circumstances

The practitioners have been approved as designated Professionals by the Operational Group.

The practitioners are contracted by health to provide services as part of an agreed NHS local service delivery initiative.

20

The practitioners will be expected to comply with all arrangements and procedures relating to Community Equipment Service provision and the terms of any service

delivery contract in place.

Protocol for the Provision of Community Equipment Service for Referrals from Professionals outside Bury

The Community Equipment Service will provide equipment to customers who are

residents in Bury, registered with a GP and have been assessed by Community Equipment Service designated Professionals. The range of equipment available will

be as specified in the Community Equipment Service Catalogue, and should be essential discharge equipment only.

Equipment Ordering Arrangements

The Out of Area Professional must make a formal request to their respective counterparts in the appropriate community service. The Professional must provide

all the customer details and the equipment information. On receipt of the request to the service, they will process the order.

The Community Equipment Service staff will fit any equipment delivered. It will be the responsibility of the Professional to engage with any colleagues in Bury

regarding the on-going care etc that the customer may require associated with the

equipment provision.

Equipment Collection Procedures

The Community Equipment Service will arrange the collection of equipment when requested to do so and in accordance with the Equipment Collection Procedure.

Protocol for Community Equipment Provision to Support Respite/Shared Care

On occasions it is recognised that customers who have been issued with community

equipment may receive care and support in a variety of locations including respite care accommodation.

Where it is known that customers are likely to receive care in a variety of locations e.g. shared care between family members the Professional must provide advice to

the customer with regard to equipment safety. Some community equipment will be supplied to be used in a variety of locations

e.g. a 3 wheeled walker, walking stick. Other types of community equipment will be supplied only for use in a specific assessed location e.g. a profiling bed. It is the

responsibility of the Professional to make known the conditions that apply to the particular equipment supplied to customers to support their care and independence.

21

In keeping with good practice and health and safety risk management, equipment

must not be dismantled, adapted, adjusted, transported inappropriately, stored in conditions likely to compromise its integrity, or used in any way other than for its

intended purpose. Where equipment has been provided for use in a specific assessed environment it must not be relocated from that place.

Protocol for the Transfer of Equipment

Community equipment is provided to customers following an individual assessment by Community Equipment Service designated Professionals. The use of community

equipment by anybody other than the assessed customer is not permitted. The reasons for this are to prevent unacceptable exposure to risk, to promote user

health and safety and prevent infection control procedures being compromised.

Where it is identified to the Community Equipment Service that community

equipment is being used by another family member in the household the following action will take place:

The Community Equipment Service will refer the family member together

with the equipment details to the appropriate professional. The referral will be reviewed and assessed by appropriate staff.

The assessor will be responsible for carrying out an appropriate level of intervention and advising the Community Equipment Service of the outcome.

In the event that the equipment is suitable for the family member, the

Equipment Ordering Procedure must be followed and the appropriate documentation completed. A statement on the form detailing that the

equipment is already in situ must be recorded on the requisitioning documentation.

In the event that the equipment is not suitable for the family member, the assessor will be responsible for discussing this with the customer and

making arrangements for the equipment to be collected by the Community Equipment Service if appropriate. The Equipment Collection Procedure must

be followed and the documentation completed. The Community Equipment Service will process all documentation received

and amend their records accordingly.

Protocol for the Exchange of Equipment

Community equipment is provided to customers following an individual assessment by approved designated Professionals. In certain circumstances the equipment

provided may need to be exchanged for particular reasons which may be either customer related or equipment related. Where this is identified and raised with the

Community Equipment Service action will be taken to ensure customer/carer safety with regard to continued use of community equipment.

22

Equipment Exchanges Linked To Changes in the Customer/Carer

Circumstances

In the event it is suspected that the equipment supplied is no longer suited to the customers' needs for reasons relating to:

changes in functional ability

changes to physical presentation e.g. limb loss, weight gain changes to customer’s environment e.g. house move

evidence of risk management concerns e.g. report of injury to service user involving the equipment with no associated equipment failure

The Professional will be contacted and become responsible for advising on the

continuing equipment provision arrangements. Where the Professional is no longer available, the appropriate manager of the staff group concerned will be contacted to

progress the matter and provide the Community Equipment Service with instructions for equipment management. Equipment exchange can only take place

when the Community Equipment Service has been advised what action must be taken.

Equipment Exchanges Linked To Equipment Factors

Where there is no evidence to indicate a change in the customer/carer

circumstances and an equipment exchange is required due to equipment linked

factors (e.g. equipment failure, equipment damage) arrangements will be as follows:

a 'like for like' replacement of the equipment will be provided to ensure

continuity of provision e.g. to replace equipment in need of repair where 'like for like' replacement is not possible for any reason e.g. the

original equipment item supplied has been discontinued and is no longer available, the appropriate Service (or the manager) will be contacted for

advice on continued equipment provision. where the equipment concerned needs to be assembled, fitted or adjusted at

delivery and the Community Equipment Service has no record of these specifications and requirements on the original requisitioning documentation,

the Professional (or the ICES manager) will be contacted for advice on continuing equipment provision.

Where there is discrepancy or a time lapse, it is good practice to re assess.

23

Training & Competencies – TBC

Managers, Professionals and Community Equipment Service staff have a responsibility to ensure that skills related to the provision of Community Equipment

are appropriately developed and maintained.

Service Managers are responsible for

ensuring that their staff are aware of Community Equipment Service provision

protocols and procedures ensuring that their staff are suitably trained to undertake their duties related

to community equipment provision and management

Professionals are responsible for

ensuring that they participate in training activity related to Community

Equipment Service provision attending specific equipment related training to maintain ‘ordering rights’ for

that equipment e.g. Pressure Redistributing Equipment, Hoists.

Community Equipment Service Staff are responsible for

ensuring that they participate in training activity related to Community

Equipment Service provision

attending specific equipment related training to enable the performance of their duties with regard to equipment handling practices, fitting, maintenance

and infection control procedures.

Staff should not undertake any activity with regard to Community provision for which they are not skilled or adequately trained. In the event

of any concern staff must approach their manager for advice and support.

24

Driver Delivery and Equipment Fitting Arrangements

Equipment Delivery

Community Equipment Store delivery staff are trained in the safe delivery of all

community equipment. In addition to ensuring the safe delivery of all requisitioned equipment, some staff are trained to fit and install an agreed range of equipment at

the delivery location, for specified professionals.

Confirming Delivery Arrangements

Please note the following:

Failure to provide all the necessary information to action the delivery will

result in the return of the documentation to the Prescriber and will delay equipment provision

Where the delivery arrangements cannot be completed by the delivery staff e.g. unable to adjust/fit equipment safely, the equipment will be returned to

the Community Equipment Store, after which the Prescriber will be contacted. No alternative equipment will be provided until the Prescriber’s new

instruction. Where the customer is unavailable, a card will be left asking the customer to

contact the Equipment Service to arrange delivery.

Prescribers will be responsible for:

The assessment and selection of the correct item of community

equipment for the customer Ensuring that the equipment item requisitioned and the delivery

arrangements requested are permissible Indicating any special requirements.

Recording all appropriate information e.g. heights for equipment to be set at to enable the delivery arrangements to be applied to the

provision of the equipment Educating the customer in the safe use of the equipment, where there

has been delivery only.

Delivery staff will be responsible for:

Providing the customer with manufacturers’ instruction leaflets

Obtaining the signature of the customer (or representative) as proof of receipt of equipment and acceptance of the loan conditions.

Fitting as appropriate (see above)

Routine 7 Working Days

Urgent 3 Working Days

High Risk (End of Life / Essential for hospital discharge / Urgent risk of admission

24 Hours

25

Equipment Ordering Flowchart – This needs updating - JP

26

Stock Equipment - Orders Procedure

Orders Procedure

There are three distinct categories of equipment that are available to be ordered

and loaned from the Community Equipment Service.

Stock Equipment – a range of frequently demanded equipment, routinely

available from the Store, ready to be supplied on request. Special Equipment – a variation of the above equipment, held in the Store

and therefore readily available for prompt supply, but this needs authorisation from an appropriate professional line manager.

Bespoke Equipment Usually has to be purchased specially from the supplier to meet the request of the Clinician. This may take some weeks.

What conditions apply to requisitioning ‘stock’ items of equipment?

The Clinician is responsible for identifying the stock equipment solution that meets the customer’s assessed needs.

Stock equipment provision must comply with the specific eligibility criteria detailed in this document.

Stock equipment can only be supplied when the order is placed by designated Professionals.

Consideration must always be given to meeting need with stock

equipment.

27

Non Stock Equipment Orders Procedure

What is ‘non stock’ equipment? Specials

It is recognised that, in certain circumstances, ‘stock’ equipment may not be the most suitable equipment solution to meet the particular assessed needs of the

customer. In such circumstances it may be possible to requisition equipment that is not held as stock but that does meet the assessed needs of the customer. This type

of equipment is referred to as ‘non stock’ equipment or ‘specials’. It can only be

supplied by the Community Equipment Service as a ‘special order’ when particular conditions are met and the ‘non stock equipment’ requisitioning procedure is

followed.

What conditions apply to requisitioning ‘non stock’ items of equipment?

The readily available stock equipment is not suitable for the customers

assessed needs. Non-stock equipment must be a variation of a stock item readily and

routinely available via the Community Equipment Service. The non-stock equipment item recommended must comply with the stock

item eligibility criteria detailed in this Catalogue. A visit to the Community Equipment Service must be undertaken to establish

there is no suitable equipment solution available to issue from the Store. During the visit there will be an opportunity to review the equipment available

in the Store.

Please note that visiting procedures must be adhered to.

Consideration must always be given to meeting need with a stock item in the first instance. Only where this is not possible should a ‘non stock

requisition’ be raised.

What is the procedure for ordering bespoke equipment? (Specials)

Before an order can be processed via the Community Equipment Service the Clinician will be responsible for the H2A. The form, together with a completed quote

from a suitable supplier, must then be submitted The Community Equipment Service for recording purposes, who will then forward to Clinician’s Manager/Senior

for consideration. Forms must be signed by the Clinician and the Manager. This indicates that the conditions for supply are fully met. Failure to follow the procedure

and complete the documentation required will result in delay of equipment supply.

Completed forms must be sent to the Community Equipment Service for action

28

The Care Act 2014

Eligibility Introduction The Care Act 2014 introduces a national eligibility threshold1, which consists of three

criteria, all of which must be met for a person’s needs to be eligible. The eligibility

threshold is based on identifying:

1 This replaces ‘Prioritising need in the context of Putting People First: A whole system approach to eligibility for social care: Guidance on Eligibility Criteria for

Adult Social Care, England 2010’ - usually referred to as the Fair Access to Care (FACS) guidance

whether a person’s needs are due to a physical or mental impairment or illness

to what extent a person’s needs affect their ability to achieve two or more specified outcomes

and whether and to what extent this impacts on their wellbeing.

Local authorities can decide to meet needs that do not meet the eligibility criteria.

Where they decide to do this, the same steps must be taken as would be if the person did have eligible needs (for example, the preparation of a care and support

plan). Where local authorities choose to exercise this power to meet other needs, they must inform the person that they are doing so.

Where a local authority has reasonable cause to suspect that an adult in its area

(whether or not ordinarily resident there) is experiencing, or is at risk of, abuse or neglect, then under section 42 of the Act the authority must make enquiries. Where

this is the case, a local authority must carry out (or request others to carry out)

whatever enquiries it thinks are necessary in order to decide whether any further action is necessary. The decision to carry out a safeguarding enquiry does not

depend on the person’s eligibility, but should be taken wherever there is reasonable cause to think that the person is experiencing, or is at risk of, abuse or neglect.

National eligibility threshold

Firstly, in considering whether a person’s needs are eligible for care and support, local authorities must consider whether the person’s needs are due to a physical

or mental impairment or illness. This includes conditions such as physical, mental, sensory, learning or cognitive disabilities or illnesses, brain injuries and

substance misuse.

29

If they do have needs caused by physical or mental impairment or illness,

the local authority must consider whether the effect of the adult’s needs is that they are unable to achieve two or more of the following specified

outcomes: a) Managing and maintaining nutrition

Local authorities should consider whether the adult has access to food and drink to

maintain nutrition, and that the adult is able to prepare and consume the food and drink.

b) Maintaining personal hygiene

Local authorities should, for example, consider the adult’s ability to wash themselves and launder their clothes.

c) Managing toilet needs

Local authorities should consider the adult’s ability to access and use a toilet and manage their toilet needs.

d) Being appropriately clothed

Local authorities should consider the adult’s ability to dress themselves and to be appropriately dressed, for instance in relation to the weather to maintain their

health.

e) Being able to make use of the adult’s home safely

Local authorities should consider the adult’s ability to move around the home safely, which could for example include getting up steps, using kitchen facilities or

accessing the bathroom. This should also include the immediate environment around the home such as access to the property, for example steps leading up to

the home.

f) Maintaining a habitable home environment Local authorities should consider whether the condition of the adult’s home is

sufficiently clean and maintained to be safe. A habitable home is safe and has essential amenities. An adult may require support to sustain their occupancy of the

home and to maintain amenities, such as water, electricity and gas.

g) Developing and maintaining family or other personal relationships Local authorities should consider whether the adult is lonely or isolated, either

because their needs prevent them from maintaining the personal relationships they

have or because their needs prevent them from developing new relationships.

h) Accessing and engaging in work, training, education or volunteering Local authorities should consider whether the adult has an opportunity to apply

themselves and contribute to society through work, training, education or volunteering, subject to their own wishes in this regard. This includes the physical

access to any facility and support with the participation in the relevant activity.

i) Making use of necessary facilities or services in the local community including public transport and recreational facilities or services

30

Local authorities should consider the adult’s ability to get around in the community

safely and consider their ability to use such facilities as public transport, shops or recreational facilities when considering the impact on their wellbeing. Local

authorities do not have responsibility for the provision of NHS services such as patient transport; however they should consider needs for support when the adult

is attending healthcare appointments.

j) Carrying out any caring responsibilities the adult has for a child

Local authorities should consider any parenting or other caring responsibilities the person has. The adult may for example be a step-parent with caring responsibilities

for their spouse’s children. The regulations provide that ‘being unable to achieve’ specified outcomes includes

circumstances where the person: is unable to achieve the outcome without assistance. This includes where the

person may need prompting, for example some adults may be physically able to wash but need reminding of the importance of personal hygiene.

is able to achieve the outcome without assistance but doing so causes the adult significant pain, distress or anxiety. For example, an elderly person with severe

arthritis may be able to prepare a meal, but this leaves them in severe pain and

unable to eat the meal;

is able to achieve the outcome without assistance, but doing so endangers or is

likely to endanger the health or safety of the adult, or of others. For example, if the health or safety of another member of the family, including any child could

be endangered when an adult attempts to complete a task or an activity without relevant support; or

is able to achieve the outcome without assistance but takes significantly longer than would normally be expected. For example, a young adult with a physical

disability is able to dress themselves in the morning, but it takes them a long time to do this and exhausted and taking the remainder of the morning to

recover.

Finally, and crucially, local authorities must consider whether, as a consequence of

the person being unable to achieve two or more of the specified outcomes there is, or is likely to be, a significant impact on the person’s wellbeing. Local

authorities should determine whether:

the adult’s needs impact on an area of wellbeing in a significant way; or,

the cumulative effect of the impact on a number of the areas of wellbeing mean that they have a significant impact on the adult’s overall wellbeing.

To do this, local authorities should consider how the adult’s needs impact on the

following nine areas of wellbeing in particular (but note that there is no hierarchy of needs or of the constituent parts of wellbeing):

personal dignity (including treatment of the individual with respect);

physical and mental health and emotional wellbeing;

protection from abuse and neglect;

31

control by the individual over day-to-day life (including over care and support

provided and the way it is provided); participation in work, education, training or recreation;

social and economic wellbeing;

domestic, family and personal relationships;

suitability of living accommodation;

the individual’s contribution to society.

In making this judgement, the local authority should look to understand the adult’s needs in the context of what is important to him or her. The impact of needs may

be different for different individuals, because what is important for the individual’s wellbeing may not be the same in all cases. Circumstances which

create a significant impact on the wellbeing of one individual may not have the same effect on another.

For more detail please see…..

32

Equipment Collection Procedure

Effective Equipment Management

Community equipment is supplied to individuals on loan for the period of time it is required to support care and independence and safety. When community

equipment is no longer required, it must be returned to the Community Equipment Service as soon as possible. Professionals have a responsibility to explain this to

customers (or their representatives).

Equipment return is an important part of managing equipment effectively -

minimising equipment loss and maximising recycling opportunities. This approach benefits customers by helping to ensure equipment availability and it prevents the

need to purchase replacement equipment unnecessarily, conserving valuable resources that must always be soundly invested in promoting effective service

delivery and provision. Some items of equipment are designated as not cost effective for return. These are some designated items where it would be more

costly to collect than the cost of the item to purchase.

In very particular circumstances where it is identified that equipment is no longer required by the customer assessed for its provision but it is being used by any

other individual in the household, staff must refer to the conditions described in the ‘Protocol for the Transfer of Equipment’

Arranging Equipment Collections

In all circumstances when community equipment is no longer required the Community Equipment Store must be notified of the situation.

Customers/their Representatives/Carers can request equipment collections by

contacting the Community Equipment Store by telephone, when a convenient collection time will be arranged. Where the community equipment can be safely

handled and managed by customers or their representatives, it may be returned to the Community Equipment Store facility directly during opening hours. This is not

recommended in circumstances where the customer, the representative and/or the equipment may be at risk of harm or damage during this

activity.

Community Equipment Store staff - will provide all necessary support and will

be responsible for co-ordinating the arrangements to ensure the prompt collection of equipment from the community location and its return to the Community

Equipment Store facility.

Only Equipment supplied by the Community Equipment Store is eligible for collection

33

Data Collection: 7 - working days Delivery Target Performance Indicator

for the provision of

Community Equipment Services

The seven working day delivery target performance indicator is one of the nationally agreed performance indicators used to measure the quality of equipment

provision to customers. Compliance with this performance indicator ensures customers’ needs are addressed within nationally accepted timescales. In addition,

the indicator is considered as part of the review of the overall performance of

Health Trusts and Local Authorities, contributing to the determination of the quality ratings of those organisations.

Compliance with the seven working day delivery target is measured by counting the

number of ‘working days’ from the date the responsible authorising Professional makes the decision that equipment is to be supplied (‘Decision to Supply Date’) to

the date when the equipment is supplied and delivered to the customer. For the purposes of the calculation ‘working days’ are taken to mean Monday to Friday and

are inclusive of Bank Holidays.

In order to achieve the target, professionals, managers and Community Equipment Service staff must work together to ensure that equipment is

provided within the timeframe specified in the performance indicator. Achieving the target is a shared responsibility. It requires a collaborative

effort from all involved in the equipment provision ‘chain’.

Professionals must ensure that requisitions for equipment are sent to the

Community Equipment Store on the same date as the decision to supply date. This will support prompt equipment supply and compliance with the

performance indicator.

Definition –‘decision to supply date’

Decision-making is a process that starts with assessment and is completed when the responsible authorising officer/professional makes a final identification,

selection and determination of what equipment is to be provided to meet the needs of the customer. The date when that final decision is made is the ‘Decision

to Supply Date’. This date must be recorded in appropriate box labelled ‘Decision to Supply Date’.

Responsibility for recording ‘Decision to Supply Date’

The ‘Decision to Supply Date’ must be recorded by the person who has responsibility and is authorised to make the final decision regarding ordering the

equipment.

34

GUIDELINES FOR SELECTION OF BATHING/SHOWERING EQUIPMENT

Bathing/showering equipment can be provided to meet either the customer or carer

needs for three main reasons.

To facilitate:

Strip washing

Where it is the personal choice of the customer As a short-term management solution, i.e. post operatively while the

customer is unable to access the bath/shower. As a risk management measure i.e. while a customer is waiting for an

adaptation to be completed.

Bathing

Where there is only a bath in situ.

Showering

Where there is a shower facility over the bath Where there is a shower cubicle

Where there is a level access shower

Paediatric Equipment for Toileting

Description Supportive toilet seat (potty or chair over toilet).

Criteria

The child has disabilities which mean they are unsafe on the toilet without assistance.

The carer is unable to support the child safely when he/she is using the toilet.

Supporting the child without the toileting equipment is putting the child and/or

carer at risk.

Considerations The home environment is suitable for the equipment to be used safely for both the

child and carer.

Privacy when in use.

Safe storage

Safety of other family members.

Standard children’s equipment available off the shelf should be considered first.

Check the make and compatibility of the existing toilet seat.

35

Guidelines for the Selection of Bathing Equipment NEED TRIGGER QUESTIONS

Which part of this activity is the

customer having difficulty with?

Yes/No SOLUTIONS TO

CONSIDER

(any/all)

Strip Wash

Customer needs to

sit down in order to

be safe having a

wash.

Can the customer stand safely to

carry out the activity?

Is the customer/carer capable of

moving and positioning equipment?

Is the environment suitable for the

equipment?

No

Yes

Yes

• Shower/bath board over

the bath

• Perching stool

• Shower stool

Bathing

To bathe safely to

maintain an

acceptable level of

personal hygiene for

physical,

psychological or

health related

reasons.

Can customer step in/out of bath

safely?

Is customer able to lift legs in/out of

bath, sit down to bathe and rise up

safely after bathing?

Can the customer sit unsupported

on a bath board/bath seat?

Do any of the equipment solutions

previously listed meet the need?

Yes

Yes

Yes

No

• Bath step.

• Grab rails.

• Bath seat .

• Bath board & bath seat.

• Swivel bather.

• Bath lift.

• Hoist and bath panel

removal.

• Information on private

purchase bathing/showering

solutions.

• Recommendation for

adaptation.

Shower Over

Bath

To transfer into the

bath to use the

shower either

standing or sitting

Is the customer safe to step in/out

of the bath to shower?

Is customer safe to stand in the bath

to shower?

Can customer sit unsupported on

shower board?


listed meet the customer need?

Yes

Yes

Yes

No

• Bath step.

• Grab rails.

• Grab rails.

• Bath/Shower board .

• 12” bath seat.

• Swivel bather.

• Hoist and bath panel

removed.

• Information on private

purchase showering/bathing

solutions.

• Recommendation for

adaptation.

Level Access

Shower

To be able to access

shower area and

shower either

sitting or standing

Can the customer use the shower

facility safely?


listed meet the need?

Can any bespoke equipment be

identified to meet the need?

No

No

Yes

• Grab rails.

• Shower stool.

• Shower chair.

• Mobile self - propel shower

chair.

• Mobile attendant propelled

shower chair

• Review bespoke

equipment.

36

Criteria for Bath Seat

Who Can Order?

All qualified assessors for Occupational Therapy

Customer has difficulties lowering/raising fully into/out of a bath but can safely lower to and rise from a low-level seat either independently or with

assistance and is able to sit unsupported for the duration of bathing

activity.

Criteria Notes

The customer must either:

Have sufficient physical strength, mobility and balance to safely perform the movements and transfers involved in using the equipment

Or be able to undertake the movements and transfers involved safely with

assistance that does not expose a carer to unacceptable risk.

Guidelines for selection and use of bath seat

• Bath seat would not normally be used alone, but in conjunction with a bath

board. • The equipment is not suitable for those with uncontrolled or unpredictable

movements.

• Select equipment with a safe working load (SWL) that is compatible with the customer’s weight.

• Select equipment compatible with the bath into which it will be fitted. • Consider customer/carer’s capacity to remove/re-install equipment safely if

necessary. • Consider equipment storage arrangements if removed from bath for any

reason.

Risks and Precautions

If using a seat in conjunction with a board, ensure there is sufficient space between the board and seat so that the user doesn't catch their back on the

board during transfers. Generally, if you can fit your arm down between the two items, the position is approximately right. If the space is too wide, the

customer will have difficulty putting their feet on the floor of the bath to

transfer safely. When using the seat in conjunction with a board, ensure that the user has

one or both hands on the board when transferring up from a seat, to prevent it being dislodged during transfer.

37

Customers must be instructed not to get further down into the bath and/or

remove during use as the equipment cannot be refitted safely in this situation.

The use of grab rails may compromise the safety of the patient when getting from seat to board, as they may lean too far or use them inappropriately,

egress should be by pushing up on the bath board (if fitted), not pulling on a

rail. Recommend the use of a non slip mat in conjunction with this equipment.

N.B. The bath seat should not be placed on top of the mat. (this item is not supplied by the Community Equipment Service).

Emollients should not be used when using a bath seat. Some baths have textured surfaces that may not be suitable for bath seat

suction.

Prescriber is responsible for:

• Specifying weight limit and seat height required.

• Conducting an appropriate risk assessment of the environment where the equipment will be used

• Ensuring the safe use and demonstration of specified pieces of equipment to the customer and/or primary carer.

• Ensuring the safe hand over of the equipment to the customer • Explaining to the customer/carer what to do in the event of a change in the

customer’s and/or carer’s abilities to use the equipment safely

• Explaining what to do in the event of equipment failure or other emergency that may arise during the use of the equipment

• Explaining the conditions associated with the loan of equipment.

38

Criteria for Bath/Shower Board

Who Can Order?


Customer can safely transfer in/out of a bath from a seated position, and

is able to safely lift legs over the side of the bath.

Criteria Notes

The customer must have sitting balance and be able to sit unsupported for duration of bathing activity.

The customer must have sufficient mobility and physical capacity to move lower limbs in/out of the bath independently or with minimal assistance.

Guidelines for selection and use of bath/shower board

• The equipment is not suitable for those with uncontrolled or unpredictable movements.


Select equipment compatible with the bath into which it will be fitted. Corner baths or baths with internal curved/contoured sides may not be

suitable for equipment fitting • Where the customer wishes/needs to be immersed to bathe, (and fulfils the

safety criteria) a bath seat may be considered for use with the bath/shower

board.

Risks and Precautions If the board is slatted there is a risk of genitalia and/or prolapse entrapment

when using this equipment. If using a seat in conjunction with a board, ensure there is sufficient space

between the board and seat so that the user doesn't catch their back on the board during transfers. Generally, if you can fit your arm down between the

two items, the position is approximately right. If the space is too wide, the customer will have difficulty putting their feet on the floor of the bath to

transfer safely. If using a seat in conjunction with a board, ensure that the user has one or

both hands on the board when transferring up from a seat, to prevent it being dislodged during transfer.

Some customers may want to get further down into the bath and may

suggest removing the equipment to enable them to have a 'proper' immersion bath. This is not to be recommended, as equipment cannot safely

be refitted in this situation. Consider the provision of appropriately placed grab rails to use in conjunction

with this equipment. Fitted shower screens may prevent the board being placed at the shower end

of the bath.

39

Remind the user to place the shower curtain appropriately to prevent water

running off shower board onto floor. Recommend the use of a non-slip bath mat.

If used in conjunction with an over bath shower consideration should be given to how the customer accesses the controls safely.

Measuring for a bath/shower board Measure from the wall to the outside edge of the bath. If the bath is free

standing, measure between both outside edges. There must be at least 1” (25mm) on each side of the bath for the board to

rest on. The correct sized board is the largest that will fit on the bath without

overhanging.

Prescriber is responsible for: Specifying the customer’s weight

Conducting an appropriate risk assessment of the environment where the equipment will be used. Demonstrating the safe use of the equipment to the

customer and/or primary carer. Explaining to the customer/carer what to do in the event of a change in the

customer’s and/or carer’s abilities to use the equipment safely. Explaining what to do in the event of equipment failure or other emergency

that may arise during the use of the equipment.

Explaining the conditions associated with the loan of equipment.

Paediatric Bathing

Description

Specialist equipment suitable to assist bathing a child

Criteria The child has physical and/or learning disabilities that mean they are unsafe

independently in the existing bath / shower.

The family have tried commercially available equipment which has not been effective in meeting the child’s needs.

The carer is unable to bathe the child without the assistance of a specialist item.

Considerations

An assessment is carried out by an occupational therapist with the carer/s present. This may include joint assessment visit with a company representative.

The home environment is suitable for the equipment to be used safely for both the child and carer.

Privacy when in use.

Occupational therapist to ensure that current stock has been checked for

availability of suitable equipment prior to ordering new stock.

40

Criteria for Bath Step

Who Can Order?

All qualified assessors for Occupational Therapy / Physiotherapy

Customer can get in and out of bath/shower safely by means of a

graduated entry/exit route provided by an adjustable height step.

Criteria Notes

The customer must be able to negotiate steps safely either independently or with the assistance of a carer.

The floor space to be used to site the equipment during use must be level and adequately accommodate the dimensions of the step.

Guidelines for selection and use of bath step

This equipment is not suitable for use for those with poor mobility and balance.

Where floor space is limited the equipment may introduce a tripping hazard into the environment.

For maximum customer stability during bath/shower entry and exit, the step and the ‘floor’ of the bath/shower should be level in height with one another.

This will reduce the risk of overbalancing at the moment when the customer is standing with one foot on the step and the other in the bath/shower during

entry/exit.

This equipment may be used in conjunction with other bathing equipment to facilitate safe access/egress when bathing/showering.


Where it is the intention to build a stack of units on top of one another, the

rubber feet must remain in place on the base unit of the stack and be removed from the additional units used to build the stack

Recommending the use of a non-slip mat in conjunction with this equipment. Mat to be used in bath not on step

Consider the use of grab rails to use in conjunction with this equipment


• Conducting an appropriate risk assessment of the environment where the

equipment will be used

• Explaining to the customer/carer what to do in the event of a change in the customer’s and/or carer’s abilities to use the equipment safely



41

Criteria for Bath Lift – Special Order Only

Who Can Order?


Customer can safely transfer on/off bath lift but is unable to rise and lower themselves using alternative bathing equipment solutions, either

independently or with assistance and needs to maintain an acceptable

level of hygiene for physical, psychological or health related reasons.

Criteria Notes

The customer must be able to safely transfer in a seated position either independently or with assistance.

The customer requires the support of a powered lifting/lowering device to facilitate safe and adequate bathing.

Other bathing equipment solutions are not suitable to meet the customer’s needs.

Guidelines for selection and use of Bath Lift

• The customer and/or the carer must have sufficient cognitive ability to operate the equipment safely.

• The customer and/or the carer must have sufficient physical dexterity to use the hand control effectively.

• Select equipment with a Safe Working Load (SWL) that is compatible with the

customer’s weight. • Select equipment compatible with the bath into which it will be fitted.

• Consider availability of a suitable power source for recharging equipment. Consider equipment storage arrangements if removed from bath for any

reason. Consider customer/carers ability to remove and refit equipment

correctly/safely – consider weight of equipment, whether it splits into component parts.

Consider customer/carers ability to remove and clean the equipment. Consider the length of the bath and how flat it is.

Recommend the use of a non slip mat in conjunction with this equipment. NB bath lift should not be fitted on top of the mat.

Emollients should not be used with bath lifts, there is a serious risk of slipping and the oil causes the equipment to perish.

Some baths have textured surfaces that don’t accept certain suckers.

Consider hand control for those with impaired vision or limited movement in hands

42


If side flaps catch on bath handles, a plastic slider is available that fits over the handle, enabling the flap to slide up it.

Although most bath lifts are able to carry out several lifts before they require recharging, charge as per manufacturer’s instructions.

Do not allow the battery to become fully discharged. The lift will always go up if uncharged but not down.

The flaps are removable this maybe required if there is insufficient room for

the flap to lie flat when the lift is at the top of the bath or something is in the way e.g. a soap dish.


Specifying weight to be accommodated. Conducting an appropriate risk assessment of the environment where the

equipment will be used. Ensuring the safe hand over of the equipment to the customer

Explaining to the customer/carer what to do in the event of a change in the customer’s and/or carer’s abilities to use the equipment safely

Explaining what to do in the event of equipment failure or other emergency that may arise during the use of the equipment

Explaining the conditions associated with the loan of equipment. Arranging safe demonstration in use of the equipment to the customer and/or

primary carer.

Driver responsible for:

Demonstrating the safe technical use of the equipment to the customer and/or

primary carer but not for a full demonstration of how to get in/out of the bath.

43

Criteria for Shower Chair

Who Can Order?


Customer must be seated to shower safely. Equipment for use only in level access or larger shower cubicle. This may be static, attendant controlled or

self propelled. They may also be wall mounted.

Criteria Notes

The customer is at risk of falling when standing to shower.

The customer’s ability to sit unsupported is limited. The customer must have sufficient mobility and balance to safely perform the

movements and transfers involved in using the equipment or are able to undertake the movements and transfers involved safely with assistance that

does not expose a carer to unacceptable risk. • Customer may be hoisted into the chair.

Guidelines for selection and use of shower chair

Select equipment with a safe working load (SWL) that is compatible with the customer’s weight.

Select equipment compatible with the shower into which it will be fitted. Where there is limited mobility or a requirement to reduce handling/transfer

activity a wheeled shower chair may be considered. In such circumstances

the shower should be level access. Consider customer/carer’s capacity to remove/re-install equipment safely if

necessary. Consider equipment storage arrangements if removed from shower for any

reason. Where equipment may be required to support bathing and toileting needs a

modular chair may be considered to meet both sets of needs.


Be aware of the possibility of genitalia and/or prolapse entrapment. Customer should be made aware of this and advised to sit on towel/flannel during

equipment use in some types of chair. Be careful when removing pin clips, cover or aim away from yourself or other

people to avoid injury should they spring out.

Consider the provision of grab rails to use in conjunction with this equipment Consider the position of the shower chair and the customer’s ability to reach

the shower controls.

44

Consider the type of shower base. Shower seating should be appropriate for

the type of base. Some acrylic bases are very thin and may crack easily under the pressure of the legs of the seat.

Consider the stability of the equipment by taking account of the physical stature and weight distribution e.g. bi-lateral amputee.

Ensure that this equipment is not used in a bath fitted with a shower.

Measurement Information

The prescriber must specify the height required; this is the measurement

from the floor to the seat. If a customised Modular Shower/Commode Chair is required, specifications

must be stated.


• Specifying the seat height adjustment required

• Completing a special requisition form where a modular chair is required. • Specifying the frame size, armrest type, backrest type, footplates, seat type,

and commode pan in the customer case notes for future reference. • Conducting an appropriate risk assessment of the environment where the

equipment will be used • Demonstrating the safe use of the equipment to the customer and/or primary

carer in the case of a modular chair.

• Ensuring the safe hand over of the equipment to the customer for a modular chair.




45

Criteria for Shower Stool

Who Can Order?


Customer must be seated to shower safely.

Criteria Notes

The customer is at risk of falling when standing to shower.

The customer must have sitting balance and be able to sit unsupported for the duration of the showering activity

The customer must have sufficient mobility and balance to safely perform the movements and transfers involved in using the equipment or be able to

undertake the movements and transfers involved safely with assistance that does not expose a carer to unacceptable risk.

Guidelines for selection and use of shower stool


Select equipment compatible with the shower into which it will be fitted. Where the shower space is limited a corner shower stool may be considered.

Consider customer/carer’s capacity to remove/re-install equipment safely if necessary.

Consider equipment storage arrangements if removed from shower for any

reason.


Be aware of the possibility of genitalia and/or prolapse entrapment during equipment use – a towel laid on the seat may minimise this risk.

Be careful when removing pin clips, cover or aim away from yourself or other people to avoid injury should they spring out.

Consider the provision of grab rails to use in conjunction with this equipment Consider the position of the stool and the customer’s ability to reach the

shower controls. Consider the type of shower base. Shower seating should be appropriate for

the type of base. Some acrylic bases are very thin and may crack easily under the pressure of the legs of the seat. An alternative style, which

spreads the load, may be more appropriate.

Consider the amount of legroom available in a shower cubicle – a corner shower stool may give more space.

Ensure this equipment is not used in a bath fitted with a shower. If used in conjunction with an over bath shower consideration should be

given to how the customer access the controls safely

46


Specifying floor to top of seat measurement

Conducting an appropriate risk assessment of the environment where the equipment will be used

Demonstrating the safe use of the equipment to the customer and/or primary carer.

Ensuring the safe hand over of the equipment to the customer




47

Criteria for Swivel Bather

Who Can Order?


Customer is able to sit over a bath to shower or strip wash and requires

support when seated. Or be assisted to bathe by a carer.

Criteria Notes

The customer’s sitting balance may be limited and/or variable. The customer must have sufficient mobility and physical capacity to move

lower limbs in/out of bath independently or with minimal assistance. The customer/carer must be able to manoeuvre (swivel) the seat into

position for safe transferring and bathing whilst it is occupied. Must be able to lift legs over side of bath unaided, or be able to undertake

the movements and transfers involved safely with assistance that does not expose a carer to unacceptable risk.

Guidelines for selection and use of swivel bather


Select equipment compatible with the bath into which it will be fitted. Consider customer/carer’s capacity to remove/re-install equipment safely if

necessary.

Consider equipment storage arrangements if removed from bath for any reason.

Consider the availability of a carer to assist


Fitting varies according to model provided, fit according to manufacturers instructions.


48

Measuring for a Swivel Bather

Measure from the wall to the outside edge of the bath. If the bath is free

standing, measure between both outside edges of the bath. There must be at least 1¼” (30mm) on each side of the bath for the frame

to rest on. The correct size is the largest that will fit on the bath without

overhanging. Excessive overhang should be avoided to prevent tipping during equipment use.

Prescriber must specify the frame width measurement and equipment weight limit (SWL) required.



Prescriber to specify frame width. Conducting an appropriate risk assessment of the environment where the

equipment will be used Ensuring the safe use of the equipment to the customer and/or primary

carer in accordance with service delivery protocols Ensuring the safe hand over of the equipment to the customer


Explaining what to do in the event of equipment failure or other emergency

that may arise during the use of the equipment Explaining the conditions associated with the loan of equipment

49

GUIDELINES FOR THE SELECTION OF BED EQUIPMENT

Bed Equipment can be provided to meet either customer or carer needs, for three

main reasons; to facilitate: Care giving

Independence in bed transfers Positioning

NEED TRIGGER QUESTIONS

Which part of this activity is the

customer having difficulty with?

Yes/No SOLUTIONS TO CONSIDER

(any/all)

Care Giving

Does the customer require

frequent/regular nursing care on the

bed?

Is the bed a suitable height for the

carer?

Is there an alternative suitable bed

available within the home?

Yes

No

No

Bed Raisers

Profiling bed (N)

Bed Raisers

Consider alternative bed.

Customer must purchase

suitable bed if not for nursing

care.

Independent

Transfers

Does the customer have difficulty

transferring on/off the bed

independently?

Is the bed too low?

Is there an alternative suitable bed

available within the home?

Can the bed be raised?

Is customer able to pull self into sitting?

Does the height of the bed have to be

variable to enable safe independent

transfer?

(i.e. high to get off and low to get on)

AND

Does the customer need assistance to

go from lying to sitting?

Yes

Yes

Yes

No

Yes

Yes

No

Yes

Alternative bed

raisers for bed

• raisers for bed

• swap beds

•consider purchase of bed

• Bed raisers

• bed leaver

• Pillow lifter

• mattress variator

Profiling bed (S.S. OT)

Positioning

Does customer need to sleep in a

raised/upright position for medical

reasons? or

Is the position static or changed with

assistance of a carer?

Does the position need to be changed

by customer without assistance?

Yes

Yes

Extra pillows

Back rest

Pillow lift

Mattress variator

50

Criteria for Back Rest

Who Can Order?


Customer/carer requires support to maintain a fixed sitting/upright

position in bed.

Criteria Notes

The customer must have sufficient head and trunk/upper body co-ordination

to achieve the fixed resting posture offered by the back rest or be able to achieve the required posture with assistance from a carer.

The customer must have sufficient head and trunk/upper body co-ordination to minimise risk of falling to the side during equipment use.

Guidelines for selection and use of back rest

Consider the stability of the equipment when in position/use on the bed. Consider the suitability of the equipment if being used in combination with

other bed care equipment. Consider who will adjust back rest if a change of angle is required.

Consider potential entrapment risk. Consider customer’s comfort and potential pressure care risks from contact

with frame of back rest.


There is a tendency for the backrest to slide off the head of the bed if there is no headboard/wall to prevent it doing so.

Pillows must always be used with this equipment.


Conducting an appropriate risk assessment of the environment where the

equipment will be used Demonstrating the safe use of the equipment to the customer and/or

primary carer. Explaining to the customer/carer what to do in the event of a change in the

customer’s and/or carer’s abilities to use the equipment safely Explaining what to do in the event of equipment failure or other emergency

that may arise during the use of the equipment


51

Criteria for Bed Grab Rail (Lever/bed stick) – Special Order Only

Who Can Order?


The customer/carer requires assistance to turn or move in bed. and/or

The customer or carer requires support to transfer on/off the bed.

Criteria Notes:

Moving in bed

The customer requires sufficient upper limb strength and function to use the equipment.

Transferring in/out of bed

The customer requires sufficient upper limb strength and function to use the equipment.

The customer’s capacity or the carer’s involvement in transferring safely on/off the bed is facilitated using the equipment.

Guidelines for selection and use of bed lever

The customer must have sufficient head, trunk and upper limb co-ordination to use the equipment safely.

Consider compatibility of the equipment with the type of bed - size and design.


Consider available height between top of mattress and bed lever, e.g. if two mattresses are fitted to bed.

Consider customer/carer ability to remove/refit equipment as required.


Consider any potential entrapment risks. The equipment must be used only to assist movement whilst in bed and

transferring on/off the bed. It must not be used as a mobility aid when

approaching the bed. The equipment must not be used to prevent customer falling out of bed.

Standard rail should not be used with sprung bases and lightweight mattresses, as there is risk of the bar slipping out. Alternatives may be

considered.

52

Nominated Prescriber is responsible for:

Conducting an appropriate risk assessment of the environment where the equipment will be used, and completing the risk assessment form.

Ensuring safe demonstration in the safe use of the equipment to the customer and/or primary carer.


Explaining what to do in the event of equipment failure or other emergency

that may arise during the use of the equipment Explaining the conditions associated with the loan of equipment.

The form below must be filled out for every customer and kept in the

records; it is the responsibility of the prescriber to ensure that this happens.

53

RISK ASSESSMENT BED GRAB RAIL

This form must be completed in full before a customer can use a bed grab rail.

If any of the questions are answered ‘no’, or you consider there to be any other risk, then the

bed grab rail must not be fitted and collection of the equipment must be arranged.

Name: Identifying Number.

Address: D.O.B.

Name of Assessor: Designation: Date:

Have you been trained in the safe fitting and use of the bed grab rail? YES/ NO

Is the bed grab rail suitable for the customer? YES/ NO

Is the bed suitable for the bed grab rail to be fitted? YES/ NO

Is the customer, carer or relative aware of the bed grab rail’s function, and has this been

explained?

i.e. To assist customer to stand, sit, turn and sit up in bed.

(MUST NOT BE USED AS A COT SIDE) YES/ NO

Is the bed grab rail correctly positioned and has this been explained to customer,

carer or relative?

(The distance between either head board or wall and the bed lever should be less than

60mm, or greater than 250mm) YES/NO

Is the gap between the bed grab rail and the mattress, when compressed, less

than 100mm? YES/NO

Are you confident the provision of a bed grab rail will not cause other moving and

handling risks for the customer, carer or relative? YES/NO

Has the risk of entrapment been explained? YES/NO

Is the bed grab rail close fitting to the bed and mattress, positioned correctly,

with no excessive movement to the bed grab rail when being used? YES/NO

Are you confident that the customer, carer or relative understands the safe use

and fitting of the bed grab rail? YES/NO

Have you explained to the customer, carer or relative that the bed grab rail must not be

fitted on any other bed without another risk assessment being completed? YES/NO

Brief description of bed

All individuals present on assessment

Name: Designation: Signature:

C.E. Feb 2012

54

Criteria for Safety Bed Rail for Divan Beds (Cot Sides) – Special Order Only for beds that have been provided by the Community Equipment Service

Who Can Order?

Disability Services Occupational Therapists - Note: These are a bespoke order

only. All qualified assessors for Children’s Community Nursing Team and District Nursing

Customer is at risk of falling out of bed and alternative bed safety and falls management strategies have been judged to be not suitable to maintain

user safety. At present these are only supplied for Profiling Beds

Criteria Notes:

Equipment is required to manage the risk to the customer of falling out of

bed. Equipment reduces risk to customer and/or carer of customer falling out of

bed during provision of care. This equipment can only be ordered by nominated, trained Prescribers.

Guidelines for selection and use of safety bed rail:

Bed rails must not be used as a method of restraint.

Alternative methods of bed management have been assessed and are unsuitable. These may include the following options – tucking in

sheets/blankets; bed height set to lowest level; use of alarm systems to detect movement in bed; use of cushions/thin mattress to protect from

injury; rearrange furniture position. Alternative falls management approaches have been assessed as unsuitable.

This equipment may be unsuitable for people who are restless or confused at any time, or for whom use of bed rails may increase agitation or confusion.

Consider whether the customer will need to get out of bed unsupervised, e.g. for toileting.

Consider the customer/carer ability to use the equipment. Bed rails are not for supply to residential homes


This equipment carries an entrapment risk.

The Prescriber must undertake the mandatory risk assessment associated with the provision of this equipment and record the findings on the bed rails

risk assessment documentation. Appropriately trained staff must fit the equipment and the details of the

fitting activity must be recorded on the bed rails fitting documentation.

55

Bed rail bumpers may be required and can be ordered to afford additional

protection to the customer assessed at risk of injury when using bed rails. Bed rail bumpers must be compatible with the bed rail.

Nominated Prescriber is responsible for:

• Completing mandatory form ‘Use of Safety Bed Rails Risk Assessment’ prior to ordering this equipment.

Fitting the equipment, or ensuring fitting by other appropriately trained staff. (Fitting and Safe Use of Bed Rails Check List)

• Conducting a review of the customer’s and/or carer’s needs at a maximum of 12-monthly intervals


• Demonstrating the safe use of the equipment to the customer and/or primary carer




56

Disability Services Occupational Therapy & Community Nursing

RISK ASSESSMENT FOR BED RAILS (COT SIDES)

Customer Name:

Address:

Dob:

Part 1

Complete assessment prior to recommendation.

Individuals present on assessment Name: Designation:

Yes No 1) Is the customer at increased risk of falling out of bed?

2) Is the customer at increased risk of being severely injured?

3) Have other means been investigated to reduce the risk? E.g. relocation of bed, furniture on which customer could

injure themselves. Use of soft material such as mattress on floor.

4) Is the customer likely to climb over the bed rails?

5) Does the customer present with signs of confusion?

(6) (a) Does the customer understand the risks of using bed sides?

(b) Have the risks been explained to the customer and/or carers?

7) Does the customer live alone?

8) Will the provision of bed rails cause other moving and handling risks for staff or carers?

9) Will the restriction of movement affect customers behaviour?

10) Have any other safety precautions been prescribed?

E.g. Bumpers, harness

57

Part 2

Following installation of bed rails, complete section before first use of bed rails by customer.

Individuals present on assessment

Name: Designation:

11) Are the bed rails well designed and constructed? E.g. are bed rails compatible with bed? Bolts and/or fixings correctly fitted reducing the chance of

collapse or concertina when leant against.

Yes No

12) Are the bed rails fitted correctly and close fitting?

13) Have cot bumpers been fitted?

14) Have any further padding needs been identified?

15) Have any trapping hazards been identified? E.g. between bars or between bed sides and mattress.

16) Have the customer and/or carers been instructed in the use of bed rails?

Include any other personal safety precautions being used.

Where appropriate this risk assessment should be completed as part of a multi-

agency consultation.

Bed Rails should normally be provided with Bumpers to reduce the risk of any

trapping hazard.

Completed by:

Part1 Part 2

Name:

Name:

Signature:

Signature:

Date:

Date:

58

Criteria for Bed Raisers

Who Can Order? All qualified assessors for Occupational Therapy / Physiotherapy

Customer is unable to lower into sitting, raise up into standing or transfer

safely from own bed as it is too low.

Criteria Notes

Customer must have good sitting and standing balance.

Customer must be able to place feet firmly on floor to ensure safety when

moving and transferring. Bed must be in good condition.

Bed is too low for use of a mobile hoist.

Guidelines for selection and use of bed raisers:

• The equipment raises the bed to a fixed, static height. If variable height

adjustments are required this equipment is not suitable. • Equipment choice will be determined by the type of legs/castors on the bed to

be adapted. • Where a bed is being raised and its base divides/folds in the middle, equipment

offering a central support will be essential. • The combined weight of the bed and the user(s) of the bed must not exceed the

safe working load (SWL) of the equipment. • Ensure raising the bed does not compromise its stability.


Consider whether the equipment presents a risk to any other user of the bed to which it is fitted.

Beds will not be raised at one end only.


The Prescriber must specify the height of the raise required.

The Prescriber must identify which bed is to be raised.



• Explaining to the customer/carer what to do in the event of a change in the

customer’s and/or carer’s abilities to use the equipment safely • Explaining what to do in the event of equipment failure or other emergency that

may arise during the use of the equipment Explaining the conditions associated with the loan of equipment.

Explaining to customer that drawers may not be able to be used.

59

Criteria for Electrically Operated Height Adjustable Profiling Beds

Who Can Order?

All qualified assessors within Disability Services and Occupational Therapists, Children’s Community Nursing Team and District Nurses in consultation with

Designated Assessors.

Customer requires assistance with care, positioning and/or transfers and customer’s own bed can not be adapted to meet individual need and/or

safety requirements.

Description:

A range of beds that can be raised/lowered and have profiling capacity, i.e.

an electrically operated backrest and knee bend capability.

Criteria Notes

There must be complex moving and handling issues which remain after considering all other types of equipment. E.g. bed raisers, mattresses,

elevators, hoists etc. Beds will not be supplied to residential or Nursing Homes to address manual

handling issues-this is the responsibility of the individual care home.

You may wish to advise them to redirect any queries to a rental agency, if they do not wish to buy.

Occupational therapists may assess for beds for daily living activities when a rise and fall bed would assist with the promotion of independence.

Guidelines for selection and use of electric profiling bed

Nursing

Assistive equipment has been tried and found to be unsuitable for needs. The customer must have an existing condition which requires nursing

Procedures to be carried out on a bed at various heights. They must be visiting the customer a minimum of once per week.

It is not the responsibility of the prescriber to train paid for carers in the use of equipment, they must have had separate training, and demonstration

may be given in the use of that particular piece of equipment for that

particular customer. The customer requires the use of a hoist and their existing bed is not

suitable for raising. Adjustable beds should not be provided as an alternative to the customer

acquiring a suitable standard bed which could then accept assistive devices. The above criteria is to aid nurses in the safe moving and handling of the

customer if their own bed is unsuitable. The profiling bed must have access to a suitable power source.

There must be adequate space for safe use of the bed.

60

The equipment is suitable only for use or operation by customers or carers

with sufficient cognitive and physical abilities. A profiling bed will not be provided solely for the purpose of a customer who

does not possess a bed of his or her own. The bed will be supplied with a standard mattress unless a special pressure

re-distributing mattress has been requested. (this must be by a named

nurse)

Disability Services Occupational Therapist

• The user is unable to get in/out of a standard height bed and the existing bed is not suitable to accept assistive devices e.g. bed stick/mattress

elevator/fixed raiser, or that these items have been tried unsuccessfully and there is a risk assessed need for height adjustment and/or profiling. The bed

should aid independence so that there is a lessened care package or the customer becomes fully independent in transfers and positioning.

• Adjustable bed should not be provided as an alternative to the service user acquiring a suitable standard bed, which could then accept assistive devices,

or where the hoist is in use for all bed transfers and the bed can be raised to a suitable fixed height.

• Bed provision to be countersigned by a Senior Clinician. • Adjustable beds should not be provided as an alternative to the customer

acquiring a suitable standard bed which could then accept assistive devices.

• The above criteria is to aid nurses in the safe moving and handling of the customer if their own bed is unsuitable.

• The profiling bed must have access to a suitable power source. • There must be adequate space for safe use of the bed.

• The equipment is suitable only for use or operation by customers or carers with sufficient cognitive and physical abilities.

• A profiling bed will not be provided solely for the purpose of a customer who does not possess a bed of his or her own.

• The bed will be supplied with a standard mattress unless a special pressure re-distributing mattress has been requested. (this must be by a named

nurse)

61


• Where beds are moved into rooms containing gas appliances the latter must

comply with Gas Safety (Installation and Use) Regulations 1998. It is the user’s responsibility to arrange this. Information can be obtained via the Gas

Safety Advice line on: 0800 300 363.

• The prescriber should inform Community Equipment Service where the bed is to be positioned. Beds will not be carried up/downstairs the customer may

arrange a representative to do this for them. A risk assessment must be carried out by a member of the Integrated Community Equipment Service to

ascertain whether this will be possible. - Beds are to be assembled by ICES Staff.

• Where a bed is provided with cot sides a risk assessment should be completed and cot bumpers recommended where risk of trapping is identified.

• User/carer should be instructed in the use of the handset controls. • Ensure that no obstructions, such as furniture, exposed pipes or wall-

mounted fixtures are in the way as this may obstruct movement of the bed and cause damage.

• The bed is designed so that, when unoccupied it can be moved around a room to facilitate domestic cleaning. It is not designed to move around any more

than this, i.e. between rooms or large distances. • If the customer is unattended ensure that the bed base (platform) is adjusted

to it’s lowest position to minimise risk of injury to the user if he/she was to

fall trying to get out of bed. • Ensure that the back and leg rest sections of the platform are set to the

lowest position before transfer of the user on/off the bed to prevent damage to the bed due to safe-working loads being exceeded.

• If the bed is occupied by the user then no other person should sit/put their weight on the bed to prevent equipment failure or damage, if this will result

in the safe working load being exceeded. • Ensure the mains cable is routed so that it cannot become pulled or trapped

or sustain damage when the bed is operated or moved, e.g. hoisting. • Any alterations made to the bed are the responsibility of the professional

prescribing the alterations. • The user/carer should be instructed in the use of the handset.

• Some conditions may make the use of the profiling system uncomfortable e.g. back problems, poor trunk control.

• If the user tends to move down the bed when the backrest facility is used

then the use the knee bend should always be considered, to prevent the user’s feet becoming wedged against the footboard.

62

Technical advice:

• MDA Safety notice ‘MDA SN 2001 (32)’ to be issued with each loan.

“Entrapment risk is Electrically Operated Adjustable Variable Height Beds and Related Equipment’ concerning the risk of entrapment of children in moving

mechanisms of a range of beds used in domiciliary, social and community

care environments”. (ICES does not currently supply beds for children, these are funded

separately, however the safety precautions still apply)

Community Equipment Service to issue this to all users/carers. Follow the manufacturer’s user instructions at all times.

Where applicable, disconnect the power supply when the equipment is not in use.

The beds are not suitable for users less than 4’ (140cms) in height. For very obese users consult the manufacturer’s guidelines re weight limit

and safe working load, i.e. patient’s weight plus weight of bedding, mattress and other ancillary equipment.

Yearly electrical testing and servicing required Before cleaning/decontamination of the bed, disconnect the mains supply

plug and ensure that it cannot come into contact with water/cleaning agent. • Ensure that none of the electrical components show signs of any external

damage.

• If water or moisture has penetrated an electrical component immediately switch off at the mains and disconnect the plug, label clearly as defective and

report the fault immediately to Community Equipment Service • If the bed is suspected of having damage/malfunctioning, the bed should

immediately be taken out of service and should not be used until it is exchanged or repaired.


Trailing electric wires/cables can introduce a tripping hazard in the environment.

Where the customer has tissue viability issues an appropriate mattress must be identified and ordered. (Nurses only)





• Explaining the conditions associated with the loan of equipment

63

Hospital Beds for Children

Description

A metal framed hospital type bed with a multiple adjustable base ~ adjustable height, electrically operated by clients/carer, integral bed rails, lockable castors

Not suitable for children under 4’ 10”. The profile section is not the right size; these beds are not covered by regulations only adult beds.

Criteria

All social services equipment to adapt existing bed / cot has been deemed to be unsuitable

Child’s medical/physical condition requires a multi-adjustable bed to ensure correct positioning and to ensure safe moving and handling.

Child needs regular changes of position and the bed will allow increased

independence.

Considerations

Beds must not be issued to clients on the grounds of financial difficulty, comfort or poor repair.

Beds will not be issued solely because the client needs access to a bed downstairs

and they do not already possess a suitable bed.

Some children need to be maintained at a specific angle or position for overnight feeding in accordance with their feeding regime.

A suitable hospital style mattress will be provided when hospital beds are required.

This will be a low pressure risk / option 1 or 2 style mattress. If specific tissue viability management is needed, then additional advice from an appropriately

qualified clinician will determine which mattress is required. All pressure care mattresses must be prescribed by a qualified nurse.

64

RISK ASSESSMENT FORM FOR THE USE OF ELECTRIC PROFILING BED New Risk

Assessment Form to be inserted here - JP

Name: D.O.B: Identifying Number:

Assessment completed by: Date of Risk Assessment: Designation:

Current provision New Assessment (Please tick relevant box)

Has the reason for the use of the bed been explained to the customer/carers?

YES NO

Purpose of bed: If ordered by D/N it must be for nursing procedures by the D/N, who must be visiting more than once per week. If ordered by OT must be for independence as per bed guidelines.

Has alternative equipment/solution been considered/tried?

YES NO If yes: why was it unsuccessful? If no; could you try alternative provision instead of

specialist bed provision?

Can the existing bed be adapted? bed raisers; bed lever; monkey pole;

mattress variator?

3. Environment

Risk(s) Identified

Comments

Is there e sufficient room for the

bed. A minimum of 2.30m x 2.30m is needed to facilitate access to bed and use of equipment.

If no can the room be cleared?

Is there sufficient room for carers to access both sides of the bed?

Is there a gas fire in the room?

Advise customer re carbon monoxide risks.

Is there an accessible power

supply?

65

Are cot sides needed? Profiling bed only, there is a separate risk assessment for

cot sides for a divan bed. If so you must complete the following risk assessment. (this replaces the separate risk

assessment for cot sides, but should be read in conjunction with the guidance.

Cot Sides YES NO Comments

Have you been trained in the safe

use of the cot sides?

Is the customer at increased risk

of falling out of bed?

Is the customer/carers or relative

aware of the risks of using cot

sides?.

Have other means been

investigated to reduce risk?

E.g. relocation of bed.

I s the customer likely to climb

over the bed rails?

Does the customer need to get out

of bed at night?

Does the customer present with

sign of confusion?

Will the restriction of movement

affect customer’s behavior?

Will the provision of cots sides

cause other moving and handling

risks for the carers?

Do the dimensions and overall

height of the mattress compromise

the safety of any cot side? Is an

extra height cot side needed?

(consider particularly when the bed

is in profile)

Have any other safety precautions

been prescribed. E.g. bumpers

Is the customer at risk of injury

due to their movements in bed?

Do the rails require any in fills to

reduce the risk of entrapment?

Does the customer require a

pressure relief mattress?

Is a sleep system or similar used

or to be used with the bed?

Outcome/Recommendation

Profiling Bed Yes No

Cot Sides

Bumpers

Specialist Mattress

66

PRESSURE REDISTRIBUTION EQUIPMENT (Mattresses) - Need more info

from Estates

67

Criteria for Lifting Pole– Special Order Only

Who Can Order?


Customer needs assistance to change position whilst in bed. and/or

Customer/carer needs assistance to facilitate provision of care. These can

be attached to a profiling bed/freestanding or wall mounted.

Criteria Notes

Bespoke Item for Profiling Beds

Moving in bed

Customer requires upper body and arm strength/function to use the

equipment.

Provision of care

The customer’s capacity or the carer’s involvement in moving in bed, or in the

provision of care, is facilitated using the equipment

Guidelines for selection & use of lifting pole

The customer must have good head, trunk and upper limb co-ordination to

use the equipment safely. Consider compatibility of equipment with type of bed.

Consider whether use of equipment will exacerbate any pre-existing physical or medical conditions.

Consider length of strap and height of bed (if customer’s own bed is used). Consider the safe working load (SWL) of the equipment and the customer’s

weight.


Consider whether free standing equipment will introduce a tripping hazard in the environment

Equipment must be used for its intended purpose only



equipment will be used Demonstrating the safe use of the equipment to the customer and/or primary

carer.

68

Explaining to the customer/carer what to do in the event of a change in the



69

Criteria for Mattress Variator

Who Can Order?

All qualified assessors for Occupational Therapy / Physiotherapy and District Nursing Team

Customer requires assistance with adjusting and maintaining sitting position in bed and/or Customer or carer requires a variable positioning system to facilitate safe

transfers on/off bed.

Criteria Notes

The customer must have sufficient head and trunk/upper body co-ordination

to minimise risk of falling to the side during equipment use. The customer requires support to vary resting position in bed.

The customer’s carer requires assistance to support the customer in the achievement of a variable resting position in bed.

The customer’s capacity or the carer’s involvement in transferring safely on/off the bed is facilitated using the equipment.

Guidelines for selection & use of mattress raiser

This equipment is suitable only for use by customers or carers with sufficient cognitive and physical abilities.

Consider the customer/carer ability to operate the hand control effectively.

Consider the mattress type and its compatibility with the ‘bending’ action of the equipment during use. Some types of mattress – heavy duty and

orthopaedic, may be damaged by the stress of regular bending. Equipment fitted to a double mattress will raise both the right and left-hand

sides of the mattress simultaneously. The mattress may ‘slip’ towards the foot of the bed due to the action of the

equipment and will require repositioning occasionally. Advice may need to be sought when fitting to wooden/metal, slatted/mesh

bed frames. This equipment requires a suitable electricity supply.

When extending the width of the equipment ensure the mattress overhangs the equipment by at least 2”.

Ensure that you follow manufacturers fitting instructions. Ensure the customer knows that the equipment does not lie fully flat.


Consider any entrapment risk associated with the use of the equipment e.g. where children may be present, visual impairment.

The customer may slide down the bed when the equipment is used. If the bed has no footboard this may introduce a hazard for the user.

The electrical wires may introduce a tripping hazard into the environment.

70

The equipment may be noisy when in use.

Not to be fitted with electric blankets. This equipment must not be used in combination with any pressure

redistributing mattresses.



equipment will be used Demonstrating the safe use of the equipment to the customer and primary

carer in accordance with service delivery protocols Explaining to the customer/carer what to do in the event of a change in the



71

Criteria For Pillow Lifter– Special Order Only


Customer requires assistance with adjusting and maintaining sitting position in bed

and/or

Customer or carer requires a variable positioning system to facilitate safe transfers on/off

bed.

Criteria Notes

The customer must have sufficient head and trunk/upper body co-ordination to minimise risk of falling to the side during equipment use.

The customer requires support to vary resting position in bed. The customer’s carer requires assistance to support the customer in the

achievement of a variable resting position in bed. The customer’s capacity or the carer’s involvement in transferring safely on/off

the bed is facilitated using the equipment.

Guidelines for selection and use of pillow lifter

This equipment is suitable only for use by customers or carers with sufficient

cognitive and physical abilities.

The customer/carer must be able to operate the hand control effectively. Equipment fitted to a double mattress will raise only the pillows on the side of

the bed to which the equipment is fitted. The equipment requires a suitable electricity supply.

Consider the customer/carer ability to remove/refit equipment as necessary.


The electrical wires may introduce a tripping hazard into the environment.

Consider any entrapment risk associated with the use of the equipment. This equipment may carry an entrapment risk for those who may share the

environment where the equipment is used e.g. partner (when used on a double bed); children; visually impaired.

The equipment may be noisy when in use.

Consideration must be made where a bed rails are used. This equipment must not be used in combination with any pressure

redistributing mattresses.

72



Demonstrating the safe use of the equipment to the customer and primary carer in accordance with service delivery protocols

Ensuring the safe hand over of the equipment to the customer Explaining to the customer/carer what to do in the event of a change in the

customer’s and/or carer’s abilities to use the equipment safely



73

Criteria for Trolley

Who Can Order?

All qualified assessors for Occupational Therapy / Physiotherapy & Trusted Assessor

Customer is unsafe to carry items when mobilising and

requires support.

Criteria Notes

Customer must be fully weight bearing on both lower limbs

Customer must have the ability to manoeuvre the trolley safely Customer must have a need to move items to maintain independence

Consider usage if there is somewhere safe to sit and eat or drink in the

kitchen area.

Guidelines for selection and use of the trolley

Consider the environment of use e.g. thresholds, floor surface, rugs, space to

manoeuvre Trolley is suitable for indoor use only

Trolley heights are user specific and the prescriber must indicate the height setting required.


The Prescriber must specify the height from floor to top of handle when ordering


Not suitable for customers who are not fully weight bearing. Not to be used for hot items e.g. dishes from the oven, pans, teapot etc.




carer in accordance with service delivery protocols Explaining to the customer/carer what to do in the event of a change in the



74

GUIDELINES FOR THE SELECTION OF WALKING EQUIPMENT

Criteria for Elbow Crutches

Who Can Order?

All qualified assessors for Physiotherapy

Customer needs to reduce the weight through lower limb joint(s) e.g.

following fracture and has no previous mobility problems.

Criteria Notes

The customer must have sufficient balance to use crutches

Customer must be able to understand the instructions for the safe use of the equipment

Guidelines for selection and use of elbow crutches

Customer needs to reduce weight bearing on one or both legs

Crutches must be measured to individual customer’s height. More likely to be suitable for the younger/fitter age group

Customer must have ability to use arms Customer must satisfy assessment using TUSS (>60 seconds and ability to

stand on good leg for 30 seconds or more)

This equipment may not be suitable for customers with impaired upper limb/hand function


Particular attention must be paid to the need for customer to go up and down steps or stairs safely using the equipment

When used as a pair, crutches must be from same supplier and be of equal height

If customer is older consider walking frame as an alternative solution.


Prescriber must specify height measurement from floor to top of handle of

elbow crutch. Handle of crutches will be set at this height.

75

Criteria for Walking Frame

Who Can Order?

All qualified assessors for Physiotherapy / Occupational Therapy

Customer needs to reduce the weight through lower limb joint(s) or

needs maximum support and stability to improve balance.

Criteria Notes

The customer must be able to lift the frame

Customer must be able to understand instructions re safe use

Guidelines for selection and use of walking frame

Customer requires support for walking indoors Customer may need to be non-weight bearing on one limb

Check weight bearing limits of the equipment and ensure it is comparable with customer need


Unsuitable for customers with dementia-related problems

Must not be used on stairs

If fitted with net, customer should be advised regarding safe loading.


Measurement specified by Prescriber will be used to set height of walking

frame. The measurement should be the height from the floor to the top of the handle of the frame.


Specifying the height adjustment required. Conducting an appropriate risk assessment of the environment where the

equipment will be used Demonstrating the safe use of the equipment to the customer and/or

primary carer Explaining to the customer/carer what to do in the event of a change in

the customer’s and/or carer’s abilities to use the equipment safely



76

Criteria for Walking Frame with Wheels

Who Can Order?


Customer needs to reduce the weight through lower limb joint(s) and requires some support to maintain balance whilst offering maximum

mobility.

Criteria Notes

Customers must be able to push the frame Customers must be able to lift the frame for turning purposes.

Customer/carer must be able to understand the instructions re: the safe use of the equipment

Guidelines for selection and use of walking frame with wheels

Suitable for customer who has pain in the shoulders or weak upper arms

and is unable to lift frame Customer may need to be non-weight bearing on one limb

Customer needs a smooth walking pattern A 3-wheeled walking frame is too fast for customer

Safe working load of frame must be compatible with weight of customer


Customer must be checked using equipment Must not be used on stairs

If fitted with net, customer should be advised regarding safe loading.


Measurement specified by Prescriber will be used to set height of frame

from top of handle to floor.


Specifying the height adjustment required. Conducting an appropriate risk assessment of the environment where the


Demonstrating the safe use of the equipment to the customer and primary carer in accordance with service delivery protocols




77

Criteria for 3-Wheeled Walking Frame

Who Can Order?


Customer needs minimal balance support but requires some support to walk outside and maintain mobility and confidence.

Criteria Notes

This walking frame provides more support than a stick. It is foldable for transport purposes

Unsuitable for customers who have moderate balance problems Suitable mainly for outdoor mobility

Customer/carer must be able to understand safe use of equipment

Guidelines for Selection and use of 3-Wheeled Walking Frame

Customer must be able to perform TUSS – >60 seconds “Timed

Unsupported Standing” and 170 turn in no more than 5 – 6 steps

The walking frame can be provided with a tray to carry items


Ensure customer is safe turning with wheeled walking frame both ways i.e. to the left and to the right

Not to be used on the stairs and only with caution on ramps and inclines Not to be used for customers with impaired balance.

Ensure locking mechanism is engaged before walking commences.


Measurement specified by Prescriber will be used to set height of walking

frame from floor to top of handle. Prescriber to specify brake option required


Specifying height adjustment required Specifying brake preference when ordering

Specify equipment is to be fitted with a tray accessory. Conducting an appropriate risk assessment of the environment where

the equipment will be used Demonstrating the safe use of the equipment to the customer and/or

primary carer Explaining to the customer/carer what to do in the event of a change in


78

Explaining what to do in the event of equipment failure or other

emergency that may arise during the use of the equipment Explaining the conditions associated with the loan of equipment.

79

Criteria for 4-Wheeled Walking Frame with Seat– Special Order Only

Who Can Order?


Customer needs support to walk outside and maintain mobility and

confidence. Customer requires to rest frequently whilst mobilising.

Criteria Notes

This walking frame provides maximum support and can be folded but it is relatively cumbersome to handle

The customer must be able to weight bear on both legs

Guidelines for selection and use of 4-wheeled walking frame with seat

Customer needs maximum support and stability when walking outside Customer’s medical condition indicates that they need to sit and rest

frequently e.g. heart condition, COPD, complex neurological condition Unsafe with 3-wheeled walking frame


Ensure customer is safe turning with wheeled walking frame both ways

i.e. to the left and to the right Must not be used on stairs


Measurement specified by Prescriber will be used to set height of walking frame floor to top of handle.


Specifying height adjustment requirement Conducting an appropriate risk assessment of the environment where the

equipment will be used Demonstrating the safe use of the equipment to the customer and

primary carer in accordance with service delivery protocols Explaining to the customer/carer what to do in the event of a change in




80

Criteria for Adjustable Height Walking Stick

Who Can Order?


Customer has a need to reduce weight on lower limb joint(s) to reduce pain or customer requires minimal support for balance and for

confidence when walking.

Criteria Notes

The customer must be able to stand independently

The customer must be able to bear weight on both legs The customer must be able to understand the instructions re: the stick’s

appropriate use

Guidelines for selection and use of walking stick

TUSS >60 seconds - “Timed Unsupported Standing” or 170 turn in <5-6

steps both ways Customer requires minimal support for weight bearing or to assist balance

Starting to ‘furniture walk’ with light touch Customer needs to reduce weight from painful limb


Customer to be taught correct gait pattern for use of stick



equipment will be used Demonstrating the safe use of the equipment to the customer and

primary carer in accordance with service delivery protocols Explaining to the customer/carer what to do in the event of a change in

the customer’s and/or carer’s abilities to use the equipment safely Explaining what to do in the event of equipment failure or other

emergency that may arise during the use of the equipment


81

Criteria for Walking Stick with Moulded Handles (Fischer Sticks)

Who Can Order?


Customer has a need to reduce weight on lower limb joint(s) to reduce pain or customer requires minimal support for balance and for

confidence when walking and has reduced hand function or impaired

grip.

Criteria Notes

The customer must be able to stand independently.

The customer must be able to weight bear on both legs. The customer must be able to understand instructions re: the stick’s

appropriate use. The customer must have reduced hand function.

Guidelines for selection and use of walking stick with moulded handles

– (Fischer Sticks)

Use TUSS >60 seconds “Timed Unsupported Standing” or 170 turn in 5 –

6 steps

These sticks are fashioned for left hand or right hand use


The appropriate stick must be ordered (left or right-handed)

Customer to be taught correct gait pattern for use of stick


Measurement specified by Prescriber will be used to set height of stick from floor to top of handle.


Prescriber must specify right or left hand requirement.



carer in accordance with service delivery protocols Explaining to the customer/carer what to do in the event of a change in

the customer’s and/or carer’s abilities to use the equipment safely Explaining what to do in the event of equipment failure or other

emergency that may arise during the use of the equipment Explaining the conditions associated with the loan of equipment

82

GUIDELINES FOR SELECTION OF SEATING SOLUTIONS

Seating equipment can be provided to meet either the customer or carer needs for

two main reasons – to facilitate:

Safe transfers and independence

Independence in activities of daily living

The equipment provided is not an alternative to reasonable safe seating within the home; the customer has a responsibility to provide this.

Need

Trigger Questions Yes

/No

Solutions to Consider

To facilitate safe transfers and

independence

Can the customer rise from sitting in a chair to

standing without help/support?

Or

Does the existing

furniture enable the

customer to comply with post-operative

Precautions?

No

No

Chair Raiser.

Information on private purchase

High Seat Chair Short

Term Loan only.

To facilitate

independence in

activities of daily living

Is the customer able to

stand unsupported for

the duration of activities of daily living?

No

Perching Stool

Chairs are a piece of everyday furniture and as such it is the general expectation that people with disabilities provide themselves with seating that is comfortable and

suitable or their use.

Where a chair is required for a short term post operative period (usually a hip

replacement where no other suitable chair is available) a chair may be ordered.

This may also be considered where a customer is terminally ill and being nursed at home.

Efforts my be made to advise on the suitably of a chair for a customer to purchase.

83

Criteria for Chair Raisers

Who Can Order?


Customer has reduced ability to stand safely from existing chair, and is at risk of falling or failing to access facilities, as seat is too low and

there is no other suitable chair available.

Criteria Notes

Customer requires a chair at a suitable height for safe and independent transfers and has a suitable chair for raising.

Generally only one chair should be raised. If the chair is required short term (e.g. for post-operative precautions) then

a high seat chair is more appropriate.

Guidelines for selection and use of chair/ raisers

The customer must be able to put feet firmly on floor when seated correctly

(please consider seat depth) ● Consider the state of repair of the chair/ selected for raising.

● Consider the range of raising equipment available. ● Ensure the customer’s weight and the safe working load (SWL) of the

equipment are compatible.


Take account of the SWL and suitability. Take account of other users who may use the furniture.

The raised chair must be compatible with a hoist if this is to be used. The equipment should not be fitted to chairs/s that rock, swivel or recline

as stability may be compromised. All points of contact with the floor are supported.

Consider the type of flooring – raisers may slip on laminate type flooring. The use of pressure redistributing equipment on the seat should be

considered when calculating height adjustment required.


Specifying the type of raiser.. The Prescriber must identify which chair/ is to be raised.

Specify pairs/singles – the number to be ordered




84

The Fitter is responsible for:

● Conducting an appropriate risk assessment of the environment where the


● Demonstrating the safe use of the equipment to the customer and/or primary carer

● Ensuring the safe hand over of the equipment to the customer

85

Criteria for High Seat Chair

Who Can Order?


Customer requires a height adjustable chair with arms and a high back

to facilitate an independent transfer or a transfer using a hoist.

Criteria Notes

Customer requires to be hoisted into a chair and own chair is unsuitable for use with hoist.

Customer needs to comply with joint replacement Precautions Note: High seat chairs are for short term loan only usually following planned

hip surgery.

Guidelines for selection and use of a high seat chair

● The height, width and depth of the chair for safe use should be suitable for the customer.

● The safe working load (SWL) of the chair must not be exceeded. ● Tissue viability may need to be considered – high seat chairs tend to have firm

seating. ● Ensure customer is able to place feet firmly on floor when sitting in the chair.

● The environment where the chair is to be used must be capable of

accommodating it safely.


Care should be taken if pressure redistributing cushions are provided as this may

alter the customer’s position in the chair and affect the overall raised height in sitting.

Consider equipment delivery advice and information to enable safe delivery arrangements e.g. steps to be encountered, narrow doorways etc.


The height of the chair should be set from floor to top of seat, so that the warehouse staff can set this prior to delivery only.


The Prescriber is responsible for specifying the height adjustment required.





86

Children’s Chairs

Description

A highly adaptable chair designed to provide postural support to enable the promotion of independence in functional tasks.

Criteria To promote and/or maintain skills to ensure safe eating and drinking.

The child has complex and additional needs which mean they need assistance to

independently maintain an appropriate posture required for a specific functional task.

A standard commercially available chair would not provide appropriate postural

support.

Considerations An assessment is carried out by an occupational therapist with the carer/s present.

This may include joint assessment visit with a company representative.

The home environment is suitable for the equipment to be used safely for both the child and carer.

Occupational therapist to ensure that current stock has been checked for

availability of suitable seating prior to ordering new stock.

Use of the chair should be demonstrated to carer/s and user instructions are provided with the chair.

Where a specialist moulded wheelchair best meets the postural need, no alternative

seating would be issued unless a height adjustable base is appropriate to maximise independence. A compatible tray would be provided for regular wheelchair use to

meet the functional needs at home.

87

Criteria for a Perching Stool

Who Can Order? All qualified assessors for Occupational Therapy / Physiotherapy & Trusted Assessor

Customer has limited/impaired standing tolerance for activities of daily

living and does not have a suitable chair or stool to use.

Criteria Notes

Customer must have good sitting balance

Guidelines for selection and use of a perching stool

The height and width of the stool should be suitable for the customer The safe working load (SWL) of the stool must not be exceeded

Consider the customer’s ability to transfer on/off the stool safely Consider the customer’s ability to move the stool for access and safe use

The environment where the stool is to be used must be capable of accommodating it safely


Ensure when all legs are adjusted the perching stool is stable for safe use. The customer’s feet should be firmly on the floor when using the perching stool.


The Prescriber is responsible for measuring the correct height setting for the equipment

The measurement must be the distance between the floor and the front of the seat


Specifying the height adjustment required


Arranging demonstrating the safe use of the equipment to the customer and primary carer in accordance with service delivery protocols

Explaining to the customer/carer what to do in the event of a change in the

customer’s and/or carer’s abilities to use the equipment safely Explaining what to do in the event of equipment failure or other emergency that


88

Criteria for Riser/Recliner Chair - CURRENTLY NOT SUPPLIED BY ICES

Who Can Order?

Special Requisition to Disability Services Occupational Therapists Only

Customer is unable to independently transfer from a standard or raised chair. To promote independence in activities of daily living,

Criteria Notes

The customer needs assistance to rise from sitting.

No other seating equipment solutions are suitable to meet the customer’s assessed need.

The customer needs to be able to vary position and posture, in order to perform activities of daily living, and is unable to achieve and/or maintain this

independently or with help from carers. Where provision would reduce the need for care input.

The chair is not to be used as an alternative to a bed. These chairs do not provide a clinically effective position to manage oedema.

Guidelines for Selection And Use Of A Riser/Recliner Chair

The height, width and depth of the chair should be suitable for the customer

The safe working load (SWL) of the chair must not be exceeded

Tissue viability must be considered and positioning of feet on chair should be assessed to reduce risk of any pressure on heels

The customer and/or carer should have sufficient cognitive ability to operate the equipment safely

The customer and/or carer must have sufficient physical dexterity to use the hand control effectively

There should be a suitable power source to operate the equipment safely and the electric cable should not introduce a tripping hazard

The environment where the chair is to be used must be capable of accommodating the chair allowing it to rise and recline without obstruction

This equipment may not be stable when positioned on certain types of flooring surfaces e.g. wooden, laminate, tiles etc.


Consider equipment delivery advice and information to enable safe

arrangements e.g. steps to be encountered, narrow doorways etc. Consider continence issues for chair user and any risk to the motor unit.

Riser/recliner chairs must not be fitted with chair raisers. Entrapment risk to small children/babies/pets

89


Prescriber to specify seat size required Providing delivery specific information to facilitate the safe installation of the

equipment at the delivery location Conducting an appropriate risk assessment of the environment where the


carer in accordance with service delivery protocols



Explaining the conditions associated with the loan of equipment

Currently there is no provision for chairs to meet health needs only,

including pressure relief and postural management, although these cases should still be highlighted.

90

GUIDELINES FOR SELECTION OF ACCESS SOLUTIONS

These systems enable carers or other authorised people to gain access, either

by remote entry, or simply by providing a digital lock on a safe by the door that conceals a spare key.

Need Trigger Questions Yes/No Solutions to

Consider

For carers to

gain access

Can the customer reach the door

safely unaided and allow access.

Does the customer live alone?

Is the customer bed bound.

Are carers involved ?

No

No

Yes

Yes

Keysafe

Other occupants to

open door

Relatives could hold

keys

Keysafe

To open door for

visitors when it

takes a long

time to reach

the door.

Can customer walk safely but

takes too much time to answer

the door, and visitors leave.

This may include an upstairs flat.

Yes

Door Intercom

91

Criteria for Door Intercom

Who Can Order?

All qualified assessors.

Criteria Notes

A special unit fitted near a customer’s front door to allow them to remotely open the door, after speaking to the caller.

Guidelines for Selections of Door Intercom

The person is unable to safely and independently answer their own door due to

cognitive, sensory or physical impairment. Alternative methods have been considered and ruled out. i.e. safe, key holder if

this is the only proposed use for the unit.


Installation must be carried out by a competent electrician.

Permission may need to be sought from a landlord. This device can only be used on Yale locks, and customer must be made aware

that they cannot have additional locks while using the system. Consider whether there needs to be 2 hand sets, one for bedroom one for

lounge area.


Specifying where the hand set is to be placed. Conducting an appropriate risk assessment of the environment where the

equipment will be used Explaining to the customer/carer what to do in the event of a change in the


may arise during the use of the equipment


Door intercoms are fitted by an external contractor.

Customer is unable to access door in reasonable time

92

GUIDELINES FOR SELECTION OF TOILETING EQUIPMENT SOLUTIONS

Toileting equipment can be provided to meet either the customer or carer needs for

two main reasons – to facilitate:

Use of own toilet facilities

Where the customer is mobile and the environment is suitable for use of

equipment Where the customer requires support to mobilise to the toilet location and the

environment is suitable for the use of equipment

To support continence where the customer is unable to access and use own toilet facilities and requires alternative arrangements

As a short term solution e.g. post operatively while the customer is unable to

access own facilities. Need Trigger Questions Yes/

No


To use own

facilities

Is the toilet at a suitable height

for the customer to transfer

safely?

Can the customer transfer safely

without the support of their

upper limbs?

Do any of the previous

equipment solutions listed meet

customer need?

Is the environment suitable for

above equipment?

No

No

No

No

Raised Toilet Seat

Grab rail

Toilet frame, freestanding

or floor-fixed

Raised Toilet Seat with

integral arms combined

raised toilet seat and

frame, freestanding or

floor-fixed

Mobile Commode

To support

continence with

toileting

arrangements

Can the customer safely get to

the toilet location when needed?

No

See Mobility Equipment

Solutions

Urinal

Slipper pan

Static commode

93

Criteria for Commode – Static

Who Can Order?

All qualified assessors for Occupational Therapy / Physiotherapy and District Nursing Team & Trusted Assessor

Customer is struggling or having difficulty with access to existing toilet facilities and requires equipment to support continence.

Criteria Notes

Customer’s ability to access existing facilities may be variable. Customer must be able to transfer on/off equipment safely.

Guidelines for selection and use of commode

The customer must have physical and cognitive ability to use equipment safely. The customer’s weight must be compatible with the safe working load (SWL) of

the equipment. Consider the space available for the safe use and storage of the equipment.

Consider the arrangements for emptying the commode.


The customer’s posture when using the equipment may affect bowel function.

Select the minimum height required for safe transfer to minimise this effect. Consider the stability of the equipment and the customer’s ability to transfer

safely.


The Prescriber must specify height required The required height must be the measurement from the floor to the seat of the

commode.


Specifying the height adjustment required Conducting an appropriate risk assessment of the environment where the

equipment will be used Ensuring the demonstration and safe use of the equipment to the customer and

primary carer in accordance with service delivery protocols Explaining to the customer/carer what to do in the event of a change in the




94

Criteria for Raised Toilet Seat

Who Can Order?


Customer requires toilet seat to be at a suitable height to enable safe transfers on/off toilet

OR

Customer needs to comply with joint replacement precautions

Criteria Notes

Customer must have good standing balance.

Customer must have good/moderate muscle power in lower limbs. Customer must have good sitting balance.

Guidelines for selection and use of raised toilet seat

• Ensure the toilet bowl is compatible with the raised toilet seat equipment.

• Consider customer/carer’s ability to remove/refit equipment safely. • Select equipment with correct height.

• Not suitable for customers whose weight exceeds the safe working load (SWL) of the equipment.

• Not suitable to be provided in isolation if customer requires assistance/support

to raise and lower themselves when standing and sitting down. Consider use of additional support equipment e.g. rails, toilet frame


The user’s position when using a raised toilet seat can affect bowel function. Select the minimum height required for safe transfer to minimise this effect.


The Prescriber must specify the height of raised toilet seat required.



• Explaining to the customer/carer what to do in the event of a change in the


may arise during the use of the equipment • Explaining the conditions associated with the loan of equipment.

• Demonstrating the safe use of the equipment to the customer and primary carer in accordance with service delivery protocols

95

Criteria for Toilet Frame

Who Can Order?


Customer has reduced ability to transfer safely without using

hands/arms to control movement.

Criteria Notes

Customer must have good sitting and standing balance

Customer must be able to support themselves using both arms of the toilet frame when sitting down and standing up

Guidelines for selection and use of toilet frame

• The customer’s weight must be compatible with the safe working load (SWL) of

the equipment • The customer must have sufficient physical and cognitive function to use

equipment safely


The equipment may not be suitable where the space between the toilet facility

and the wall is limited – allow 100mm wall clearance on either side to ensure

safe fitting The equipment fitting may be compromised by the position of the soil pipe and

other pipe-work which may obstruct its correct siting Free standing equipment is not suitable for customers who have an appreciable

difference in functional ability between the right and left hand sides of the body as the equipment may tip over when in use and put the customer at

unacceptable risk of falling Consider the impact of other users of the toilet facility.


Free-standing Frames:

The Prescriber must specify height required. The required height must be the measurement from the floor to the top of the armrest.

Calculating the measurement is the Prescriber’s responsibility.

Fixed Frames

Floor fixing requirement must be stated if required.(Fitted by HIA)

96


• Complying with the ‘Measurement Information’


• Demonstrating the safe use of the equipment to the customer and primary

carer in accordance with service delivery protocols • Explaining to the customer/carer what to do in the event of a change in the

• customer’s and/or carer’s abilities to use the equipment safely • Explaining what to do in the event of equipment failure or other emergency that


97

Criteria for Combined Raised Toilet Seat and Frame (COMBI-LOO)

Who Can Order?


The customer requires both a raised toilet seat and support when transferring on and off the toilet and other equipment

options/combinations are not appropriate.

Criteria Notes

The customer’s movement in the lower limbs is limited or must be restricted e.g. to comply with joint replacement Precautions

The customer is unable to stand up or sit down safely without support/assistance.

Guidelines for selection and use of combined raised toilet seat and

frame

• The customer’s weight must be compatible with the safe working load (SWL) of the equipment.

• The customer must have sufficient physical and cognitive function to use the equipment safely.

• This equipment is supplied with a sleeve which fits inside the toilet bowl, sleeve

may not be suitable for low-level toilets.


The equipment may not be suitable where the space between the toilet facility

and the wall is limited – allow 100mm wall clearance on either side to ensure safe fitting.

The equipment fitting may be compromised by the position of the soil pipe and other pipe work which may obstruct its correct siting.

Free standing equipment is not suitable for customers who have an appreciable difference in functional ability between the right and left hand sides of the body

as the equipment may tip over when in use and put the customer at unacceptable risk of falling.

The customer’s posture when using this equipment may affect bowel function. Select the minimum height required for safe transfer to minimise this effect.

The equipment is wider at the base than at seat level and this should be

considered when ordering. Consider the impact of the equipment on other users of the toilet facility.

98

GUIDELINES FOR THE SELECTION OF EQUIPMENT TO FACILITATE

TRANSFERS, MOVING AND HANDLING

Equipment can be provided to meet either the customer or carer needs for the following reasons

To facilitate:

Transfers on/off a bed - Where the customer needs to move from and/or return to a lying position

Transfers from one surface to another - Where the customer has good/moderate

capability to sit and stand

Transfers from one surface to another - Where the customer has poor/no capability to sit and stand

99

Need Trigger Questions Yes/

No


Transfers

on/off a bed

Can the customer roll and reposition in

bed?

Can customer move safely unaided or

with minimal carer assistance from

lying to sitting (or vice versa)?

Does the customer have the strength

and co-ordination to use the

equipment?

Can the customer get legs into/out of

bed

Does the customer have the strength

and co-ordination to use the

equipment?

Is the height of the bed suitable for the

customer to move or be moved on/off

it safely?

Is a fixed height adjustment suitable

for the customer/carer need?

No

No

No

No

No

No

No

Sliding sheet

-

Bed lever(see Bed Care

Equipment Solutions)

Pillow lifter (See Bed Care


Mattress raiser (See Bed Care


Leg lifter

Carer assistance

Alternative bed already in the

home

Bed raisers(where bed is too

low) – See Bed Care

Equipment Solutions

Profiling Bed (See Bed Care


Transfers

from one

surface to

another -

customer has

good/modera

te capability

to sit and/or

stand

Can the customer adjust position in

sitting before/after transfer?

Does the customer need to stand in

order to transfer safely?

Can the customer rise from sitting to

standing without help/support?

Can the customer stand and step to

transfer safely without help/support?

No

No

No

No

Sliding sheet

Glide & lock sheet

Transfer board

Transfer board and handling

belt

Handling belt

Bed/Chair Raisers – see Bed

care/Seating Equipment

Solutions

Stand & pivot transfer aid

To transfer

from one

surface to

another –

customer has

poor/no

capability to

sit and/or

stand

Do any combinations of the equipment

solutions listed above meet the

customer need?

No

Hoist and sling

- Recommendation for Social

Services adaptation.

100

Criteria for Handling Belt

Who Can Order?


The customer/carer requires minimal support/assistance to transfer safely.

Criteria Notes

The customer must have good/moderate balance and functional ability. An able carer must be available to use the equipment with the customer.

Both parties must be able to co-operate with each other to minimise risk of injury.

Guidelines for selection and use of handling belt

• The equipment is not suitable for use by customers or carers with uncontrolled and/or unpredictable movements.

• Select equipment size appropriate for the size/girth of the customer. The handling belt must be capable of being fitted around the customer’s waist and

securely fastened to ensure safe use. • The equipment may not be suitable for use with customers who find the

handling belt uncomfortable for any reason when it is fitted on them, have tissue viability problems or osteoporosis issues.


The handling belt should be visually checked before every use to ensure that the buckle, seams and handling loops are intact and undamaged.

The equipment is not to be used as a lifting aid.

The equipment is not to be used as a mobility aid.



equipment will be used Demonstrating the safe use of the equipment to the customer and primary carer

in accordance with service delivery protocols Explaining to the customer/carer what to do in the event of a change in the



101

Criteria for Hoist and Sling – Special Order Only

Who Can Order?.

Disability Services Occupational Therapists/Community Occupational Therapists/Community Physiotherapists/Community Nurses/NOCN trained staff

All other transfer equipment solutions have been considered and eliminated. Customer is unable to weight bear and requires maximum

support to transfer safely.

Criteria Notes

The customer is unable to weight bear sufficiently to support safe transfer

activity. The equipment is suitable only for use or operation by carers with sufficient

cognitive and physical abilities. The equipment must be required for regular and frequent use.

Guidelines for selection and use of hoist and sling

• Consider the number of carers who may need to be available to safely complete

the transfer activity. • There must be enough space available to use the equipment safely.

• If used to facilitate bed transfers, there should ideally be access to both sides of

the bed and enough space to position the base of the hoist under the bed to ensure safe use.

• If used to facilitate chair transfers consider the dimensions of the chair and compatibility with the hoist base.

• Select equipment with a safe working load (SWL) that is compatible with the customer’s weight. If you are unable to weigh the customer, a ‘best guess’

should be used, and erring on the side of caution where the weight is thought to be near the sling limit.

• Select a sling that provides suitable support and is the correct size for the customer.

• Consider availability of safe storage arrangements for the equipment when not in use.

• Consider the condition of the surfaces the equipment may need to be moved over (including the presence of any changes in level) that may interfere with

the safe operation of the equipment e.g. thresholds, carpets.

• Consider availability of a suitable power source for safe operation/recharging equipment.

● State what the sling is to be used for.i.e. toileting/bathing.

102

Ordering Options – Hoists/Slings Equipment

The Prescriber has two options when ordering hoists and slings.

Option 1 – generic

ordering

The prescriber will be supplied with any hoist with an appropriate SWL from the available range to

meet the specified weight of the customer. The prescriber must specify customer’s weight and order

correct sized sling separately as required.

Option 2 – specific

ordering

The prescriber orders the exact model of hoist required and the specific type of sling required.


A hoist is designed to enable supported, safe transfers and must not be used

as a method of customer transport. Hoist and sling equipment must be compatible with each other.

Consider Hoist and sling compatibility with other equipment e.g. Porta Hoist 130 is compatible with the Petite and Standard seat-sized riser/recliner chairs but is

it not compatible with the Grande seat-sized model. Specialist advice is available from the Manual Handling Advisor.

Brakes must not be applied during the operation of the equipment






Children’s Postural Management

Description This is adaptable specialist equipment to provide safe postural support when in the

lying position (bed / floor)

Criteria The child and / or carer have completed a full 24 hour postural management

pathway assessment with the paediatric therapist.

The child’s medical / physical condition requires a multi-adjustable postural system

to ensure correct positioning.

103

Criteria for Leg Lifter


The customer/carer is unable to manoeuvre and position customer’s legs without some assistance when moving legs on/off surface.

Manual(standard stock) or Electric (special stock)

Criteria Notes

• The customer/carer must have sufficient upper limb strength and function to

use the equipment safely.

Guidelines for selection & use of leg lifter

• The equipment is not suitable for use by customers or carers with uncontrolled and/or unpredictable movements.

• The equipment may not be suitable for use by customers who have tissue viability problems or oedematous lower limb.


• The leg lifter should be visually checked before every use to ensure that the seams and loops are intact and undamaged.

• Consider the risk of injury consequent to customer/carer adopting unsafe handling practices.

• Consider skin condition of leg, foot. Seek advice if unsure. • Consider strength, dexterity and sitting balance of the customer to carry out

task safely.

• It is essential that the customer/carer is informed of the danger to children and pets becoming trapped under the lifter when it is in use. The lifter must only be

operated when safe to do so. • Children must not use the equipment.


• Ensuring an appropriate risk assessment of the environment where the equipment will be used




104

Criteria for Sliding Sheet

Who Can Order? All qualified assessors for Occupational Therapy / Physiotherapy and District

Nursing Team

Carer can assist a customer to transfer, move and/or change position in

bed/chair.

Criteria Notes The customer’s ability to actively participate in the movement may be very

limited.

Guidelines for selection and use of sliding sheet

• The equipment provides support to the customer and minimises the effort

required from carers to move and/or reposition customer in bed/chair. • The equipment is suitable only for use by carers with sufficient cognitive and

physical abilities. • Select equipment of suitable size for the customer, the activity to be

undertaken and compatible with other equipment and the environment where it is to be used.

• One or more sliding sheets can be used in combination e.g. one under the trunk and one under the heels to support transfer activity.

• Where the customer requires assistance to achieve and maintain good sitting posture a Glide and Lock sheet may be considered as it will reduce the need for

repeated handing and repositioning.


A sliding sheet must not be used as a lifting aid.

A sliding sheet must be removed from under the customer when the transfer activity is completed.

The equipment should be stored safely and off the floor when not in use to minimise risk of injury.


• Specifying the size of sheet required. (i.e. for a bed or a chair). • Conducting an appropriate risk assessment of the environment where the

equipment will be used • Demonstrating the safe use of the equipment to the customer and primary



may arise during the use of the equipment • Explaining the conditions associated with the loan of equipment

105

Criteria for Transfer Board

Who Can Order?


Customer is unable to weight bear but can transfer safely and independently from one surface to another whilst in a sitting position Or

Carer can help a customer to transfer safely from one surface to

another whilst customer remains in a sitting position.

Criteria Notes

The customer must have sitting balance and upper body co-ordination and strength if transferring independently.

The transfer surfaces involved must be height compatible with one another and accommodate the Board safely.

Where the equipment will be used by the carer to support the customer’s transfers both parties must be able to co-operate with each other to minimise

risk of injury.

Guidelines for selection and use of transfer board

• The equipment is not suitable for use by customers or carers with uncontrolled and or unpredictable movements.

• The equipment is suitable only for use by customers or carers with sufficient cognitive and physical abilities.

• Select equipment with a safe working load (SWL) that is compatible with the

customer’s weight. • Consider whether the addition of a handling belt or a transfer board glide sheet

(see equipment criteria) will assist a carer to further support transfers using the Board.

• The Board must be resting on stable transfer surfaces to facilitate safe use. • The equipment may not be suitable for use with some wheelchair seating

systems.


The equipment is only suitable for use where the transfer surfaces are similar in height to one another.

The equipment is not to be used with electrically inflated pressure redistributing mattresses and cushions.

The equipment may not be suitable for those with compromised tissue viability

or sensory impairment.

106


• Ensuring an appropriate risk assessment of the environment where the equipment will be used

• Demonstrating the safe use of the equipment to the customer and/or primary carer



107

Criteria for Stand and Pivot Transfer Aid


Customer can stand but is unable to take a step and requires assistance to

transfer safely from one seated position to another.

Criteria Notes

The customer must be able to use upper limb strength to support weight bearing posture.

The customer must be able to weight bear for the period of time taken to stand and transfer using the equipment.

The customer must be able to grasp the equipment securely during use. A carer must be available to use the equipment with the customer.

Both parties must be able to co-operate with each other to minimise risk of injury.

Guidelines for selection and use of stand & pivot transfer aid

• The equipment is not suitable for use or operation by customers or carers with uncontrolled and or unpredictable movements.

• The equipment is suitable only for use by customers or carers with sufficient cognitive and physical abilities.



Should not be used in combination with handling belt.

The equipment is a transfer device not a transport device.



equipment will be used • Demonstrating the safe use of the equipment to the customer and primary




108

Criteria for Standaid

Who Can Order? Disability Services Occupational Therapists/Community Occupational Therapists

/Community Physiotherapists/Community Nurses/NOCN trained staff

Customer requires assistance and support to stand and transfer safely.

Criteria Notes

The customer’s ability to stand independently may be variable. The customer must be able to weight bear for the period of time taken to stand

and transfer using the equipment. The customer must be able to maintain head and trunk/upper body control for

the duration of the equipment use. The customer must have cognitive ability, be able to co-operate and understand

instruction. The equipment must be required for regular and frequent use.

Guidelines for selection and use of standaid

• The equipment is not suitable for use or operation by customers or carers with

uncontrolled and or unpredictable movements. • The equipment is not suitable for use or operation by customers or carers with

uncontrolled and/or unpredictable behaviours. • The equipment is suitable only for use or operation by customers or carers with

sufficient cognitive and physical abilities. • If a standaid hoist is issued a hoist will not be provided.


The customer must be reassessed at a minimum of 3 monthly intervals to ensure safe continued use of the equipment throughout the loan period.

Consider the condition of the surfaces the equipment may need to be moved over (including the presence of any changes in level) that may interfere with

the safe operation of the equipment e.g. thresholds, carpets.

Consider the availability of a suitable charging point Brakes must not be applied during the operation of the equipment



equipment will be used • Demonstrating the safe use of the equipment to the customer and/or primary

carer • Explaining to the customer/carer what to do in the event of a change in the



109

APPENDIX ONE

REQUEST FOR EQUIPMENT H2A Equipment Requisitioned For:

Name DOB

Address Post Code

Telephone

Authority to which Council Tax is payable

Is Client a Nursing Home Resident YES/NO

Council Property/Private/Rented

Ethnicity

(see inside cover )

GP’s Name and Address

Nature of Disability

Is Client a permanent wheelchair user YES/NO

Equipment Required Home Visit Undertaken YES/NO (Out of Area OTs only)

REQUEST FOR BEDS, COT SIDES, BUMPERS, MATTRESSES AND BED LEVERS MUST

BE ACCOMPANIED BY A COPY OF THE RISK ASSESSMENT (REF MDA/2007/009 )

ITEM

QUANTITY

ITEM DESCRIPTION

CODE FROM

CATALOGUE

1

2

3

4

FURTHER INFORMATION ON ABOVE ITEMS – FOR SPECIAL ORDERS ONLY –

STATEMENT OF CASE MUST BE ATTACHED

ITEM

(as

above)

NAME OF

COMPANY

TEL NO

FAX NO

SALE OR

RETURN

BASIS?

COST

CODE FROM

MANUFACTUER

CATALOGUE

1

2

Special Instructions re Delivery

Alternative Contact Details Any Known Allergies to Latex YES/NO

Requisitioner Details

Name (print) Contact Tel and

Fax No

Signature Job Title

Employment Address

Date of Decision to Supply

(ie – Date when decision to supply the equipment/adaptation was made

110

REQUEST FOR SPECIAL EQUIPMENT H2A

Name: DOB:

Address: Post Code: Ethnicity: Telephone:

Is Client a child? YES/NO

Clinical Case for Provision of Non Stock Equipment:

Nature of disability/medical details:

Ability to transfer and mobilise?

What is the main purpose of this equipment and is the equipment required for moving and

handling of the customer/carer?

How will this equipment improve independence for customers/carers?

Will standard stock fulfil the function needed and available in store? (where possible a visit to

stores).

Have you considered any other equipment?

Is there a cheaper version of this equipment which will fulfil the same function?

(2 quotes MAY be needed for comparison).

What is the risk if this equipment is not supplied?

How often will the equipment be used?

How urgent is this request?

Equipment Required Home Visit Undertaken YES/NO

ITEM

(as

above)

NAME OF

COMPANY

TEL NO

FAX NO

COST

CODE FROM

MANUFACTUER

CATALOGUE

Special Instructions re Delivery:

Alternative Contact Details:

Requisitioner Details

Name: Telephone:

Signature: Job Title:

Employment Address

Date of Decision to

Supply:

111

BED AND CHAIR RAISER REFERRAL

BEDS

BED SIZE

KING SIZE/

DOUBLE

OR SINGLE

NO OF

LEGS OR

CASTORS –

(please

stipulate

which)

BED TYPE

EG, STEEL

FRAMED,

WOODEN

FRAME

DRAWER

DIVAN

TYPE BED

BED

HEIGHT TO

BE SET

UNLOADED

ANY OTHER

INFORMATION

CHAIR/SETTEE

CHAIR

SIZE,

SINGLE

OR

SETTEE

NO OF

LEGS OR

CASTORS

(please

stipulate

which)

CHAIR

TYPE, EG,

MODERN,

RECLINER,

HEAVY

WOODEN

CHAIR

HEIGHT TO

BE SET

UNLOADED

ANY OTHER

INFORMATION

IF THIS FORM IS NOT COMPLETED AND ATTACHED TO H2 WHEN ORDERING THE

EQUIPMENT, IT WILL RESULT IN DELAYS FOR DELIVERING/FITTING.

112

Resource Panel Proforma Equipment and Adaptations

Panel Members:

Date Request Received:

Date of Panel Consideration:

Referrer Name:

Client Name:

Adult / Paediatric (please specify)

Budget (please specify) Health Social Minor Other

Details of Request:

Costs Involved:

Panel Decision and Recommendations:

Request Approved: Yes No Deferred Referred to: (if applicable)……………………………………………………………… Signed:……………………………………………….. Date:………………………….

113

Resource Panel Proforma

Equipment and Minor Adaptations

Attendance Date: Panel Members:

Referrer Patient Request Details Request Approved (Approved/Declined/Deferred)

Recommendations Referred to

Please return referral to: Posture and Mobility Centre, Callaghan House, Cross Street,

Heywood. OL10 2DY Tel No. 01706 676349 or Fax 01706 676350

The Posture and Mobility Centre Referral Form (Wheelchair Services)

The service can only accept referrals for those who would use a wheelchair as their only form of mobility indoors, have been identified as nearing the end of life and on the Gold Standards Framework or will be excluded from mainstream support services without this equipment.

NB – incomplete referrals will not be accepted and will be returned to the referrer

Name ………………………………………. NHS number ……………………............................

Male / Female DOB …………………………………………………..

Address ……………………………………. ……............. Tel no…………………………………………

………………………………………………...................... Mob. no……………………………………………… Postcode …………………………………... GP name …………………………………………….. Next of kin name……………………………………………. GP tel no……………………………………………… NOK relationship……………………………………………. GP address…………………………………………... NOK contact number………………………………………. ………………………………………………………

Patient weight.………… Patient height.………… Taken by.………………………………. When……………….

Primary diagnosis……………………………………………………………………………………………………..... ……………………………………………………………………………………………………………………………..

Previous medical history……………………………………………………………………………………................. ……………………………………………………………………………………………………………………………..

Prognosis: Is the client identified as being in the last TWELVE MONTHS of their life as a result of a life shortening medical condition (for adults are they classified as on the gold standards framework)?

Yes No (please circle)

Time wheelchair needed for: Less than 6 months More than 6 months

Wheelchair use: Indoors Outdoors Indoors and Outdoors

Wheelchair frequency of use: Daily Between 2-6 times a week Once a week or less Transfer method: Independent Assistance of 1 Assistance of 2 Transfer board Hoist

Mobility aids used ……………………………………………………………………………………………………... Pressure care needs ……………………………………………………………………………………………………. Postural needs (if cannot sit unsupported)…………………………………………………………………………… ……………………………………………………………………………………………………………………………..

Attends: Day centre Educational facility Work place

The person is being referred to the Posture and Mobility Centre because: (Please tick which applies, please note that if one of the below does not apply PMC will be unable to provide

equipment)

1. THEY ARE WITHIN THE LAST 12 MONTHS OF LIFE (FOR ADULTS THEY ARE ON THE GOLD STANDARDS FRAMEWORK)

2. A WHEELCHAIR WILL BE THEIR ONLY FORM OF MOBILITY INDOORS 3. THEY WILL BE EXCLUDED FROM DAY CARE, SCHOOL OR EMPLOYMENT



Signed ………………………………………………………. Print name. ………….……… ………………………. Designation………………………………………………………………………………………………………………. Contact address………………………………………………………………………………………………………..... ………………………………………………………………………………………………………………………………. Tel no:……………………………………………………………………………Date………………………………….

INITIAL REFERRALS MUST BE FROM A GP, REGISTERED NURSE OR REGISTERED HEALTH CARE PROFESSIONAL

Please return referral to: The Posture and Mobility Centre, Callaghan House, Cross Street, Heywood, OL10 2DY

Tel No: 01706 676349 or Fax: 01706 676350

Supporting information: ……………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………….. …………………………………………………………………………………………………………………………………..

If the person being referred is in a residential home which has been provided with pool chairs please state the reason a pool chair cannot be used: ……………………………………………………………………………………… ………………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………….. …………………………………………………………………………………………………………………………………..

If the person being referred already has a wheelchair provided by the NHS please state the reason this wheelchair is no longer suitable:…..………………………………………………………………………………………... ………………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………….. …………………………………………………………………………………………………………………………………..

If the person being referred is in a rehabilitation facility is their care being funded by an out of area commissioning body (i.e. not Bury or Rochdale) YES NO If yes which commissioning body is funding the place …………………………………………………………….. Please be advised if an out of area commissioning body is funding the rehabilitation placement then written agreement for wheelchair assessment will be required before the Posture and Mobility Centre can accept the referral



The Posture and Mobility Centre Accredited Therapist Referral Form (Wheelchair Services)

The service can only accept referrals for those who would use a wheelchair as their only form of mobility indoors, have been identified as nearing the end of life and on the Gold Standard Framework or will be excluded from mainstream support services without this equipment.

If the person being referred is in a rehabilitation facility is their care being funded by an out of area commissioning body

(i.e. not Bury or Rochdale) YES NO If yes which commissioning body is funding the place …………………………………………………………….. Please be advised if an out of area commissioning body is funding the rehabilitation placement then written agreement for wheelchair assessment will be required before the Posture and Mobility Centre can accept the referral

Patient weight …………………. Patient height …………………. Patient BMI………………………………. Primary diagnosis……………………………………………………………………………………………………............................ ……………………………………………………………………………………………………………………………………………… Previous medical history……………………………………………………………………………………...................................... ……………………………………………………………………………………………………………………………………………… Prognosis: Is the client identified as being in the last TWELVE MONTHS of their life as a result of a life shortening medical condition (for adults are they classified as on the gold standards framework)? Yes No (please circle)

Name ………………………………………. NHS number ……………………............................

Male / Female DOB …………………………………………………..

Address …………………………………………............. Tel no…………………………………………

………………………………………………...................... Mob. no……………………………………………… Postcode …………………………………... GP name …………………………………………….. Next of kin name……………………………………………. GP tel no……………………………………………… NOK relationship……………………………………………. GP address…………………………………………... NOK contact number………………………………………. ………………………………………………………

The person is being referred to the Posture and Mobility Centre because: (Please tick which applies, please note that if one of the below does not apply PMC will be unable to provide equipment)


2. A WHEELCHAIR WILL BE THEIR ONLY FORM OF MOBILITY INDOORS

3. THEY WILL BE EXCLUDED FROM DAY CARE, SCHOOL OR EMPLOYMENT

If the person being referred already has a wheelchair provided by the NHS please state the reason this wheelchair is no longer suitable:…..……………………………………………………………………………………….............................................. …………………………………………………………………………………………………………………………………………….... …………………………………………………………………………………………………………………………………………….... ……………………………………………………………………………………………………………………………………………....



A) Seat Width .................... B) Seat Depth ................... C) Footplate Height ................... D) Armrest Height ................... E) Backrest Height ................... F) Height to top of head ...................

Wheelchair Type Transit Self Propel Wheelchair Size 15x16 16x16 17x17 18x17 Cushion 2” vinyl Essential Visco Accessories Stump board - left / right Elevating legrest - left / right

PLEASE NOTE: - IF REFERRALS ARE INCOMPLETE THEY WILL NOT BE ACCEPTED AND WILL BE RETURNED TO THE

REFERRER

- IF YOU ARE NOT ACCREDITED THROUGH AN NHS WHEELCHAIR SERVICE WE CANNOT ACCEPT THE REFERRAL AS AN ACCREDITED THERAPIST REFERRAL – INSTEAD THE CLIENT WILL BE LISTED ONTO OUR WAITING LIST FOR PMC ASSESSMENT

- IF THE MEASUREMENTS FOR SEAT WIDTH ARE OVER 18” WE CANNOT ACCEPT THE REFERRAL AS AN ACCREDITED THERAPIST REFERRAL – INSTEAD THE CLIENT WILL BE LISTED ONTO OUR WAITING LIST FOR PMC ASSESSMENT

Signed ............................................................... Print Name ............................................................................... Accreditation Number ................................................................ Contact Address ................................................................................................................................................................................................... ……………………………………………………………………………………………………………………………………………… Tel No ................................................................ Date ........................................................................................


Wheelchair use: Indoors Outdoors Indoors and Outdoor

Wheelchair frequency of use: Daily Between 2-6 times a week Once a week or less

Transfer method: Independent Assistance of 1 Assistance of 2 Transfer board Hoist

Mobility aids used ……………………………………………………………………………………………………...

Pressure care needs …………………………………………………………………………………………………….

Postural needs (if cannot sit unsupported)…………………………………………………………………………… ……………………………………………………………………………………………………………………………..




The Posture and Mobility Centre Accredited Therapist Referral Form (Wheelchair Services) – VASCULAR PATHWAY

The service can only accept referrals for those who would use a wheelchair as their only form of mobility indoors, have been identified as nearing the end of life and on the Gold Standard Framework or will be excluded from mainstream support services without this equipment.

If the person being referred is in a rehabilitation facility is their care being funded by an out of area commissioning body

(i.e. not Bury or Rochdale) YES NO If yes which commissioning body is funding the place …………………………………………………………….. Please be advised if an out of area commissioning body is funding the rehabilitation placement then written agreement for wheelchair assessment will be required before the Posture and Mobility Centre can accept the referral

Patient weight …………………. Patient height …………………. Patient BMI………………………………. Primary diagnosis……………………………………………………………………………………………………............................ ……………………………………………………………………………………………………………………………………………… Previous medical history……………………………………………………………………………………......................................

…………………………………………………………………………………………………………………………………… Prognosis: Is the client identified as being in the last TWELVE MONTHS of their life as a result of a life shortening medical condition (for adults are they classified as on the gold standards framework)? Yes No (please circle)

Name ………………………………………. NHS number ……………………............................

Male / Female DOB …………………………………………………..

Address …………………………………………............. Tel no…………………………………………

………………………………………………...................... Mob. no……………………………………………… Postcode …………………………………... GP name …………………………………………….. Next of kin name……………………………………………. GP tel no……………………………………………… NOK relationship……………………………………………. GP address…………………………………………... NOK contact number………………………………………. ……………………………………………………… The person is being referred to the Posture and Mobility Centre because: (Please tick which applies, please note that if one of the below does not apply PMC will be unable to provide equipment)


2. A WHEELCHAIR WILL BE THEIR ONLY FORM OF MOBILITY INDOORS

3. THEY WILL BE EXCLUDED FROM DAY CARE, SCHOOL OR EMPLOYMENT

If the person being referred already has a wheelchair provided by the NHS please state the reason this wheelchair is no longer suitable:…..……………………………………………………………………………………….............................................. …………………………………………………………………………………………………………………………………………….... …………………………………………………………………………………………………………………………………………….... ……………………………………………………………………………………………………………………………………………....



A) Seat Width .................... B) Seat Depth ................... C) Footplate Height ................... D) Armrest Height ................... E) Backrest Height ................... F) Height to top of head ...................

Wheelchair Type Transit Self Propel Wheelchair Size 15x16 16x16 17x17 18x17 Cushion 2” vinyl Essential Visco Accessories Stump board - left / right Elevating legrest - left / right

Signed ............................................................... Print Name ............................................................................... Accreditation Number ................................................................

Contact Address .................................................................................................................................................................................................... ……………………………………………………………………………………………………………………………………………….. Tel No ................................................................ Date ...........................................................................................

PLEASE NOTE: - IF REFERRALS ARE INCOMPLETE THEY WILL NOT BE ACCEPTED AND WILL BE

RETURNED TO THE REFERRER

- IF YOU ARE NOT ACCREDITED THROUGH AN NHS WHEELCHAIR SERVICE WE CANNOT ACCEPT THE REFERRAL AS AN ACCREDITED THERAPIST REFERRAL – INSTEAD THE CLIENT WILL BE LISTED ONTO OUR WAITING LIST FOR PMC ASSESSMENT

- IF THE MEASUREMENTS FOR SEAT WIDTH ARE OVER 18” WE CANNOT ACCEPT THE REFERRAL AS AN ACCREDITED THERAPIST REFERRAL – INSTEAD THE CLIENT WILL BE LISTED ONTO OUR WAITING LIST FOR PMC ASSESSMENT


Wheelchair use: Indoors Outdoors Indoors and Outdoor

Wheelchair frequency of use: Daily Between 2-6 times a week Once a week or less

Transfer method: Independent Assistance of 1 Assistance of 2 Transfer board Hoist

Mobility aids used ……………………………………………………………………………………………………...

Pressure care needs …………………………………………………………………………………………………….

Postural needs (if cannot sit unsupported)…………………………………………………………………………… ……………………………………………………………………………………………………………………………..


community equipment provision policy€¦ · equipment service. community equipment provision will...

Documents