Single-Handed Care continues to remain high on the agenda for many Local Authorities and NHS trusts across the UK.

Often described as an “Assessment of an individual’s moving and handling needs, ensuring they receive the right amount of care, in the right environment, at the right time” (Harrison 2020). Many also consider it to be a reduction in care provision, going usually from 2 to 1. However, using Harrison’s clear description it is and should be about the RIGHT care provision. So that could mean from 2 to 1 or it could mean from 4 to 2 or even a mix of care givers throughout the individual’s day. For the purpose of this piece, 1 carer will be used in the discussion.

Often known as Proportional Care, Caring with Dignity, Right Care for You, amongst other project names; we know how Single-Handed Care can positively impact a multitude of stakeholders in an individual’s journey across the health and social care economy. It’s a win for improving the patient flow through the hospital in-patient system, reducing the time an individual must wait for a “traditional” double up care package and therefore having a positive impact on reducing the number of days a person no longer meets the criteria to reside in hospital.

It’s a win for increasing capacity within the care agency sector.

It’s a win for the individual, reducing the likelihood of deconditioning, improving independence outcomes, and accessing a care package in a timely manner.

It can give the individual a sense of dignity and provides of a more person-centred interaction. Single-Handed Care is most certainly a win for the person delivering the care. Whether they are a paid, commissioned carer or a loved one. On initial contemplation, it could seem like more work, responsibility and expectation is being put upon a single care giver, however, with the correct techniques and with the correct equipment and adaptations to support them, it can be far less physical effort and certainly a more efficient and positive process.


Risk Assessment  

When considering any type of care provision, any type of equipment or any adaptations, a risk assessment is essential. For Single-Handed Care it is no different. Of course, with the provision of any equipment or adaptations, the home environment is an extremely important aspect of the risk assessment to consider.

Getting the balance right between bombarding someone’s home and space with equipment and adaptations whilst providing safe and suitable care can be difficult, but with the correct choices and clear, honest communication with all those living in the home, it can be achieved.

There are definite things within the home environment that should be considered with the provision of equipment or adaptations.

  • Access and space to move and safely reach the individual.
  • Appropriate floor surfaces to manoeuvre any equipment on with ease.
  • Clearance. Around furniture. Under furniture. Over furniture. Clutter free.

This ensures that a single carer can assist with transfers and likewise with providing care on the bed.


Considering the Home environment and adaptations in relation to care tasks:

Bed Care

When all care is on the bed, it is important to consider the bed height, (in fact a rise and fall hospital style bed would frequently be recommended) for all care givers. The advantage for the single-handed carer is that they can have the bed at their preferred height rather than having to work at the height favoured by a second carer. Ensuring the care giver has access to both sides of the bed within the home environment is also essential so that the care giver doesn’t overreach or forward bend, putting unnecessary pressure on their back.

Elderly lady in a bed reading a book.

Hoisting

When delivering care single-handedly another adaptation which plays an important role is the track hoist. It takes away all the pushing and pulling of the mobile hoist, stops the issues with clearance under and over the bed, as well as over thick carpet and it eliminates the need for a second person to keep watch on the individual being moved whilst the other operates and moves the hoist into position. Situated correctly, a ceiling track can facilitate a smooth, obstacle free, quick transfer that a single care giver can deliver with ease.

Assistance with manual transfers

When assisting with sit to stand from a bed, chair or commode/toilet it is essential that the home environment is arranged to facilitate ease from A to B. A single care giver should be mindful to have everything to hand and plan the move first. The individual should not be taken over a long distance with any product designed to assist with a transfer and care should be taken not to broach room thresholds which can be an extremely scary experience for an individual. The environment may need to be arranged so that the care giver can stand close to the individual or indeed the environment may dictate the choice of product you choose.

Providing Toileting Care

For those who are no longer continent providing toilet hygiene care can be done on a bed.  A single care giver can achieve this with simple equipment and innovative technique.

For an individual who is still continent and yet requires some assistance with personal care, it could be more difficult for a single-handed care giver, particularly if reaching behind to clean themselves, or maintaining a full stand for a care giver to assist has become a problem. Recommending the provision of a Closomat wash and dry toilet would be a perfect and dignified solution to this problem. Not only would a Closomat eliminate the need to reach round to attend to toilet hygiene for the service user, but it would put a stop to the awkward, back breaking positions care givers often find themselves in when trying to attend and assist to this task. Indeed, a Closomat can make the act of attending to toilet hygiene an independent task.

Providing assistance with maintaining personal hygiene

Maintaining an individual’s personal hygiene can be achieved in a number of ways within the home environment. A good old fashioned bed bath can be effective and can certainly be completed using a one-person approach. The environment needs to ensure privacy and access to both sides of the bed to prevent poor posture for the care giver.

Strip washing or bathing equipment, grab rails and tried techniques may also provide maintenance of hygiene with the assistance of one.

Alternatively adapting the home environment to include accessible showering facilities and appropriate shower seating can aid one care giver to accomplish effective personal hygiene. It is important here that there are half screens and easy reach of controls for the person assisting to assure good posture.

Of course, using a wash and dry toilet is a good way of managing intimate aspects of personal care, particularly if access is inhibited or challenging within the shower space or due to dynamic sitting balance.

In conclusion, with the right equipment, technique and adaptations Single-Handed Care can be accomplished within an individual’s home, providing a positive personalised care experience for the person on the receiving end and for the person delivering it too.