Reablement and Post Fall Management – why the UK leads the world in manual handling best practice

We invited Deborah Harrison to assess the Mangar Eagle, the latest lifting cushion (lifting chair)  in the range and to talk all things moving and handling.  Deborah is the founder of A1 Risk Solutions and is recognised internationally for her work in manual handling, ergonomics and vocational rehabilitation within the Health, Social Care and Education Sectors. A champion of single handed care for many years, her experience in the best way to transfer people is exceptional.

Unsurprisingly, the impact of COVID is a hot topic and the knock on effect facing Reablement Teams supporting patients to return home using a mix of care and equipment packages.

After speaking internationally in America, Australia New Zealand and across Europe, Deborah is keen to point out that the UK leads the world when it comes to standards of manual handling and protecting both workers and patients.  With manual handling regulations protecting carers and the Care Act 2014 designed to safeguard the aims and goals of service users, the UK has the framework in place to develop good outcomes for all.

Deborah says, “the provision of equipment in other parts of the world can be challenging and I’ve seen the community sector in the US having to fund raise to get the kit they need. I’ve also seen manual lifting teams being called to move patients with no equipment available to support them.  The likelihood of injury for both caregiver and patient is significant in this scenario and I know professionals in this part of the world aspire to work as we do in the UK”.

But things are changing in the UK and even before COVID, there were increasingly fewer hospitals with rehabilitation on the wards.  The trend now is to ‘discharge to assess’, when people are medically optimised using reablement services to return patients to the community or their homes.  Reablement supports people by giving them the right tools to rebuild their strength and independence.

Deborah continues, “in these circumstances it is important we manage the risk and adopt good ways of working.  At first, as patients become more active there will be an increased likelihood of falling, however good the prevention strategies are.  We encourage people to get the right equipment to help them through the reablement process with the longer term aim of removing it once recovery is achieved.

“We can get resistance from the informal care giver as it can appear they are ‘been doing a poor job and sometimes feel inadequate’ and generally they have no thought for their own health,  but when we explain what might happen if they drop their loved one or sustain an injury, acceptance comes more readily”.

During COVID the ability to assess service users has become more of a challenge and has often had to be done virtually.  Deborah explains, “every service user will have different needs and to ensure we understand the nuances of every situation it is much easier to be face to face.  However, virtual assessments have their place and in future, we may well continue to assess virtually at the review stage if we feel it is appropriate to do so.

“The important thing is not to add to the anxiety levels of the service user or informal carer and prescribe the right equipment to support their individual need.  We look at their environment as well as medical need and this is where a piece of kit like the Eagle will be a perfect fit.  The ability to use it in a tight space, such as a bathroom will be valuable to many and the angle of the backrest makes it ideal for anyone who may have breathing problems, support individuals with distressed behaviours.”

The manual handling landscape will be changing over the coming years and a White Paper published by the Department of Health and Social Care earlier this year, set out legislative proposals to integrate the care system in England.  Deborah believes the Health community can learn a lot from Social Care and is keen to consult with NHS England and NHS Improvement about her experiences on getting the best outcomes for Service Users.

There is no doubt about Deborah’s passion for good practice in manual handling and she interrogates the capabilities of the Eagle Lifting Cushion rigorously. She discusses its stability, suitability for patients living with Parkinson’s, feeling of being cosseted during the lift, flexibility and ease of transferring off.  Her ability to critically assess equipment, patient need and environmental impacts is renown and her company A1 Risk Solutions provide training platforms for clinicians globally.

More recently Deborah was invited to a church group in Cumbria where she talked ergonomics to a meeting of builders, farmers and landed gentry.  Not her usual type of delegates but reportedly as enthusiastic as any others!