Thrive Better Living · moving and handling assessment report

Optimal Handed Care review: Client ID LA-EXAMPLE-01

Illustrative example. A fictional case in the format we deliver, so commissioners can see what a decision-ready report contains. It is not a real person and not clinical advice.

Referred by: Adult Social Care, review team
Setting: Own home, ground floor
Priority: Amber: seen within 9 working days
Assessed by: Occupational therapist, HCPC registered
Date of visit: [date]
Present: The person, daughter, two regular carers

1. The question asked

Is two-carer support still required for transfers and personal care, or can any task be delivered safely by one carer with the right method and equipment?

2. Summary and recommendation

Bed to chair and chair to commode: one carer with a standing and raising aid, after an observed trial on two visits. Retain two carers for the first two weeks while the provider signs off competence.
Repositioning in bed: two carers with slide sheets remain necessary. Sitting balance and shoulder pain make a single-carer method unsafe.
Personal care in bed: two carers until the profiling bed is replaced (current bed does not reach a working height; see 6).
Net effect: daytime transfers move to one carer; morning and evening bed care stays double-handed. Reviewed at 4 weeks and on any trigger.

3. What was observed

Sit to stand	Stands from the bed edge with a standing aid on the second attempt; takes weight through both legs for up to 20 seconds; fatigues after two repetitions. Verbal prompts followed reliably.
Sitting balance	Independent when feet are supported; leans right after 3 to 4 minutes; cannot correct without cueing.
Bed mobility	Bridges with cueing; cannot roll independently; right shoulder pain limits pushing up. Slide sheets needed for repositioning.
Cognition and consent	Understands the assessment and consents; short-term memory affects carry-over, so cues must be the same every time.
Pain and skin	Right shoulder pain 4/10 on movement; sacral skin intact; heels intact; sits out for up to 3 hours.

4. Risk assessment (TILE)

Task	Transfers 6 to 8 times a day; repositioning 4 times; personal care twice.
Individual	Weight 71 kg; partial weight bearing; right shoulder pain; fatigue; needs consistent cues.
Load and equipment	Standing and raising aid (SWL 150 kg) suitable for transfers; slide sheets for bed; current bed is fixed height (risk to carers).
Environment	Bedroom 3.1 × 2.8 m; turning space adequate once the bedside cabinet is moved; laminate floor; commode chair fits the route.
Residual risk after controls	Low for transfers with one trained carer; moderate for bed care until the bed is changed.

5. Clinical reasoning

Transfers are an active task the person can contribute to, so a standing aid preserves function and reduces the handling load compared with a hoist. The person's leg strength and prompt-following were consistent across the visit, which supports a single carer for that task. Repositioning is different: sitting balance and shoulder pain remove the person's contribution, and a single-carer slide sheet method would place the carer at the bed side beyond a safe reach on a fixed-height bed. The alternative (a hoist for all tasks) was rejected because it would remove participation without lowering the risk.

6. Equipment

Standing and raising aid: [make and model], SWL 150 kg, knee pad at setting 3, handles at the upper position. LOLER thorough examination in date; next due [date].
Slide sheets: two flat sheets, tubular for repositioning, kept on the bed.
Profiling bed: recommended to replace the fixed-height bed; ordered through the community equipment service. Until then bed care stays double-handed.

7. The plan carers follow

Feet on the plate, knees against the pad, hands on the handles; "ready, steady, stand" and a pause before the turn.
Stop points: pain in the right shoulder above 4/10, knees giving way, dizziness, or the person asking to stop.
Two carers for all bed tasks; slide sheets; cues agreed and written the same way every time.
Competency: the provider signs off each carer on the real task before they deliver it alone.

8. Review triggers and date

Any fall, new pain, a change in weight bearing, sitting balance, cognition or skin.
New equipment, a change of carer team, or the profiling bed arriving (bed care re-assessed then).
Scheduled review at 4 weeks regardless.

9. Outcome measures agreed with the commissioner

Baseline	Two carers, 8 visits a day, 14 care hours a week attributed to double-handed tasks.
After implementation	Two carers for two visits a day; one carer for the rest. Reported as hours actually delivered, not modelled.
Safety	Incidents and near misses reported by the provider at 4 weeks.
Person's experience	Asked at review: comfort, confidence, dignity.

10. Sign-off

Assessor: name, profession, HCPC number, date

Provider lead: name, role, date competencies signed

Illustrative document. Real reports are shared only through the commissioning organisation's agreed route and never contain more identifying information than the client reference. Thrive Better Living Ltd, company 15248600.