Locality Team, Bournemouth Adult Social Care Moving and Handling Equipment in the prevention and management of Contractures Teresa Stanley Operational Manager Locality Team, Bournemouth Adult Social Care

Equipment to consider for the prevention of or to reduce the risk of contractures

T- Rolls : available in different sizes T- Rolls : available in different sizes. Help prevent contractures and deformities in hips and knees and are used whilst on the bed. Foam type splints with Velcro strapping

Symmetrisleep System by Symmetrikit which aids postural management , particularly overnight when muscle tone is usually reduced. Postural repositioning is aided by the use of a variety of foam pads which can be added to or removed and gently supports an individual in comfortable, potentially corrective postural positions. Can be used in supine, prone or side lying. This system would generally be used in conjunction with hoisting and would require a joint approach with either Physio or OT guidance

Hoisting and slings: Using slings in closed leg position is often more comfortable rather than trying to feed sling legs through contracted legs Leave in situ slings reduce the amount of moving and handling in trying to remove or fit standard slings Overhead hoisting systems are more beneficial when using turning systems, extra wide spreader bars are available to carry load more evenly. The use of overhead hoists can also enable single handed care and are effective when used with inbed systems, such as the wendylett and Symmslide

Wendylett in bed moving and handling system, by Romedic Ideal for moving people up and across the bed to prevent the need for rolling to install slide sheets. System remains in the bed. Come in 2 way and 4 way glides – 2 way allows person to be moved onto their side 4 way allows person to be moved onto their sides and up and down the bed and enables repositioning on the bed as required. Etac have a similar turning system. The top sheet has a divide / split system inbuilt within it to facilitate turning by one person with a hoist whilst also allowing access for personal care

Seating: Often one of the causal factors in the development of contractures is the person remaining in bed due to the lack of suitable seating available for the person to sit out in. It is essential that appropriate seating enables the person to achieve a functional position to allow them to eat and drink / maintain hydration which is difficult to achieve whilst laid on their side / foetal position in bed Chairs which provide postural support should be readily available eg

Seating matters: Will offer a trial period / hire arrangement Careflex; the seats can be readjusted to meet the individual needs of a person and there are accessories which can be added, removed to improve and increase postural support as needed. Careflex will visit and carry out an assessment and provide you and your staff training on how to adjust the seat as required. Kirton: Offer a variety of ‘dynamic’ chairs which assist in the repositioning of an individual throughout the day. If a person remains in a static position for prolonged periods this increases the risk of contractures developing. The seats can be readjusted to meet the individual needs and also come with accessories as required. Kirton also offer free assessments and training.

Equipment provision: Prevention and Early intervention is key to the successful management of contractures. It is crucial that individuals are encouraged to move regularly or are repositioned by care staff. Equipment can be hired or purchased via NRS but as providers you would be encouraged to invest in a variety of chairs and moving and handling equipment which can be generically used. Historically equipment was purpose built for individual needs and rarely could be reused, but this is no longer the case. Items such as the Wendylet, Etac systems and leave in situ slings can be purchased ‘off the shelf’ and companies will readily provide training in the use of their products. OT’s and Physio’s can assess for specialist equipment particularly when contractures have already formed, resulting in difficulties with repositioning and moving and handling an individual.

Both Bournemouth and Poole Local Authorities offer moving and handling training and support to yourselves as providers Staff should be trained in all the equipment which you as a provider use within your homes and you should ensure that you are satisfied your staff are competent in the use of the equipment. In Bournemouth Janet Jones also provides support and advice in other areas of care provision as required, including appropriate paperwork and documentation and as registered managers you are able to contact her directly for relevant support.