The purpose of the guidance produced by the Royal College of Occupational Therapists is to identify a number of principles which need to underpin local decision-making when planning the provision of, or providing, equipment for care home residents.
Principles advocated by Royal College of Occupational Therapists
1. Residents of care homes should have the same access to a need’s assessment, with the provision of equipment and other services, as any other resident in their local area.
2. The focus of the planning and provision of equipment to care homes starts with the residents and their needs, with their chosen goals or outcomes. Equipment is a tool to enhance wellbeing, enabling a person to actively and safely participate in occupations (everyday activities).
3. No single organisation can step back from their responsibility to be part of a comprehensive service to care home residents.
4. The totality of equipment provision services in an area are primarily shaped by the needs of residents, not by funding structures. Provider partners should plan and work together to prevent delays in equipment provision
Residents have the right to safety and security; respect, privacy and dignity; freedom of thought, faith and self-expression; autonomy and choice; participation, inclusion and society.
Equipment can assist in meeting and maintaining these rights and support people’s health and wellbeing in the following ways:
Equipment enables occupational engagement. It optimises independence, choice and participation. Occupational engagement encompasses performance of and participation in activities that are meaningful to the individual, such as self-care, social and leisure activities. When a resident’s needs are assessed, this includes the need for equipment to enable occupational engagement.
Occupations are fundamental to human health and wellbeing because they provide meaning, identity and structure to people’s lives and reflect society’s values and culture. To deny suitable equipment to achieve these would potentially limit a person’s autonomy and access to the lifestyle of their choice.
Appropriate provision and use of equipment can maintain and increase physical health. By facilitating good positioning and movement, equipment can optimise the normal use of many body systems which support health and wellbeing, for example the musculoskeletal, respiratory, circulatory and digestive systems.
Equipment contributes to safety, independence, quality of life and personal dignity. Timely provision of appropriate equipment can help to prevent deterioration in health, skin integrity, welfare and independence, leading to a long-term cost saving for care providers.
Assessment
Equipment provision should be based upon the assessed needs of the resident’s. These are met with the most appropriate equipment. There is no ‘standard’ resident or ‘one size fits all’ response.
Very particular or specialised needs, outside the care home’s stated purpose, should be assessed and met with specific applicable equipment from the most appropriate provider. Equipment provided to meet a particular resident’s needs should only be used with that resident.
The individual who is assessing the need for, recommending, providing, or using the equipment, must be demonstrably trained and experienced to do so. Expert advice and assistance should be shared across provider partners when necessary.
Provision of equipment
A care home should provide a range of standard equipment to meet the needs of its residents and its aims, as defined by its statement of purpose, and to fulfil its health and safety obligations to its own staff. This includes equipment to cater for residents with a variety in height, weight, size and support needs and, where possible, the resident’s preferences (Care Quality Commission 2015, p28).
Maintenance of equipment
Care home staff should ensure that a piece of equipment is safe, clean, comfortable and suitable for use by residents. They should be able to recognise when a resident’s level of health, wellbeing, mobility or functional ability reduces, indicating that they need a review of their equipment needs. This review must then be actioned.
Summary
According to the Royal College of Occupational Therapists current legislation and guidance do not always provide clear-cut answers to certain questions concerning the provision of equipment in care homes. The new guidance should be welcomed by managers and the principles advocated adopted.
The availability of assessment and provision of appropriate equipment is an important part of many residents’ lives in care homes and crucial to a person’s autonomy and access to the lifestyle of their choice and to their quality of life.
Albert Cook Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy