Debbie Bissell, Specialist Occupational Therapist, on behalf of Promoting Independence, was commissioned to carry out an independent specialist seating assessment in South Wales for a client who had been in bed for a considerable period of time, could be supported more appropriately within the care environment and become more engaged with activities regularly provided by the home, rather than spending all day every day in his room with limited social contact.
Stuart Barrow, Managing Director of Promoting Independence explained:
“I was contacted by a solicitor at ME Law who was acting as a client’s deputy to see if the client could be supported better within his care home? The client had no family, hence the decision to appoint a representative to act in his best interests. The solicitor/deputy did not know which equipment to buy and realised the benefits and need for a skilled assessment by a qualified professional. Because I am a local OT company and work with ME Law and the clients care home, the solicitor asked me if I knew an appropriate assessor. I suggested one of my specialist seating assessors, Debbie Bissell, to assess if the client should/could have a chair as he was then bed bound and in end stage dementia and perhaps a chair would enable him to come out of bed and engage with the homes activities.”
Debbie visited the out of area client and conducted a physical examination and assessment to gauge postural needs. Debbie was able to ascertain exact postural needs and identify suitable options for specialist seating by matching needs with seating specifications
Debbie Bissell explains:
I had been advised by the deputy that the client would self-fund any identified equipment to avoid application delay with the NHS or LA. The client did have sufficient funds and it seemed the right decision*.
However, what was paramount was my assessment identifying the right equipment.
My physical assessment also needed to capture aspects of the environment and nursing home routine for my client. I contacted a reputable company, CareFlex, with whom I liaised closely, and requested specialist seating with exact specifications to meet the unique needs of the individual.
I requested a trial of the seating. A trial enables ongoing assessment. Try before you buy. I was acting in someone’s best interests and it was vital to ensure the best outcome was achieved together with aspects of cost efficiency. The seating was trialled for a week.
I provided the staff at the home with my ‘evaluation tool’ to complete each time the seating was used to enable me to conduct a thorough evaluation.
Correct positioning and use of functions was demonstrated to staff.
As the client had been bed bound, staff had to be encouraged to sit my client out regularly while the trial opportunity was available. Opportunities needed to be maximised.
I rang the home each day to prompt and ensure this would happen. After the trial period the evaluation forms were returned to me to analyse for tolerance and patterns as well as skin integrity and comfort.
Analysis enabled me to make an accurate, informed decision for my client to ensure the product was matched to the individual needs. A professional written report with assessment findings was sent to the deputy.
A quote was requested and sent to the deputy with the exact specification. He was advised that VAT not payable as individual purchase.
Advantages of the Chair
- The client received the right chair for his needs with the right specification
- There were no waiting times for assessment or equipment
- The chair was trialled before purchase
- The chair chosen was the most cost efficient
- No one involved was influenced by a specific seating company. There was no bias.
- The assessment was made by a qualified professional
- There was noticeably improved health and well-being of client: cognitively physically and emotionally.
Six weeks after provision of the chair Stuart was advised that the client had significantly changed in terms of his engagement within the home, now communicating with staff and spending everyday sitting out in his new chair engaging in the care home’s activities. Meinir Evans of ME Law who commissioned the assessment as the deputy explained that:
“The change in the client is remarkable and his quality of life has significantly improved since the assessment and provision of the CareFlex chair”.
The DOLS/best interest assessor for the local authority also commented and acknowledged the great improvement in the client’s wellbeing, interaction and overall presentation.
Stuart advised that it is essential to ensure the client’s needs are assessed by a competent practitioner and they should attend regular training to ensure that if they are asked to carry out an assessment they have the skills required to do so. To book an assessment or product demonstration please call 0800 018 6440 or email firstname.lastname@example.org.
Specialist Occupational Therapist
Secretary of State Approved Best Interest Assessor
BSc OT (Hons)
Specialist Advisor to CQC
HCPC – Registered
Debbie Bissell Occupational Therapy Services Ltd
. ‘Photos are not representative of the client in this case study’.