AT Today Winter/Spring 2020

TODAY Issue 2 | Winter/Spring | Assistive Technology

SINGLEHANDEDLY TRANSFORMING HEALTHCARE The winning A1 Risk Solutions approach to single-handed care

ASSISTIVE INNOVATIONS | EXPERT ADVICE & INSIGHTS | CPD & EVENTS

Stiltz Homelifts.

Facilitating in-home enablement.

Physical health and mental wellbeing are known to be inter-related. Being able to live independently is a big contributor to helping people feel better about themselves.

Stiltz Homelifts believe designing attractive AND affordable accessibility products will help reduce the difficulties of living with limited mobility leading to positive outcomes for all concerned. A Stiltz Homelift is surprisingly affordable and eligible for DFG funding.

Our OT Service Charter promises: • Nationwide assessment visits • 24hr local support, 365 days a year • Lift tailored to customer need • Ambulant and wheelchair options • Requires no major structural work • Can be fitted almost anywhere • Peace-of-mind safety sensors • Fast-track installations offered • Unique through-car option

• 12 month parts and labour cover • Extended warranty • Costs comparable with other through-floor lifts!

For more information or to arrange a meeting, contact Stiltz on enquiries@stiltz.co.uk or call 0330 222 0334

www.stiltz.co.uk

CONTENTS

FROM THE EDITOR After having the fantastic opportunity of putting together the first edition of the brand-new AT Today, I’ve since had the pleasure of seeing plenty of new assistive innovations that are taking the healthcare sector by storm. Whether it’s a clever new AAC device or a modular cot for disabled children, there’s certainly no shortage in new independent living products.

04 COVER STORY

46 PAEDIATRIC PRODUCTS

62 EVENTS & CPD COURSES

04 MOVING & HANDLING

26 DLF TRUSTED ASSESSOR

12 OT SHOW HIGHLIGHTS

28 SPECIALIST SEATING

16 BATHING & TOILETING

36 REHACARE HIGHLIGHTS

24 LET’S TALK TELECARE

42 TRY BEFORE YOU BUY

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One of the highlights from 2019 was visiting The OT Show and viewing everything from dynamic arm supports and sleek homelifts to accessible toilets and riser recliners. It was great to see the enthusiasm from visiting OTs, which highlighted the passion and dedication within the assistive technology sector. This issue looks at some of the key products on display at the event.

The front cover story is a thoroughly thoughtprovoking piece by A1 Risk Solutions’ Deborah Harrison which explores the barriers and benefits of single-handed care. Where the A1 Risk Solutions approach has been introduced, the number of councils that have converted cases from double-handed to single-handed care has increased from 40 percent to 60-89 percent.

As well as Deborah’s article, the DLF discusses the significance of its Trusted Assessor training and how it has impacted on the way professionals across health, housing and social care work.

Don’t miss out on the product showcases in the telecare, moving & handling, bathing and toileting, specialist seating and paediatrics sections, where AT Today has highlighted some of the latest and greatest products available to busy healthcare professionals.

Feel you have some expertise to share with the industry? Then please get in touch by emailing sarah.sarsby@bhtaengage.com Sarah Sarsby, Editor

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Joe Fahy – 07384 258 372 joe.fahy@bhtaengage.com

PRODUCTION & DISTRIBUTION Calvin Barnett calvin@bhtaengage.com

AT TODAY 3

MOVING & HANDLING

SINGLE-HANDED CARE PART ONE: Deborah Harrison is the founder of A1 Risk Solutions, an independent organisation that specialises in moving & handling, training risk assessment and consultancy.

Deborah started as a nurse and furthered her postgraduate studies in moving & handling, ergonomics and vocational rehabilitation.

Deborah has an active role on the ISO committee working on the international standards for hoists and slings.

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The winning formula Single-handed care (SHC) has been around for many years, however, many authorities have not yet adopted this working methodology.

This will be the first in a series of three articles concerning SHC designed to help anyone interested in implementing such a policy. Each article is based on extensive research and real-life studies carried out by A1 Risk Solutions.

• Part One: Exploring barriers, who you should engage with and potential benefits.

• Part Two: Examining more of the barriers, learning what an engagement day is and how you can set this up, and learning about the implementation of your strategy.

• Part Three: Evaluating a different way of implementing SHC across health and social care.

The aim of this three-part series is to: assess the impact that adopting SHC has had on local authorities

and NHS organisations, evaluate the success stories, and explore what lessons can be learned and how the future may look.

KNOWING WHAT THE BARRIERS ARE TO SINGLEHANDED CARE IS THE ONLY WAY TO CREATE SUSTAINABLE SOLUTIONS

PART ONE: EXPLORING BARRIERS, WHO YOU SHOULD ENGAGE WITH AND POTENTIAL BENEFITS Knowing what the barriers are to SHC is the only way to create sustainable solutions.

The main barriers to the implementation of SHC are: 1. Lack of collaboration and engagement of the relevant stakeholders 2. Lack of education and awareness

years and now exists as a three-day Level 4 accredited qualification. It has been adopted by over 40 councils across the UK (England, Scotland, Wales and the Channel Islands). The councils that have adopted this way of working have seen extraordinary successes above and beyond what the original study demonstrated in 2016. The original study found that the majority of councils were converting approximately 40 percent of cases from double-handed to single-handed care (Harrison 2017, 2018). Where the A1 Risk Solutions approach has been introduced, this has increased to 60-89 percent.

3.

Limited training in SHC and availability of equipment 4. Limited ongoing support and tools During 2016, A1 Risk Solutions conducted an extensive review of 4,586 stakeholders. This unexpectedly identified that the source of the barriers came principally from occupational therapists, care workers and moving & handling professionals.

Further investigative clarification in 2017 and 2018 confirmed these findings.

The disparity of the barriers presented by these groups was particularly apparent and what was needed was a strategy that took an integrated approach. This required all stakeholders to recognise, understand and accept the barriers presented by other groups in order to concentrate on moving forward cohesively.

Given this information, A1 Risk Solutions developed the initial Change Management Programme. This involved a full day of change management, exploring organisational, team and individual barriers and how these could be overcome. This was then followed by two days of practical skills and problem-solving focusing solely on SHC moving & handling techniques in both common and complex situations.

This programme has been refined and developed over the last three

IT DOES NOT ALWAYS MEAN REDUCING CARE PACKAGES DOWN TO ONE PERSON, IT CAN MEAN REDUCING THE PACKAGE FROM FOUR TO TWO, ONE TO NONE OR EVEN AN INCREASE IN CARE TIME.

WHAT IS A SINGLE-HANDED CARE APPROACH? Many organisations have been naming their projects “moving with dignity” due to the negative association with the term “single-handed care”.

How would you describe this?

A1 Risk Solutions collated the description below from 750 delegates over three years to describe SHC: “A person-centred review of an individual’s care needs, allowing effective use of resources in a safe and dignified manner. Freeing up carers reduces the level of unmet need and improves patient flow throughout the acute hospitals, enabling a timely hospital admission and discharge resulting in more people to be cared for in their own homes.”

It does not always mean reducing care packages down to one person, it can mean reducing the package from four to two, one to none or even an increase in care time. It may mean reducing the number of carers at some – but not all – of the calls and it may increase the time required at the call for the remaining carer.

This will free up carers, who will then be able to attend to those service users with unmet needs in the community.

SHC in an acute hospital setting for discharge is a relatively new concept.

Using the same equipment available in the community on the wards has several benefits. One simple example is the patient on discharge is no longer asked to use an unfamiliar piece of equipment at home. This will reduce anxiety, increase cooperation and has the potential to improve safety and reduce failed discharges.

THE FUTURE VISION If the therapist in the hospital can confidently assess for SHC and access equipment, they will create a system that facilitates a timely discharge

process into the community. No longer will the community OT be required to reassess when the patient gets home, it will merely require a review. This will save time and resources for the community OT. Despite the obvious advantages, this is not mainstream and there are only a few hospital trusts where this is implemented. This will be discussed further in Part 3 in later publications of AT Today.

COLLABORATION AND ENGAGEMENT One of main themes identified as being a barrier was effective engagement. Engaging with people on a meaningful level that addresses their concerns, allows them to have a voice, explores their fears and resistance without fear of retribution is critical.

An effective strategy must outline the engagement plan, identify who to collaborate with and take into consideration how to approach each group or individual. Spending time identifying who the key parties are and securing their involvement early on is critical. This allows for an intensive exchange of ideas which leads to creative solutions. Who you do involve will depend on your vision.

A1 Risk Solutions considers it vital to include your NHS health colleagues at the beginning of the process, even if they push you away. Persistence is part of the course.

There are distinct benefits in involving the following people and organisations: 1. A board representative such as an assistant director of services or a transformation director 2. Commissioners of adult services 3. Legal department 4. CCG (Clinical Commissioning Group) 5. Care providers 6. Heads of services from the following groups: • Occupational therapy • Physiotherapy • Moving & handling professionals • District nursing • Social workers • Hospital discharge team • Intermediate care • Rehabilitation • Equipment stores 7. Service users and their families A BOARD REPRESENTATIVE Ideally, they will be your sponsor

AT TODAY 5

MOVING & HANDLING

and support your project at board level, ensuring it gets the airtime it deserves. They can often bring together a range of people that you will not even be aware existed. They may find a route for funding for your projects. Most projects have been initially funded from the Better Care Fund in England. There are similar funding routes for projects that integrate health and social care in Scotland and Wales.

COMMISSIONERS These are the people who will assist you in realising your potential. They will open doors that you did not know were there. They can help redirect your focus and have a distinct knack of cutting through the barriers. They have the ability to influence the care agencies via policy changes and contract amendments. They will be able to assist you with building business cases if you are not experienced in this.

LEGAL DEPARTMENT There are several common blocks that will require legal input. It makes perfect sense that the organisation is prepared for these blocks and for any difficult questions as less time will be wasted in developing solutions.

CARE PROVIDERS These can be the most resistant group initially. If you do not have the care agency on board, it is 100 percent certain it will be a fight all the way. The care providers will have no incentive to adopt this change in practice without training and support from the local council.

The care agency managers have a difficult job on their hands convincing the staff to work differently. However, there are many ways to support the agencies.

6 AT TODAY

Here are a few examples: provision of training for the care agency trainers and risk assessors, provision of a free-of-charge training room with the correct equipment in place, loan of equipment, the occupational therapist to meet with the carers and demonstrate and guide the risk assessor and available carers, an online system such as that provided

by A1 Risk Solutions, regular update sessions, and the creation of a network of SHC practitioners across all sectors.

If you use all of the techniques, you are more likely to ensure the adoption of the approach is smoother for all parties.

THERAPISTS AND MOVING & HANDLING PROFESSIONALS These groups frequently demonstrate signs of anxiety which can come across as resistance. “Why should I change?” “It will never work.” “How am I supposed to carry out single handed care assessment when I am unsure myself?”

Once they have attended training and received support, they see it as tool to change their practice for the good of the community and realise how they can positively effect change themselves.

EQUIPMENT LOAN STORES Loan stores managers should be involved from the beginning as they are crucial to ensuring the required SHC equipment is purchased. To ensure buy in of these managers, you need to outline where the money will be coming from for the initial and continued spend. The SHC equipment needs to be segregated from the general equipment for ordering.

PLANNING AND PREPARATION A great deal of both is required by an organisation prior to training delivery.

ENGAGING WITH PEOPLE ON A MEANINGFUL LEVEL THAT ADDRESSES THEIR CONCERNS, ALLOWS THEM TO HAVE A VOICE, EXPLORES THEIR FEARS AND RESISTANCE WITHOUT FEAR OF RETRIBUTION IS CRITICAL

Funding needs to be agreed, knowing how much money you think you will need and what you require the funds for is essential. It is a spend to save model. A1 Risk Solutions has a calculator that takes into account projected hours, money saved and money spent throughout the course of the project.

Recording of your data is vital; if it has not been recorded correctly, who is going to believe it actually happened? A1 Risk Solutions has developed a separate tool that helps you record 36 Key Performance Indicators (KPIs). This enables you to instantly see the following: • Assessment time spent on each case • Assessment time spent on the project • Time spent sourcing products and other tasks • Time it takes to recoup the spend on individual cases on equipment and therapists’ time • What time of the day you are making your savings, useful for workforce planning • Numbers of equipment types ordered • Cost of equipment spend • Savings in care hours • Saving in money • Complaints and why • Well-being KPIs • Cost of therapist time • Conversion rate • Non conversion and reason why not There are plenty of other things to be considered as part of your strategy.

Here is an overview of some them: 1. A pilot first and then a dedicated team 2. An in-depth equipment evaluation to determine which pieces of SHC equipment will become part of your core stock 3. Implementation of a funding stream to come from money saved to replenish the equipment stores budget 4. An engagement event quickly followed by the training for the therapists, moving & handling team, care agency risk assessors and trainers Next time in Part Two, we will explore more of the barriers, what an engagement day is, how you can set this up and implementation of your strategy.

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Ultra-lightweight magnesium / aluminium alloy frame, Max speed 4mph, User weight 23.6 stone, Electronic regeneration disk brakes, Brushless motors, Weight with battery 26Kg, Chargeable on and off-board, Seat height 20.3”, Seat width and depth 18” x 17”, Foldable and portable.

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sales@monarchmobility.com

MOVING & HANDLING

PRODUCT SHOWCASE Helping keep busy healthcare professionals stay up-to-date about the latest moving & handling innovations, AT Today has rounded up six key products that professionals should be aware of, from mobile lifting hoists to ceiling lifts.

8 AT TODAY

LIFTING CLIENTS’ SPIRITS The Luna overhead lifting system is a great choice for healthcare professionals worldwide because of its functionality combined with stylish aesthetics. Easy to install and offering optimal room coverage, it is an ideal solution for use in a home or care environment.

The Luna lifts up to 275kg and can be uniquely switched between fixed or portable mode using an innovative quick release system. The Luna range also includes a bariatric model that has a 400kg lifting load.

For an immediate or temporary lifting solution, there is also a gantry option which is quick and easy to fit and remove.

To order a brochure, email sales@mangarhealth. com or learn more at www.mangarhealth.com

SMOOTH MOVE Joerns Healthcare’s new Oxford Up manual stand aid and seated transfer device is designed to support safe and efficient patient transfers and rehabilitation.

It is suitable for clients who require some assistance when standing but are able to participate in the process, playing a supportive role in patient rehabilitation and independence.

Injury reduction and fall prevention were key considerations during the standing aid’s development. Helpful positioning of both the swing-away seat pads and knee support help ensure optimum patient positioning.

Adjustable legs and a contoured base allow improved access for the patient and promote better posture and ease of use.

It has a maximum safe working load of 200kg and easy manoeuvrability across a range of floor surfaces also ensures minimal effort on the part of the carer.

Where required, the Oxford Deluxe Standing Sling (with clips) is available in three standard sizes and offers additional seated support. www.joerns.co.uk

AN ALTERNATIVE SOLUTION Co-invented by award-winning inventor David Garman OBE, the AIR CRADLE transfer system has already been positively reported on by medical research charity BackCare and was a finalist in the Blackwood Design Awards 2019.

For years, David considered the difficulties and risks detailed in `The Guide to the Handling of People´ whilst devising a means of moving and handling patients in a more dignified, safer, less stressful and relatively discomfort-free manner, aimed at dealing with those. Consequently, the AIR CRADLE is a helpful, safe, dignified and easy-to-use alternative to hoists and slings.

David E. T. Garman Concepts Ltd, which owns the international intellectual property relating to the AIR CRADLE, commented: “There is already demand for the AIR CRADLE® and we already have distributors worldwide expressing interest in it.

Suitable investors and intellectual property licensees are, therefore, sought such that the system may be manufactured and sold internationally.”

For further information, visit aircradle. co.uk

AT TODAY 9

MOVING & HANDLING

NATURAL MOVEMENT The Invacare ISA is an ergonomic stand assist lifter which is designed to support patients who cannot transfer from one seated position to another unaided and to encourage standing rehabilitation.

The lifter is compact, fully adjustable and promotes a natural pattern of movement. It is designed so that the combined operation of the lifting arm and lower leg support assists a natural sit to stand movement, engaging muscles, thus helping to support safe, comfortable transfers and assist rehabilitation.

Key features of the lifter include removable footplates in three different heights and an extendable lifting arm, offering nine positions for a range of heights, as well as a soft, padded lower leg support that has built-in articulation to move with the lower leg.

For carers, an ergonomically shaped push bar helps to improve positioning and manoeuvrability, and flexible hooks provide quick and straightforward sling attachment. www.safepatienthandling.co.uk

MANOEUVRABILITY AND MOBILITY Following key input from moving & handling specialists, the Herida H-180 mobile lifting hoist boasts an attractive outlook and ergonomic design.

Paired with impressive lifting capabilities, the first in Herida Healthcare’s new range of hoists allows ease of manoeuvrability even under maximum load.

The high boom coupled with ultra-low lifting positions ensure that the flexible mobile hoist fits perfectly into any care home, residential setting or acute application. Conveniently, the H-180 can be easily folded which provides a handy storage and transport solution. www.heridahealthcare.co.uk 10 AT TODAY

ONLY THE ESSENTIALS Designed by Prism Medical UK, the Mackworth Essentials Mobile Hoist is designed to be a cost-effective, mobile moving & handling solution. The reduction in cost is achieved by only including “essential” components and features to reduce manufacturing complexity without sacrificing quality, says Prism.

The hoist boasts a 180kg lifting capacity, powered leg opening and Linak actuators and motors. It is also easy to position with four large swivel castors and ergonomic handles.

The Mackworth Essentials Mobile Hoist can lift a patient from the floor and only requires one person for installation. www.prismmedical.co.uk

N T! EWUC

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Up Supporting safe patient transfer and rehabilitation The Oxford Up is designed for patients who require standing assistance but are able to contribute effort to the process. By encouraging user participation, the Up can play a key role in patient rehabilitation and on-going independence.

Safe Working Load 200kg / 31st / 440Ibs Among the lightest in its class Adjustable legs for access around furniture Padded, contoured swing-away seat pads 5 year warranty as standard!

Contact Joerns Healthcare to find out more:

(T) 0844 811 1158

(E) info@joerns.co.uk

(W) Joerns.co.uk

OT SHOW HIGHLIGHTS

OT SHOW

highlights The Occupational Therapy Show 2019 – the UK’s largest dedicated CPD education and trade event for occupational therapists and managers working with the equipment services teams alongside them – took place at the NEC in Birmingham on 27th & 28th November.

OTs at the event were able to access over 80 hours’ free CPD education, see some of the latest assistive products and innovations available, network with industry peers and update their knowledge and understanding across all occupational therapy areas.

The 2019 show boasted a lively and welcoming atmosphere, with plenty of healthcare professionals going onto stands to learn more about some of the latest assistive products.

Seminars and talks also generated significant interest amongst visiting OTs, with topics including occupational therapy as a social practice, legal challenges with manual handling, supporting active transfers to benefit health and well-being, and future-proofing occupational therapy.

Attending the 2019 event, AT Today has rounded up the key products from the show that caught OTs’ attention and facilitated greater independence and enhanced well-being.

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OT SHOW HIGHLIGHTS

ABLE2 USE A KETTLE WITH EASE

Customisable commode

The new Swift Mobil-2 by Etac is a flexible attendant-propelled shower commode chair that gives carers the best possible access for personal care tasks. It is easy to manoeuvre and can be customised to varying user needs.

Adaptability to individual user needs is key with a 45-60cm seat height range, laterally adjustable fold-up arm rests and a wider XL back option. A Safe Working Load of 160kg ensures the Swift Mobil-2 is suitable for most users.

The range includes four variations: Swift Mobil-2, Swift Mobil-2 XL with an extra 6cm of width for larger users, Swift Mobil-2 24”, for self-propelling and Swift Mobil-2 Tilt with tilt-in-space functionality. www.etac.com

WEIGHTLESS ARM Bambach UK and Fortuna Mobility sell the Armon Zero Gravity Dynamic Arm Support to clients in the UK. It is a dynamic arm support that has a unique mechanism that compensates for the weight of the user’s arm, making it feel weightless.

The Armon is designed to take the weight from the user’s arm so as they move their arm around, the weight stays at zero. For people with a heavier arm, the dynamic support can be set with more uplift, and for those with a lighter arm, it can be set with less uplift.

To stop the client’s arm from lifting up or sinking, the Armon is set so the uplift exactly balances the weight of the user’s arm.

Adaptable and versatile with four different versions available, the Armon support can meet a wide range of needs, such as helping people with repetitive strain injuries, rotator cuff injuries, arthritis, fatigue, multiple sclerosis, stroke and spinal cord injuries. There are also a wide range of places the arm support can be fixed to, such as powerchairs, manual wheelchairs, tables and desks.

Importantly, the device augments movement that the user already has; it is not designed to replace the function of a human arm. www.fortunamobility.com

14 AT TODAY

An innovative, elegant kettle for those with limited dexterity was showcased at The OT Show by Able2 UK and Uccello.

The Uccello Kettle is a practical assistive technology device that makes pouring a kettle feel light and is ideal for people with limited dexterity to handle boiling hot water safely.

Unlike other kettles and kettle-tippers, the circular shape of the Uccello Kettle - combined with its rotating cradle – moves around the body of water to assist the flow of the pour, so clients don’t have to lift, strain or balance, making it ideal for those with restricted mobility.

Attending OTs commented that they liked that the kettle looked good as well as functioned safely.

Able2 and Uccello announced their partnership earlier in 2019, with Able2 taking the reins as the sole distributor of the Uccello Kettle in the UK. www.able2.eu / www.uccellodesigns.com

INCREASED VISIBILITY Terry Lifts’ new prototype three-door glass lift generated significant positive interest amongst OTs at the show. According to the company, occupational therapists were interested in how the lift is being developed with greater dimensions and its ability to accommodate wheelchair users and more than one person.

As the new prototype lift is fully glazed, it offers increased visibility and improves sightlines for people both inside and outside the lift.

“The full-length glass lift door panels also give virtual transparency meaning it is sympathetic to any interior and will suit most properties,” said Terry Lifts Commercial Director Adrian Sunter.

Above all, the most significant feature of the new lift is the ability to open the lift on three sides, which Terry Lifts boasts is an industry first and is an important step to improving accessibility and home aesthetics. www.terrylifts.co.uk

I N T R O D U C I N G T H E N E W H E R I DA H - 1 8 0™

ERGONOMIC IN DESIGN MOBILE HOIST LIFTING DEVICE

L o o k o u t f o r o u r N E W M ov i n g & H a n d l i n g R a n g e t h r o u g h o u t 2 0 2 0

Herida Healthcare are proud to introduce our NEW H-180 modern mobile hoist, ergonomically designed, allowing ease of maneuverability, even under maximum load.

Easy to use with a multi-functional hand set.

High boom coupled with ultra-low lifting positions.

The H-180 model will be available from March 2020.

Call our sales team for more information +44 (0) 800 193 6030

Features wide leg opening - Easy to approach large complex seating solutions. Perfect for any care home, residential or even acute hospital settings.

Neatly folds for ease of transportation & storage.

HERIDA HEALTHCARE LTD

Herida House, Unit 2, Leeds 27 Industrial Estate, Bruntcliffe Avenue, Morley, Leeds, LS27 0LL

Freephone: +44 (0) 800 193 6030 Email: sales@heridahealthcare.co.uk Web: www.heridahealthcare.co.uk

BATHING & TOILETING

Reducing costs and

care intervention Going to the toilet: it’s something we all do, and, on average, eight times a day.

In fact, the average person spends three hours or more a week sat on the toilet, according to a survey by UKActive.

Robin Tuffley joined Closomat 15 years ago. Thus, he has a wealth of market and marketing knowledge about the home adaptations and assistive technology industry for all sectors impacting on the process of delivering means to enable people to live independently.

16 AT TODAY

Using the toilet is one of the five key activities of daily living that are used to assess someone’s need for care support. It also accounts for even more time than referred to above, if they do need help. What about the minutes spent helping the person into the bathroom, adjusting clothing, supporting them to transfer on and off and wiping them clean after? All that time impacts on the care support required.

The bathroom is the room most commonly the subject of a home adaptation. The toilet is the fixture therein most frequently altered, whether it be a seat changed, a grab rail added, or the whole unit replaced.

It is therefore one area where assistive technology can really come into its own, and where the true value of single-handed care can be appreciated. In the bathroom, and particularly in using the toilet, equipment can not only reduce the number of carers needed from two to one, but can go further, and, where appropriate, empower the person to

THE BATHROOM IS THE ROOM MOST COMMONLY THE SUBJECT OF A HOME ADAPTATION

perform the activity unaided without any care intervention.

And it can deliver better value: cost analysis shows provision of appropriate equipment can cost just a quarter the outlay to provide even just one carer to do the same job. So, in one year alone, four people can be enabled to retain their independence, instead of just one. Further, the equipment is a one-off cost, whereas the carer is needed day in, day out, for potentially years. Thus, potentially the number of people who can be helped is significantly higher…

Beyond the pure financial implications, there are the hidden costs. The person retains their dignity and independence, which enhances their mental wellbeing and mental health. They are equipped to undertake daily living tasks safely. The carer’s health is improved too, reducing the amount of manual handling being undertaken with all its associated strains on backs. Healthcare intervention – and, thus, strain on our health service – is reduced.

There are two key pieces of equipment that can play a significant role in empowering people to remain independent in the toilet as per the Person Environment Occupation (PEO) model: toilet lifters and wash & dry toilets.

TOILET LIFTERS A toilet lifter is the most basic piece of assistive technology to reduce,

or eliminate, care intervention in the toilet. In essence, it is the toilet equivalent of a riser recliner chair.

It is installed over the toilet and automatically, at the push of a button, lowers the user from standing to a sitting position over the pan whilst they ‘go’, then raises them back to standing. A toilet lifter is suitable for people who have sufficient body flexibility and manual dexterity to be able to clean themselves, but have mobility issues, certainly to the degree that they need help with the transfer from standing to sitting and back.

A key consideration from a specification point of view is the user’s balance. It impacts on whether integrated arms are important for their balance and safety during the movement. It impacts on their ability to themselves accommodate the transfer motion – the majority of toilet lifters tilt as they rise, in effect ‘pushing’ the user to a standing position. For some, this could make them feel insecure that they might fall, so a vertical lift may be a more appropriate selection.

WASH & DRY TOILETS Also known as shower toilets, automatic toilets or smart toilets, wash & dry toilets feature integrated douching and drying, so there is no need for a carer to wipe clean. They were originally introduced into the UK more than half a century ago (by Closomat), specifically for disabled

and elderly people. In Japan, by contrast, they are perceived as an everyday piece of tech, as common in homes as a TV. Whereas the UK has a long way to go to reach that level of market penetration, ‘smart’ toilets are becoming more widely known and are increasingly perceived as an aspirational fixture.

As with most pieces of technology, the style and features vary widely.

Entry level versions simply clip onto the existing toilet, whereas some just wash and some wash and dry. Some go even further, offering a choice of wash options. Most wash & dry toilets are floor-mounted, but wall-hung versions are increasingly available too. Thus, the user’s bathroom can still be modern, stylish, and functional without becoming institutional in appearance.

The specification comes down, in part, to cost and the recipient’s cognitive and manual skills. It is worth pointing out that the majority of wash & dry toilets rely on the user being able to push buttons, be it on the unit itself or on a remote control. Models are available that offer alternative operating mechanisms, so someone with little or no use of their hands could still manage the various functions.

The performance varies significantly too, particularly the effectiveness of the douche. Everyone is different, so what works for one

may not for another. Douches vary by volume and power of the water as well as the angle of the spray. People can also specify single or twin douche.

THE USER’S BATHROOM CAN STILL BE MODERN, STYLISH, AND FUNCTIONAL WITHOUT BECOMING INSTITUTIONAL IN APPEARANCE

HELP AT HAND Going to the toilet is, probably more than any other, the one function that people are most resistant to have a care intervention. It is probably the one area where they are most likely to be appreciative of technology that can enable them to retain their dignity and independence. It makes sense financially to follow that route too.

Bear in mind that any adaptation or new piece of equipment can take some time for the user to adjust to, so it needs to be ‘future-proofed’: What happens as their condition deteriorates? How long will they benefit from the technology? Can the ‘tech’ itself be adapted and accessorised so it continues to deliver even as needs change?

To help all involved in the provision of assistive technology get it right in the bathroom, there is now a raft of supportive specification guidance available. An OT-led analysis document plus cost analysis, relevant white papers and “top tips” on the creation of a domestic accessible toilet facility and the specification of a wash & dry toilet can be found under the resources tab on www.closomat. co.uk

AT TODAY 17

BATHING & TOILETING

PRODUCT SHOWCASE

When it comes to maintaining independence, the bathroom is one of the key areas to helping clients feel at ease and preserving their dignity. Helping people remain as independent as possible, the following products provide the extra support and reassurance that can make all the difference.

18 AT TODAY

STYLISH SHOWER SEATS FOR ALL

COMPLEX CONDITION? NO PROBLEM The new Invacare Aquatec Ocean VIP Ergo is a tilt-in-space, modular shower chair commode. Designed to meet the personal care needs of those with complex conditions, the shower chair commode specifically addresses postural stability, safety, comfort and ease of use.

Features include a contoured, ergonomic seat which provides a stable and comfortable seating position, as well as a new ‘centre of gravity’ tilt mechanism offering a smooth +40° seat tilt angle. A Dual VIP model also features a backrest recline for specific positioning needs.

This latest shower chair commode is customisable and comes with a vast range of built-in adjustments as well as a comprehensive selection of postural support and safety accessories. www.invacare.co.uk

Developed in consultation with OTs, users and installers, the new 1000 Series and updated 3000 Series shower seats from AKW deliver functionality and safety without compromising style.

AKW created the entry-level 1000 Series to ensure that there is a shower seat at every price point.

As well as having side transfer and colour padding options for users with visual impairments, the 1000 Series is also height adjustable, has a padded backrest on the frame and a maximum weight of 25 stone.

AKW’s improved 3000 Series shower seat offers users and installers a strong and durable chair.

This mid-range shower seat is height adjustable, has a half back support with padding and PU arms with top padding. It also has a maximum weight of 30 stone. www.akw-ltd.co.uk

COMFORTABLE BATHING The KANJO Power Bathlift from H&M Bathlifts offers users hygiene and safety when bathing.

An ergonomically designed seat and back, and a function that adjusts from a fixed to a reclining position at the push of a button, allow the user to relax and bathe in comfort. Optional covers made of tear-resistant and in some cases, antibacterial materials, are also available.

H&M Bathlifts says the KANJO Power is lightweight, strong, stable, versatile and reliable, allowing users to get low in the bath (6.5cm) to soak and bathe comfortably. It can be folded into two main components and has a skin-friendly, non-slip surface. www.hmbathlifts.co.uk

AT TODAY 19

BATHING & TOILETING

SINGLE-HANDEDLY REVOLUTIONISING ACCESSIBLE TOILETING Bringing a fresh new approach to single-handed care, the Asana wash & dry toilet removes the need for a carer while an individual uses the toilet, helping to restore dignity and independence.

The Asana is a “revolution” in single-handed care as it potentially eliminates the need for any care support while using a toilet. It combines a wall-hung, contemporary toilet with integrated douching and drying. A choice of mechanisms also enables the user to operate the technology by waving their hand or touching a button.

In a ‘year of care’ cost analysis by the Money Advice Service in 2018, provision of a Closomat Asana was 50 percent (or above) better than the cost of providing care support. The Asana is also a one-time purchase compared to the ongoing cost of care provision, which, over time, proves to be more cost-efficient for individuals. www.closomat.co.uk

ATTRACTIVE YET FUNCTIONAL Combining functionality with aesthetics, Osprey Healthcare’s Flyta-Active shower chair is designed for active wheelchair users.

The Flyta-Active was developed in response to feedback from active wheelchair users in the community and at exhibitions who asked for a product that looks more like the active chairs they use on a day-to-day basis. Additionally, the users noted that they wanted something less clinical and more dynamic.

A unique product, the shower chair comes with two standard seat widths of 17” and 19”. It is also compatible with the Gebereit Aqua Clean and Geberit Mera toilets. www.ospreyhealthcare.com

MODERN TOILETING The new AquaClean Sela is a modern wash & dry toilet that is designed to fit in seamlessly with any bathroom.

It features Geberit’s patented WhirlSpray shower technology, which ensures precise, thorough and beneficial cleaning. The shower spray is enhanced with dynamic aeration for targeted and thorough cleaning.

Additionally, the AquaClean Sela has a rimless ceramic pan for increased hygiene. The entire inner ceramic surface is completely rinsed, with no hidden areas for germs and bacteria to hide.

The wash & dry toilet also comes with a soft glowing orientation light that appears upon approach. Orientation lighting is used to create a soft directional glow that eliminates the need to switch on additional lighting in the middle of the night. With a choice of seven colours, the light can be changed to match clients’ personal preference or bathroom design. www.geberit.co.uk

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DESIGNING AN ACCESSIBLE BATHROOM:

The do’s and don’ts There are many things that need to be considered when designing an accessible bathroom for elderly and disabled people due to it being one of the key rooms in the home for enabling people to remain independent. Whether it’s considering turning spaces for wheelchair users, gathering insights from the client’s occupational therapist or thinking about how an accessible bathroom can work for an entire family, there are plenty of points that need to be carefully approached.

To find out more, we spoke to two of the leading players in the field of accessible bathroom design: Peter Davies from Ropox and Dale Spademan from KingKraft, who have worked together on many accessible bathrooms over the years in domestic, SEN schools and Changing Places environments.

WHAT SHOULD BE TAKEN INTO CONSIDERATION PRIOR TO ANY INSTALLATION? Information gathering is vital! How does the client transfer to the toilet, shower seat and access the basin, and what is their level of independence? Most equipment can be tailored to be used with a left or right hand, therefore, it is important to ascertain if the client is stronger on one side should they be using the equipment themselves.

Space is always one of the primary topics for discussion. You need to be aware of required turning spaces for

22 AT TODAY

a wheelchair and reach to ensure that taps, shower valves and support rails are all in the correct positions to provide as much independence as possible. If carers are needed, how much space will they need to facilitate their work? It is also important to consider the possible changing needs of the client in the future.

The best way to gain all this information is by talking to the client, family members, healthcare professionals and anybody else involved in providing day-to-day care to ensure the final bathroom ticks all the boxes. It is then a case of designing a bathroom which best suits the needs of everyone who will be using it and this can often include adults and children if it is a family home.

WHAT ARE THE MOST COMMON MISTAKES PEOPLE MAKE WHEN DESIGNING AN ACCESSIBLE BATHROOM? Using the Part M guidelines, which are useful but only apply to adult wheelchair users and are not mandatory in a private bathroom.

Removing and replacing the wash basin for a small inaccessible one to create more space, which then often makes the basin impractical to actually use, is a common mistake.

Providing drop down grab rails that do not project beyond the toilet, which makes transferring harder, is another common mistake.

REMOVING AND REPLACING THE WASH BASIN FOR A SMALL INACCESSIBLE ONE TO CREATE MORE SPACE, WHICH THEN OFTEN MAKES THE BASIN IMPRACTICAL TO ACTUALLY USE, IS A COMMON MISTAKE

Dale Spademan has worked in the bathroom adaptations business for 19 years and comes from a career in plumbers’ merchants selling bathroom products. Dale joined Kingkraft in 2012 and has been involved in many domestic and commercial projects adapting bathrooms and Changing Places with the Kingkraft and Ropox range of baths, wash basins, hoists and changers. Many of these projects have been complete turnkey adaptations including all the necessary work required.

WHEN PLANNING A BATHROOM, IN ADDITION TO THE CLIENT, DO YOU WORK ALONGSIDE OTHER PEOPLE, SUCH AS THEIR HEALTHCARE PROFESSIONAL AND FAMILY MEMBERS? Yes, as everyone can offer valuable insight and information – it is a bit like putting a jigsaw together. OTs will give insight into the needs of the client that an architect may not see, but the architect/technical officer may know the limits of the building and what is physically possible with the space and it is our role to help everyone get what they want and what is possible.

Ultimately, no one knows the client better than their family so their input is also extremely important.

HOW HAVE ACCESSIBLE BATHROOMS AND THE EQUIPMENT AVAILABLE EVOLVED OVER THE YEARS? Greatly, including recommendations and requirements such as building regulations which now require accessible height switches and ground floor toilets in all new builds. Also, in the last twenty years, equipment and product design has become less institutional. Products no longer look like they have come straight from a hospital or care home, but as though they belong in a home and people can have a stylish adapted bathroom which fits seamlessly within their own home.

WHAT ARE THE MOST COMMON MISCONCEPTIONS PEOPLE HAVE ABOUT WHAT CAN BE INCORPORATED INTO AN ACCESSIBLE BATHROOM? That there is not enough space for everything. Having flexible equipment which can move, such as shower chairs or the Ropox wash basins, can greatly improve accessibility and make the best use of the space that is available.

DO YOU THINK THAT INSTALLING AN ACCESSIBLE BATHROOM/ CHANGING ROOM IN A PERSON’S HOME IS A BETTER OPTION THAN MOVING HOUSE OR POTENTIALLY MOVING INTO A CARE HOME? Yes! Many people we work with have been living in their current family home for years and they do not want to move out as a consequence of their reduced mobility. They just need equipment that will provide them with more independence and this is where we can help. It is also far more cost effective for all concerned to adapt an existing bathroom, if possible, compared to the cost of either moving house or going into a care home.

WHAT HAS BEEN THE MOST CHALLENGING DOMESTIC INSTALLATION YOU HAVE COMPLETED? We recently had to completely overhaul a family bathroom for a client, but this room was being used

OTS WILL GIVE INSIGHT INTO THE NEEDS OF THE CLIENT THAT AN ARCHITECT MAY NOT SEE, BUT THE ARCHITECT/ TECHNICAL OFFICER MAY KNOW THE LIMITS OF THE BUILDING AND WHAT IS PHYSICALLY POSSIBLE WITH THE SPACE

Peter Davies has been working with Ropox products and been involved in designing kitchens and bathrooms for people with disabilities for over 30 years. Peter is passionate about helping people with limited mobility live as independently as possible by opening their minds to what is available when it comes to using a kitchen or bathroom with confidence and dignity.

by everyone so it had to be practical, have the features the user needed, but also look like a standard domestic bathroom that anyone would be happy with in their own home. Space and time were both an issue as the clients were going on holiday but we achieved it and the client was very happy.

LOOKING TO THE FUTURE, WHAT DO YOU THINK WE WILL SEE IN TERMS OF PRODUCT INNOVATION? In the future, we will see even more aesthetically pleasing products and connectivity. As technology evolves, we will also see products using the internet, so users will get alerts if a product needs servicing or something, such as ‘the temperature may need adjusting’.

For more information on the full range of products available from Ropox or to book an assessment call 07831 401118, email pd@ropox.com or visit www.ropox.com To speak to KingKraft about its products or to book an assessment call 0114 2690697, email info@ kingkraft.co.uk or visit www.kingkraft.co.uk

AT TODAY 23

TELECARE

LET’S TALK

telecare

Telecare is a rapidly expanding sector in the world of assistive technology and helps clients feel safe in their own homes with the reassurance that a loved one or carer is able to monitor them for any signs of risk or that they can access help quickly, where required. Here are some of the latest telecare innovations available to give clients confidence and carers vital insights.

ACTIONABLE INSIGHTS Providing unobtrusive home care through the use of smart sensors and monitoring capabilities, Memo is an innovative digital telecare platform that gives loved ones and carers greater insights to an individual whilst they’re at home.

The telecare platform consists of the Memo Hub, which connects a user to a help centre, while connecting all products in the range; the Memo app, which allows family to set reminders, receive updates and view wellbeing data in real time; the Memo Dashboard, which presents actionable insights to social services and care providers; and sensors, a range of devices such as door, motion and fall detectors which link with the Memo Hub. Memo is a feature-packed platform designed to prolong independence, provide reassurance and produce actionable insight by bringing together behavioural, health, social and economic data in one place to offer a complete service.

Alongside the benefits to individuals at home, Memo also presents cost savings and frees up carers’ resources and time. www.memohub.co.uk

ASSISTING ANYWHERE The SureSafeGO ‘Anywhere’ Alarm is a leading mobile alarm in the UK, designed to combine the best features of other alarms into one easy-to-use and affordable safety alarm.

Feature-packed, the SureSafeGO is a genuine ‘anywhere’ alarm, meaning it can be used in the home, in the garden, at the shops and in many other scenarios. It is ideal for active seniors. The alarm sends its GPS location when activated, so respondents always know where the wearer is and where to send help to. Additionally, carers can request the location of the pendant at any time, which is ideal for patients who wander.

The alarm has a simple-to-use SOS button for manual activation and also includes fall detection technology as standard. This means the alarm can detect a fall and call for help, even when the wearer is unable to press the SOS button.

The SureSafeGO allows the wearer to talk to the respondent directly through the pendant, meaning they don’t need to worry about being next to the base unit to communicate. Thus, the respondent knows what is happening and can arrange for the right help, fast. It also gives the wearer peace of mind that help is on the way. The pendant is water resistant for use in the shower.

The SureSafeGO also has options for TSA-accredited 24/7 monitoring or it can be set up to contact family and friends directly in an emergency. www.personalalarms.org

NON-INTRUSIVE CARE Tunstall Healthcare’s CareAssist is a portable telecare alarm designed to support carers to deliver non-intrusive care.

The device can receive telecare alerts and display the type of sensor activated as well as the location of the sensor and/or the name of the person the sensor has been assigned to.

This means that onsite carers can be quickly made aware of any incidents. CareAssist also removes the need for a telephone line or monitoring centre service.

With a radio range of up to 200 metres, it is particularly suited to small specialist dementia care, intermediate care, learning disability, residential and care home, and respite care facilities.

CareAssist can also benefit private individuals and their informal carers who may prefer not to be connected to a 24-hour monitoring centre service. www.uk.tunstall.com

24 AT TODAY

FLOOD DETECTOR The Doro Flood Detector provides early warnings of potential flood situations, such as the bath overflowing. It can be placed under the sink, in the bathroom next to the toilet or under the bath.

If the detector senses water, the unit will provide two types of alarm. The first is a local audible alarm and the second will activate the home unit, which will automatically raise a call at the monitoring centre.

This offers extra protection to individuals who are likely to be at risk from leaving taps turned on, such as those with dementia. www.care.doro.co.uk

TWO-WAY CONNECTION Appello’s emergency alarm gives clients peace of mind that help can be accessed at the press of a button. The alarm is an ideal solution for anyone who lives alone or who wants the reassurance that they can continue to live independently and get help if required.

The pendant can either be worn on the wrist or around the neck. If the client wants to alert Appello’s 24/7 careline team, they can press the pendant button. After, Appello will call the client via the Personal Alarm’s base unit to see if they are okay or if help is needed.

The base unit facilitates two-way speech between the client and the Appello team. Importantly, the pendant is waterproof, so if an emergency occurs when the client is having a shower or bath, they can still reach the Appello team. www.consumer.appello.co.uk

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Time to prioritise

a trusted formula?

Changing demographics and increasing budget pressures are dictating the need for better partnership working between housing, health and social care. Smarter ways of working are essential to ensure better outcomes for service users and to alleviate the daily pressures facing health and social care professionals. Occupational therapists (OTs) are among those most affected by increasing caseloads and limited resources.

For 50 years, the Disabled Living Foundation (DLF) has been supporting OTs in equipment assessment practices. Trusted Assessor training has been a cornerstone of our service, alongside the Hamilton directories of yesteryear and our current knowledge base, DLF Data. The time was right for a reappraisal of the Trusted Assessor concept and in 2018, we interviewed a range of practitioners, collated their feedback and updated DLF’s portfolio of training courses and tools.

Clare Barber is a training services development Manager at the DLF. A qualified OT she specialises in equipment provision and is leading the development of the charity’s equipmentrelated training for healthcare professionals.

At its heart, the genius of Trusted Assessor is its simplicity: by training a variety of staff to provide advice and carry out basic assessments for equipment for independent living, we can reach more vulnerable people, more quickly. We interviewed over 50 professionals in health, housing and social care across the UK to find out their perspective of the Trusted Assessor concept and how it had impacted on the way they worked.

The concept has been around for almost twenty years and has been an integral part of many of our respondents’ organisations, in some cases for many years. Over 40% of respondents told us that Trusted Assessor had been first introduced to their organisation over 10 years ago, a further 31% had been using it for six to 10 years and a further 27% had introduced it within the past five years.

When we asked who had been trained as a Trusted Assessor, we found people had come from a variety of work backgrounds and teams, including drivers, alarm scheme staff and equipment technicians. But by far the most common users were people working in occupational therapy (OTs and OTAs), both in hospitals and in the community within social services and housing.

We found around 60% of respondents had 10 or under

Under 5 years

6-10 years

10+ years 0

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AT ITS HEART, THE GENIUS OF TRUSTED ASSESSOR IS ITS SIMPLICITY:

BY TRAINING A VARIETY OF STAFF TO PROVIDE ADVICE AND CARRY OUT BASIC ASSESSMENTS FOR EQUIPMENT FOR INDEPENDENT LIVING, WE CAN REACH MORE VULNERABLE PEOPLE, MORE QUICKLY

5

10

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trained Trusted Assessors in their organisations, with 18% between 11 and 25. Three organisations reported having over 50 trained Trusted Assessors.

We asked respondents about the impact of using Trusted Assessors within their workplace/role. Following the introduction of Trusted Assessors, almost a quarter mentioned the reduction in waiting times. Many mentioned how the new skills they had acquired enabled them to be confident in their understanding of equipment and in assessing for minor equipment and low-level interventions, such as bathing aids, grab rails and toileting equipment.

Being able to respond more quickly and having equipment installed in a timely manner created a much better overall experience for the service user. One respondent (#53) quoted: “Using a trusted assessor is a good way forward for a person being referred to social services requesting an assessment, compared with going to panel which takes a long time for work to be completed.”

Respondents also reported that staff such as OTAs felt more confident and that the addition to their skill set added another dimension to their jobs, improving their satisfaction levels. Other respondents reported faster discharge times from hospital.

Housing providers felt that service users were receiving a better quality of service.

The survey findings demonstrated that there are benefits in introducing new ways of working for both staff and service users.

Spontaneous responses to the question about how roles have changed are set out below: DLF recently worked with Sandwell Metropolitan Borough Council to train technicians to enable them not only to deliver, but to set up, demonstrate and review the effectiveness of equipment once it was in a client’s home. They also wanted to ensure that technicians were able to recognise any potential risks in other areas within the home. Following the training, learners reported they were confident in their new duties.

Equipment orders prepared by OTAs Fewer visits Reduction in costs Integration / reorganisation of roles Professional development / autonomy Maximise patient's independence / reduce risk Reduction in waiting time / discharge time New roles are involved in assessing for equipment OTs have more time for complex cases / higher intervention / advisory role / other work 0

The training was followed by a policy

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complex cases, allowing them to

DLF recently worked with Sandwell Metropolitan Borough Council to train technicians to update with regards to equipment spend more time, and achieving better enable them not only to deliver, but to set up, demonstrate andcases. review the effectiveness of and assessment and a review of outcomes, with the needier example, one respondent (#30) equipment suppliers.

Sandwell has home.For equipment once it was in a client’s They also wanted to ensure that technicians were stated: “OTs can assess more complex reported a reduction in re-visits able to recognise any potential risks in other areas within the home. Following the training, and a greater capacity within their needs and spend more quality time learners reported were confident in their new duties. training was followed by a therapy services asthey a result of the with clients with handsThe on therapy.” policy update with regards to equipment and assessment and a programme.

Respondent #24 reinforcedreview that: of equipment “There in is are-visits place forand people to do low TrustedSandwell Assessorshas havereported sometimes suppliers. a reduction a greater capacity within their level assessments instead of OTs.” been viewed as a way of replacing the therapy services as a result of the programme.

This view was also shared by #8: work of the occupational therapist.

“It is important workers are the work of the However, our survey suggests the Trusted Assessors have sometimes been viewed as a social way of replacing opposite: 40% of interviewees stated trained as assessors because our DLF FIRMLY occupational therapist. thewith opposite: councilsuggests has merged the NHS40% and of interviewees that because OTs now hadHowever, the ability our survey BELIEVES stated that because OTs now tonow delegate assessment work to confident staff, to delegate assessment work to had the ability OTs are being spread very thinly.” aspect ofcases, the allowing themTHAT confident they could prioritise they couldstaff, prioritise home visits and focusAnoninteresting more complex to spend home visits and focus on more survey was exploring what future TRUSTED

more time, and achieving better outcomes, with the needier cases.

ASSESSOR TRAINING IS For example, one respondent (#30) stated: “OTs can assess more complex needs and spend A KEY TOOL more quality time with clients with hands on therapy.”

THAT SHOULD Respondent #24 reinforced that: “There is a place for people to do low level assessments BE IN THE insteadCreated of OTs.”over 15 years ago, the Trusted Assessor concept KIT OF has evolved and become the standard new way of working PROFESThis view alsoprovision. shared by #8: “It is important social workers are trained as assessors forwas service SIONALS TO Created by has a working government because our council mergedgroup with put the together NHS and by OTs are now being spread very thinly.”

HELP CREATE to increase equipment provision, the Trusted Assessor SMARTER An interesting aspect of out the competencies survey was exploring whatbe future Framework lays that should held plans our professionals WAYS envisaged their teams and organisations.

Of those thata part responded, 29% focused on OF how for in a person to prescribe equipment safely.

DLF, of WORKING they could involve others to receive training in an aim to reduce care packages, enhance

ABOUT TRUSTED ASSESSOR

the original working group, created the original popular training course to meet the competencies and ensure learners could gain knowledge required for equipment provision.

DLF has trained over 10,000 people in various sectors from local authorities, domiciliary agencies to housing associations. The concept has proven to reduce waiting lists for OT departments, increase equipment provision and decrease hospital admissions.

DLF Training can be contacted on 0207 289 6111 or training@dlf.org.uk our website is www.training.dlf.org.uk

plans our professionals envisaged in their teams and organisations. Of those that responded, 29% focused on how they could involve others to receive training in an aim to reduce care packages, enhance partnership working and to be able to delegate to support staff. Others mentioned being able to translate what they had learnt to assist with assessing real life scenarios, for example when standard equipment sizes do not work in modern homes.

Trusted Assessor training can be viewed as a transformation tool. DLF recently trained 45 learners from Royal British Legion, the country’s largest armed forces charity. Learners were a mixture of Independent living advisors, regional leads and handy van fitters who were taught how to recognise a need for equipment, how it might enable independent living, measure for it and fit it into the environment. Feedback was that leaners felt more knowledgeable and confident and this in turn has led to more accurate and up-to-date advice and guidance being given to RBL beneficiaries.

They also reported feeling more able to communicate with external services, such as local councils. The charity believes that they are now undertaking a more comprehensive and robust approach towards tackling the increasing demands and casework within their independent living service.

DLF firmly believes that Trusted Assessor training is a key tool that should be in the kit of professionals to help create smarter ways of working.

In 2018, DLF developed a new suite of courses aimed at closer alignment with specific job roles, as well as a choice of competency levels of Trusted Assessor training. Later on this year, DLF will introduce versions of those courses that specialise in certain settings and product categories to support the increasing specialisation of organisations and new technologies.

Also, in 2019 we will launch a conversation about the development of a registration scheme and professional support network.

We are keen to raise the profile of Trusted Assessor training so that it has national recognition as an essential tool for professionals.

One thing we know for sure is that change is inevitable and Trusted Assessor training has shown it is a relevant and effective tool that works and is flexible enough to be here for the long haul.

AT TODAY 27

SPECIALIST SEATING

PARKINSON’S AND SEATING

What to consider when specifying a chair Many occupational therapists will have worked with, or be currently working with, clients who are living with Parkinson’s disease and will therefore be all too aware that providing the correct seating for someone with this condition is vital.

Kate Sheehan, Director of The OT Service, is an occupational therapist specialising in environmental design and equipment provision.

She is well respected as a leader in the field of product and commercial consultancy and is passionate that products are designed to meet function, enable occupation, are simple and intuitive to use.

28 AT TODAY

In this article, Repose Furniture, one of the UK’s leading manufacturers of bespoke seating solutions, discusses what to take into consideration when specifying a chair for someone with Parkinson’s with its retained occupational therapist Kate Sheehan.

Parkinson’s disease is caused by the death of specific neurons in the brain area called the substantia nigra. These nerve cells produce a

THE MOVEMENT FROM SITTING TO STANDING IS MORE COMPLEX THAN WE OFTEN APPRECIATE

substance called dopamine, which is therefore lacking in people with Parkinson’s disease. Dopamine is a chemical that is responsible for the normal working of the part of the brain that controls movement.

Dopamine deficiency leads to the following symptoms of the disease: • Tremors, which are generally more pronounced whilst resting • Slowness of movement • Stiffness of movement, making initiating movement difficult • Impaired balance The cause of Parkinson’s disease is not yet fully known, however, both genetic and environmental factors are considered to be involved. The disease is a degenerative condition which will present differently for everyone and as there is currently no cure, symptoms are treated as and when they appear.

Due to Parkinson’s disease causing a number of movement problems, including difficulty or delay of initiating movements, this can make getting comfortable in, or rising from, a chair difficult.

The movement from sitting to standing is more complex than we often appreciate. It requires us to gain sufficient propulsion from a resting position to move forwards and then upwards out of the chair. Then follows the change in centre of gravity as we lean forward to generate initiation of movement.

This movement requires a certain amount of force and speed, and difficulty or slowness initiating movement can result in insufficient momentum to rise from the chair then mobilise safely.

In the early stages of the condition, strategies to improve position and momentum can help, such as moving first to the front of the seat, tucking the feet in under the knees and having the arms positioned to push

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SPECIALIST SEATING up can help prepare a client to coming forwards and upwards. Rocking back and forth a few times before trying to rise can increase the momentum and force to continue the movement.

Cuing your client (“ready, steady, stand”) can also help to prepare and initiate the movement.

As the condition deteriorates, initiating movement can be so difficult or slow that standing even from a previously useable chair can be challenging. A chair, such as the Repose C-air, with a rise function may provide extra support and propulsion which is perfect for helping to initiate standing. Most riser chairs work by slowly tilting and elevating the seat to lift and angle your pelvis forward.

Sometimes just a small angle on the riser function is enough to initiate a natural stand. Otherwise, the seat angle can be elevated until you are almost in an upright position, allowing you to finish with a small stand and walk off from the chair. Due to the support being provided, the rising function significantly reduces the risk of falls on initiating walking from the stand.

In the later stages of the condition, when the client finds it extremely difficult or impossible to move without carers support, considering comfort and the carer’s abilities to work with the client to achieve the optimal position, comfort and movement is essential.

It is at this stage that considering a chair that can adjust with the client’s changing ability is vital and the Repose Boston portering chair is a perfect example of such a chair as it offers a variety of features and benefits to make it the ideal seating

solution for both the client and their carer by incorporating the following: TILT-IN-SPACE This allows the seat back angle to remain the same whilst the whole seating system is tilted backwards, allowing the angle of the hips, knees and ankles to remain unaffected which reduces shear and friction on the bottom and back during this movement. It also reduces the weight on the Ischial Tuberosities by redistributing the weight through the back.

This feature can also help when transferring someone in a sling as it can support better pelvic positioning by using gravity to position the user in the back of the chair in the optimal position.

INDEPENDENT BACKREST By incorporating this feature, the chair can be moved independently which maintains flexibility over the client’s body position, particularly the amount of hip flexion, allowing for the optimal position for comfort.

INDEPENDENT LEG REST This offers the client additional flexibility over positioning, allowing them to use it in conjunction with the recline feature to create the optimal postural position for their body shape.

ADJUSTABLE FOOTREST This feature allows the footrest to be moved away to allow clear access for the user to be hoisted from the front or obliquely.

PRESSURE RELIEVING In the later stages of Parkinson’s, it is essential that a client’s skin integrity is monitored and reviewed due to the potential of pressure sores developing. A chair

30 AT TODAY

AS THE CONDITION DETERIORATES, INITIATING MOVEMENT CAN BE SO DIFFICULT OR SLOW THAT STANDING EVEN FROM A PREVIOUSLY USEABLE CHAIR CAN BE CHALLENGING

with pressure relieving properties built into its design, which can be up-graded as the condition changes, is essential, for example, different and interchangeable pressure management seat and back cushion options.

PORTERING The ability to move a client from one room/position to another in comfort and with ease to reduce the number of hoist moves is vital to enable the client to be transported from one room to another so they can be involved in different activities. As well as the Boston, the Repose Harlem Porter Chair is a great example of a chair which meets these demands and more.

All of these options allow the chair to be adapted to the client’s changing conditions, without impacting on their comfort and pressure issues.

They also continue to encourage occupational performance.

Repose is a family business with over 100 years of combined experience in designing innovative seating solutions that deliver quality and comfort for the home, health and care markets. Working in partnership with healthcare professionals and through progressively more intensive research, Repose continues to refine its seating solutions to conform to the rigorous standards of the healthcare market.

For more information on the full range of bespoke seating solutions available from Repose Furniture call 0844 7766001, email info@reposefurniture.co.uk or visit www.reposefurniture.co.uk

SPECIALIST SEATING

PRODUCT SHOWCASE With a vast range of seating options available to suit a huge range of needs, AT Today has highlighted some of most versatile and game-changing products within the field, covering pressure ulcer risk, portable and hybrid chairs, and dual motor options.

32 AT TODAY

LUXURIOUS LIFTCHAIR Manufactured by Pride Mobility, the Monmouth is a dual motor liftchair with a powered headrest and powered lumbar support.

A more luxurious option, this riser recliner is available in a range of colours and comes with an extended footrest, a powered lumbar support and a 10” powered headrest. With the dual motor option, clients can operate the backrest and footrest separately on the liftchair.

As well as having a lateral or waterfall back, the Monmouth comes with an LED Control. This enables users to control the powered headrest, lumbar support and independent dual motors to find their preferred position.

The LED lights on the control help users pinpoint their chosen position. www.pride-mobility.co.uk

PRESSURE CARE FOR RISE & RECLINE CHAIRS The MicroCell Companion an ultra-thin mattress designed to fit over any rise & recline chair with the aim of reducing the risk of pressure ulcers in people who use chairs as beds for long periods of time.

Available in different sizes, such as two-thirds size and bariatric versions, the MicroCell Companion comprises a patented micro cell slim alternating air mattress with an easy-to-use pump to retro fit any recliner chair.

MediSmart’s sales director David Beavis said the product has received a lot of interest when it has been shown to clinicians and therapists.

He added: “Especially with regard to the issue that regularly occurs whereby users, on many occasions, use these chairs in a supine position as a bed for long periods of time without always having the appropriate alternating support surface as they would do in a profiling bed, therefore sometimes contributing to an increase in pressure ulcers.” www.medismart.co.uk

AT TODAY 33

SPECIALIST SEATING

ADJUSTABLE ADELPHI The Adelphi care chair by Primacare uses soft cushioning and conventional wings to give postural support, sometimes with optional extras such as soft lateral support cushions.

Giving clients greater choice, the Adelphi is available with manual or electric controls for its three main operations: leg rest, independent tiltin-space and back angle. Providing users with a range of options to suit their individual needs, the back angle, seat depth, seat width, arm height and footplate can all be adjusted.

The Adelphi comes with three fibre filled waterfall back cushions which are removable and can be repositioned. In addition, the arms can be removed for seat width adjustment or for ease of side transfer. www.primacare.co.uk

DISCREET OPERATION The Three Tier Fabric Rise & Recliner by Drive DeVilbiss Healthcare is a dual motor chair featuring a mechanism that allows independent operation of the legrest and backrest, providing more flexible support options for the client.

Alongside quiet motors for discreet operation, the chair’s three tier waterfall back design offers extra comfort and support. The chair has an ergonomically contoured seat and back, and padded upholstery for added comfort and support.

Providing reassurance to the client and carer alike, a safety key is built into the chair’s hand controller to prevent accidental movement and entrapment.

According to Drive, this riser recliner is ideal for individuals who have difficulty standing up and sitting down due to restricted mobility, such as those with multiple sclerosis, arthritis and circulation problems. www.drivedevilbiss.co.uk

SAFER SITTING AND STANDING Dubbed “the world’s first portable smart rising seat”, the SitnStand enables disabled and elderly people to travel with ease by ensuring safer sitting and standing.

As it is lightweight and portable, the SitnStand can be used, for instance, at home, on holiday, in airports, on buses and on cruises. It incorporates air driven inflation and advanced technology – delivering an elevating level seat pad suitable for all types of chair, in any situation or location.

The SitnStand promotes independence and freedom, and gives users a sense of confidence and inclusion, whilst reducing the need for manual assistance when sitting or standing. www.sitnstand.com 34 AT TODAY

HYBRID CHAIR The Configura Porter Chair is an innovative hybrid chair that combines the function and benefits of a riser recliner with a portable care chair. It is ideal for users with moderate to severe postural requirements and users with progressive conditions, and incorporates four posture options and an adjustable seat width.

Featuring three, interchangeable pressure care options, the Configura Porter Chair is suitable for clients with pressure care requirements.

There is also the option to change the integrated pressure cushion that comes with the chair for a different pressure cushion.

The chair is suitable for ambulant, semiambulant and nonambulant users, individuals with neurological conditions, users who need to elevate their feet above their hips, users with a limited range of hip movement, users who need to be transported from room to room and more. www.configura.uk.com

MR2 MemRabel 2i Memory prompting daily calendar clock with Smartphone setup APP

KFM30C Recording Wi-Fi connected observation camera with live view smartphone APP

The MemRabel 2i is a user friendly looking product with a choice of 10 different clock faces with selectable contrast and digit/background colours.

MemRabel 2i can connect to home or business Broadband to allow the MemRabel 2i APP (Android or iOS) to send media files and alarm time setup data to the calendar clock.

The KFMM30C is an affordable Wi-Fi camera, which connects to home or business Broadband to allow remote viewing of live video and images.

An intuitive Smartphone APP makes setup and operation of the camera really easy.

PRODUCT CODE: MR2

£199.99

£47.99

PRODUCT CODE: KFM30C

POC-940K Long range waterproof call button transmitter with data message pager

Children's Epilepsy Seizure Alarm Medpage MP5V2 High Sensitivity Seizure Monitor

Part of the POCSAG long range radio paging system. This (portable) easy press emergency button sends an alarm to the EM300 pager when triggered. Featuring a transmission range of up to 400 metres, this alarm is ideal for use in medium to large sized care homes and larger domestic properties.

The Medpage Model MP5V2 epileptic seizure movement detector is designed to detect a variety of seizure types from all ages, including tremor, Tonic phase and seizures that cause limb twitching movements.

PRODUCT CODE: POC-940KIT

£124.80 Visit us at the OT Show on stand

D43

MP5V2 will detect movements resulting from an epileptic nocturnal seizure including minute prolonged movements from children.

PRODUCT CODE: MP5-V2

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For more details check out our Brand Guidelines.

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REHACARE HIGHLIGHTS

REHACARE

highlights Taking place from the 18th-21st September 2019 at Düsseldorf in Germany, international trade fair Rehacare returned for another year, showcasing a wide scope of innovations and assistive products in the rehabilitation and care industry.

751 exhibitors from 43 countries were at the show with over 38,600 visitors coming to the trade fair halls to learn more about aids that make life easier for elderly people, people with disabilities and people who require care. Innovations included digital self-help platforms, stair climbers, chairs inspired by Segway technology, smart rehabilitation gloves, exoskeletons and mobility aids.

Attending the 2019 show, AT Today discovered some of the latest and greatest products that are helping people to live independently. Whether it’s wheelchair wheels that reduce damaging vibrations for wheelchair users or a high-tech robotic arm to carry out tasks that a human arm can do, there was certainly no shortage in innovations at Rehacare 2019.

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Photos: Messe Düsseldorf, Constanze Tillmann​

Dignified lifting

Liftup revealed the Raizer II at Rehacare – a mobile lifting chair that helps people who have fallen on the floor to get up again within a few minutes. Raizer II is an updated version of the original Raizer lifting chair and only requires one person to operate the device, resulting in minimal manual handling.

The device is simple to set up as it has four identical legs and two identical backrests to ensure correct assembly every time. Raizer II is a safe and dignified way to lift a fallen person - perfect for shared spaces, such as care homes or public places. It also allows elderly people to live independently in their own home for as long as possible.

For more information go to felgains.com/raizer2 or call 01473 741144

FREEDOM ONE LIFE Designed by a powerchair user who understands disabled people’s daily struggles, the Freedom One Life Series 5 powered wheelchair is sleek and elegant, boasting a variety of seat sizes, up to 50° tilt and optional lift seating system.

A top speed of 8mph combined with wide, shock absorbing rear tyres make the Series 5 ideal for everyday use. Importantly, the powerchair has a 24-mile range, which has been tested in real-world conditions, before it needs charging again.

According to Freedom One Life, the Series 5 is one third lighter compared to equivalent powerchairs available and with a transport safety-certified battery and accessible lift points for transit, the powerchair makes a great travel companion.

Other key features of the Series 5 powerchair include an easy-to-remove backrest, a compact design for precise manoeuvrability, a handy on-board USB charging point, a large adjustable footrest, and low-pressure rear tyres for a smoother ride. www.freedomonelife.com

AT TODAY 37

REHACARE HIGHLIGHTS

REHABILITATION INNOVATION Winner of the Best New Aids and Equipment category in the 2018 Blackwood Design Awards, the RAPAEL Smart Glove by NEOFECT is a virtual reality glove for patient rehabilitation.

The Smart Glove incorporates an interactive gaming element, which motivates users to keep repeating measured movements, making rehabilitation seem fun and rewarding rather than difficult or a reminder of the individual’s injury or condition.

It offers a range of games that adapt to the progression of its users, bringing feeling and movement back to inactive parts of the user’s hand, wrist and forearm. The glove increases the difficulty of the movements and games with the patient’s progression as well as tracks and records their development.

NEOFECT’s virtual reality glove can help: people with neurological conditions, such as cerebral palsy and multiple sclerosis; target certain movements, such as wrist flexion and fingers extension; and people with musculoskeletal diseases, such as arthritis and bone fractures. www.neofect.com/en/

iARM The iArm Robotic Arm by Assistive Innovations can be attached to any wheelchair to give disabled people or people with restricted mobility more choice and independence, as the robotic arm is designed to do pretty much anything a human arm can do.

For instance, the clever robotic companion can adjust glasses, open doors, assist with grocery shopping and open water bottle lids, changing the way that people with reduced mobility can interact with objects.

There are various control options for the iArm device such as a wheelchair joystick, keypad or smartphone to meet a diverse range of user needs. www.assistive-innovations.com

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e t a m i t l u The e t a m i t n i in s s e n i l n a e cl

“The Closomat is the most wonderful thing of all the living aids we have added to our home, it’s beautiful!

I now don’t have to get my wife to help me.”

Karl van Gool, Halesowen

Quality • Service • Heritage www.closomat.co.uk Tel: 0800 374 076 Email: info@clos-o-mat.com

SHOW HIGHLIGHTS

NEXT-LEVEL CHAIR Scewo Bro is an innovative and versatile blend of a powerchair and a stair climber that enables hassle-free travel for disabled people.

The device automatically maintains a level seating while driving and due to its large wheels, tackling uneven or tricky terrain is easy. Alongside the neat powerchair function, Scewo Bro can also climb steps, whether the user is going up or down or whether the stairs are straight or curved.

The powerchair also has an individual height adjustment feature, which, for instance, allows the user to sit comfortably at a table. www.scewo.ch/en

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40 AT TODAY A1A1 Risk Risk Solutions Solutions LtdLtd - Office - Office 4 Copley 4 Copley MillMill Demesne Demesne Drive Drive Stalybridge Stalybridge SK15 SK15 2QF 2QFtel:tel: 0161 0161 304304 7137 7137email: email: admin@a1risksolutions.co.uk admin@a1risksolutions.co.ukwww.a1risksolutions.co.uk www.a1risksolutions.co.uk

Try before you buy Stuart Barrow of Promoting Independence is a member of the Royal College of Occupational Therapists and a recognised expert in the field of home adaptations. His experience is sought by manufacturers and service providers looking for an expert opinion.

Stuart also runs the Occupational Therapy Adaptations Conference (OTAC).

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With assistive technology more advanced than ever, healthcare professionals and their clients have an incredible amount of choice.

But how do you know what and what not to invest in?

I started studying as an OT twenty years ago, graduating in 2002.

And whilst the premise of the job has remained the same in the last two decades, so much of it has changed, just like in other healthcare areas.

The reason for that change?

The rapid growth of technology.

We can now recommend things for our clients that we’d never have dreamt of in 1999, and, as a result, can access a myriad of assistive technology that makes their lives a lot easier.

But, how do you know which tech to invest in, and which to avoid?

It’s a question without an easy answer. After all, when you’re doing the ‘day to day’, it’s not exactly easy to travel to specific retailers and manufacturers to try things out, and although the marketing material you can request from those companies is helpful, it’s nothing compared to

OTAC WAS DESIGNED TO BRIDGE THE GAP BETWEEN THE HEALTHCARE PROFESSIONAL AND THE SUPPLIERS OF EQUIPMENT AND TECHNOLOGY

actually experiencing a product in the flesh.

In truth, that’s one of the principal reasons why I started the Occupational Therapy Adaptation Conference (OTAC) back in 2015.

OTAC was designed to bridge the gap between the healthcare professional and the suppliers of equipment and technology, allowing OTs and others to make better educated decisions for their clients, and allowing the suppliers to get fantastic new products out there.

We’ve been going four years now and we’ve steadily added and refined each event to ensure that it delivers maximum value.

So, in 2020, OTAC is going to be one of the very best places for healthcare professionals to access assistive technology, helping you to make the right decisions for you and your clients.

Here’s just some of what you can expect: 500 EXHIBITORS ACROSS TEN EVENTS We’re running ten events across England and Wales (Scotland and NI news coming very soon), and we’ll have 500 exhibitors at them.

This means that whatever assistive

tech you’re interested in finding out more about, the chances are you’ll get your opportunity to do that at OTAC. And with an average of 400 delegates at each event, you’ll have a great opportunity to talk to fellow professionals and get their take on the tech that’s working for them in their context.

BRAND NEW SEMINARS AND TRAINING We’ll have seminars at every single event, with hundreds of hours of CPDapplicable knowledge on offer and plenty of opportunities to see up close assistive tech.

We’ll cover topics like ‘returning to work’, ‘prison environments’ and ‘adaptations’, as well as focusing on specific rooms and the adaptations and technology to help in each area, whether kitchen, bathroom, bedroom or living space.

I’m also delighted that stairlift and patient handling specialist Handicare will be delivering training at each event next year, so you’ll get an opportunity to see their products first-hand.

POSTER PRESENTATIONS There’ll be a variety of poster presentations at each event, many of them focused on assistive technology as well as other useful topics related to the healthcare sector.

ADAPTATIONS WITHOUT DELAY TRAINING You’ll likely be familiar with the Adaptations Without Delay document that launched in 2019 that now shapes the assessment framework, and we’ll have specific training on that at each event, run by authors of the document and supported by special guests and an expert in Healthcare Law and Ethics expert (yours truly)!

In short, we’re more committed to promoting assistive technology than ever before, and we’ve deliberately ensured that OTAC 2020 serves to make people aware of the tech on offer, as well as educating and upskilling them on it too.

To book your free ticket to your local OTAC event, just visit www.otac.org.uk

Don’t forget…

To pick up your free copy of AT Today at any of the OTAC events throughout the year.

OTAC Events 2020 OTAC Midlands

OTAC Reading

OTAC Llanelli

OTAC Southampton

OTAC Leeds

OTAC Newcastle

OTAC Exeter

OTAC Kent

OTAC Cambridge

OTAC Chester

Wednesday 22nd January

Who else wants their product in front of HUNDREDS of occupational therapists?

OTAC is the UK’s only FREE occupational therapy and adaptations conference, giving retailers valuable opportunities to showcase their products, and OTs crucial knowledge of products that can make their clients’ lives better?

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Wednesday 9th September

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Wednesday 4th November

Wednesday 9th December

All 8 Events Proudly Sponsored by:

To talk to us about exhibiting at OTAC, call us now on: 02921 900 401 or email karen@promoting-independence.co.uk

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HANDCRAFTED FURNITURE C O M P L E T E LY T A I L O R M A D E T O F I T Y O U R E X A C T R E Q U I R E M E N T S

Manufacturers of bespoke rise and recline chairs and handcrafted adjustable beds for the mobility and healthcare market

Delivery in 7 - 10 days* For furniture offering comfort, independence and a higher standard of care, contact;

Tel: 0115 913 3572

email: info@riseandreclinehealthcare.co.uk www.riseandreclinehealthcare.co.uk *On a wide range of products

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ise & Recline Ltd has been successfully servicing the needs of the mobility and healthcare industry since 2001 through a combination of superbly designed and crafted chairs, beds and accessories, with a rapid turnaround of orders and a dealer support service that is second to none. Our ethics centre around not just delivering a product but delivering an experience, from assessment straight through to delivery and after sales.

Attention to detail, unsurpassed quality, superior service and fast 7-10 day delivery turnaround of bespoke furniture, that is unmatched in the marketplace.

Rise & Recline Ltd has always believed in giving its customers the products that best suit their individual needs. This means listening closely to its customers to identify new market trends and, where applicable, responding quickly to develop new products that can be recommended to their customers with confidence.

Through its state of the art facility in Long Eaton, Nottingham, Rise and Recline Ltd demonstrates its commitment to upholding the traditional virtues of British design and craftsmanship. This philosophy runs through every item it produces and is the reason Rise & Recline Ltd continues to set the highest standards in the industry. Employing multi-skilled staff, from the local and surrounding

areas, we pride ourselves in keeping British manufacturing thriving.

Rise & Recline Ltd is proud to hold both the ISO 9001 and 14001 accreditations, for which it works hard to maintain. The whole business works towards this high standard on a continuous basis, improving efficiency, capacity and service. As a business we also hold the approval by Trading Standards to call ourselves a truly “bespoke” company, a classification not many companies hold. Besides belonging to the BHTA, we also belong to the BFM Association (British Furniture Manufacturers) and are members of the UK Centre of Quality Upholstery Manufacture. Our chairs also hold the Medical Devices Class 1 certification.

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PAEDIATRIC PRODUCTS

Designing and implementing manual handling systems to

support disabled children Many children with disabilities and special educational needs (SEN) can benefit from a broad-ranging physical curriculum which covers every aspect of their development. With each unique child comes a varied learner profile, incorporating strengths, needs and short and long-term goals. Catering for a group of children with a complex and diverse range of physical, sensory, learning and medical needs takes strategic planning.

Designing accessible areas for children with disabilities requires careful consideration and should be undertaken in conjunction with an occupational therapist and other healthcare professionals. Whether they are adaptations to existing buildings or new installations, the design and installation of systems to support hoists requires considerable thought. If successful, such a system will enable children with a range of complex needs to move freely around a room or hall with ease. This

James Rhodes, Marketing Manager at Hillrom (Liko), in charge of early mobilisation and falls prevention.

46 AT TODAY

facilitates independence, which can be liberating for children and young adults.

There are a number of factors that should be considered when designing accessible areas within a special or mainstream school or care setting.

SELECTING A MANUAL HANDLING SYSTEM A wide variety of hoisting systems are available and the most effective approach for each setting will depend on the physical environment and the precise functions that need to be carried out. These include: • Free-standing portable tracks to support hoists: These can be easily carried and transferred from room to room via a fixed track. A free-standing system has no structural requirements on the ceiling or walls, making them easy to remove when the lifting system is no longer needed.

• In situ ceiling hoist track: Ceiling hoists and associated tracking are designed for use in multi-purpose environments, from halls to swimming pools or sensory therapy areas. They offer increased flexibility, reduced lifting and patient transfer and increased safety for clients and professionals alike. This type of system can run through doorways

•

CATERING FOR A GROUP OF CHILDREN WITH A COMPLEX AND DIVERSE RANGE OF PHYSICAL, SENSORY, LEARNING AND MEDICAL NEEDS TAKES STRATEGIC PLANNING

into bedrooms, shower and swimming pool areas.

Gateway systems: These can be used through multipurpose environments, by connecting up neighbouring rooms with flexible turntables to navigate tight curves.

This can enable transfer from bedroom to bathroom or bathroom to living room, where no additional transfer is required.

TRAINING AND EQUIPMENT MAINTENANCE The introduction of a safe-patient handling policy, together with compulsory manual handling training, is essential for all staff involved in moving and lifting patients.

Unfortunately, healthcare consistently ranks among the highest occupations for disabling and debilitating back injuries. Poor moving & handling practice can lead to back pain, musculoskeletal disorders and even accidents for those doing the lifting.

PAEDIATRIC PRODUCTS Of course, poor practice can also result in discomfort and a lack of dignity for the person being moved.

Regular assessments can ensure that procedures are carried out in a safe, legal and acceptable manner.

These should be untaken and logged for each hoisting and lifting scenario, whether this is in a living, teaching, therapeutic or recreational area.

It is also important to ensure lifting equipment is properly maintained.

To avoid the possible transmission of infectious diseases, equipment should be cleaned regularly, following the setting’s disinfection policies.

In terms of servicing and ongoing maintenance, many contractors offer ongoing service contracts or the ability to train in-house maintenance personnel, which can often be speedier and more efficient.

MARRYING MANUAL HANDLING AND AN SEN CURRICULUM Chailey Heritage Foundation provides education and care for children and young people with complex neurodisabilities. Most of its young people have cerebral palsy, with associated complex health needs, and many have visual impairment and dual sensory impairments. All the young people are wheelchair users.

The charity uses a mobility and track system with more than 170 overhead hoists across the site. This includes the school, bungalows, the

ABOUT HILLROM (LIKO) Working in partnership with occupational therapists within the UK since 1994, Hillrom (Liko) offers extensive experience in the lifting and transferring of patients with greater safety and care.

Hillrom (Liko) can support with installations in a variety of settings including homecare, schools/colleges, pool locations, rehabilitation/ physiotherapy, hospital ward, intensive care units and room to room options. www.hillrom.co.uk/uk/ Our-Company/About-Us/ brands/liko/

48 AT TODAY

pool and horse-riding facilities, the Life Skills Centre and the Hub. The school has developed its own curriculum based on individual learner’s needs. Physical development is one of the key areas of the curriculum so using the mobility, track and hoisting system to create possibilities for learning is vital; children and young people are able to explore their environment and are more engaged, responsive and independent. Children are encouraged to take part in physical activities to improve their ability to sit, encourage postural and head control, improve limb control and dexterity, and improve coordination and spatial awareness.

A series of hoists within classrooms also encourage and promote socialisation for children.

Freeing physically disabled children from inhibitive equipment allows for increased communication and natural interaction with their peers.

This could be as simple as the ability to touch each other or something more involved such as participation and contact in a variety of verbal and physical games.

“It’s easy to forget the importance of physical contact as part of a child’s natural interaction with another child,” says Helen Springall, SEN teacher at the School. “Free from cumbersome equipment, mobilised children with severe physical disabilities are able to build closer relationships and interact in a way that was previously denied to them.

This mobilisation gives them a freedom and independence to select the games and activities they want to take part in – and pushes boundaries not just in their physical development but opens their minds to new opportunities and aspirations.”

ABOUT CHAILEY HERITAGE FOUNDATION Chailey Heritage Foundation was the first purposebuilt school for children with disabilities in the UK. It has a national reputation for its work around communication and developing independence through powered mobility.

Every year, it supports hundreds of children, young people and their families, by providing a range of world-class services, especially catering for those with a neurological motor impairment, such as cerebral palsy. Its aim is to provide a stimulating and inclusive environment where all young people are given every opportunity to make progress towards fulfilment and develop life skills in preparation for adulthood. www.chf.org.uk

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PAEDIATRIC PRODUCTS

PRODUCT SHOWCASE Helping support disabled children as they grow and their needs change, AT Today has outlined some of the key products that can support children in the bedroom, bathroom and when out and about. Most of the products can evolve with the child as their needs change, making them a cost-effective solution.

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Promoting posture

Aimed at children between 3-16 years old and available in three different sizes, the Leckey Mygo+ is a versatile seating system that offers postural support and promotes function and mobility.

As the product is adjustable, it provides clinicians with the tools to maximise upper limb and head function through pelvic stability, alignment and positioning.

The Mygo+ can support children in a variety of positions so they can enjoy additional functional activities while maintaining the postural benefits. For those who require a mobility base, the Mygo+ can easily interface with a range of bases, including powerchairs, non-powered wheelchairs, strollers and hi low bases for indoor use.

There are also a vast range of optional accessories for the seating system, including a chest pad or harness, pelvic cradle, supportive contoured headrest, grab rails and hip guides. www.leckey.com

A WORLD FIRST The Mascot Mk2 Cot from Theraposture is the world’s first fully modular cot bed system; it is an adjustable solution that can change as the child’s needs change. It presents cost savings and a hassle-free solution for children and their parents.

A safe place for children to sleep, the Mascot Mk2 provides manual handling assistance for those helping children, particularly with its height adjustments to achieve safe working heights.

As the Mascot Mk2 is fully modular, it can be built up to different heights and doors can be added on one side or both sides retrospectively. Optional profiling is available and the whole Mascot rises to maintain the full cot side height, even when fully raised.

The cot’s internal divider system allows for the cot to be shortened in length whilst a child is small and can be removed as the user grows. This also creates a useful storage area. www.theraposture.co.uk

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PAEDIATRIC PRODUCTS

CHANGING NEEDS

BRIDGING THE GAP Developed by Made for Movement, the Hibbot is an individual dynamic walker which allows children with functional movement disorders to walk and participate in everyday life.

Uniquely, the Hibbot stabilises pelvic and trunk instability with just enough support for the individual child. The clever device can also be adjusted as needs change.

According to Made for Movement, it is the first walking aid that aims to

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replicate physiotherapists’ hands-on gait training. Hibbot also helps bridge the gap between therapy intervention and daily stimulation of a child’s walking skills.

With flexible accessories such as the brace system and wheels in different sizes, the Hibbot can be used from a height of 60cm to 125cm and a user weight up to 30kg. www.madeformovement.com

Qimova’s Paediatric Comfort Chair is designed especially for small children, with an effective seat width down to 32cm, seat depth down to 30cm and extra short leg rests and back rest.

Offering disabled children comfort and flexibility, the wheelchair is designed to adjust to the child’s changing needs over time.

The wheelchair provides a vast range of adjustability features, including the wheel base, seat height, centre of gravity, back rest, seat width and length, arm rests and calf supports. The Paediatric Comfort Chair also offers a fully reclining back rest, front or rear wheel drive options, pressure cushion choices and 45-degree tilt-in-space with anterior tilt.

All of the wheelchairs are tailor-made. The manual version of the chair can also easily be upgraded at any time to a fully powered indoor/ outdoor version for greater independence. www.qimova.com

FLEXIBILITY AND FREEDOM The R82 Rabbit Up provides static and mobile standing as well as greater flexibility and freedom for young users.

Its robust design is suitable for use indoors and out, and includes self-propel removable wheels for independent mobility. The wheels have closed push rims and an adjustable camber angle for easier propulsion, enhanced by a narrow frame for better manoeuvrability. When a stationary position is required, the wheels can quickly be removed by a caregiver or parent, so ergonomic access to school desks and play tables is possible.

The Rabbit Up facilitates eye level engagement with other children, promoting greater participation and inclusion. Through its adaptable prone support, children benefit from standing therapy and the ability to enhance motor skills and upper body muscle function.

The device can be configured to suit the individual needs of children aged 1-18 and is available in four sizes. www.r82.co.uk

SAFE BATHING Part of Jiraffe’s Rifton range, the Wave Bathing System is a bath chair that aims to improve bathing and showering for the user and the carer.

Responding to requests from therapists and carers, the chair accommodates for larger users and protects skin integrity through generous padding under a soft knit fabric.

As well as mounting the bath chair on a tub stand or rolling shower stand, there is also the option of a tub transfer base to change the way carers transfer and bathe larger users.

The chair comes in three different sizes.

Offering easy adjustments, the backrest angle can be adjusted with one hand which allows the carer to keep the other hand on the user for safety and reassurance. When the Wave Bathing System is not in use, it can be folded flat and hung on the wall out of the way.

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Kidz to Adultz MIDDLE 2020 Disabled Living has an enviable reputation of organising the very prestigious Kidz to Adultz event since 2001 and now hold five of the largest FREE UK exhibitions totally dedicated to children and young adults up to 25 years with disabilities and additional needs, their parents, carers and all the professionals who support and work with them.

The exhibitions are a one stop shop for the most up to date advice and information on mobility, funding, seating, beds, communication, sensory, and much more.

Visitors can also gain credits by attending one or more of the free CPD accredited seminars, covering a wide range of interests to families and carers of children with disabilities and special needs, and the professionals who work with them.

UPCOMING KIDZ TO ADULTZ EVENTS KIDZ TO ADULTZ MIDDLE Wednesday 4th March 2020 KIDZ TO ADULTZ SOUTH Thursday 7th May 2020 KIDZ TO ADULTZ WALES & WEST Thursday 2nd July 2020 KIDZ TO ADULTZ SCOTLAND Thursday 10th September 2020 KIDZ TO ADULTZ NORTH Thursday 12th November 2020

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2020

Kidz to Adultz Middle FREE event organised by Disabled Living

120+ Exhibitors

Fun & Features

NEW DATE! WEDNESDAY 4th March 2020, 9.30am - 4.30pm Ericsson Exhibition Hall, Ricoh Arena, Coventry, CV6 6AQ

Dedicated to children and young adults with disabilities and additional needs, their parents, carers and the professionals who support them.

CPD Seminars

FREE Parking

Kidz to Adultz is a Trademark registered to Disabled Living. Registered charity no: 224742

www.kidzexhibitions.co.uk

info@disabledliving.co.uk

0161 607 8200

Med-Tech Innovation Expo 1-2 APRIL | NEC, BIRMINGHAM UK Med-Tech Innovation Expo is the UK’s and Ireland’s leading event for medical device design and manufacturing technology. A host of new floor features, great content, discussion panels and amazing exhibits will be the catalyst for the UK MedTech market to come together in April next year.

This free-to-attend event offers a unique platform for visitors to meet with peers, designers, engineers, innovators and manufacturers from the MedTech sector.

A key element at Med-Tech Innovation Expo every year is the wide range of presentations across three stages that highlight the latest developments in MedTech, medical plastics, digital health tech and pharmaceutical manufacturing technologies.

MED-TECH INNOVATION CONFERENCE CURATED BY MEDILINK UK The CPD-certified programme will offer high-level thought leadership 56 AT TODAY

from the sector’s biggest names.

Presentations on this stage will explore regulatory and market access challenges and opportunities as well as future insights from policymakers and influencers.

HEALTHTECH STAGE SPONSORED

BY HESSEN TRADE & INVEST (HTAI) CPD-certified presentations focused on finished medical devices, conception, development, and commercialisation. Expert OEMs will also examine the R&D and clinical trial processes, regulatory hurdles, usability testing and material compliance behind these products.

INTRODUCING STAGE Host to a new feature for 2020....

PITCH @Med-Tech Innovation 2020, a start-up competition for leading earlystage MedTech start-ups. Finalists will give a live, on-stage acceleratorstyle pitching session for the chance to win 12 months of mentoring and investment from NIHR and partners.

MED-TECH CONNECT 1:1 MEETINGS PROGRAMME New for 2020 is a purpose designed, fully managed meetings programme that will enable visitors, exhibiting companies and sponsors to request scheduled meetings in advance and during the event in a dedicated meetings area.

INTERACTIVE CLEANROOM FROM ISO PODS LTD Another great new feature live on the show floor will be an interactive cleanroom. Visitors will be able to enter the cleanroom and experience the simplicity the pre-qualified units have to offer. www.med-techexpo.com

The Largest & Fastest Growing Disability Event in the South

Tues 15th Sept 2020 9am - 4pm

Kent Showground Maidstone, ME14 3JF

XPO

REGISTER 4 FREE - INCREASE YOUR CPD! Housing & Adaptation

Moving & Handling Ability & Advice

Health & Community Care Occupational Therapy Integration rise4disability.com 2020 Show Sponsor:

@rise4disability Working in Partnership with:

Kids Corner

info@rise4disability.com

EVENTS & TRAINING

CPD Courses BLUE STREAM ACADEMY Providing a range of online CPD courses to healthcare professionals, Blue Stream Academy has a variety of options available.

Courses include: Learning Disabilities Awareness, Medical Devices, Moving and Handling,

Carer Awareness, The NHS Health Check and Pressure Ulcer Management.

To find out more about the CPD options, email info@ bluestreamacademy.com, call 01773 822549 or visit the website www.bluestreamacademy.com

CARE QUALITY COMMISSION The Care Quality Commission (CQC) offers a broad range of CPD-certified courses for healthcare professionals to help them achieve excellence in care.

CPD courses available from the CQC include: Dementia Champion, Dignity in Care, Managing Challenging Behaviour, Moving & Handling Awareness and Pressure Area Care.

To find out more about its range of courses, contact 03333 441 066, enquiries@ cqc-uk.com or visit www.carequalityconsulting.com

DOCKLANDS TRAINING CONSULTANTS Docklands Training Consultants specialises in providing training and consultancy for those involved in health and social care.

The range of CPD workshops it has available include: Introduction to Manual Handling, Manual Handling for Therapists and

Moving & Handling Key Trainer Course.

For further information, visit the website www.docklandstraining. com or contact info@ docklandstraining.com or 01776 810873 / 07768 631851

ETD TRAINING ETD Training has a range of online CPD-certified courses for healthcare professionals, which aim to be a cost-effective solution for those wanting an engaging experience.

Course subjects include: Basic First Aid Course, Falls Training, Manual Handling Training and The Management of the Bariatric Patient.

To find out more about these courses, contact 01588 641 915, info@etdtraining. com or visit www.etdtraining.com

ME LEARNING

HANDICARE Designers of solutions that increase the independence of elderly and disabled people, Handicare has a range of CPD courses available for healthcare professionals.

The courses on offer are: Application, Assessment, & Use Of Hoisting/Lifting Slings, Single

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Carer Management, Handling heavier clients, Sit To Stand, and In Bed Management.

To find out more about Handicare’s CPD workshops, visit www.handicare.co.uk, email enquiries@handicare.co.uk or call 01384 408700

Me Learning offers online social care training courses to councils, schools, health and care homes.

The range of CPD courses it has available include: Manual Handling Introduction, The Care Act: Care and Support Planning, Making Every Contact Count: Loneliness and Isolation, NHS Continuing Healthcare, Dementia Awareness, and Parkinson’s Disease Awareness.

For further information about the range of CPD courses Me Learning offers, call 01273 499 100, email enquiries@melearning.co.uk or visit the website www.shop. melearning.co.uk

KINGKRAFT Kingkraft has three free CPD seminars available for OTs and specifiers.

The company has a team of healthcare professionals and nationwide coverage, and provides help and guidance to its clients in making major decisions about room design, layout and specification.

Kingkraft has the following CPD courses available: Designing & Planning Changing Places Bathrooms, Designing Sensory Bathrooms for People of Varying Ability, and Designing Bathrooms for People of Varying Ability.

Courses normally run at the client’s premises and interested individuals can send across their preferred dates to Kingkraft to arrange a time for the CPD seminar.

To book onto any of the three courses, email info@ kingkraft.co.uk and with the reference ‘CPDAT’ to get premium cakes at the seminar.

SKILLS FOR CARE Skills for Care has three CPD modules available, with each course lasting for one day.

The CPD modules are: Understanding Performance Management, Understanding Selfmanagement Skills and Understanding Workplace Culture.

They cover the essential skills that managers need to

MY LEARNING CLOUD

OPLEX CAREERS Oplex Careers provides a wide range of CPD courses for those who want to gain new skills, recognised certificates and update their knowledge.

Course subjects include: Special Education Needs (SEN), Autism Awareness, Physiotherapy, British Sign Language, Dementia Care

lead and develop busy, high-quality services focusing on the importance of self-management, developing a positive workplace culture and performance management.

To find out more about the courses and to find a Skills for Care endorsed provider to book onto the CPD modules, visit www. skillsforcare.org.uk

and Awareness Course and Safe Moving and Handling Training.

For further information about the CPD courses, email info@ oplexcareers.com, call 0203 282 7296 or visit the website www. oplexcareers.com

My Learning Cloud offers a vast range of online CPD courses for healthcare professionals, aiming to provide a cost-effective solution that can be accessed at anytime from anywhere.

With over 80 courses available, topics include Manual Handling, The Care Certificate, Health and Safety Awareness, Dementia Awareness, Disability Awareness and Autism Awareness.

To find out more about the CPD courses, call 0800 088 6109, email enquiries@mylearningcloud.org.uk or visit the website www.mylearningcloud.org.uk

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NAIDEX 46

Aspiring for a better future of independent living With 20 percent of the UK’s population being disabled, it’s time for disability to be in the spotlight - Welcome to Naidex 46!

Europe’s most established event dedicated to the disability and independent living industries is back for its 46th anniversary on the 17th & 18th March 2020 at Birmingham’s NEC. Always looking to bring you the latest solutions that allow disabled people to live more independently, this year’s show will put its focus on the key topics taking the industry by storm - from inclusion and accessibility to mobility and employability, Naidex 46 has you covered.

You’ll be able to shop from 400 world-class suppliers and try before you buy, but Naidex has always been much more than a marketplace where visitors can find the latest innovations - it is a place where people come together and learn about the industry’s future.

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As the epicentre of the disability and healthcare world, Naidex 46 will also boast an unparalleled speaker line-up, providing you with 300 inspirational seminars. Throughout both days, seminar theatres will be brimming with information and advice, leaving audiences uplifted and empowered.

What’s more, you’ll be able to immerse yourself in countless interactive features, test the very latest mobility products on the Mobility Test Track and get involved in the Live Sports Arena to discover your next passion.

With all this lined up, Naidex will once again become the hub of the disability world, offering all the innovations that are empowering people with a disability.

Register for your FREE ticket at www.naidex.co.uk

17 & 18 MARCH 2020

NEC

FOLLOW THE SHOW!

BIRMINGHAM

@NaidexShow #Naidex46

ASPIRING FOR A BETTER FUTURE OF INDEPENDENT LIVING

400

WORLD-CLASS SUPPLIERS

300

INSPIRATIONAL SEMINARS

MOBILITY TEST TRACK

LIVE SPORTS ARENA

AND MUCH MORE!

REGIS T FREE ER FOR T NAIDE ICKETS X.CO.U K

RUNNING ALONGSIDE:

FOR CONNECTED & ASSISTED LIVING

EVENTS & CPD COURSES

Events calendar JANUARY 22, 2020 Midlands – OTAC www.otac.org.uk or 02921 900402 JANUARY 27-30, 2020 Arab Health – Dubai World Trade Centre www.arabhealthonline.com FEBRUARY 5, 2020 Llanelli, Wales – OTAC www.otac.org.uk or 02921 900402 MARCH 3-5, 2020 Medtrade Spring – Mandalay Bay Convention Centre, Las Vegas www.medtrade.com MARCH 4, 2020 Kidz to Adultz Middle – Coventry www.kidzexhibitions.co.uk MARCH 17-18, 2020 Dementia, Care & Nursing Home Expo – NEC, Birmingham www.carehomeexpo.co.uk MARCH 17-18, 2020 Naidex – NEC, Birmingham www.naidex.co.uk

WWW.TRIRIDE.UK

APRIL 1-2, 2020 Med-Tech Innovation Expo 2020 – NEC, Birmingham www.med-techexpo.com

JULY 2, 2020 Kidz to Adultz Wales & West – Bristol www.kidzexhibitions.co.uk

APRIL 22, 2020 Leeds – OTAC www.otac.org.uk or 02921 900402

JULY 2, 2020 Reading – OTAC www.otac.org.uk or 02921 900402

MAY 7, 2020 Kidz to Adultz South – Farnborough International Centre www.kidzexhibitions.co.uk

JULY 12, 2020 Disability Awareness Day 2020 – Walton Hall and Gardens in Warrington www.disabilityawarenessday.org.uk

MAY 13, 2020 Exeter – OTAC www.otac.org.uk or 02921 900402 JUNE 5-6, 2020 The Alzheimer’s Show – London Olympia www.alzheimersshow.co.uk JUNE 17, 2020 Cambridge – OTAC www.otac.org.uk or 02921 900402 JUNE 24-25, 2020 Health+Care – ExCel London www.healthpluscare.co.uk

SEPTEMBER 9, 2020 Southampton – OTAC www.otac.org.uk or 02921 900402 SEPTEMBER 15, 2020 Rise 4 Disability Expo 2020 Kent Event Centre, Maidstone www.rise4disability. com or 01268 206111

2020 SEPTEMBER 23-26, 2020 REHACARE – Dussledorf, Germany. www.rehacare.com OCTOBER 21, 2020 Newcastle – OTAC www.otac.org.uk or 02921 900402 NOVEMBER 2-4, 2020 Posture & Mobility Group Conference – Telford International Centre, Shropshire www.pmguk.co.uk NOVEMBER 4, 2020 Kent – OTAC www.otac.org.uk or 02921 900402 DECEMBER 9, 2020 Chester – OTAC www.otac.org.uk or 02921 900402

SEPTEMBER 15-16, 2020 Dementia, Care & Nursing Home Expo – ExCel London www.carehomeexpo.co.uk

THE BEST TECHNOLOGY FOR YOUR FREEDOM

VIP 2

The new VIP 2 is the updated version of the VIP series of folding tilt in space wheelchairs, building on many years of experience of design and development.

As well as 35 degree tilt it now has either fixed or adjustable recline.

CR

D

TES T E SH

A

A

D

CR

It also now comes with an improved headrest design and a deeper seat.

TES T E SH

a 35° Tilt-in-Space

a 30° Anti-Sliding Recline

a Foldable and Durable

Tilt-in-space system further enables attendant to tilt the chair up to 35 degrees, allowing user to change to the most comfortable position helping to reduce the potential of developing pressure ulcers.

Sliding has always been one of the greatest concerns for people in a standard reclining chair. The VIP2 solves this problem by locating the reclining pivot point of the chair close to the human hip joint, which synchronizes the motion of the body and the chair.

The VIP 2 is light and folds fitting easily into a car boot.

The lateral push-bar strengthens the durability of this foldable chair and makes it easier to push the chair.

T: 0845 630 3436 E: INFO@KARMAMOBILITY.CO.UK WWW.KARMAMOBILITY.CO.UK

KARMA MOBILITY LTD UNIT 6 TARGET PARK, REDDITCH WORCESTERSHIRE B98 8YN

T US R A RES ND O O FI NE ST LI ITY ON BIL O M

High performance ferrules for everyday adventures Flexyfoot – an ergonomically designed range of award winning walking aids with a flexible and shock-absorbing foot that securely grips almost any surface range of easy-to-fit ferrules, folding and telescopic • Complete sticks, crutches, hiking poles and accessories

• 50% more grip than standard ferrules • Help reduce trips and falls • Help reduce referred pain • ISO tested for grip and endurance • User tested for comfort Visit flexyfoot.com for more information

Confidence Security Style