Integrated Community Equipment Service Provision of Equipment into Community Day Care, Registered s Non-Nursing Care and Registered s Nursing Care for Adults and Older People July 2011 Nottingham & Nottinghamshire Integrated Equipment Service (ICES)
Provision of Equipment into Community Day Care, Registered s Non- Nursing Care and Registered s Nursing Care CONTENTS Page Number Introduction 2 Policy 2 Legislation 3 Advice and Guidance 4 Procedure 4 Abbreviations 7 Contact Numbers 7 Equipment Tables 8 1. INTRODUCTION 1.1 This policy covers eligibility for Health and Social Care equipment for residents in registered care homes and community day care services, in line with the National Minimum Standards for Registered s and defines: The requirements on s to provide standard equipment in line with the National Minimum Standards which can be viewed on line at: http://www.dh.gov.uk/en/publicationsandstatistics/legislation/actsandbills/dh_4001911 The statutory requirements of Primary Care Trusts who have responsibilities to provide certain equipment for people assessed as eligible for NHS Continuing Health Care in line with the National Framework for NHS Continuing Health Care and NHS Funded Nursing Care. (revised 2009) Bespoke equipment to be provided by ICES to their service users with an assessed need. 1.2 The Nottinghamshire ICES Partnership provides equipment to eligible people resident within the Nottinghamshire county boundaries. (Note: this is making a distinction between local authority boundaries which work to resident population as compared to PCT s which normally work to GP registered populations) 2. POLICY 2.1 An Integrated Community Equipment Service has been established through a Partnership Agreement between the Local Authorities, Nottingham City Council, Nottinghamshire County Council, and the three Primary Care Trusts within Nottinghamshire, Nottingham City, Bassetlaw and Nottinghamshire County. For the purpose of this document, PCT translates into any Health successor bodies. 2.2 A pooled equipment arrangement means that all the funding for the community equipment service from the two local authorities and the three Primary Care Trusts in Nottinghamshire goes into a common purse. This is managed by - 2 -
Nottinghamshire County Council on behalf of all the agencies and applies to all equipment. 2.3 Equipment will only be supplied following an assessment by Health and / or Social Care workers in accordance with each agency's eligibility criteria, as determined by the respective authorities and outlined in the Nottinghamshire ICES Eligibility Criteria. 2.4 It is recognised that in complex situations where a range of equipment may be required, it may be necessary to complete a joint assessment between Health & Social Care Professionals to identify provision. 2.5 Only equipment required to meet an essential need as defined by the eligibility criteria of each authority will be supplied. If the standard catalogue equipment on general distribution does not meet the service users assessed needs, the assessor will follow agreed procedures to identify suitable non standard alternative. 2.6 Equipment will be delivered and fitted by the service provider agreed within the Contract. All equipment is bar coded for audit purposes and regularly serviced and maintained by the Service Provider. 2.7 All equipment is allocated on a loan basis. When it is no longer required by the named service user it must be returned to the Service Provider. British Red Cross - is the provider of the equipment service in Nottinghamshire known as ICES Nottingham City and Nottinghamshire (Integrated Community Equipment Service). Phone no. 0845 127 2911 and Fax no. 0845 127 2912 For the purposes of this document the Service Provider is BRC British Red Cross 3. LEGISLATION 3.1 The relevant legislation can be found within outcome 11 on: http://www.cqc.org.uk/_db/_documents/essential_standards_of_quality_and_safety_march_20 10_FINAL.pdf 3.2 The regulations ensure that service users have access to the adaptations and equipment they need and place responsibility for providing these services onto care homes. This expectation complies with not only their statement of purpose but also with the contract they have with the statutory agencies. Under this contract providers are required to meet the needs of their residents. This should include an assessment by the manager prior to placement and the need for equipment should be part of this assessment. 3.3 s should have sufficient adaptive equipment to meet a range of mobility needs. This should include items such as hoists, slings, parker baths, bath hoists, handrails etc. - 3 -
3.4 Moving and Handling advice, training and the provision of equipment is strictly not within the remit of the statutory agencies as this is expected to be provided by the. 4. ADVICE AND GUIDANCE 4.1 Care homes may decide to seek advice from suitably qualified professionals and the Care Quality Commission about registration or about undertaking further assessments with individual residents, but it is the responsibility of the care home to arrange and pay (if required) for both the advice and any equipment needed. Disabled Living Centres may offer assistance to residents and registered patients of Nottingham City. 4.2 The Statutory Agencies may provide bespoke equipment in order to respond to exceptional assessed needs. Bespoke equipment, is equipment which is specifically tailored to meet an individuals assessed need. E.g. exceptionally tall or exceptionally obese individuals to support a Health/Social Care plan. 4.3 The PCT s are responsible for providing both bespoke and specialist equipment for people eligible for NHS Continuing Healthcare. 5. EQUIPMENT PROVISION IN DAY AND REGISTERED HOME SETTINGS 5.1 Day care units and Registered s are expected to provide service users with all the equipment in accordance with the minimum standard for Registered s required: a) To meet the needs associated with the registration category of their home, and b) To meet the Health and Safety obligations for their staff. 5.2 Day services manager/owner /registered person should ensure that service users bring with them any specialist equipment essential to meet their needs during their time at day services, provided that contamination protocols can be met. Assessing staff will include in their assessment the need for specialist equipment and liaise with the day service manager/owner / registered person or health care worker as appropriate. In the case of slings, staff will need to consider compatibility with hoisting equipment available. 5.3 Prior to residential care (planned respite or long-term) the key worker will include in their assessment the need for bespoke equipment only and liaise with the home as appropriate. Equipment (with the exception of bespoke equipment) must not be transferred between locations due to the risk of contamination. Seven days notice is required for ordering equipment with delivery and collection dates. 5.4 For equipment requirements in the case of unplanned/ emergency respite, contact the Notts ICES Partnership Manager or your respective ICES Clinical Lead. 5.5 Registered s are expected to provide equipment fit for purpose in line with the National minimum standards for a registered care home, to meet - 4 -
individual needs identified by the care plan. Homes also have obligations to their workforce in respect of health and safety. 5.6 Equipment supplied by ICES for an identified specific need and in line with the guidance developed and set out in this document, must be returned following the death or discharge of the Service User within the specified timescale; a hire charge or full replacement cost will be administered for failure to comply. 5.7 PCT s are responsible for providing specialist medical and nursing equipment e.g. specialist feeding equipment for residents in s. This relates to the individuals assessed clinical need and is prescribed by the identified NHS professional and recorded in the care plan. 5.8 The tables included in this document indicates where ICES is responsible for providing equipment. 5.9 All equipment issued to an individual service user will be bar coded by ICES and must be signed for on delivery. The paperwork is to be retained on the service users file as proof of receipt. This information will be required when the equipment is collected. All equipment provided should be listed in the service user s care plan and copy given to the service user or their representative. 6. PROVISION AND RETURN OF EQUIPMENT 6.1 Equipment provided by the PCT s or ICES will be for a named individual on a loan basis from the Integrated Community Equipment Service (ICES) 6.2 Where equipment is loaned by a community equipment service, it will be for the exclusive use of the person for whom it is prescribed. If other end users and staff use the equipment provided for a specific individual and an incident occurs, the equipment service should not be held liable. 6.3 Equipment MUST NOT be directly moved to another service user 6.4 To reduce the risk of contamination homes must follow the latest infection control guidance issued by the Department of Health. 6.5 Hoisting and Electrical equipment on loan will be serviced by the agency providing the equipment, e.g. ICES equipment the Equipment Service Provider or Wheelchairs Wheelchair Loan Service. The is responsible for servicing their own equipment. 6.6 The Equipment Service Provider must be informed of any service users change in circumstances, e.g. change of address or death. The equipment must be returned in a fit for use condition when the person no longer requires it. 6.7 If returned equipment is not in a fit for use condition ICES will charge the Care Home for the full repair or replacement costs. 6.8 All equipment collection requests should be made direct to the Equipment Service Provider Tel: 0845 127 2911 Fax: 0845 127 2912-5 -
6.9 The Equipment Service Provider will complete regular reviews to ensure equipment is returned to the Service Provider. s will be charged the full replacement cost for equipment not returned. 7. BESPOKE SLING PROVISION 7.1 Where bespoke slings have been provided by ICES, it is expected that a minimum of 2 bespoke slings per service user will be provided to allow for laundering. The responsibility for provision of the hoisting equipment and slings is included in the following equipment table. 7.2 Bespoke slings should not be used for anyone other than the person they have been assessed/provided for, for reasons of possible cross infection. 8. MOVING FROM THE COMMUNITY TO A HOME OR TRANSFERRING TO A HOME IN ANOTHER AUTHORITY 8.1 ICES Funded Equipment 8.1.1 When a person is admitted to a long term care placement, all Standard equipment prescribed to a service user in their own home, from the ICES loans service must be returned to ICES. 8.1.2 When transferring from a care home within the Nottinghamshire partnership area to a care home in another area, again, standard equipment provided to the service user must be returned. The key worker will liaise with the new area to arrange for equipment provision from the relevant equipment service. 8.1.3 For bespoke equipment ordered through the ICES service, arrangements will need to be made for the equipment to be transferred with the service user and the new authority invoiced for the current value of the equipment. The new authority will then become responsible for the ongoing service and maintenance. The key worker must agree with the new authority that a transfer can be completed, but the ICES Partnership Manager is responsible for negotiating a suitable transfer price. Infection control procedures must be followed to support all transfers. 8.2 PCT / Continuing Care Funded Equipment 8.2.1 Where a person in receipt of NHS Continuing Health Care moves to a PCT outside of the Nottinghamshire Partnership area, all ICES standard community equipment should be returned to the ICES service that provided the equipment. Unless alternative arrangements have been made and agreed by the two PCT s involved. Bespoke equipment may be transferred with the person to their new placement. 8.2.2 Bespoke equipment that is tailored to the individual, including wheel chair special seating, orthoses (callipers, splints etc), artificial limbs, environmental controls and computer aided communication aids will be retained by the service user. The responsibility for maintenance will be transferred to the new authority of residence. - 6 -
Abbreviations DLC - Disability Living Centre DN - District Nurse GP - General Practitioner FACS - Fair Access to Care Service ICES - Integrated Community Equipment Service NHS - National Health Services BRC - British Red Cross OT - Occupational Therapy services in the community PCT - Primary Care Trust Physio - Physiotherapy services in the community TVN - Tissue Viability Nurse Contact Numbers British Red Cross Phone 0845 127 2911 Fax 0845 127 2912 ICES Partnership Manager Phone 0115 854 6206 Fax 0115 854 6209-7 -
Equipment provided by a Registered for Nursing and Residential Care: Please refer to www.cqc.org.uk for all policies and legislation on provision Equipment (/ICES (/ICES Bathing Bath / Shower seats, boards & steps, shower chairs and bath lifts Bespoke bathing ie;moulded shower chairs RESIDENTIAL RESIDENTIAL / OT / OT / OT ICES /Continuing Care - based on assessed clinical need for bespoke provision / OT ICES /Continuing Care - based on assessed clinical need for bespoke provision Beds Standard bed min. 900mm wide Height adjustable beds Profiling Beds District Nurse / OT ICES - based on assessed clinical need for client benefit and to aid nursing care for short term use only 8
Equipment (/ICES (/ICES RESIDENTIAL RESIDENTIAL OT ICES /Continuing Care - based on assessed clinical need for client benefit and to aid nursing care care Beds cont. Bespoke Beds OT ICES /Continuing Care - based on assessed clinical need for client benefit and to aid nursing Bed Accessories Bed Rails, Bumpers, Bed Wedges Bed extensions, mattress elevators Bed Levers, Lifting Poles etc / OT / DN /ICESbased on assessed clinical need for client benefit and to aid nursing care OT / DN /ICES- if part of ICES bed package Communication Aids Loop Systems Continence Incontinence Pads PCT NHS provision following assessed clinical need DN PCT NHS provision following assessed clinical need 9
Equipment (/ICES (/ICES Daily Living Aids Adapted utensils/ kitchen and household aids e.g. Dining Trolley, Perching Stool, Dressing Aids (Approach OTs for advice if specialist equipment required) RESIDENTIAL (Approach OTs for advice if specialist equipment required) RESIDENTIAL Minor Adaptations Grab Rails, stair rails, ramps,steps, threshold strips, furniture raises, etc. (Approach OTs for advice if specialist equipment required) (Approach OTs for advice if specialist equipment required) Intravenous Equipment and Symptom Control Syringe Drivers, needles and Giving Sets (for individually assessed packages of care) PCT s / End of Life Team or via District Nursing (Syringe drivers only held by ICES for City) DN / End of Life Team PCT s / End of Life Team or via District Nursing (Syringe drivers only held by ICES for City) Mattresses 1. Standard and Cushions Standard Foam Mattress Pressure Relieving Foam Mattress or cushions (e.g. Soft Form, repose cushions and boots, basix visco) OT /DN / OT /DN ICES 10
Equipment (/ICES (/ICES 2. High Risk foam/gel cushions Mattress Overlays High specification cushions on ICES contract Cubed Foam, e.g. Propad TVN (unless patient is transferred with grade 3 or 4 pressure sore, then a mattress will be loaned from ICES for a 4 week period) RESIDENTIAL TVN RESIDENTIAL ICES / DN DN / OT ICES based on risk clinical need Static Air e.g. Repose / DN DN / OT ICES based on risk clinical need Alternating Air Overlay Mattress e.g. Alpha X Cell (TVN or DN where appropriate) DN / TVN /OT ICES based on risk clinical need Mattress Replacement Systems Alternating Mattress Replacement or Low Air Loss Mattress replacement TVN (unless patient is transferred with grade 3 or 4 pressure sore, then a mattress will be loaned from ICES for a 4 week period) TVN ICES - based on risk clinical need 11
Equipment (/ICES (/ICES Specialist Mattresses and cushions Other pressure relieving equipment Mobility Aids Specialist mattresses, air cushions or very high risk cushions, not held on the ICES contract. Delta Frames, Walking frames, Walking sticks and Crutches TVN Physiotherapists / OT GP sticks only ICES PCT to fund through Continuing Care based on risk clinical need where stage 3 or 4 pressure sores are inherited by the home or prevention is deemed necessary ICES based on risk clinical need for named individuals only RESIDENTIAL TVN Physiotherapists / OT GP sticks only RESIDENTIAL ICES PCT to fund through Continuing Care based on risk clinical need where stage 3 or 4 pressure sores are inherited by the home or prevention is deemed necessary ICES based on risk clinical need for named individuals only Moving & Handling aids Hoists & slings / OT for specialist advice / OT for specialist advice Bespoke slings OT ICES/Continuing Care based on assessed clinical need Standing Hoists / OT for specialist advice OT / OT for specialist advice ICES/Continuing Care based on assessed clinical need 12
Equipment (/ICES (/ICES Rotunda Standing aid turning platform / OT / Physio for specialist advice Transfer board / OT / Physio for specialist advice Slide Sheets / OT - for specialist advice RESIDENTIAL / OT / Physio for specialist advice / OT / Physio for specialist advice / OT / DN - for specialist advice RESIDENTIAL Ramps & passenger lifts Ramps & passenger lifts Respiratory & Consumables Nebulisers Respiratory Services Specialist Practitioners/ GP s to have at least 1 In exceptional circumstances additional Nebulisers may be borrowed from the PCT (via PCT Respiratory Services) Respiratory Services Specialist Practitioners/ GP s to have at least 1 In exceptional circumstances additional Nebulisers may be borrowed from the PCT (via PCT Respiratory Services) Consumables for Nebulisers GP prescription Consumables are available on prescription GP prescription Consumables are available on prescription 13
Equipment (/ICES (/ICES Respiratory & Consumables - continued Tracheostomy tubes, consumables and suction machine consumables Suction Machine ENT / Specialist Nurse Specialist Practitioners PCT / Continuing Care ICES/Continuing Care based on assessed clinical need. RESIDENTIAL ENT / Specialist Nurse / DN Specialist Practitioners RESIDENTIAL PCT / Continuing Care ICES / Continuing Care based on assessed clinical need. Seating Standard Seating (Chairs) Suitable / Adequate Ie; High back, riser recliners *Specialist Seating eg. Hydrotilt / Riser Recliner tilt in space, Hydro Thoracic Support, pressure care, etc / OT / Physio TVN (Specialist assessment only) OT/ Physio TVN (Specialist assessment only) / Private Funding OR ICES / Continuing Care - based on risk identified essential clinical need. * Authorisation by OT Team Manager is required. 14
Equipment (/ICES (/ICES Toileting Aids Raised Toilet Seats, Toilet Frames, urinals, commodes and Mowbray s RESIDENTIAL RESIDENTIAL Wheelchairs General transfer Short term loan for an individual (max 12 weeks) NORTH NOTTS ONLY OT / GP ICES for trauma/ orthopaedic need to facilitate hospital discharge NORTH NOTTS ONLY OT / DN / GP ICES for trauma/ orthopaedic need to facilitate hospital discharge NORTH NOTTS ONLY Long Term/ Permanent Individual service User GP / OT / Physio NHS Long Term Wheelchair Service GP / OT / Physio NHS Long Term Wheelchair Service 15