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Independent moving and handling assessments

Better movement.Better care.Better living.

The right support, the right skills, the right outcome. Independent moving and handling physiotherapy, clinical assessment and workforce support for individuals, homecare agencies, care homes and Local Authorities.

  • HCPC-registered physiotherapists & occupational therapists
  • Minimum 10 years’ clinical experience per clinician
  • Enhanced DBS · adult workforce
  • Medical malpractice & public liability insured
  • Aligned to the LGA High Impact Change Model for Optimal Handed Care (Dec 2025)
  • HSE TILE(O) · MHOR 1992 · LOLER 1998 · Care Act 2014 · MCA 2005
  • Not an emergency service
Clinical reasoning in motion

We observe function before we decide support.

Every recommendation starts with what the person can actually do, observed in the real task, not inferred from a diagnosis.

01

Observe

Ability, consent, pain, confidence and what matters to the person, seen, not assumed.

02

Analyse

The demands of each task: sit-to-stand, transfers, bed mobility, walking, and where the risk actually sits.

03

Decide

The least restrictive safe method, the equipment that solves the problem, and the number of carers it genuinely needs.

04

Enable

Trial it in the real environment, teach the technique, fit the equipment and write the plan the team will follow.

05

Review

A review date and the triggers: a fall, new pain, a change in cognition, that bring the plan back for reassessment.

The assessment model

Five factors decide a safe transfer: not the equipment catalogue.

Change one factor and the safe option changes. Select each to see what we assess.

Person

1 / 5

    The frame we work within

    This is the HSE TILE(O) risk-assessment logic applied to people rather than loads (Manual Handling Operations Regulations 1992). Hoists and slings are lifting equipment under LOLER 1998. Support must be proportionate and promote independence (Care Act 2014), with consent and capacity considered under the Mental Capacity Act 2005. We work alongside the Local Authority’s own assessment, we do not replace it.

    Optimal Handed Care

    The least restrictive safe support, delivered with dignity and confidence.

    Where a person can safely achieve more independence, we help make that possible. Where more support is required, we say so and set it up properly. Four things must be true before any package changes.

    • Function, task, equipment, environment and staffing assessed together, with the person’s consent
    • The one-carer method trialled in the real setting and the equipment fitted and compatible
    • Staff shown competent, with a contingency and an escalation route if anything changes
    • A review date and triggers agreed with the person, family and provider
    Where one carer is safe and sustainableWe document exactly how, with what, and when to review, so the decision can be defended.
    Where two carers remain necessaryWe say so, with the clinical reasoning, over-provision and under-provision are both failures of assessment.
    Where function can improveRehabilitation is written into the plan, so support follows the person’s ability, in some cases all the way to walking with a frame and no hands-on care.
    Services

    Start with the right assessment.

    Pick the closest service; triage confirms the pathway. Every assessment ends in a written plan carers can follow.

    01 Transfers, mobility and the handling plan

    Moving & Handling Assessment

    Assessment of transfers, mobility, positioning, manual handling risks and care requirements.

    02 Is two-carer support still needed?

    Optimal Handed Care Review

    Optimal Handed Care review of an existing two-carer package or a proposed one-carer pathway, trialled, with contingency and review triggers.

    03 Restore function around the person's goals

    Rehabilitation & Reablement

    Restore function and independence where possible, around goals that matter to the person.

    04 The right device for the actual transfer

    Equipment & Transfer Assessment

    Identify the equipment that solves the actual transfer problem, person, task and environment together.

    05 Evidence for the specialist wheelchair service

    Wheelchair Referral Support

    Functional, transfer, posture and environmental evidence to support referral to the specialist wheelchair service. Not a direct wheelchair assessment.

    06 Entrapment, compatibility, alternatives

    Bed Rail & Bed-System Risk Assessment

    The relationship between the person, bed, rails, mattress, accessories and environment.

    07 Half-day, on-site, observed sign-off

    Optimal Handed Care Training & Competency

    Half-day, on-site, case-led session for up to six staff, with observed competency sign-off records. Full-day sessions and larger groups quoted.

    08 Scoped across a whole service

    Care Home & Provider Programmes

    On-site assessment, review, training and optimisation across a service, scoped to your caseload.

    One assisted transfer, bed to chair

    One transfer, start to finish.

    Consent & participationThe person agrees the route and does what they can, sitting forward, holding on, guiding the sling.
    01Consent
    02Equipment
    03Environment
    04Staff
    05Landing
    Moving & handling plans

    From assessment to action.

    Every assessment ends in a written plan a carer can follow and a reviewer can check. This is what it contains.

    Assessment findings

    What was observed, in which tasks, on which date, and the person’s own goals.

    Clinical reasoning

    Why this option, why not the alternatives, and what would change the decision.

    Risk assessment

    Risks to the person and to staff (TILE(O)), with the controls that make the task acceptable.

    Equipment

    Exact device, size, settings, compatibility and service/LOLER status.

    Technique

    Step-by-step method, what the person does, cues and stop points.

    Staffing & escalation

    Number of carers, positions, competencies, and who to call when something changes.

    Review

    A review date, plus the triggers that bring the plan back sooner: any change in ability, weight bearing, pain or cognition.

    Real plans are individual and are shared only through agreed, secure routes.

    Optimised Handling · for clinicians and care managers

    The handling plan, built and shared in minutes.

    Fifty-four verified plans with animated scenes. Tick what the person needs, edit it for them, save, and send the care team a plan code. Carers read it on any phone and confirm they have understood it.

    • Standing, walking aids, hoists, slings, bed, bathroom, wheelchair, car and floor recovery
    • Every step, cue and stop point editable for the person; version and review date on every page
    • Plan codes for care agencies, with a log of who opened and acknowledged the plan
    • Two-week free trial for every clinician; team and enterprise plans for services
    For Local Authorities & commissioners

    Better assessment. Better decisions. Better use of care.

    Independent OT and physiotherapy capacity for Optimal Handed Care reviews, alongside your own teams, under your governance, with the reasoning written down.

    The evidencePublished national and local-authority data · not Thrive outcomes
    +139%

    rise in waiting lists for occupational therapy services in England since 2019.

    LGACase for change (Dec 2025), citing Ames 2024
    50%

    of referrals in Kirklees assessed as Optimal Handed Care, ~56,500 care hours a year released for people who needed them (2017–24).

    LGACase study: Kirklees Council
    52%

    of 651 patients reviewed in Southampton’s OHC pilots had their care needs reduced, releasing 3,039 bed days.

    LGACase study: University Hospital Southampton
    ~9 hrs

    average staff time per double-handed package review. Capacity, not intent, holds waiting lists in place.

    Peer-reviewedWhitehead et al. 2022, Health & Social Care in the Community

    What you commission

    • Assessment capacity for waiting lists and double-handed package reviews, by the case or as a defined cohort (25 / 50 / 100).
    • A written report per case: findings, TILE(O) risk assessment, clinical reasoning, equipment specification, staffing recommendation and review triggers, in a format your reviewing officers can act on.
    • Provider follow-through: technique and equipment trialled with the care provider; competency sign-off; contingency and escalation agreed.
    • Reablement follow-up where function can improve, so the package follows the person, not the other way round.

    How we fit your system

    • We inform your Care Act 2014 decision; we do not replace your statutory assessment or your OT service.
    • Aligned to the LGA High Impact Change Model for Optimal Handed Care (Dec 2025, RCOT-endorsed), changes E, F, G and H: proportionate discharge language, consistent transfer into the community, carer training, and safety at home.
    • Clear escalation: if a person’s presentation changes, the plan comes back for reassessment, and you are told.
    • Governance you can check: clinical assurance, information governance, safeguarding, complaints.
    • Indicative capacity: up to 10 new cases a week, 40 a month, agreed per contract, never assumed.
    Commissioning pathway

    Start small, measure honestly, scale on evidence.

    1. Week 001

      Discovery call

      30 minutes, no charge. Your area, your waiting list, the cohort you want to start with and the measures you will judge it by.

    2. Weeks 1–1002

      Pilot cohort

      25 cases, scoped in writing. Each case: assessment, TILE(O) risk assessment, clinical reasoning, equipment specification, staffing per task, provider sign-off, review triggers.

    3. Week 1203

      Evaluation

      Against the measures agreed at the start: care hours released, unchanged or increased support (reported with the same rigour), implementation rate, safety events, the person’s experience.

    4. From week 1304

      Scale or retain

      A 50 / 100-case cohort, a rolling caseload at agreed weekly capacity, or a retained partnership with priority response, plan audits and training days.

    SpotBy the case

    Referral to report in an agreed timescale. No commitment.

    Cohort25 / 50 / 100 cases

    Inclusion criteria, monthly reporting and an evaluation built in. The usual starting point for a council.

    RetainedMonthly partnership

    Agreed weekly capacity, priority response for red cases, plan audits, competency training days and a named clinical lead.

    Programmes are scoped per contract and confirmed in writing before mobilisation. Clinical recommendations are never driven by a required saving.

    Figures are published national and local-authority evidence, not Thrive outcomes. Every case is assessed individually; where two carers remain necessary, that is documented with the same rigour.

    For homecare agencies & care homes

    Make every transfer safer.

    Inspectors compare the written plan with what they see on the floor. Six things we check in the room. Select a point, or let it play.

    1

    What you receive
    01

    Competency sign-off records

    For the staff who deliver it, with the triggers for refresher input: an incident or near miss, new equipment, or a change in the person’s plan.

    02

    A fast route back

    When a resident’s presentation changes, so two carers are not left in place by default.

    Book an assessment

    Book the first visit. Triage does the rest.

    Choose a priority, choose a service, pick a time. Not sure which service? Book a Moving & Handling Assessment, triage confirms the pathway.

    Thrive Clinical TeamOn-site or remote consultationSecure online booking
    Contracts & commissioning

    Have a caseload, waiting list or care pathway to discuss?

    Talk to Thrive Better Living about assessment capacity, provider support, rehabilitation and moving & handling optimisation.

    For emergencies call 999. This form is not an urgent clinical referral route.

    Better living starts here

    Better movement starts with better assessment.

    Care that fits the person keeps them safer, more independent and at home for longer, and directs care hours to the people who need them. Start with the clinical question: what can this person do?