Safety
Safe for the person and for every member of staff, every time — not just on the day of assessment.
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Independent · Physiotherapists & occupational therapists · Optimal Handed Care
Better movement.Better care.Better living.
Moving & handling assessment, rehabilitation and care optimisation — so support is proportionate, safe and independence-focused.
- 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
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
Two carers, to one, to none — only when the assessment supports it.
Optimal Handed Care (also called single-handed or proportionate care) is an outcome of assessment, never an assumption. Four things have to be true before a 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.
Our position
Proportionate care is better care.
The right level of support, by the right number of carers, at the right time.
Reducing care is never the objective. Delivering more assistance than a person needs erodes independence and dignity; delivering less is unsafe. The objective is all five of these, together.
Independence
The person does what they safely can. Support fills the gap; it does not replace ability.
02 / 05Dignity
Privacy, choice and participation are designed into the plan, not traded for speed.
03 / 05Sustainability
It still works on a bad day, with a new carer, six months from now.
04 / 05Reliability
Written so any competent carer can follow it and any reviewer can check it.
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Rehabilitation & care optimisation
From below baseline. Towards independence.
Function is not fixed. Deconditioning after a hospital stay, a fall or a period of over-assistance is often recoverable — and the care package should follow the person’s function, not freeze it.
BaselineCurrent function and current support, honestly recorded — the line every later decision is measured against.
RehabilitateGoal-led work on strength, balance, transfers and confidence, where there is potential to improve.
OptimiseTechnique, equipment and environment re-matched to the new level of function.
ReviewCare input adjusted only when reassessment supports it — in either direction.
Services
Start with the right assessment.
Pick the closest service; we confirm the right pathway at triage. Standard fees shown — travel, urgent input and programme work are agreed before you commit.
01
£200standard fee
Moving & Handling Assessment
Assessment of transfers, mobility, positioning, manual handling risks and care requirements.
02
£250standard fee
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
£175standard fee
Rehabilitation & Reablement
Restore function and independence where possible, around goals that matter to the person.
04
£225standard fee
Equipment & Transfer Assessment
Identify the equipment that solves the actual transfer problem — person, task and environment together.
05
£200standard fee
Wheelchair Referral Support
Functional, transfer, posture and environmental evidence to support referral to the specialist wheelchair service. Not a direct wheelchair assessment.
06
£175standard fee
Bed Rail & Bed-System Risk Assessment
The relationship between the person, bed, rails, mattress, accessories and environment.
07
£450standard fee
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.
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Scoped
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, and the triggers that bring the plan back sooner: any reported change in functional ability, weight-bearing, pain or cognition that affects safe transfer or mobility.
Real plans are individual and are shared only through agreed, secure routes.
For Local Authorities & commissioners
Better assessment. Better decisions. Better use of care.
Independent assessment capacity for Optimal Handed Care from physiotherapists and occupational therapists — working alongside your own OT and social work teams, under your governance, with the clinical 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, ~£1.1M annual cost avoidance (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 CommunityWhat 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.
- 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.
- Weeks 1–1002
Pilot cohort
25 cases at a fixed price per case. Each case: assessment, TILE(O) risk assessment, clinical reasoning, equipment specification, staffing per task, provider sign-off, review triggers.
- 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.
- 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
Standard assessment fees. Referral to report in an agreed timescale. No commitment.
Cohort25 / 50 / 100 cases
Fixed price per case, 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.
Programme prices 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 care providers & 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.
Priority triage
Assessed at the right speed.
Choose the priority you need and it is carried straight into your booking. Clinical triage confirms it from your details. Every pathway stays bookable.
1
Red
24–72 hours
Urgent assessment
Urgent, non-emergency need where clinically appropriate.
- A transfer has broken down
- A new injury risk to staff or the person
- A discharge that cannot proceed without a plan
Priority assessment
A decision is needed soon.
- A care package under review
- A provider concern or planned equipment change
- A reablement window closing
Planned assessment
Scheduled work agreed in advance.
- Scheduled reviews and audits
- Training programmes
- Cohort and caseload work
Response targets are service aims, not guaranteed or statutory response times.
Not sure? Start the booking and choose there
This service is not an emergency medical response. If there is immediate danger, serious injury or acute medical deterioration, call 999. If you believe an adult is at risk of abuse or neglect, contact your Local Authority safeguarding team — see our safeguarding policy.
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.
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.
Who assesses
A team of physiotherapists and occupational therapists — every clinician with at least ten years of moving & handling, rehabilitation and community practice.
10+years’ clinical experience — the minimum for every clinician on the team
2professions in the team — physiotherapy and occupational therapy reasoning on the same plan
5factors assessed on every transfer — person, task, equipment, environment, staff
6-monthlyLOLER thorough-examination status checked on every hoist and sling we plan around
Evidence of registration, insurance, DBS, information governance and safeguarding arrangements is provided for contract due diligence on request.
Better living starts here
Better movement starts with better assessment.
Reviewing a care package, supporting someone at home, or running a care service — start with the clinical question: what can this person do, and what support is genuinely needed?
Start where you are
Individuals & familiesBook a first assessment — no clinical records needed to start.
Care providers & care homesA plan for the floor, competency sign-off, a fast route back.
Local AuthoritiesDiscovery call → 25-case pilot → evaluation → scale.
07901 603714Not an emergency line — in an emergency call 999.