Support Wedge Introduced at Surrey and Borders Partnership Trust

Surrey and Borders Partnership Trust has consistently been at the forefront of delivering care to individuals with complex health needs. The trust had previously seen significant success with the implementation of Safety Pods, a key tool in providing safe, effective care in challenging situations. Building on this success, the Trust recently introduced the Support Wedge, a specialized piece of equipment designed to support individuals with complex care needs, particularly in situations where conventional methods might not provide the required safety or efficacy.

The Case

The person under consideration has a history of very complex medical needs, including the necessity for frequent clinical interventions. One of the major challenges faced by staff was the person’s resistance to necessary clinical procedures, such as NG (nasogastric) feeding and wound care. On several occasions, the individual would resist these interventions by either placing themselves on the floor or into difficult environments, where they would not be easily accessible for care.

As a result, staff often faced significant risks to their own safety, as well as the safety of the individual. Without an appropriate means of physical support, these interactions would frequently escalate into situations of heightened distress, physical strain, or even injury to both the patient and staff.

Additionally, the Trust needed a reliable way to conduct routine and urgent clinical assessments, including taking blood samples to assess the person’s need for life-saving treatments. In such complex cases, every intervention matters, and without an effective solution, staff were concerned that crucial assessments might not be carried out in time, or at all.

The introduction of the Wedge presented the opportunity to offer an alternative method of support. On introduction of the Support Wedge, staff noted benefits in two key areas: safety and clinical intervention.

1. Safety for Staff and Patient: The Wedge enables staff to safely support the individual while they are on the floor, preventing potential injuries to both the person receiving care and the staff providing it. In previous situations, the lack of proper support might have resulted in staff being injured during the attempt to manage the individual’s resistance, or worse, failure to intervene at all
2. Clinical Intervention and Assessment: The Wedge offers a stable platform that allows staff to continue with necessary clinical assessments and treatments, even in difficult or non-compliant scenarios. This includes:
   • Wound care: Staff can now assess and treat serious wounds more effectively and safely
   • Blood sampling: The ability to take blood samples has been crucial for ongoing medical assessments. These samples are used to determine whether the person requires further life-saving treatment, a decision that is vital in complex care situations
   • NG Feeding: The Wedge was also used successfully during one instance of NG feeding, providing the stability and safety required to perform the procedure

The introduction of the Wedge has had a marked positive impact on both staff and patient outcomes, with the team reporting:

• Reduced Incidents of Injury: There has been a significant reduction in the number of incidents where either the patient or staff were at risk of injury due to improper positioning or resistance during procedures
• Improved Clinical Outcomes: With the ability to carry out necessary clinical procedures, such as blood sampling and wound care, the Trust has been able to provide timely and effective interventions. This has likely prevented situations where the patient’s condition could have worsened due to lack of assessment or treatment
• More Effective and Humane Care: The Wedge has allowed for a less restrictive, more supportive approach to care, aligning with the Trust’s ethos of providing compassionate, person-centred care. By minimising the need for prolonged restraint in uncomfortable positions, the Wedge has ensured that the care provided is both more effective and more respectful of the individual’s dignity

The successful introduction of the Wedge into the care model at Surrey and Borders Partnership Trust has proven to be a game-changer. It has not only enhanced the safety and well-being of staff and patients but has also enabled the Trust to provide more effective clinical care to an individual with highly complex needs. This case highlights the critical importance of innovative, patient-centred tools in transforming care delivery and outcomes in challenging situations. By continuing to adapt and introduce such solutions, the Trust is further solidifying its commitment to high-quality, compassionate care.