I also heard Deborah’s presentaion on this at the conference and have some concerns about this issue being that single handed care is prevalent in home care and carried out by caregivers who often lack a voice when decisions are made as to the need for one or two caregivers.
The decisons are also ususally made on the basis of availability of funding rather than actual client assessment
Anyway here is an exert from the Moving and handling guidelines NZ (Pg 65)about this.
“For clients in home care, an initial on‑site risk assessment should be carried out by a
carer deemed qualified by the organisation. It should involve the client, the client’s
family where appropriate and if applicable the funder. The risk assessment should
note what moving and handling equipment will be required, what changes (if any)
are needed in room or building layout, and whether the client will require assistance
from one or two carers for specific transfers (see Appendix 3.3). The carer assigned to
the client will be responsible for carrying out the care specified by the risk assessment
prior to each client transfer. Sole carers should be able to request specialist risk
assessments following any significant changes in clients’ mobility, profile or
environment, or following any indication that more than one carer or different
equipment may be required to transfer clients.”