MAT-doc Mounting Assistive Technology Documentation

Using the Documents

MAT-doc is available in a Short Form and Long Form. The Long Form covers all considerations, the Short Form can be though of as a summary. The Long Form has been designed so unnecessary sections can be deleted when not required.

The documents are available as a Microsoft Word Documents which can be completed on your computer, or printed and filled in manually. Some fields in the document properties have been used so you will only need to enter the information once, and the relevant parts of the document will be completed automatically.

To open document properties, click the ‘File’ tab in Microsoft Word, and click ‘Show All Properties’ towards the bottom right. This will reveal the ‘Subject’ and ‘Company’ properties which we use to store the client name or reference and your service name respectively.

Word full document properties screenshot

We recommend that you avoid using any client identifiable information in the document, and you use a client reference in the ‘Subject’ field.

The document has been produced with a grey background which will not be shown when you print the document. This enables the areas that need to be completed to be easier to see. The areas that need completing are shown in white.

Short Form

Once you become competent in mounting, you may find it unnecessary to always be referring to the complete documentation. We have produced a summary sheet that enables you to record the important information and that you have considered all relevant factors. You can use the main document as reference, but complete the summary form once you are comfortable with the full contents.

If the mounting is particularly complex, or you need to complete a risk assessment as part of the provision, or carry out a stability test or driving assessment, we would recommend you use the complete form in place of the document summary.

Long Form

The form has been designed for you you to delete sections that are not required for a particular client. Sections can be completed at different times during the provision of equipment.

Section 1 - Pre Assessment Information

This section can be used to gather information before considering the type of solutions you might like to provide. It is always worthwhile at this stage to take or obtain some photographs of any wheelbases that are being considered, in particular with the proposed device in the approximate position in which it is likely to be used.

Much of this information could be completed by other members of the team, or a teacher or parent for example.

It is useful to ask about the environment so a mounting solution can be provided that best meets the user’s lifestyle needs. There is little point mounting to a wheelchair if it is only used for 30 minutes per day to get to and from school. Other bases may be more appropriate.

You can start to making some initial decisions in this section which will be looked at in more detail later on.

Section 2 - Wheelbase Information

It is likely that mounting to at least one wheelchair will be required. It is important to ensure that the sum of the weight of the equipment you are planning to mount, the equipment that has already been attached to the wheelchair (such as a special seating unit), and the user’s own weight falls within the weight limit of the chair.

Attaching a switch or a light device such as an iPad onto a powerchair, it has little impact on stability. Attaching a large eye gaze at nearly 4kg in front of the user has a bigger impact especially when being mounted to a lightweight manual wheelchair. Some AAC devices are becoming smaller and may be positioned close to the user, others are getting larger and need positioning further away from the user. They may be higher risk.

Use this section to note all the relevant information on the wheelbases you may wish to mount to. This information should normally be on labels on the chair, one from the manufacturer, and often one from the service or organisation that supplied the base.

Section 3.1 - Feasibility of Wheelchair Mount

You can use the decision tree below to help establish if you should proceed with your proposed solution, or if additional investigation or risk assessment is required.

Wheelchair mount decision tree

You should be careful to ensure that all the factors listed have been considered when selecting the type of mount to use, and for its location on the wheelbase.

Section 3.2 - Feasibility of Desk/Table

You can use the decision tree below to help establish if you should proceed with your proposed solution, or if additional investigation or risk assessment is required.

Desk or table mount decision tree

Section 3.3 - Feasibility of Floor Mount

You can use the decision tree below to help establish if you should proceed with your proposed solution, or if additional investigation or risk assessment is required.

Floor mount decision tree

You should be careful to ensure that all the factors listed have been considered when selecting the type of mount to use.

Floor mounts can be surprisingly challenging to get right. Space can be a real issue in some environments, especially when a large device may imply a large floor stand. Moving a floor stand can be difficult, and they can create trip hazards especially for the very young or very old if not managed well.

Section 3.4 - Feasibility of Bespoke/Hybrid Mount

You can use the decision tree below to help establish if you should proceed with your proposed solution, or if additional investigation or risk assessment is required.

Bespoke or hybrid mount decision tree

You should be careful to ensure that all the factors listed have been considered when selecting the type of mount to use, and for its location on the wheelbase.

Section 4 - Wheelbase Stability Assessment

We’ve provided this assessment to help guide your decision-making around static stability testing. It shouldn’t be considered definitive; you may disagree with some of the assumptions or want to change the scoring. It can be useful as it is though, to help identify situations of risk which you may wish to investigate further.

You should, however, consider these comments on static, as opposed to dynamic stability testing.

Static stability testing is used by some services to determine whether a system is safe to use once modified to include a seating system or some other devices. It is a measure of static stability and uses a pass or fail criteria. In the case of a pass, it gives no indication of how easily the system passed.

Where static stability testing is carried out, services often test to 12 degrees for attendant chairs, and 16 degrees for powered and self-propelled chairs. MHRA guidance (DB2004) implies that load cell methods for measuring static stability are preferred as they have a lower risk for clients and clinicians carrying out the test.

It is important to consider wheelchair manufacturers’ information on the safe usage of their products.

A typical powered wheelchair may only be suitable for use on a slope of 10 degrees less or a maximum kerb height of 6cm.

To put this into context:

  • A typical kerb height is likely to be more in the region of 10cm height. On a typical powerchair this equates to a 12 degree ramp once the castors are at the higher level.
  • Wheelchair ramp manufacturers recommend ramp rate of no more than 1 in 12. This equates to 5 degrees.
  • 1 in 15 (4 degrees) is the recommended maximum concrete slope, with 1 in 20 (3 degrees) preferred. We need to consider the risks of doing a static stability test versus the risks of not doing a stability test. It may be that a driving test in the user’s environment is more useful.

While it can be difficult to measure, dynamic stability is also crucially important. Dynamic stability is particularly important for those users who are:

  • Moving independently with powered mobility
  • Moving independently with self-propulsion

The least stable conditions can occur when:

  • stopping when travelling downhill
  • accelerating from a standstill uphill
  • navigating obstacles such as ramps or kerbs

Section 5 - Wheelchair Static Stability Test Results

Should you or the local wheelchair service decide that a static stability test is useful, you can record the results in this section. You may choose to complete several test to investigate various circumstances, or look at how the location of the device is affecting stability with high risk configurations. In that case, use several sheets if you need to in order to record all the results.

Section 6 - Driving Assessment

A driving assessment may be useful if you have concerns about the user’s ability to navigate their environment. It could be more challenging once the assistive technology has been mounted to the wheelchair. Look for signs on the wheelchair for damage, particularly at the extremities (sides of armrests, castor forks or housings, footplates) – these can be an indicator that navigation is tight or tricky somewhere – find out where the issue is.

If you feel a driving assessment is necessary, this section of the form will help you identify any issues. You could also use it to identify the impact adding the assistive technology has had on driving or driving accuracy. It may lead you to consider a mount with two mounting positions, or a mount that can be folded out of the way.

Section 7 - Risk Management

This section can be used to help you quickly identify risks and hazards, to document them, and provide a process for more detailed risk management.

You may find that your organisation or trust has their own risk management policy which you may need to use. Even so, the Risk Identification Checklist can help you note down and think about any potential problems with the system.

Use the checklist to list the hazard (e.g. device obscures view) and the risk (e.g. drives into obstacle). If you feel it’s unlikely the hazard will occur, you can document a ‘No’. If you think it might, or you don’t know, you can document a ‘Yes/Don’t know’ and investigate the issue further.

The Risk Analysis part of the process allows you to note all the risks identified in the checklist and then to methodically record the Severity (‘S’) if the risk occurred, and the Probability (‘P’) of it happening. These two numbers are then multiplied together to obtain the Total (‘T’).

You can choose to use one of the example Risk Matrices provided. Use this, and the terminology definitions to determine what course of action to take.

Section 8 - Safety Information

It is important to ensure the client is fully aware of how to operate any equipment you provide, and in particular any important safety issues.

Please remember that most people do not read instructions so providing 50 pages of documentation will not help them to be safe. It is important to find a way that communicates important and relevant issues effectively.

One way to do this is to have a small (no more than ten) number of key bullet points of the most pertinent information. This can be given to the user verbally at the time of handover, as well as in the printed information.

You may also find it useful to provide information that is relevant to the particular configuration you are providing. One format is shown in the section ‘Information Specific to this Configuration’ section. Here the sentence in each paragraph that is most relevant, based on your judgement and any risk management outcomes, can be retained with the sentences that do not apply being deleted. This should leave you with once sentence per paragraph, and a list that will be relevant and pertinent to the user.

The remainder of this section can be changed to suit you and your service needs, based on the policies of your organisation.