The Benefits Of Using Hybrid Mattress Surfaces In Nursing Home Care

Pressure area care surfaces have long been used in nursing homes and the community but a lack of understanding and confusion around the products have seen many of the new support surfaces and new technologies under utilised.

What Are The Different Types Of Support Surfaces Available

There are two main approaches to preventing pressure ulcers using support surfaces which are commonly utilised in nursing homes. These are known as active/ dynamic surfaces and static/ reactive surfaces.

Each has a different function and capability for use according to different care needs of individuals. This is where confusion can set in, especially when using mattresses that are already in use within a nursing home setting. It may mean that a different surface is required but the right surface has not been specified, or the price of the specified surface may prohibit the purchase.

Static /Reactive Surfaces

Static systems may comprise of foam, foam and air, gel or layers of different foam densities. Some air-filled support surfaces allow air to escape through small holes and require a continuous pumped air supply. These are called low-air loss systems and are still classed as a static system.

A reactive/static mattress works on the principle of distributing the individual’s weight over a maximum body surface area. It does this by conforming to the patient’s body contours to increase the area in contact with the support surface. It provides a constant low-pressure profile whereby the pressure at every contact point is reduced. This alleviates localised internal tissue loads to help prevent the development of a pressure ulcer. These can also be called ‘reduction surfaces.’

Active/Dynamic Surfaces

Active/dynamic systems, (also known as alternating or airwave mattresses) require a power supply to mechanically alter the pressure beneath a person, using a regulated cycle of inflation and deflation of cells of the support surface. This allows pressure to be taken from parts of the person and then reapplied, reducing the duration of pressure on the body. These can also be called ‘relief surfaces.’

NB: Repositioning of the person is still required on alternating support surfaces as on static surfaces


Hybrid support surface technology is now being recommended by Tissue Viability nurses in both community and nursing home settings and combines foam and air to maximise the benefits offered by both static and alternating surfaces. This makes choosing a mattress simpler and is one piece of equipment that is suitable for a much broader range of people.

This has reduced some confusion and enables the surface to be used in a ‘step-up’ or ‘step-down’ approach regards to an individual’s care pathway. However, there is still a lack of clarity about what these products are, how they work and which patients they are suitable for, as there are two different types of hybrid support surfaces – those with a pump and those without a pump. The systems are designed to be suitable for a range of pressure ulcer risk levels and categories of tissue pressure damage.

It is essential to check the information provided by the manufacturer to ensure that the correct mattress is used up to the appropriate risk level and category of pressure ulcer for individuals.

Hybrids Without A Pump

Non-powered hybrids work on the principle of air displacement. When a person repositions their weight, air moves within the mattress to surrounding cells for optimum pressure redistribution. This allows the mattress to conform to the shape of the person’s body as he or she moves, increasing the surface area in contact with the mattress and reducing the patient/support surface interface pressures. This minimises the potential for cell and tissue breakdown.


Hybrids With A Pump


Powered hybrids also consist of foam and air cells, most typically configured as a layer of foam (this may be simple foam or a castellated foam) at the top surface against the body, with a series of air cells beneath.

The mattress has air cells around the foam inserts, which provide a layer of alternating air cells above the foam.


All of the powered hybrids in the non-powered mode function much like the non-powered hybrid mattresses. With the attachment of a powered pump, the mattress can inflate and deflate alternate air cells at regular intervals. Depending on where the air cells are in relation to where the individual touches the mattress, this can offer increased pressure redistribution or even intermittent offloading of pressure.

How To Select The Correct Hybrid System For You

When selecting a powered hybrid system, it is important to consider whether it offers both pressure redistribution in the static mode and pressure relief in the alternating mode. Hybrid systems where there is a layer of foam above the air cells provide active redistribution at a constant low pressure. Where the foam is positioned inside the air cells the system functions as an alternating pressure system, providing additional pressure relief in the powered mode. The presence of a foam core within the air cells means that air movement is not restricted by a top layer of foam and less air is required to inflate the cells, allowing the pump to be smaller and more efficient.


The Top Benefits of Using Hybrid Surface Technology

Clinical Benefit

The option for both static and alternating pressure therapy means a hybrid surface can work to prevent and treat a wider range of pressure ulcer categories than either static or alternating surfaces alone. This removes the concern of transferring individuals from a static surface to an alternating one or vice versa – Stepping -up or Stepping-down. Instead, they can have the best of both by incorporating the powered pump. In the event of a power cut, hybrid mattresses still offer support so there’s no risk of finding your resident sinking through the mattress onto the bed frame, causing more damage and upset.

Comfort Benefit

Comfort is vital for rest, recovery and aid in the prevention of pressure ulcers. The air cells are encased by foam which moulds to the contoComfort is vital for rest, recovery and to aid in the prevention of pressure ulcers. The air cells are encased by foam which moulds to the contours of the body. When the mattress is in static mode the air cells remain full but with the layer of foam on top, this creates a soft and supportive flat surface for the patient. Part of being comfortable is also being able to lay in a quiet environmenturs of the body.

Active Dynamic surface pumps can often be loud and create buzzing noises and vibrations that can affect a resident’s sleep and in turn, their mood and wellbeing. Hybrid pumps, in contrast, are remarkably quiet, creating a more calming environment for the user. Utilising SSKIN 3 will also aid in the comfort of the resident and cut down on pressure ulcer formations.

Cost Benefit

Due to the hybrid system incorporating both sets of technology you can use the mattress in 2 ways, saving on buying additional equipment and servicing. Hybrid technology surfaces still require cleaning and maintenance to make sure they are always in working order and hygienically clean for the next person who requires the equipment. Decontamination and service work can be carried out all at the same time cutting down on pre-planned maintenance and Pat testing. They also save on space as you only need to store one mattress and not two.

You can view our range of hybrid mattresses on our website here

If you would like a full hybrid mattress demonstration at your home to understand how they can benefit your home why not get in touch call Belinda on 07968 994 660 or email

Watch the video on the benefits of a hybrid mattress here


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Customer Testimonials

“We’ve built a strong working relationship with Hcsuk over many years, having used them to source, install and service our medical training equipment. We have always found the team very professional, helpful, and well-organised. We’d like to give a particular shout out to Phil, the technician / engineer who has been the consistent friendly face visiting our business to inspect and test our mobility hoists every 6 months. Thank you for all your support and advice.”

P. B. (Care Manager), Blue Bird Care Ltd

You are part of a great company, if we can help you grow by contracting you out to our sites its good for you, but it’s great for us because your service is fantastic, very efficient, everyone within Hcsuk is super helpful in answering queries and every time we’ve had an issue, Hcsuk has always been there to solve the problem almost immediately, which is fantastic.

Leicestershire County Council

Truly exceptional levels of customer service, the best I have experienced for many years. Very helpful staff made follow up calls to ask how the equipment was performing and supplied extra user instructions to supplement the manufacturers manual. I would not hesitate to order from this company again.

Savills Estate Agents

We would just like to pass on our thanks for all of your help with our orders and would be pleased if you would also pass on our thanks to the manufacturers for being so accommodating in meeting our requirements. We have found everyone very helpful.

Lincs Partnership NHS Foundation Trust

Since I set up the account for Hcsuk over 18 months ago I have found them to be an excellent advocate of our products. They have been willing to learn about the technical and servicing elements to our hoists and the sales staff have really taken on board and proactively promoted our range where possible. I feel that as a company Hcsuk have got the desire and right people in place for growing in this competitive industry. They seem to push themselves to go that little bit further and offer that little bit more to stand out from the rest. May our relationship continue going from strength to strength.

Joerns Healthcare

As a care home manager I have used Hcsuk for my supplies for the last 20 years in two homes. I have always found them to be helpful and reliable. Their products are of the highest standards, they are able to source anything. The delivery service is prompt and regular so I do not have to keep large amounts of stock. They supply extra services such as servicing and repairs which are done efficiently, and training in COSHH. The reps are pleasant and helpful bringing new products to my attention but are never ”pushy”. Aftercare is good, any problems soon sorted. I would recommend them highly and would not think of using anyone else.

Littleover Nursing Home

HPC have supplied Hcsuk (Health Care Services Ltd) for well over a decade now and we would consider them to be a high quality and professional business run in an organised and progressive manor. We do not rank our customers or have a preferred customer status but if we were to introduce such a scheme I can confirm that Hcsuk would easily make such a grade.

HPC Healthline

As a manufacturer we look for key values in a distributor some of these include honesty, reliability, commitment and reputation. Hcsuk carry all of these and many more. With a twenty plus year working relationship we now place Jo and the team at the top of our distributor list. I have no hesitation in recommending Hcsuk to any prospective manufacturer or customer and wish Jo and the team all the best for the future.

Cleenol Group Ltd

It is brilliant that we are able to ring Health Care Services and that you will go the extra mile to get us the stock we need as soon as possible.

Rykneld View Nursing Home

Just to say a huge thankyou to you and your fantastic team, and I mean that from the Heart. I have never before experienced such a person centred company.

Hampton Grange Nursing Home

What I like about working with Health Care Services is the relationship we have built up and the personal service. The homes report that you always deliver on time, the quality is consistently good and the prices competitive. Your team members are always willing to go that extra mile for us and if ever we have an issue there is always someone there to save the day.

Eastgate Care

Thanks to Jo for going over and above to get us our items in time for our special event at Buddleia House – it was very much appreciated. A massive thankyou for your continued assistance as a supplier to ourselves.

Buddleia House

We have always received excellent services from everyone at HCS at our 2 care homes, especially Lee, Jo and Phil. Always professional with a quick response time. Nothing ever seems too much trouble. Recently I had to use them personally for equipment to enable my mothers discharge from hospital. I had a response within the hour for prices and delivery came straight from the manufacturer to speed up delivery. Phil arrived at the same time to put the equipment together for us! I can’t thank them enough for putting our minds at ease and for the continued support from a personal and professional perspective. I’d recommend them to anyone requiring care equipment and its nice to support local businesses. Especially when they do such a good job!!

Orla House

I contacted HCSUK trying to find a hoist that could be operated unaided by the client. I had become very disheartened, no-one was really helpful until I spoke to Donna at HCSUK.

Donna was incredibly understanding, her professionalism raised my spirits again. Everything Donna said she would do she did, including arranging for me to speak to Andrew the salesman who like Donna was incredibly helpful, happy to bring two machines to demonstrate.

I can’t recommend them highly enough. They are good people.

Penelope C

I spoke to Lee Atterbury 2 weeks ago, when I was despairing about the prospect of finding any equipment to help my husband in the bathroom. I had tried all the popular brands, but none were right for his needs.

When I spoke to Lee he understood what I was saying and set about trying to find what we need. He was so patient and understanding and gave me the confidence to explore outside the box.

I spoke to Lee today and was able to tell him that we, hopefully, have found the solution. I am sorry that it was not a product you sell, though you may in the future, but will certainly look first to HCS for other products.

Thank you so much to Lee for first class customer service.

Christine G, Sheffield

VAT Relief Information

Conditions for VAT relief for disabled people

Some of the products which can be purchased from the Hcsuk website are available for an eligible person to purchase without paying VAT on them. HM Revenue and Customs sets out the conditions when equipment for disabled people might be free of VAT and how to claim exemption from paying VAT on these products.

Products a can only be exempt from VAT when all the following conditions are met:

  1. The customer is eligible to purchase supplies at the zero rate
  2. The goods are for the personal or domestic use of the customer
  3. The goods and services are eligible to be supplied at the zero rate

A more detailed explanation of each of these conditions is given below, but you should visit the HM Revenue and Customs Website to fully understand the conditions

The product must be being purchased for someone who is chronically ill or disabled.

A person is ‘chronically sick or disabled’ if he/she is a person:

It does not include a frail elderly person who is otherwise able-bodied or any person who is only temporarily disabled or incapacitated, such as with a broken limb.

‘personal or domestic’ use means that the supply must be made available specifically for the use of an eligible individual.

You don’t have to physically buy the goods in person. If your parent, guardian or wife or husband buys the goods and services for you, then you won’t be charged VAT.

What counts as personal or domestic use?

Personal or domestic use means that the goods or services are supplied for your own private use, rather than for business purposes. Also, the goods or services must be just for your own use – not for use by anyone else, or chronically sick or disabled people in general. However, if you and your partner are both chronically sick or disabled and you buy goods or services for both of you to use, then you won’t have to pay VAT.

Products which are offered for sale on this website which qualify for VAT relief to be claimed for an eligible person.

The products which can be bought without paying VAT are:

Only the products on our site carrying the VAT exemption price (the smaller price marked ex VAT) are eligible to be purchased this way and you must tick the box on the basket page indicating that you wish to claim VAT exemption on the items in your basket that are eligible for VAT relief.

How to claim

On the my basket page of this website a link to the online declaration form is provided if the basket contains a product that qualifies for VAT relief. You must tick the box to state you wish to claim VAT relief on the eligible product and complete in full the reason by which you are ‘chronically sick or disabled’ and name and address of the claimant. If possible the person making the claim should complete this form, but a family member, carer or medical professional may complete the form on the claimants behalf. To submit the claim and receive the VAT relief, click the ‘Submit VAT Relief Claim’ button before proceeding to the checkout.

Please note that all orders submitted with a VAT relief claim form completed are checked before the order is processed.

It is necessary to complete a separate claim form each time a qualifying product is purchased from Hcsuk.


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