DOCUMENT CONTROL PAGE

Transcription

1 Title: Manual Handling NHSLA 4.5 Document Type: Scope: All staff DOCUMENT CONTROL PAGE Author: Miss K Woodward Manual Handling Advisor Version Number as from December 2004: 6 Policy Classification: Policy Groups Consulted: Health and Safety Committee and Executive Board, Professional Advisory Group, Wheatley Emma, Scott Peter, Sanjay Sastry, Williams Ryan, Mobb Gillian, Lipscombe George, Varghese Joseph, Mather Sharon, Regan Kerrie, Guerney Yvonne, Walters John, Dave Butler, Mark Grey, Miller Barry, Cummings Jean, Hart Susan, Gibbons Carol, Houghton Yvonne, Cunliffe Sharon, Grealey Barbara, Fallon Jane, Tomkinson Kath, Meadows Margaret, Bleakley Tina, Rodmell Kathleen, Hopkins Christine, Pitfield Beverley, Parkinson Mike, Bene Jackie, Bharaj Harni, Ellahi Nashaba, Maguire Kathy, Woods Linda, Whittam Sue, Ingham Nicky, Richley Paul, Furnival Joy, Bradshaw Ken, Schenk Anne, Edwards Heather, Powell Peter, Andrew Beverley, Doherty Lesley, Fairhurst Kath, Furnival David, Moss Tracey, Palmer Nigel, Smith Valerie, Steel Esther, Trembath Carolyn, Wheatcroft Rae, Bridge Rebecca, Kendall Nyree, Wilson Steve, Riley Gina, Suzanne Lomax, Ann Lloyd, Deborah Hutcheson-Davey, Caroline Greenhalgh, Validated By: Health and Safety Committee Equality Impact Assessed: Yes Date: (If appropriate) Replaces Description of amendments: Replaces June 2011 Reviewed to reflect changes in manual handling practice within the organisation. Authorising Body: Health and Safety Committee Date of Authorisation : 2 nd Oct 2012 Master Document Controller: Annette Cox Clinical Governance Secretary Review Date: Oct 2015 Or earlier if required. Key Words: Manual Handling, Risk Assessment, Bariatric, Patient, Mobility, Acute, Community Validated by the Health & Safety Committee 2 nd October 2012 minor changes 1 of 35 Bolton NHS Foundation Trust Manual Handling Policy

2 INDEX 1. Purpose and Scope 4 2. Policy Statement 4 3. Definitions 5 4. Duties/Guidelines/Procedures/Methods (NHSLA 4.5a) 6 5. Manual Handling Techniques (NHSLA 4.5b) Arrangements for access to appropriate specialist advice (NHSLA 4.5c) How the organisation risk assesses the moving and handling of patients and 10 objects (NHSLA 4.5d) 8. How action plans are developed as a result of risk assessments (NHSLA 4.5e) How action plans are followed up (NHSLA 4.5f) Implementation and Dissemination Special Handling Situations Other Information Monitoring process (NHSLA 4.5g) References Supporting trust documentation 14 Appendix 1 Equality Impact Assessment 15 Appendix 2 Arrangements for access to appropriate specialist advice (NHSLA 4.5c) 17 Appendix 3 - Manual Handling Key Worker Responsibilities (NHSLA 4.5a) 18 Appendix 4 - Inanimate Load Handling Risk Assessment information (NHSLA 4.5b) Bed based services 20 Appendix 5 Patient Manual Handling Assessment information (NHSLA 4.5b) Bed based services 21 Appendix 6 Patient Manual Handling Assessment Flowchart Bed based services 23 Appendix 7 Manual Handling of Loads - Assessment Checklist (NHSLA 4.5b) Community Services 24 Appendix 8 Service User/Patient Manual Handling Risk Assessments (NHSLA 4.5b) - Community Services 26 Appendix 9 Guidance notes for Service User/Patient Manual Handling Risk Assessments Community Services 28 Appendix 10 Definition of Bariatric 30 Appendix 11 Bariatric Assessment and Equipment Provision Bed based services 31 Appendix 12 Bariatric Assessment and Equipment Provision Community Services 33 Appendix 13 Bariatric Equipment Provision Community Services 34 Page. 2 of 35 Bolton NHS Foundation Trust Manual Handling Policy

3 MANUAL HANDLING POLICY MANUAL HANDLING POLICY 3 of 35 Bolton NHS Foundation Trust Manual Handling Policy

4 1. PURPOSE AND SCOPE OF POLICY Bolton NHS Foundation Trust has a legal responsibility to safeguard the health, safety and welfare of its staff, patients and visitors. It is accepted that due to the nature of the work staff have to move patients and loads manually. Whilst compliance with this policy does not guarantee that injury will not occur, staff can significantly reduce the likelihood of injury by following this guidance. It is important to understand that there is no threshold below which manual handling operations may be regarded as safe. Manual Handling injuries can happen to anyone regardless of age, strength, fitness or disability. Inappropriate manual handling practices are likely to result in musculoskeletal injury and these injuries can occur as a result of one single incidence of poor handling but are more commonly caused by repetitive poor handling techniques. 2. POLICY STATEMENT 2.1 The Trust has adopted a minimal lifting policy which defines the measures to be taken by managers and employees to reduce the risk of injury to themselves and others. 2.2 This policy applies to all manual handling tasks, whether a patient or an inanimate load, performed using human effort that have the potential to cause injury. 2.3 This policy is applicable to all staff, patients, contractors and visitors to the trust premises. The policy sets out to: 2.4 Reduce the risk, number and severity of injuries from manual handling operations to create a safe working environment for all staff involved with manual handling activities. 2.5 Ensure that equipment used, is used for its correct intended purpose. It is also a requirement that mechanical and other aids are used when identified by a risk assessment as the technique to be adopted in accordance with manufacturers guidelines. 2.6 Ensure that all staff are trained in appropriate Manual Handling skills relevant to their area of work through the promotion of ward/departmental based training and maintenance of accurate training records. 2.7 Where a risk from a manual handling operation has been identified the regulations contained within the Manual Handling Operations Regulations 1992 (MHOR 1992 as amended 2004) must be applied. 4 of 35 Bolton NHS Foundation Trust Manual Handling Policy

5 Employer responsibility: To AVOID the need for employees to undertake hazardous manual handling operations so far as is reasonably practicable. To ASSESS the risk of injury from hazardous manual handling operations that cannot be avoided. To REDUCE the risk of injury from hazardous manual handling operations so far as is reasonably practicable. To REVIEW the assessment annually, as and when changes occur or directly after an incident or injury. Employee responsibility: To follow the safe system of work. To use the equipment provided safely and for its intended purpose. To cooperate with their employer on manual handling health and safety matters. 3. DEFINITIONS 3.1 Manual Handling Operations: Manual handling is any activity requiring the use of force exerted by a person to lift, push, pull, carry or otherwise move, hold, restrain or support in a static posture, any load. It also includes the intentional dropping or throwing of a load whether into a receptacle or from one person to another. 3.2 Load: Is a generic term and includes people, animals and inanimate objects. 3.3 Risk assessment: Is the systematic evaluation of the task, individual ability, load, the environment and equipment to identify the safest method of moving; being aware of the actual/potential problems and the degree of risk associated with them. 3.4 Muscular Skeletal Disorder: Is an injury affecting bones, joints, muscles, tendons, ligaments or nerves. 3.5 Competent Person: Is someone who has the training and experience or knowledge to enable them to identify hazards, assess their importance and put measures in place to reduce risk. 3.6 Bed Based Services: Applies to all staff and patients within the hospital site and Intermediate Care 5 of 35 Bolton NHS Foundation Trust Manual Handling Policy

6 Services. 3.7 Community Service Applies to all other staff and patients within the community setting. 4. DUTIES/GUIDELINES/PROCEDURES/METHODS. (NHSLA 4.5a) 4.1 Chief Executive The Chief Executive has overall and final responsibility for ensuring systems are in place for the effective safe management and control of manual handling risks and for the implementation of this policy. 4.2 The Trust Board Will ensure that staff are trained to carry out safe manual handling techniques and that appropriate systems and processes are in place for staff to recognise any concerns with regards to poor manual handling practices and understand their responsibilities in relation to reporting it. 4.3 Heads of Divisions, Directors and Associate Directors Should ensure that staff are aware of this policy and their duties/ responsibilities for identifying and reporting any possible poor manual handling practices. They will monitor attendance of staff on manual handling training via the appropriate reporting system (as required by the trusts Statutory Mandatory Training Policy) and must ensure that staff carry out safe manual handling whilst at work. 4.4 General Managers, Professional Leads, Matrons Are responsible for: Monitoring staff attendance at manual handling training as per Statutory Mandatory Training Policy Monitoring accident/incident figures as per General Safety and Risk Management Policy Supporting their managers with their responsibilities under this policy. 4.5 Manual Handling Advisor Is responsible for: Developing, implementing and monitoring safe systems of work that will assist the trust to remain compliant with legislation and reduce the risk of injury to patients, staff and visitors to the Trust. 6 of 35 Bolton NHS Foundation Trust Manual Handling Policy

7 4.5.2 Developing, delivering, reviewing and evaluating manual handling training courses Providing advice and support to managers and manual handling key workers on manual handling risk assessments, safe systems of work, safe manual handling techniques, aids and equipment Maintaining accurate documentation of assessments and audits undertaken, and education and training developed/implemented Carrying out an organisation wide manual handling risk assessment and ensuring that any high risk is escalated to the Health and Safety Committee (NHSLA 4.5e) Advising on the purchase of manual handling equipment Following up of any RIDDOR reportable accident/incident involving manual handling. 4.6 Departmental managers/line Managers/Team Leaders Departmental managers are ultimately responsible for the following; however these tasks may be delegated to a competent person(s) Ensuring there are systems in place for identifying all hazardous manual handling activities undertaken within their area and carrying out a risk assessment of these activities, taking into account T.I.L.E. (NHSLA 4.5d). Task e.g. is it necessary, posture, repetition, distance of transfer, etc. Individual capability e.g. health problems, pregnancy, strength, knowledge and training. The load e.g. weight, size, shape, hot/cold, sharp, slippery, unpredictable etc.. Environment e.g. space available, floor surface, changing levels, heat and light. Equipment e.g. is it required, serviced, suitable, adjustable, safe, are staff competent to use? etc That the findings of the manual handling risk assessment are documented, reviewed annually; or sooner if there is a change in circumstances, incident or injury and if amended, any remedial action is recorded, and staff are informed (see Appendix 4) Ensure that where appropriate Patient Manual Handling Assessments have been completed accurately and reviewed as necessary; and that any specific manual handling needs that arise from this are documented and communicated to all staff involved (see Appendix 5 and 6) That staff only undertake duties for which they have been trained, and are competent to perform as highlighted during the Appraisal and Continuing Professional Development process. 7 of 35 Bolton NHS Foundation Trust Manual Handling Policy

8 4.6.5 Appoint manual handling key workers within their department Where a manual handling key worker has been nominated and trained, that they are allowed sufficient time to provide training or support to staff, give advice, assess and review risk and assist the Manual Handling Advisor to carry out periodic audits. It is recommended that manual handling key workers where appropriate are given approx 30 minutes to 1 hour per member of staff working within their area, for example if an area has 50 staff the key worker is allocated hours over the year to carry out their responsibilities, however if the area has 2 key workers this allocated time would be shared between them therefore hours each There is sufficient equipment available for staff to carry out safe manual handling at all times i.e. hoist, single patient use slings, slide sheets, small handling aids etc All reports of faulty or defective manual handling equipment are acted on immediately Staff are competent in the use of manual handling equipment All training activity is recorded accurately on Electronic Staff Records by the nominated person within their area That all incidents and accidents are reported in line with the Accident and Incident Reporting Policy and they assist the Manual Handling Advisor to carry out an appropriate investigation of any RIDDOR reportable incident/accidents That Managers use the Manual Handling MSK self-assessment form (following a manual handing injury) as part of the return to work process (see section 12 of this policy) They offer support to the Manual Handling Advisor to carry out periodic audits and monitoring/reviews of safe systems of work. 4.7 Manual Handling Key Worker Responsibilities (NHSLA 4.5a) See Appendix Employees It is the employees responsibility to: Take reasonable care of their own health and safety and that of others who might be affected by their actions and cooperate with their employers on Health and Safety matters Follow the safe system of work identified by the risk assessment process. 8 of 35 Bolton NHS Foundation Trust Manual Handling Policy

9 4.8.3 Make full and proper use of equipment and safe systems of work in accordance with training and instructions received and manufacturer s guidance. For staff working within the community please refer to the Joint Operational Protocol for Equipment Provision Attend manual handling training sessions as highlighted during the Appraisal/CPD process and in accordance with the Statutory Mandatory Training Policy, ensuring they keep up to date with developments in professional knowledge and practice Report any handling difficulties or hazards to their departmental line manager and if appropriate complete a risk assessment Report any defective equipment to their departmental line manager and remove from use immediately Report any accidents, incidents or near misses relating to manual handling as per the Risk Assessment Protocol and co-operate with any investigation Report any change in health or medical conditions that may affect their ability to handle loads safely Ensure that their clothing and footwear does not contribute to the risk of injury from manual handling operations (refer to Uniform and Dress Code policy). 4.9 Therapeutic Handling Therapists will: Where applicable complete a patient/service user manual handling risk assessment for patients/clients requiring therapeutic handling (see Appendix 8) Where applicable complete a Therapeutic Manual Handling Risk Assessment (see section 12 of this policy) Identify and attend appropriate manual handling training for therapists Work together across other agencies and organisations and with other professionals and carers to their levels of ability Ensure that the appropriate risk assessment is completed when teaching of assisted transfers (see section 12 of this policy) Workplace Health and Wellbeing Will be responsible for: Undertaking pre-employment health assessments in order to ensure that 9 of 35 Bolton NHS Foundation Trust Manual Handling Policy

10 prospective employees are suitable for their proposed employment Providing advice and support, and if necessary referral to other services, for those who experience musculoskeletal problems relating to manual handling Providing return to work advice and assessment for staff Estates Department The Estates Department/Community Loan Store is responsible for the annual service, 6 monthly LOLER inspection of all appropriate manual handling equipment including bariatric equipment and the general maintenance of all manual handling equipment including bariatric equipment under the Lifting Operation and Lifting Equipment Regulations (1998) and The Provision and Use of Work Equipment Regulations 1998 and for maintaining the service records. 5. Manual Handling Techniques. (NHSLA 4.5b) No manual handling which poses a risk to either the patient or staff is permitted, and the trust is explicit that the following techniques are banned and under no circumstances should they be used. i) Drag lifts, Orthodox lifts, Australian lifts and all under arm lifting techniques, are dangerous to both patient and handler and, are never to be used. ii) Hospital bedding should not be used to carry out any manual handling procedure. For information on recognised safe manual handling techniques please refer to: The Trust Intranet: A Z of services M Manual Handling Techniques Here you will be able to download small media clips demonstrating a particular technique or refer to The Guide to The Manual Handling of People, 6 th Edition kept in the Manual Handling Advisor Office. Alternatively you can contact the Manual Handling Advisor or Departmental Key Worker (see Appendix 2). 6. Arrangements for access to appropriate specialist advice. (NHSLA 4.5c) For advice on how to access appropriate specialist advice refer to appendix How the organisation risk assesses the moving and handling of patients and objects. (NHSLA 4.5d) For information on patient and inanimate load handling risk assessments see Appendix 4, 5 and 6 Bed Based Services, 7, 8 and 9 Community Services 10 of 35 Bolton NHS Foundation Trust Manual Handling Policy

11 8. How actions plans are developed as a result of risk assessments. (NHSLA 4.5e) To ensure actions are taken to address risks which are identified via the Accident/Incident reporting system, ward/departmental managers are responsible for reviewing the risk assessment already in place or developing a new risk assessment to prevent re-occurrence. Risks that cannot be managed locally will be placed onto the divisional risk register and monitored via the Health and Safety Committee. 9. How actions plans are followed up. (NHSLA 4.5f) The manual handling advisor will develop an organisational risk assessment and action plan of all key risks, reviewing it every 6 month and will escalate risks via the Health and Safety Committee. 10. Implementation and dissemination. This policy will be dissemination by the Manual Handling Advisor through manual Handling training programmes; via the Manual Handling Key Workers during worked based manual handling training and by the Mandatory Training Team as part Corporate Mandatory Training and also through team brief by the General Managers, Professional Leads, Matrons, Departmental Managers, Line Managers and Team Leaders 11. Special Handling Situations. Emergency situations. In a life threatening or emergency situation when there is no time to carry out a planned move, the individual must assess the situation and, using their professional knowledge and judgment act in the most appropriate way. In the event of cardiac/respiratory arrest where the patient is on the floor, treat on the floor until medically stable enough to transfer in a safe and appropriate manner. The patient should only be moved if there is imminent danger. Fallen patients, in confined spaces, should be encouraged to help themselves. If they are unable, slide the patient into a more spacious area and then use the hoist or other appropriate equipment. Evacuation Training. Evacuation training will be covered in local fire training were appropriate, the basic safe principles of manual handling should be followed at all times unless a life threatening situation dictates otherwise (see above). 11 of 35 Bolton NHS Foundation Trust Manual Handling Policy

12 Bariatric Handling. See Appendix 10, 11 and Other Information (available on trust intranet) Musculoskeletal Self Assessment Tool and Guidance Notes. Therapeutic Manual Handling Risk Assessment and Guidance Notes Guidance notes for Manual Handling Patients in a Therapeutic Setting within Learning Disabilities Health Services Therapy Risk Assessment for Teaching of Assisted Transfer Advice/Guidance for Person(s) carrying out Assisted Transfer All the above documentation can be found on the trust intranet: Trust Home Page A Z Services M Manual Handling Manual Handling Risk Assessments Guidelines on the use of the Slide Sheet in Emergency Situations Record of the use of the Slide Sheet in Emergency Situations This documentation is now part of the Joint Operational Protocol for Equipment Provision and can be found on the trust intranet: Trust Home Page A Z Services M Manual Handling Manual Handling Equipment 12 of 35 Bolton NHS Foundation Trust Manual Handling Policy

13 13. Monitoring Process. (NHSLA 4.5g) Monitoring process. (NHSLA 4.5g) Minimum requirement to be monitored Process for monitoring e.g. audit Responsible individual/ group/ committee Frequency of monitoring Responsible individual/ group/ committee for review of results Responsible individual/group/ committee for development of action plan Responsible individual/group/ committee for monitoring of action plan b) techniques to be used in the moving and handling of patients and objects including the use of appropriate equipment Audit of R/A folders. Audit patient MH assessment process. Health and Safety Committee Every two years Annually Health and Safety Committee Health and Safety Committee Health and Safety Committee c) arrangements for access to appropriate specialist advice Audit patient MH assessment process. Health and Safety Committee Annually Health and Safety Committee Health and Safety Committee Health and Safety Committee d) how the organisation risk assesses the moving and handling of patients and objects Audit of R/A folders. Audit patient MH assessment process. Health and Safety Committee Every two years Annually Health and Safety Committee Health and Safety Committee Health and Safety Committee e /f) how action plans are developed as a result of risk assessments and followed up. Accident/incident reports Audit patient MH assessment process. Health and Safety Committee Twice yearly. Annually Health and Safety Committee Health and Safety Committee Health and Safety Committee Bolton NHS Foundation Trust Manual Handling Policy 13 of 35

14 14. References. Health and Safety Homepages, (2007). The Health and Safety at Work Act [online] Available on: [cited 29 June 2007] Management of Health and Safety at Work Regulations SI 1999/3242. London: HMSO Manual Handling Operations Regulations SI 1992/2793. London: HMSO Health and Safety Executive, (2007). Manual Handling Operations Regulations 1992 (MHOR) (as amended 2002). [online] Available on: [cited 29 June 2007] Smith, J. Ed. (2005). The Guide to the Handling of People. 5 th Edition Middlesex: Back Care. Health and Safety Executive, (2007). Simple guide to the provision and use of work equipment regulations Available on: [cited 29 June 2007] Management of Health and Safety at Work Regulations SI 1992/2051. London: HSMO Management of Health and Safety at Work Regulations SI 1999/3242. London: HMSO Manual Handling Operations Regulations SI 1992/2793. London: HSMO. 15. Supporting Trust Documentation. NHSLA Risk Management Standards Risk Assessment Protocol. General Safety and Risk Management Policy. Accident/Incident Reporting Policy. Falls Prevention Policy. Statutory Mandatory Training Policy 14 of 35 Bolton NHS Foundation Trust Manual Handling Policy

15 Appendix 1 Equality Impact Assessment Initial Screening Tool This Initial Screening Tool is the first step in completing an Equality Impact Assessment (EIA) of your activity (strategies, functions, policies, procedures, projects, services etc). Once this is completed, it will be apparent whether or not a full EIA is required. This proforma should be used in conjunction with the EIA Guidance available on the Trust s intranet website under A-Z Services, using the Equality & Diversity link, where you will also find links to the Trust s Single Equality Human Rights Scheme (SEHRS). 1. Directorate Assurance and Public Engagement 2. Department Health & Safety/Clinical Risk 3. Name of activity being assessed Manual Handling Policy 4. Person completing this form Dave Butler 5. Date 9 th June Monitoring data/statistics compare activity data with population data (see Guidance) Patients Staff N/A Equality Target Groups (ETGs) (See guidance for detail) Figures not available 7. Which of the following Equality Target Groups will this activity impact on? 8. Could this activity have a positive and/or negative impact? yes no Positive* Negative* A. Age No B. Disability Yes Yes C. Gender No D. Race No E. Religion/Belief No F. Language Yes No G. Sexual Orientation No H. Gypsy/Roma/Traveller No I. Carers No J. Employees Yes Yes 9. Consultation/Involvement during the development of this activity? (see Guidance) Health and Safety Committee and Executive Board 10. Details of positive and negative impacts Positive Impacts Improves employees understanding of manual handling of patients and object therefore assisting to reduce injuries. Negative Impacts Potential difficulties for employees with a limited grasp of written English 11. Give details of actions required to remedy any negative impact(s) identified above. Action to address negative impact Who Target Date Identifying through induction, appraisal and supervision staff with literacy issues. Verbally discussing policy and ensuring attendance at appropriate training Departmental Managers Through induction and annual appraisal 15 of 35

16 12. If the actions in 11 above are completed (answer Yes or No) revisit section 12 when action in 11 complete Negative Impact Positive impact 1. Will the activity present any problems or barriers to any community or group? 2. Will any group of people be excluded as a result of your activity? 3. Does the activity have the potential to worsen existing discrimination and inequality? 4. Will the activity have a negative effect on community relations? Could the activity reduce inequalities? Will it (answer Yes or No) Age Disability Gender Race Religion/Belief Language Sexual Orientation Gypsy/roma Traveller no no no no no no no no no no no no no no no no no no no no no no no no no no no no no no no no no no no no no no no no Age Disability 5. Promote equality of no yes no no no yes no no no no opportunity? 6. Eliminate discrimination? no no no no no Yes no no no no 7. Eliminate harassment? no no no no no No no no no no 8. Promote good community no no no no no No no no no no relations? 9. Promote positive attitudes no Yes no no no Yes no no no no towards disabled people? 10. Encourage the participation of no Yes no no no Yes no no no no disabled people? 11. Consider more favourable no Yes no no no Yes no no no no treatment of disabled people? 12. Promote and protect human rights? no Yes no no no Yes no no no no Decision Work through the flowchart on page 24 of the Guidance, to determine whether you need to complete a Full EIA or not. Details of any objective justifications or amendments agreed with Divisional E&D Lead: None identified Full EIA required? Yes No Date approved by Divisional Boards Completed by: Karen Woodward Job Title: Manual Handling Advisor Thank you for completing this EIA initial screening tool. Please forward an electronic copy of the completed tool to your Divisional E&D Lead for ratification by your Divisional Board and a copy to: Suzanne Hudson Gender Race Religion/ Belief Language Sexual Orientation suzanne.hudson@rbh.nhs.uk Telephone extension: 4017 Gypsy/roma Traveller Carers Carers Employees Employees 16 of 35

17 Appendix 2 Arrangements for access to appropriate specialist skills. (NHSLA 4.5c). Access to specialist advice and support is via the Manual Handling Advisor or a manual handling key worker. Manual Handling Advisor: Telephone Ext Bleep 5313 Via trust address Manual Handling Key Workers: If appropriate contact the Ward/Departmental Manual Handling Key Worker. Discuss with you Ward/Departmental manager who the nominated person is. A list of all organisational Manual Handling Key Workers is available on the trust intranet A to Z Services M Manual Handling Manual Handling Key Workers 17 of 35

18 Appendix 3 MANUAL HANDLING KEY WORKER RESPONSIBILITIES. The role of the manual handling key worker is vital within the organisation. The main aspect of the role is to develop and embed safe practice within your ward/department. To support you in undertaking this role and to carry out the responsibilities linked to it effectively a set of specific objectives as listed below have been drawn up. These should be used to support you in your role as manual handling key worker, and assist you to identify your own development needs in relation to the role. These objectives can be used to assist you during the appraisal process and be used as evidence to meet your needs for KSF. Objectives: To carry out the role of manual handling key worker. To undertake associated work related to the role. To ensure safe practice is maintained. To provide staff with annual Manual Handling Training Actions: To be familiar with the Moving and Handling Policy and raise awareness of the policy within the ward/department. Take responsibility for organising the ward/department moving and handling file and ensure it contains relevant up to date information and documentation. Organise training for staff within the ward/department. Maintain a summary record of all MH training. Provide staff with a completed training matrix to place in their portfolio as evidence of training received. Ensure all training is recorded on the Electronic Staff Records System (ESR) by the appropriate person within your ward/department. In collaboration with the ward/departmental manager complete risk assessments for manual handling tasks that have a potential to cause harm or injury. Localise any generic risk assessments downloaded from the trust intranet. Encourage staff to complete incidents forms should an injury be received and report the incident to the ward/departmental manager. In collaboration with the ward/departmental manager assist the Manual Handling Advisor to investigate manual handling incidents and injuries. Encourage staff to challenge bad practice and complete incident forms should poor manual handling practice is observed. Attend key worker meetings as organised by the Manual Handling Advisor in order to receive information and updates, discuss any issues or problems and share best practice. Disseminate information from meetings to ward/department team. Provide manual handling advice to ward/department staff. Report any manual handling issues that cannot be resolved locally to the Manual Handling Advisor. Where possible ensure manufacturer s instructions available and staff known how to access them. Encourage staff to complete incident forms when equipment if found to be faulty or there is a user error. Attend Manual Handling Key Worker Updates annually as per appraisal/cpd process. 18 of 35

19 Appendix 3 continued Key Indicators and Measurement of Objectives. The key indicators and measurement of objectives are evidence that you have met and achieved the objectives set out in this document and can be used as part of your annual appraisal. Key Indicators/Measurement of objectives: 1. Evidence that staff are aware of the Moving and Handling Policy. 2. Manual Handling File is up to date with relevant information. 3. Evidence of training records available. 4. Risk assessments available for staff to consult. 5. Generic risk assessments localised. 6. Evidence of incident reporting available. 7. Attendance at Manual Handling Key Worker Meetings/Updates KSF Dimensions linked to the objectives: C1 - Communication. C2 - Personal & people development. C3 - Health, safety & security. C4 - Service improvement C5 Quality HWB3 - Protection of health and well being IK1 Information processing IK2 - Information collection and analysis G1 Learning and development This document should be kept with the Manual Handling File and a copy placed in your portfolio as evidence to assist you to meet the KSF dimension set out in your post outline. I. agree to comply to the aims and objectives within this document and report any difficulties I may be having to my departmental manager and/or the Manual Handling Advisor. Signature:. Date:.. 19 of 35

20 Appendix 4 Bed Based Services Manual Handling Risk Assessment Process. (NHSLA 4.5d) There is a requirement to undertake appropriate risk assessments for the manual handling of patients and objects including the use of appropriate equipment. It is the responsibility of the departmental manager or designated competent person to ensure that a written risk assessment has been carried out on all hazardous manual handling activities and control measures put in place to reduce any identified risk. A Manual Handling Risk Assessment Library is available on the trust intranet. These risk assessments cover a wide range of generic handling activities for both inanimate load handling and patient handling. Any risk assessment that is downloaded must be localised to the specific ward/department and kept in a clearly marked folder in an accessible place. All staff must be made aware of the risk assessment and control measures that have been put in place. The risk assessments must be reviewed annually, as changes occur to the activity or after an accident or injury. If wards/departments carry out specific manual handling activities which have not been included in the Manual Handling Risk Assessment Library they should contact the Manual Handling Advisor (see Appendix 1) who will assist them to complete the risk assessment and place it on the trust intranet for others to download as required. The Manual Handling Risk Assessment Library can be found by accessing the trust home page: A Z Service M Manual Handling Manual Handling Risk Assessments Manual Handling Risk Assessment must be reviewed annually, as changes occur to the manoeuver or process, after an accident or incident or when no longer required. Exceptions to this process are: The Laboratory of Medicine, ISS Medi-clean and Darley Court who are using alternative processes approved and monitored by the Manual Handling Advisor. 20 of 35

21 Appendix 5 Bed Based Services Patient Manual Handling Assessments (NHSLA 4.5d) It is a requirement to assess all in-patients manual handling needs within 6 hours of admission.. To ensure this is carried out correctly and that a standardized process is used there is a specific pathway that must be followed. Step 1 - Patient Assessment and Care Document (R276) Section 8 (Mobility and Skin Integrity) this section contains two screening questions that will assist staff to decide whether it is necessary to complete a Patient Manual Handling Assessment - R313. Step 2 Patient Manual Handling Assessment (R313) Complete only if indicated on R Not at Risk 6 + At Risk No further action required. Revisit weekly, as changes occur to the patients mobility, physiological or psychological condition and on transfer to another ward. Specify frequency of reassessment above (usually in line with review of care plan). Complete a Specific Manual Handling Plan. Complete a care plan taking into account the information provided above and on the Specific Handling Plan. Should you be required to complete R313 your patient will receive a score and a risk rating: Depending on the Risk Score decide on the frequency of reassessment and indicate in the section provided. Step 3 Specific Handling Plan Complete only if your patients falls into the At Risk category on R313. Step 4 Mobility Needs Care Plan (NC48) After completing R313 and the Specific Handling Plan use the information provided to complete a Mobility Needs Care Plan (NC48) Please ensure you provide the Patients details, ward, date and time and sign all entries including your designation on all documentation. 21 of 35

22 Appendix 5 continued Review of Patient Manual Handling Assessments. (NHSLA 4.5e) All in-patients must have their Manual Handling Documentation reviewed weekly, as changes occur to the patients mobility, physiological or psychological condition and on transfer to another ward. However if the patient falls into the At Risk category then this should be carried out more frequently and the frequency of reassessment indicated on the appropriate documentation. Exceptions to the above process are: 1. Maternity Services 2. Neonatal Unit 3. Childrens and Young Persons Ward 4. Darley Court 5. HDU/ICU 6. Day Care Services All the above who are using alternative processes approved and monitored by the Manual Handling Advisor. 22 of 35

23 Appendix 6 Bed Based Services Patient Manual Handling Assessment Flowchart Patient admitted to ward Yes No Complete Patient Assessment and Care Document (R276) No further action required. Revisit weekly, as changes occur to the patients mobility, physiological or psychological condition and on transfer to another ward. No further action required. Section 8: Mobility and Skin Integrity. Is your patient independently mobile? YES/NO AND/OR Does your patient weigh > 152kg and/or have a BMI > 40 YES/NO Complete Patient Manual Handling Assessment (R313) No further action required. Revisit weekly or as changes occur to the patients mobility, physiological or psychological condition and on transfer to another ward. Yes Is your patients Risk Level Not at Risk No Specify frequency of reassessment (usually in line with the review of the Mobility Needs Care Plan NC48). Complete a Specific Manual Handling Plan (NC48) Complete a Care Plan (NC48) taking into account the information provided on the Patient Manual Handling Assessment Document and the Specific Handling Plan. Yes 23 of 35 Is your patients Risk Level At Risk

24 Appendix 7 Community Services Manual Handling of Loads: Assessment Checklist. (NHSLA 4.5d, 4.5e) Section A - Preliminary: Job Title: Base: Task: *Circle as appropriate Is an assessment needed? (i.e. is there a potential risk for injury, or are the factors beyond the limits of the guidelines?) Yes / No* If 'Yes' continue. If 'No' the assessment need go no further just file this page in the relevant binder. Operations covered by this assessment Diagrams not to scale (other information). Locations: Personnel involved: Date of assessment: Section B - See over for detailed analysis Section C - Overall assessment of the risk of injury? Low / Med / High* Section D - Remedial action to be taken: Remedial steps that should be taken, in order of priority: Date by which action should be taken: Manager / Person responsible: Date for re-assessment: Assessor's Name Signature: 24 of 35

25 Appendix 7 continued. Section B More detailed assessment, where necessary: Questions to consider: The tasks - do they involve: Holding loads away from trunk? Twisting? Stooping? Reaching upwards? Large vertical movement? Long carrying distances? Strenuous pushing or pulling? Unpredictable movement of loads? Repetitive handling? Insufficient rest or recovery? A work rate imposed by a process? The loads - are they: Heavy? Bulky/unwieldy? Difficult to grasp? Unstable/unpredictable? Intrinsically harmful (e.g. sharp/hot)? The working environment - are there: Constraints on posture? Poor floors? Variation in levels? Hot/cold/humid conditions? Strong air movements? Poor lighting conditions? Individual capability does the job: Require unusual capability? Hazard those with a health problem? Hazard those who are pregnant? Call for special information/training? Other factors: Is movement or posture hindered by clothing or personal protective equipment? If yes, tick appropriate level of risk Low Med High Yes/No Problems occurring from the task (Make rough notes in this column) Describing the problems Possible remedial action (Possible changes to be made to system/task, load, workplace/space, environment. Communication that is needed). 25 of 35

26 Appendix 8 Community Services SERVICE USER/PATIENT MANUAL HANDLING RISK ASSESSMENT (NHSLA 4.5d, 4.5e) Patient/Client Name Dob:./.../... GP: Address: Present at the assessment: Job title: HEIGHT WEIGHT (estimated or actual) Very Heavy 127 kilo s (20 stone and above) Heavy kilo s (15 20 stone) Average kilo s (10 15 stone) Light 63.5 kilo s (10 stone and below) PERSONAL INFORMATION Unpredictable Unable to co-operate Difficulty following instructions or communication problems Able to follow simple instructions Able to follow instructions/co-operative PHYSICAL ABILITY Risk of falls Unable to move unaided Needs two to transfer Needs one to transfer Independent Mobility THE PERSON HAS: Problems with sight or hearing Pressure sore/pain on movement Spasms/Stiffness Paralysis Catheter or Attachments None of the above ENVIRONMENT Restricted space Poor Lighting Hazardous floor surface Extremes of temperature Unsuitable height of bed/chair DOES THE TASK INVOLVE:- Excessive Pushing, Pulling Twisting or Stooping of the Trunk Frequent or prolonged physical effort Unusual capability Hazards for those with health problems and pregnancy Total COMMENTS/ACTION 26 of 35

27 Appendix 8 continued Community Services Rating for Risk Assessment Risk Score Colour Code Action 1-3 Green Low 4-6 Yellow Moderate 8 12 Orange Significant Red High Action 1. Sitting to standing 2, Transferring: chair/chair/commode 3. Walking 4. Toileting 5. Transferring to and from bed 6. Moving, Rolling and Turning in Bed 7. Dressing/Personal Care 8. Car/Transport 9. Stairs/steps 10. Other activity/therapeutic Handling No of Staff Required Equipment Required Date Supplied No Activity, handling methods and equipment used including person s ability to help themselves. *Maybe used as a Care / Treatment Plan. Staff are reminded to work within their own individual capability in line with Moving and Handling Training and Manual Handling and Uniform Policies where appropriate. Assessment Date: Assessor Name: Signature.. Re-assessment Date Assessor Name.. Signature.. Re-assessment Date Assessor Name. Signature... Re-assessment is required whenever circumstances change or annually if the environment and other conditions are stable. 27 of 35

28 Appendix 9. GUIDANCE NOTES FOR SERVICE USER/PATIENT MANUAL HANDLING RISK ASSESSMENT FORM 1. Ring more than one box per session if necessary. 2. Write comments on any aspect. 3. Add total and identify risk. 4. Risk assessments are intended to identify a risk, which is then reduced. If risk assessments are not acted upon, they are pointless. 5. Methods of moving/handling patients should be as per training. 6. Weight approximately Very Heavy 127 kilo s (20 stone and above) Heavy kilo s (15 20 stone) Average kilo s (10 15 stone) Light (up to 10 stone) 7. Use of equipment Is the manufacturer s guidance available? Has the equipment been assessed? Have you read the protocol for use of loans equipments? 8. The risk High = 2 Staff members Medium / significant = Inexperienced not alone Low = 1 Staff member 9. Document the risk remaining; any risk identified that cannot be reduced below 8 locally through the implementation of appropriate actions should be referred to the Risk Manager/Manual Handling Advisor. 10. Re-assessment date - Document the date of next re-assessment 11. Additional problems - If a problem is identified and not met for scoring add to the list. 12. The Task Consider distance of individual from trunk posture. Does the task involve twisting and stooping of trunk, or a combination of both Excessive lifting, lowering or carrying distances. Excessive pushing or pulling. Frequent or prolonged physical effort. Likelihood of sudden movement. Rest or recovery periods. Handling whilst seated. Team handling. Twisting or stooping of trunk, or a combination of both. 28 of 35

29 Appendix 9 continued. PERSONAL INFORMATION Unpredictable behaviour Unable to co-operate Difficulty following instructions Risk of falls/drop attacks Consider verbal/physical aggression Consider learning disability, Alzheimer s, mental illness Consider learning disability, hearing impairment, problems with communication PHYSICAL ABILITY Previous falls Unable to move unaided State most recent fall State walking aids if necessary THE INDIVIDUAL HAS Pressure sore/pain Spasms/stiffness Paralysis Attachments Consider position of sore/wound, as this would affect positioning. Also pain control prior to positions, as G.P. may need to be involved. Consider general health that is, is a good day/bad day Consider which part of the body is paralysed, as limbs may be painful Consider catheters, peg feeding, intravenous drips, colostomy bags, and syringe drivers, care needs to be taken to avoid displacement. ENVIRONMENT Restricted space Poor lighting Hazardous floor Extremes of temperature Unsuitable height of chair/bed Consider sufficient room to manoeuvre hoist. Furniture may need to be re-organised. Removed. Maximise lighting conditions, change light bulb if necessary, open curtains to promote natural light. Consider rugs, worn carpets, slippery floors and uneven surfaces, trailing flexes. Consider room temperature extreme hot/cold prevents muscles from working adequately. If bed/chair too high/low refer to disability team. 29 of 35

30 Appendix 10 Definition of Bariatric: Is anyone regardless of age, who has limitations in health and social care due to their weight, physical size, shape, width, health, mobility, tissue viability and environmental access with one or more of the following: Has a Body Mass Index (BMI) greater than 40 kg/m² (NICE 2006) Weighs greater than 24 stone (152kg) Exceeds the Safe Working Load (SWL) and dimensions of the supporting surface such as the bed, mattress, chair, commode, toilet, trolley, wheelchair or hoist (please note this list is not exhaustive and other equipment may apply). National Institute for Health and Clinical Excellence (NICE) (2006) classifies obesity as follows: Classification BMI (kg/m²) Healthy weight Overweight Obesity I Obesity II Obesity III 40 or more Statement of Commitment The organisation are committed to working in partnership to meet the health and social care needs of the bariatric / very heavy people who may access our services. It is recognised that the manual handling involved in the delivery of these services has a potential to cause injury to those being assisted, their carers and staff. The promotion of safer handling procedures and environments to accommodate these needs and maximise independence will be encouraged, whilst reducing the health and safety risks to all. 30 of 35

31 Appendix 11 Bariatric Assessment and Equipment Provision Bed Based Services Assessment of the bariatric patient Bed Based Services For the assessment of a bariatric patient follow Appendix 5: All bariatric patients will fall into the At Risk category when completing the Patient Manual Handling Assessment Tool and therefore a Specific Manual Handling Plan and Mobility Needs Care Plan must be in place. For specific information on the handling of a bariatric patient please contact the Manual Handling Advisor (see Appendix 4). Arrangements for Access to Bariatric Equipment Bed Based Services Bariatric Equipment is centrally stored in the bed store. Exceptions to this are: Bariatric Motorised Trolley - stored in Paediatric A and E Bariatric Bed Scales stored in Paediatric A and E Hover Matt and Jack stored in Aspinall House If bariatric equipment is required then staff must: Make arrangement to meet portering staff at the bed store to decide what equipment they need. Using the checklist attached to the equipment check it is in good working order and not damaged Sign the equipment out of the bed store using the provided system. Take a copy of Appendix 10 of the Manual Handling Policy and attach to the Patient Manual Handling Assessment Document R313. Porters will transport the equipment to the required area If equipment is transferred between wards/departments inform the MHA via or telephone. All equipment must be checked (using the attached checklist) to ensure it is in good working order and not damaged by the RECEIVING ward/department. If equipment is received either not working or damaged, inform the MHA via or telephone and where possible RETURN the damaged equipment to the previous ward/department who will be responsible for funding and ensuring the repairs are carried out. Where it isn t possible to return the equipment to the previous ward/department it is important that you inform them of the damage immediately, noting the date, time and name of the person you informed this information should then be passed onto the MHA via or telephone 31 of 35

32 Appendix 11 continued All equipment when no longer in use must be cleaned and tagged and returned to the bed store. If equipment is returned to the bed store that hasn t been cleaned or tagged it will be the responsibility of the previous ward/department to clean and tag the equipment. If equipment is returned to the bed store damaged it will be the responsibility of the previous ward/department to fund the repairs. DO NOT remove any damaged equipment from the bed store; inform the MHA who will trace responsibility for funding and arrange for it to be repaired. If you fail to check equipment on receiving it onto your ward/department and damage is later discovered it will be assumed that the damage has occurred in your area and therefore responsibility for the repairs will lie with you. Checking the bariatric equipment on receiving it on your ward/department will highlight damage and ensure that the correct area is held responsible for funding the repairs. 32 of 35