POLICY FOR THE ISSUE AND USE OF REMOTE ACTIVATED PERSONAL ATTACK ALARMS

POLICY FOR THE ISSUE AND USE OF REMOTE ACTIVATED PERSONAL ATTACK ALARMS This policy should be read in conjunction with Health and Safety Policy, Risk Assessment Policy, Lone Worker Policy, Policy for Managing Actual or Potential Aggression, Adverse Incident Reporting Policy Document Type Corporate Policy Unique Identifier HS-102 Document Purpose To minimise the risk of injury to staff, patients and visitors in units where there may be instances of violent and/or aggressive behaviour Document Author Risk and Security Manager Target Audience All staff using remote activated personal attack alarms in units where there may be instances of violent and/or aggressive behaviour Responsible Group Health and Safety Committee Date Ratified September 2014 Expiry Date September 2017 This validity of this policy is only assured when viewed via the Worcestershire Health and Care NHS Trust website (hacw.nhs.uk.). If this document is printed into hard copy or saved to another location, its validity must be checked against the unique identifier number on the internet version. The internet version is the definitive version. If you would like this document in other languages or formats (i.e. large print), please contact the Communications Team on 01905 760020 or email communications@hacw.nhs.uk

Version History Version Circulation Date Job Title of Person/Name of Group circulated to Brief Summary of Change 1. 09/14 H&S Committee members and Union H&S Reps Minor changes as part of scheduled review 2. 09/14 Quality & Safety Committee Ratified for use Accessibility Interpreting and Translation services are provided for Worcestershire Health and Care NHS Trust, including: Face to face interpreting; Instant telephone interpreting; Document translation; and British Sign Language interpreting Please refer to intranet page: http://nww.hacw.nhs.uk/a-z/services/translation-services/ for full details of the service, how to book and associated costs. Training and Development Worcestershire Health and Care NHS Trust recognises the importance of ensuring that its workforce has every opportunity to access relevant training. The Trust is committed to the provision of training and development opportunities that are in support of service needs and meet responsibilities for the provision of mandatory and statutory training. All staff employed by the Trust are required to attend the mandatory and statutory training that is relevant to their role and to ensure they meet their own continuous professional development.

POLICY FOR THE ISSUE AND USE OF REMOTE ACTIVATED PERSONAL ATTACK ALARMS Table of Contents Page 1. Introduction 2 2. Considerations When Installing a Personal Attack Alarm System 2 3. The Red Alert Personal Attack Alarm System 3 4. Risk Assessment 3 5. Administration of the Alarm System 4 5.1 Inpatient Areas 4 5.2 Non-Inpatient Areas 5 6. Use of the Alarm System 6 6.1 Emergency Alarm Activation 6 6.2 Assistance Alarm (where configured) 6 6.3 Emergency Alarm Response Procedure 6 7. Debriefing 7 8. Staff Induction and Training 7 9. Additional Information 8 Appendix 1 - Guidance on Risk Assessment & Reduction 9 Appendix 2 General Risk Assessment Form 15 Appendix 3 Form for Issue of Equipment for Personal Use by a Member of Staff 17 which must be returned to the Trust Appendix 4 - Staff Induction into the Personal Attack Alarm System Checklist 19 Appendix 5 Alarm Fob Record Sheet 20 An Equality Analysis Assessment has been undertaken on this policy Policy for the issue & use of remote activated personal attack alarms July 2014 Page 1 of 20

POLICY FOR THE ISSUE AND USE OF REMOTE ACTIVATED PERSONAL ATTACK ALARMS 1. Introduction 1.1 Fixed alarm systems include remote activated alarms, where members of staff wear a pager sized alarm with a panic button or similar device. If used, the fixed alarm system will activate. Members of staff can be located by the central control panel or by lights outside rooms. The advantage of this type of system is that there should be fewer false alarms and, if worn properly, there should be fewer accessibility problems. 1.2 Personal attack alarms are widely available and have a place in preventing serious assaults. Again, accessibility and ease of use in an attack need to be considered along with the type of activation (they should be one time activated and not require a button to be held) and their durability if thrown to the ground in an attack. Despite these possible drawbacks, experience has shown that they are often effective and can boost the confidence of the user. 1.3 There are two types of transmission for wireless personal attack alarms (which are carried on pendants): radio and infrared. Infrared has the advantage that it can pin- point the room or area in which the attack is taking place, whereas radio can only give an indication of the area in which the attack is occurring. The disadvantage of infrared is that, if the victim falls on top of the pendant, the infrared signal may be prevented from reaching the transceiver. Radio cannot be suppressed in this way. Most wireless personal attack systems rely on either infrared or radio; however, the best type is one that uses both transmission types to compensate for the weaknesses detailed above. A formal risk and technical assessment will determine which type of system is installed. 2. Considerations When Installing a Personal Attack Alarm System 2.1 It is acknowledged that within Mental Health Units, psychiatric emergencies and crisis situations are inevitable. Some of these situations will require the calling upon of additional staff support to maintain levels of staff and patient safety. 2.2 The staff attack alarm system will help to minimise the risk of injury to staff, patients and visitors to Mental Health Units. 2.3 This is a generic policy and individual ward/unit procedures should be developed, which detail the local administration of the system and the responses to alarm situations. 2.4 There are a number of issues, which health bodies should consider before deciding to invest in personal attack alarms. Personal attack alarms: Can send a strong deterrent message to potential offenders. May also improve the feeling of confidence amongst NHS staff, helping to reduce fear in the workplace. 2.5 Physical security in the absence of proper procedures, relational security and training to prevent and manage violence may also lead to a false sense of security. It is, therefore, important that a holistic approach to the problem is adopted. The issue of personal attack alarms, as control measures, may actually increase the overall risk and their issue should be given careful thought because their use could escalate a situation from verbal abuse to physical assault. Policy for the issue & use of remote activated personal attack alarms August 2014 Page 2 of 20

2.6 Careful consideration, therefore, should be given to their use and procedures and arrangements should be in place to ensure better overall security. They should be viewed as additional to, rather than a replacement for, robust systems of de-escalation training. 2.7 Staff should be adequately trained in the use of personal attack alarms, which should be tested at weekly intervals as a minimum. If members of staff are expected to respond to an attack alarm activation, they must be fully trained to deal with the situation they may be faced with. Conversely, members of staff who have personal alarms should be trained on the action to take once they have activated the alarm. 2.8 Advice on the installation of remote activated personal alarm systems will be provided by the Risk and Security Manager in conjunction with the Facilities Project Manager. 2.9 The Risk and Security Manager/Health and Safety Manager will review incidents recording violence and/or aggression directed at staff, patients and visitors. In relation to units where remote activated alarm systems are not installed periodic site audits will be undertaken to determine if such an alarm should be installed. 3. The Red Alert Personal Attack Alarm System 3.1 The Red Alert infra-red staff attack alarm system has been installed to improve safety for staff, patients and visitors by providing an instant method of alerting the occupants of the building that a potential aggressive or violent situation is developing in a nominated area of the building. 3.2 This guidance is to ensure that all members of staff working on the ward/unit are aware of how the system operates and their roles and responsibilities in relation to operating the system. The system is to be used to summon assistance whenever an individual requires support when feeling threatened, unsafe or in a medical emergency. 3.3 The principal advantages of personal attack alarm systems are that: They are usually easy to operate and are comparatively low cost They can form an integral part of staff protection in high-risk healthcare premises or environments Where mental health services are provided in areas of high risk, an alarm indicator board could be installed on a telephone switchboard, in reception or a security control centre, with personal attack alarms indicated visibly or audibly on the board They can, and should, be used to summon assistance that may require de-escalation so that violent situations can be avoided 3.4 In order for a member of staff to be protected by the alarm system it must be worn at all times, e.g. attached to a belt. 4. Risk Assessment 4.1 The Health and Safety at Work Act (1974) states that employers must ensure the health and safety at work of their employees and others that might be affected during the course of work. 4.2 Regulations 3, 4, 7 and 10 of the Management of Health and Safety at Work Regulations (1999) also provide for the necessity of assessing the risks to the health and safety of employees, identifying the precautions needed (including arrangements for such precautions), the provision of competent person(s) and the provision of information, instruction and training respectively. Policy for the issue & use of remote activated personal attack alarms August 2014 Page 3 of 20

4.3 Measures to reduce violence need to be based on sound risk assessment and risk management underpinned by effective strategies and locally developed policies. A Safer Place to Work - Protecting NHS Hospital and Ambulance Staff from Violence and Aggression, NAO, 27 March 2003. 4.4 The causes of violence at work can be varied and may be the result of a number of factors. Managers must carry out a risk assessment, the purpose of which is to identify the: Extent and nature of the risks Factors which contribute to the risks Changes necessary to eliminate or control the risks 4.5 Under the Management of Health and Safety at Work Regulations, 1999, employers must assess health and safety risks to identify what steps they need to take to reduce them. The risk of violence must be assessed in the same way as for any other hazard. Where the assessment shows a possibility of violence occurring, employers must take action to remove or minimise that risk. 4.6 Staff who undertake assessments should be competent, have the, time, resources and decision-making authority to do the task effectively. Risk assessments should always involve the relevant members of staff and be recorded. The main aim must be to reduce risk if and whenever possible and detailed guidance is provided in Appendix 1. 5. Administration of the Alarm System 5.1 Inpatient Areas 5.1.1 Ward Managers are responsible for ensuring that all members of staff on their wards, who, following the risk assessment, have been issued with an attack alarm fob, receive appropriate training in the use of the system, and understand their roles and responsibilities. 5.1.2 Ward Managers are responsible for ensuring that the alarm fobs are regularly tested, batteries changed and, if the units are faulty, repair work is undertaken. 5.1.3 A Staff Attack Alarm System Induction Checklist (Appendix 1) is provided and once completed and signed should be placed on the staff member s personal file. 5.1.4 When completed by bank staff a copy should be retained by the ward and the original sent to NHS Professionals, for agency staff the ward retains the document. 5.1.5 The Ward Manager is responsible for ensuring that this guideline is implemented. 5.1.6 Each ward will operate a signing in and out system for the alarm fobs using the provided recording sheet (Appendix 2). 5.1.7 The Nurse in Charge of each shift, or other nominated member of staff, is responsible for the following: a) Ensuring that all staff on duty sign out and wear an alarm key fob and return it at the end of the shift, again signing to that effect, using the document provided (Appendix 2). b) Ensuring that all visiting professionals are offered an alarm fob and shown how to use it, the fob should be signed in and out. Policy for the issue & use of remote activated personal attack alarms August 2014 Page 4 of 20

c) Will carry a reset Blue fob or delegate this responsibility to another qualified nurse. The responsibility to reset the alarm system by cancelling its activation when safe to do so is the responsibility of the person carrying the Blue fob. d) In response to alarms sounding on an individual member of staff s own ward, he/she will respond promptly and either take control of the situation or take action as directed by the person in control. e) In response to an alarm from another ward or outside the ward area the person in charge of the adjacent ward/clinical area will promptly identify and send at least one member of staff to support the incident. f) All staff have the following responsibilities: i) When the alarm is raised to respond promptly and seek guidance from the nurse in charge. If delegated to attend another area to respond to an alarm and do so promptly. ii) iii) Always have an alarm fob on them when on duty and ensure that it is signed out at the beginning of the shift and back in at the end. To report any alarms that are not working and make the nurse in charge aware. 5.2 Non-Inpatient Areas such as Administrative and Reception Areas adjacent to Inpatient Areas; or Outpatient Units and Clinics 5.2.1 During local induction, line managers will be responsible for ensuring that a checklist of returnable items (e.g. keys, access control cards, personal attack alarm key fobs, etc.) is issued to the member of staff and is completed on his / her commencement in post, or soon thereafter. This should include information on the items issued and the date of issue and receipt of these items will be acknowledged by the signature of the member of staff. Copies of this form will be retained by the manager and in the member of staff s personal file. Please refer to Appendix 2. 5.2.2 Managers are responsible for ensuring that all members of staff in their areas, who, following the risk assessment, have been issued with an attack alarm fob, receive appropriate training/instruction in the use of the system, their roles and responsibilities. 5.2.3 Managers will be responsible for ensuring that: a) The alarm fobs and system is regularly tested. b) If an alarm fob, or the system, appears faulty, repair work is undertaken, as soon as possible. 5.2.4 A central point will be identified locally to store alarm fobs and record sheets. 5.2.5 Following risk assessment, appropriate members of staff will: a) Be issued an alarm fob and will be required to sign it out to acknowledge receipt. b) Receive training/instruction in the use of the attack alarm fob and system. c) Be responsible for ensuring that the fob: Policy for the issue & use of remote activated personal attack alarms August 2014 Page 5 of 20

Is carried on his/her person, at all times, whilst at work Batteries are regularly checked and, when required, changed 5.2.6 If, following checks or return by a member of staff, an alarm fob is found to be faulty, it should be repaired, as soon as possible. 5.2.7 A member of staff, having returned a faulty alarm fob, should be issued with, and sign for, a replacement alarm fob. 5.2.8 Managers and administration staff are not expected to attend an incident outside of their work area. 5.2.9 In the event of an alarm being raised in the communal, administration or management areas of a mental health inpatient unit assistance will also come from inpatient staff. 5.2.10 Each member of staff will be responsible for returning all loaned items on or before his / her termination date or change of department. 5.2.11 Failure to return, or the loss of, these items will be investigated by the local manager and action taken to retrieve them or, if lost, obtain appropriate financial reimbursement. 6. Use of the Alarm System 6.1 Emergency Alarm Activation 6.1.1 Members of staff should be able to recognise when the situation is beginning to escalate and support is needed. The personal attack alarm should be used to summon assistance at this time. 6.1.2 In order to recognise this, all members of staff issued with personal attack alarms should, as a minimum, receive training in Promoting Safer and Therapeutic Services. 6.1.3 Members of staff who have personal attack alarms should also be trained on the action to take once they have activated the alarm. 6.1.4 To summon assistance, the pin must either be pulled from the fob, or the button pressed once, both of which will automatically activate the alarm system. If the system is configured to do so, pressing the button will activate the Assistance Alarm (see below). 6.1.5 The team manager should ensure that there are local procedures in place to ensure a proper and appropriate response once an alarm has been activated. 6.2 Assistance Alarm (where configured) 6.2.1 To summon local assistance, the red button on the fob should be pressed. This will activate the alarm (intermittent tone) in the immediate / local vicinity only. 6.2.2 Only staff in the immediate / local vicinity will respond after viewing the nearest wall mounted alarm display unit. Please note - the Emergency Attack Alarm will always override the Assistance Alarm 6.3 Emergency Alarm Response Procedure 6.3.1 Alarms can only react to breaches in security and do not protect premises, objects or personnel by themselves. To offer protection, an effective response to alarm activation is required. 6.3.2 When activated, an audible alarm will sound and precise details of the Policy for the issue & use of remote activated personal attack alarms August 2014 Page 6 of 20

location of the incident will be displayed on the wall mounted display units. 6.3.3 Members of staff, in the area, should determine where the incident is by viewing the nearest wall mounted alarm display unit and report immediately, to the senior member of staff at the incident scene, to await instructions. 7. Debriefing 6.3.4 The alarm may also sound in other parts of the building, identified as a linked area, and the wall mounted alarm display unit will again show the precise location of the incident. 6.3.5 The manager in charge of the linked area will, depending on staffing resources, send MAPA (management of actual or potential aggression) trained assistance to the incident. It is desirable that at least two members of staff are sent to support from each linked area, but an absolute minimum of one MUST be sent. It should be noted that MAPA is only for the management of patients. Violent threats from other sources such as visitors should be reported to the Police. 6.3.6 Members of staff should report to the senior member of staff at the incident scene and await instructions. 6.3.7 In inpatient areas, a situation may occur with a patient where it is deemed necessary to use physical restraint in order to maintain safety. The members of staff must have the appropriate level of MAPA training before intervening. If they are not MAPA trained or do not have the appropriate level of skills, they should not be attempting any physical restraint. 6.3.8 Specific responses should be detailed in local procedures and managers should consider the following: Circumstances when they should be activated Role of staff members Nominated person(s) to co-ordinate response action Circumstances where physical restraint may be appropriate and by whom Criteria for getting police involved Reporting procedures Follow up actions Staff debriefing and counselling 6.3.9 The Senior Nurse/Person in charge of the area will be responsible for debriefing staff and resetting the alarm. Important Note All members of staff have a duty of care to the patients and a moral duty to assist colleagues in emergency situations, irrespective of whether they are trained in restraint techniques. The manager in charge of the incident may require a member of staff to give support to service users who are not involved, if adequate support is available. Therefore, it is extremely important that as much support as possible is provided. 7.1 The nurse/manager in charge of the area will determine when it is safe to reset the system. Policy for the issue & use of remote activated personal attack alarms August 2014 Page 7 of 20

7.2 The nurse/manager in charge, following the incident, should debrief staff. 7.3 The incident must be reported on the Trust s incident reporting system. 8. Staff Induction and Training 8.1 All current staff will receive training/instruction in the use of the staff attack alarm system and its protocol prior to it going live. 8.2 Regular update sessions will be conducted by the designated nurse in charge of the system and / or authorised trainers. 8.3 All new starters, in areas where the system is in use, will be expected to undertake this training/instruction, at the earliest opportunity. 8.4 It is the responsibility of all staff to familiarise themselves with the staff attack alarm system Protocol. 8.5 Staff must update training annually. 8.6 The designated nurse/manager in charge of the system will maintain training records. 9. Additional Information 9.1 The system must NEVER be switched off. 9.2 Staff must not tamper with any of the equipment. All repairs and maintenance will be carried out by the manufacturer and co-ordinated by the Estates and Facilities Department. Policy for the issue & use of remote activated personal attack alarms August 2014 Page 8 of 20

Appendix 1 Guidance on Risk Assessment & Reduction Not everyone in the area may need to be issued with an alarm fob. The risk assessment, therefore, should identify members of staff who should be issued with one and under what circumstances. 1. Identifying the Hazards The following is a helpful way of identifying hazards: 1.1 Consider the tasks that have to be done -are some of the tasks undertaken potentially dangerous, e.g. refusing an appointment, administering medication, unwelcome information etc., the hazards (i.e. something with the potential to cause harm) within these tasks must, therefore, be identified. Analysis of reported incidents can also provide valuable information regarding hazardous situations. It is important to consider if a violent or aggressive patient may increase the risk of other activities that have to be carried out e.g. safe lifting, supporting or transferring of the patient 1.2 Consider the people involved - are some people encountered potentially dangerous e.g. a history of violence, a medical condition such as alcohol, drugs or a particular mental illness. If such potential is perceived in someone, whether they are a patient, relative or another person, then he or she is a hazard. Talking to managers, employees and staff representatives will help identify hazardous situations and potential assailants. 1.3 Consider the places where you work - are some work places more hazardous or vulnerable than others, i.e. if something were to happen, it could be more dangerous than in another setting; e.g. working in isolation, divorced from support, no means of escape, many potential weapons around, etc. Are there some blind spots within the workplace, e.g. a room at the far end of the corridor out of earshot, a storeroom in which staff could be trapped, etc.? 1.4 Consider the times when the work is undertaken - are some times potentially more dangerous than others, e.g. in the dark, out-of-hours, after family visits, when medication is being changed, when no one knows where you are, etc.? 1.5 In practice many of these hazards can be grouped together, e.g. a nurse is giving bad news to a patient with a history of violence in a side room when there is no one else around. It is often the cumulative hazard(s) that members of staff typically have to work with. Considering the job in this way helps to focus on the hazard areas that need to be addressed by risk assessments. 2. Who Might be Harmed and How As part of the risk assessment it is important to gauge how likely it is for an incident to occur and if it did how severe it would be: 2.1 Consider who might be harmed It is important to identify which groups of workers are likely to be most at risk of work-related violence, e.g. members of staff, who work directly with the public, face a higher risk of violence. The level of staff training and skills must be taken into consideration as this may affect their vulnerability. It is important not to overlook members of staff, such as: Policy for the issue & use of remote activated personal attack alarms August 2014 Page 9 of 20

New or young workers (anyone under eighteen years of age) Those who are not in the workplace all of the time, e.g. cleaners or maintenance workers Those who work late evenings or early mornings Lone workers Those who work in other employers premises Voluntary staff 2.2 Consider how people might be harmed Managers should consider the effects of physical assault and of repeated or severe non-physical assaults, e.g.: Stress Anxiety Reduced morale Absence from work Where possible, systems should be developed to identify potentially violent service users, in advance, so that the risks presented by them can be minimised. 3. Evaluate the risks Existing preventative measures and current ways of working should be checked to determine if they are still adequate, e.g. is it necessary for staff to work alone? A combination of factors is often the cause of work-related violence. Some of the factors which employers can influence include the: Type and level of training, information and support provided Working environment Design of the job. Managers should question: How staff are asked to work The circumstances in which they work The system in place for sharing information about clients 4. Record the findings The main findings of the risk assessment should be recorded. They should include, amongst other things: The hazards identified Potential assailants High risk areas and/or times The workers exposed Any existing preventative measures in place An evaluation of the remaining risks Any additional measures needed The person responsible for implementing control measures The date by which things will be completed Policy for the issue & use of remote activated personal attack alarms August 2014 Page 10 of 20

A written record provides a useful working document for managers and staff 5. Review and revise the assessment The risk assessment should be checked regularly to ensure that it remains valid and reflects the current work situation. If incidents occur or the job or circumstances change then the risk assessment should be reviewed to consider what additional measures are needed. 6. Preventative Measures If the risk assessment is systematic and rigorous it will have clarified the factors in each job which pose a risk of violence and highlighted many issues that will need to be questioned or changed if the level of risk is to be reduced. It will also have made clear which groups are most at risk. Any changes must be considered in a systematic way to ensure effectiveness as there are no across the board solutions which will be effective in every situation where the risk of violence exists. A solution, which works in one context, may fail in another. The employer s legal duty to provide safe systems of work (working practices), safe workplaces, safe working environments, and information, instruction and training to employees can provide a framework for devising preventative measures. 6.1 Safe Systems of Work The following points can be used when safe systems of work are developed or changed: Why is the job done in a particular way? Is it because it has always been done that way? Has the working method just developed over time or has it been shown that it is the only way to do the job well? When decisions are taken about working methods, is any consideration given to the risk of violence? Can the way a job is done be changed to reduce the risk of violence, for example, is it necessary to have one person working alone with a client/might two be more effective? Do team discussions about service users needs also consider the health and safety of staff? Are service users given information about procedures, timing, and why some things can only be done in a specific way so that the employees are not held responsible? Is the risk of violence considered when determining: staffing levels, staffing rotas, and the length of time individuals work directly with the public? Unpredictable and unremitting workloads can lead to fatigue and a diminished ability both to identify early and to cope subsequently with violent situations There should be sufficient flexibility in the provision of staff to adjust levels to meet actual needs Policy for the issue & use of remote activated personal attack alarms August 2014 Page 11 of 20

Individuals should not be left isolated for long periods nor should junior or inexperienced staff have to cope alone, especially in situations of potential violence 6.2 Job Design The design of jobs should be examined to ensure that they do not have built in risk factors that can increase the likelihood of violence occurring. Relevant questions include: Is the use of cash avoided wherever possible? Are the credentials of service users and the arrangements for meeting away from the workplace checked? What arrangements exist to prevent/reduce violence to lone workers? Are arrangements in place for staff to keep in touch when they are away from the workplace? Is a system in place to warn staff about aggressive or violent service users? Do employees know what to do if they are involved in a violent incident? Is counselling and support available for those involved in a violent incident and for their colleagues? 6.3 The Working Environment The working environment can play a crucial role in the prevention of work-related violence. The seating, lighting, facilities available and the level of information offered while waiting may affect behaviour. Some members of staff do not work from a fixed workplace and may be at a higher risk for this reason. It is essential that this is also taken into account when the working environment is assessed. Relevant questions that the safety representatives can ask include: Can public waiting areas be changed to reduce tension levels through: lighting, decoration, making them smaller and less impersonal, the number and arrangement of seats available, access to refreshments and telephones, and the provision of children's play areas, etc? Can the system for seeing people be changed so that people do not feel that they are part of a large crowd waiting too long and for very different services? Do interviewing rooms offer staff a means of easy retreat as well as offering privacy to the client? Are any offices or work areas sited away from the main part of the unit, leaving staff to work alone but still accessible to a member of the public? Is there a policy on home visits/does it need to be re-assessed, especially with regard to visits made late at night/in isolated areas? Are only essential home visits conducted? Can members of the public wander about the workplace unnoticed and unchecked? Are any premises or parts of premises more isolated at particular times of the day or night? Are areas between buildings and car parks well lit at night? Policy for the issue & use of remote activated personal attack alarms August 2014 Page 12 of 20

Have employees been provided with an alarm/switch on their desks or in their rooms to enable them to summon help? Are these maintained and has a procedure been established to ensure that help is always forthcoming? Employees must be encouraged to use the alarms whenever they feel unsure or uncomfortable and this must not be taken as a sign of weakness 6.4 Training Training in the prevention and management of violence should be provided to all workers, where a risk of violence has been identified. Training is not a substitute for safe systems of work, but it is an essential part of any strategy developed to reduce work-related violence and the training offered must be appropriate for the risk and the particular circumstance. A training needs assessment should be carried out to identify appropriate training, but at the very least workers should be trained to recognise the warning signs of aggression, so that they can either avoid or cope with it. They should understand any system set up for their protection and should be provided with any information they might need to identify service users with a history of violence. Relevant questions include: Have all members of staff, who come into contact with members of the public in their jobs, been given appropriate training? Are other members of staff, who may have to help in the management of a potential or actual violent situation, been given specific training? Are all members of staff clear about what to do if an incident occurs? Is specific training provided for those who work alone? Is the training regularly reviewed? The Training and Development Unit is responsible for the development of the training matrix, which identifies the training needs of all permanent staff (both qualified and unqualified) based on a trust-wide training needs assessment. The matrix identifies the percentage of each staff group that requires specific training. Matrix data is used to populate the yearly training prospectus, which is published on the Trust s Intranet. Service Delivery Unit Leads, and their team and ward managers are responsible for developing action plans and monitoring attendance to ensure all permanent staff complete relevant training programmes. The Training and Development Unit supports this process through individual staff did not attend letters to line managers and monthly service and departmental attendance reports based on the Oracle Learning Management (OLM) section of the Electronic Staff Records (ESR) where training records data is collated and coordinated. Ultimately the Quality & Safety Committee monitor non-compliance with the mandatory training programme. 6.5 No Single Solutions There are no easy solutions or short cuts to preventing or reducing violence at work. Often when the risk of violence is raised, the discussion focuses on the use of personal alarms, panic buttons, mobile phones, and self-defence training. Policy for the issue & use of remote activated personal attack alarms August 2014 Page 13 of 20

These can be useful but they are not a replacement for a well-planned systematic approach and can only be part of it. In addition they focus on the individual by passing the responsibility for dealing with the risk to the worker. Personal alarms do not prevent violence but can be useful as they may enable help to arrive more quickly. They can, however, give staff a false sense of security and are no replacement for a safe system of work. Where the work involves dealing with potentially violent service users, e.g. in mental health, and the risk assessments identify the cause of the risk; MAPA training can be offered that includes methods of diffusion and/or breakaway techniques. Policy for the issue & use of remote activated personal attack alarms August 2014 Page 14 of 20

Appendix 2 Assessment Reference No. Site/Building Department/Ward Activity Assessed GENERAL RISK ASSESSMENT FORM PART 1 Assessment Date Review Date Assessor Signature Assessment of Risks Assuming No Controls (New Assessment) or Existing Existing Precautionary Measures, e.g.: Further Controls (Review Assessment) Risk Rating Controls, Information, Instruction, Action? Hazard/Practice Persons at Risk L C R Training and Supervision Yes No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Policy for the issue & use of remote activated personal attack alarms August 2014 Page 15 of 20

Assessment Reference No. Site/Building Department/Ward Activity Assessed GENERAL RISK ASSESSMENT FORM PART 2 Assessment Date Review Date Assessor Signature 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Action Required Time-scale for Action Responsibility for Action Action Completed By (Name, Signature, Date) Retained Risk L C R Policy for the issue & use of remote activated personal attack alarms August 2014 Page 16 of 20

Appendix 3 Issue of Equipment for Personal Use by a Member of Staff which must be returned to the Trust I hereby acknowledge receipt of the following item(s) of equipment: Items of Equipment Date Received Policy for the issue & use of remote activated personal attack alarms August 2014 Page 17 of 20

I confirm that I shall take good care of the item(s) of equipment provided and take all reasonable steps to ensure that they are not mislaid, misused or stolen. Unless otherwise indicated, I understand that all the aforementioned items of equipment provided by the Trust should be returned on or before the final day of service in the Trust or when I no longer have a use for any or all of the items of equipment. I confirm that if I lose an item(s) of equipment, I shall report the loss immediately to: my line manager; record the loss on the Trust s incident reporting system; and complete a loss report form (available from the Finance Department) As, when and if instructed by my line manager I shall also inform: the Trust s Risk and Security Manager; and the Trust s Head of Information Governance (where equipment is mislaid or stolen which contains person identifiable information) Name of Member of Staff:. Signature. Once signed and dated a copy of this form should be given to the member of staff and the original retained on their personal file Policy for the issue & use of remote activated personal attack alarms August 2014 Page 18 of 20

Appendix 4 STAFF INDUCTION INTO THE PERSONAL ATTACK ALARM SYSTEM Ward/Work Area Manager s Name Staff Member s Name Bank/Agency/Permanent Item Date Signature of Member of Staff Manager s Signature Demonstrated how to operate Red key fob for both assistance and for emergency call Demonstrated how to operate blue reset fob and who has this responsibility Shown the layout of the ward/work area and where the alarm wall panels are located Informed of how to respond to an alarm and their roles and responsibilities in relation to a response Demonstrated how to sign out and in a fob including the location of the fobs identification number Informed about the principle and purpose of the system Informed about storage of fobs Demonstrated how to test a fob and made aware of the location of testing device/s Informed what to do if the fob is faulty Policy for the issue & use of remote activated personal attack alarms August 2014 Page 19 of 20

Appendix 5 ALARM FOB RECORD SHEET Ward/Work Area: Name Fob Number Date Time Out Sign Time In Sign Policy for the issue & use of remote activated personal attack alarms July 2014 Page 20 of 20