Policy: L3 Lone working Policy

Policy: L3 Lone working Policy Version: L3/04 Ratified by: Trust Management Team Date ratified: 3 rd June 2015 Title of Author: Title of responsible Director Governance Committee Project Manager Community Care Services Medical director Health & Safety Group Date issued: 4 th December 2015 Review date: April 2018 Target audience: Disclosure Status All Staff Trust wide. Can be disclosed to patients and the public EIA / Sustainability N/A Other Related Procedure or Documents: West London Mental Health NHS Trust Page 1 of 26

Equality & Diversity statement The Trust strives to ensure its policies are accessible, appropriate and inclusive for all. Therefore all relevant policies will be required to undergo an Equality Impact Assessment and will only be approved once this process has been completed Sustainable Development Statement The Trust aims to ensure its policies consider and minimise the sustainable development impacts of its activities. All relevant policies are therefore required to undergo a Sustainable Development Impact Assessment to ensure that the financial, environmental and social implications have been considered. Policies will only be approved once this process has been completed West London Mental Health NHS Trust Page 2 of 26

L3 - Lone Working Policy Version Control Sheet Version Date Title of Author Status Comment L3/01 29 October 2008 L3/02 9 th L3/02 21 st February 2011 February 2011 L3/03 November 2012 Head of Standards & Compliance Local Security Management Specialist Local Security Management Specialist Original L3/02 LSMS. L3/03 Pam Scott L3/04 April 2015 Local Security Management Specialist Robert Murray Policy issued Revised Policy under consultation ending 15.02.11 Revised Policy issued Review of Policy Review of Policy Amended for NHSLA Compliance 24 th Jan 11 reviewed for NHSLA Compliance. Present to Policy Review Group 31 st January 2011 for approval approved subject to 1-week consultation No comments received during consultation period Original policy was written by LSMS. To be presented to December 2012 TMT, for approval Approved subject to minor changes Under Trustwide consultation ending 19.05.15 minor amendment to Appendix 1, section 5.7.1 reissued 04/12/15. West London Mental Health NHS Trust Page 3 of 26

Content Page No 1. Flowchart... 5 2. Introduction... 6 3. Scope... 6 4. Definitions... 6 5. Duties... 6 6. Systems and recording... 8 7. Lone working... 8 8. Training... 9 9. Monitoring... 10 10. Fraud statement... 10 11. References (external documents)... 10 12. Supporting documents (trust documents)... 10 13. Glossary of terms / acronyms... 10 14 Appendices... 11 Appendix 1 Lone working procedures... 12 Appendix 2 WLFS procedure... 18 Appendix 3 Lone worker risk assessment... 23 Appendix 4 Dynamic Risk Assessment... 24 Appendix 5 Home visiting Checklist... 25 Appendix 6 Training confirmation form... 26 Appendix 7 User profile form... 26 Appendix 8 Departmental escalation... 26 West London Mental Health NHS Trust Page 4 of 26

1. Lone worker Incident actions flowchart The most important action to maintain staff safety is to ensure preventative measures are in place, such as good clinical risk assessments and local team safety arrangements The lone worker: Incident occurs 1. activates lone worker alarm device if issued 2. removes themselves from the situation/environment to a place of safety 3. contacts: NHS lone worker service, on activation of device the activity below is triggered Lone worker device activated for a genuine alarm (a) police (b) manager/buddy 4. The lone worker returns to work base as soon as practicable to complete an incident report form or a serious untoward incident form. 5. If a physical assault, a completed form is submitted to NHS Protect. Alarm receiving centre (ARC) operator monitors the incident. A recording is made and the lone worker s location is identified. 6. The line manager initiates a postincident review in conjunction with Risk, Health and Safety and Local Security Management Specialist (LSMS). ARC operator conducts a full risk assessment of the incident and takes appropriate action, following the predetermined escalation path. If risk is severe, they contact the emergency services. Post-incident review process begins including: medical review (consultant/doctor) Safety and Security review Serious Incident Review (risk management) Counselling/support as appropriate to employee or other individuals affected by incident Following up on all witnesses to the incident. Conduct risk assessment. Review process also provides feedback on processes/systems in place, identified weaknesses and lessons learned. The LSMS listens to the recording. If no action by the police has been taken, the LSMS will, if necessary, take appropriate action to progress criminal, civil or local sanctions in conjunction with the police and Crown Prosecution Service. information If incident was a false alarm (i.e. accidental activation): 1. recording is closed with user s agreement 2. record is Deleted West London Mental Health NHS Trust Page 5 of 26

2. Introduction 2.1 This policy is concerned with Trust employees who 'work alone' with or without patients during the course of their employment. It also recognises such circumstances where it is unavoidable that a member of Trust staff should be required to work alone or in an isolated working environment. 3. Scope 3.1 Trustwide staff that are required to work alone. 4. Definitions 4.1 Lone Working may be defined as any situation where someone works without a colleague nearby, or when someone is working out of sight or earshot of another colleague. This could be outside a hospital or similar environment or internally, where staff care for patients or service users on their own (NHS CFSMS 2005). This also includes reception staff working alone, on-call staff, security staff particularly at night, staff locking and unlocking work areas early in the morning and late at night, individuals seeing patients alone on the ward or in the community and staff on escort alone. 4.2 Other descriptions commonly used are Community or Outreach Workers. Lone Working may be a constituent part of a person s usual job, or it could occur on an infrequent basis, as and when circumstances dictate. 4.3 Lone Working is not unique to any groups of staff, working environment or time of day. 5. Duties 5.1 Chief Executive The Chief Executive is responsible for ensuring that the Trust has policies in place and complies with its legal and regulatory obligations. 5.2 Accountable Director The Director of Nursing and Patient Experience is the accountable director and is responsible for the development of this policy and to ensure it complies with NHSLA standards and criteria where applicable. It must also contain all the relevant details and processes as per L3. They have overall responsibility for trust wide implementation and compliance with the policy. 5.3 Managers Managers are responsible for ensuring policies are communicated to their teams / staff. They are responsible for ensuring staff attend relevant training and adhere to West London Mental Health NHS Trust Page 6 of 26

the policy detail. They are also responsible for ensuring policies applicable to their services are implemented. 5.4 Policy Author Policy Author is responsible for the development or review of a policy as well as ensuring the implementation and monitoring is communicated effectively throughout the Trust via Service Lines/ Directorate leads and that monitoring arrangements are robust. 5.5 Local Policy Leads Local policy leads are responsible for ensuring policies are communicated and implemented within their Service Lines/ Directorate as well as co-ordinating and systematically filing monitoring reports. Areas of poor performance should be raised at the Service Line / Directorate Senior Management Team meetings. 5.6 Specific Staff for Policy The Trust recognises that as an employer, it has a duty of care towards its staff and that reasonable steps should be taken to ensure their Health, Well Being and Personal Safety at all times. It is also acknowledged that all employees have a responsibility for ensuring the safety and well being of their work colleagues, patients and visitors. This Trust will ensure so far as is reasonably practicable that employees are protected when working alone through the process of hazard identification, risk assessment and elimination; or where elimination of the risks is not possible, to reduce the risks to an acceptable level. 5.7 The Trust has systems for the review of violent incidents and authorise staff to make changes as a result of these reviews. This will be carried out through the Service Line specific Incident Review and Security Steering Groups. Risk assessments will be carried out based on findings from reviews and action plans to reduce the risk of incidents will be agreed by the stakeholders and an action plan developed. 5.8 Local Security Management Specialist (LSMS) 5.8.1 The Local Security Management Specialist is responsible for ensuring that procedures are developed locally, in conjunction with relevant stakeholders, including staff representatives, to implement NHS Protect Guidance in relation to NHS staff who work alone and to allow proper consideration of physical security measures that may be appropriate The Local Security Management Specialist is responsible for the routine management of non-clinical security issues. 5.9 All Staff 5.9.1 Team managers within the Trust are responsible for developing local procedures to minimise the risk of lone working and the action to be taken in the event of a member of staff known to work alone who cannot be contacted. This will form part of local/secondary induction to the workplace. 5.9.2 An annual audit of lone working procedures must be undertaken by each directorate and reported at divisional clinical governance/ executive meetings. The Trust will undertake an audit to validate local information yearly in partnership with staff side representatives. West London Mental Health NHS Trust Page 7 of 26

6. Systems and recording 6.1 Where recorded: Clearly identify the situation and the Lone working Situation within the IR1 incident reporting system on the Exchange 6.2 When recorded: Immediately following or as soon as possible following an incident 6.3 Recorded by whom: Any individual involved in an incident which is lone worker related. 7. Lone working 7.1 Trust Lone Working procedures set out the process and mechanisms to support staff in Lone Working situations, these include risk assessment, methods and systems in operation within the Service Line, support systems and review process. 7.2 Prevention 7.2.1 All Trust Managers must ensure that a full Lone Worker Risk Assessment ( Appendix 1) has been conducted which identifies control measures, communication systems and training requirements for staff who work alone within the confines of a building, while on domiciliary visits or otherwise on Trust business. Managers must regularly review working practices in order to ensure that all situations where staff are required to work alone are kept to a minimum and appropriate control measures are in place. 7.2.3 All employees have a responsibility to abide by this policy and any decisions arising from the implementation of it. Any possible risks to the health and safety of themselves or others should be reported to their Manager. Individuals are accountable for their own practice and where lone working safeguard processes or electronic devices are in place must adhere to these for their own safety and that of colleagues. 7.2.4 The key to preventative action is an understanding of how and why incidents occur in lone working situation s, and learning lessons from that understanding. 7.2.7 In order to achieve this, the following factors should be considered in the development of local procedures: Type of incident (e.g. physical assault / theft of property or equipment). Severity of incident. Cost to individual and organisation (human and financial). Individuals or groups of staff involved. Weakness or failures that have allowed the incidents to take place.(e.g. procedural, systems or technological). Training needs of staff. Review of measures in place to manage risk. Technology in place for the protection of Lone Workers. Local Procedures in relation to Lone Working are developed, these to include a Lone worker risk assessment completed by team Managers Appendix 1, a Dynamic Risk Assessment template is attached as appendix 3 and a Home Visiting Checklist for Managers and Staff is attached as appendix 4 West London Mental Health NHS Trust Page 8 of 26

7.3 Positive Reporting Practices 7.3.1 The Trust Incident Reporting System (IR1 system) must be used to record incidents 7.3.2 Any areas of identified risk that has not been addressed or a management plan in place must be placed on the Trust Risk Matrix. 7.4 Incident Reporting and Investigation 7.4.1 Where incidents have taken place it is important that these get reported to the LSMS, where lessons can be learned. It is important that these are fed back into revisions of procedures and systems locally, as well as national guidelines to ensure the Lone Workers are provided with the best possible protection, if the risks they face are to be minimised. 7.4.2 Where an incident is a physical or non-physical assault this must be investigated and appropriate sanctions applied in accordance with framework for tackling violence against NHS staff established in May 2004 by NHS Security Management Service. 8. Training 8.1 Training for Lone Workers Lone workers will be given the essential knowledge and skills to perform their role in a positive, confident, caring and safe manner. Training should be based on individual and local needs. To include conflict resolution training, familiarity of systems in place locally, this will be provided through induction and mandatory training, supervision and mentoring in teams and specific training provided by external agencies. 8.2 Managers 8.2,1 It is the responsibility of all managers to ensure that staff receive the appropriate support, training and guidance to carry out their duties. Risk assessments (including dynamic risk assessments) must be carried out as per local, national and statutory guidance. Managers will ensure that teams have a local arrangement whereby staffs where abouts are known and that there is an agreed method to raise alarms if workers feel at risk or is a team member is concerned about the where abouts or safety. 8.3 All Staff 8.3.1 It is the responsibility of all staff to attend the training provided to enable them to carry out their duties. Risk assessment, recording and reporting of hazards or potential hazards is an essential part of this process 8.4 Lone worker Devices In addition to mobile phones the Trust support use of electronic staff safety devices, a user guide to our current Indeticom device is attached as appendix 4 the escalation forms and request forms for training from external agencies in addition to the request forms for additional devices are attached as appendix 5,6,7 West London Mental Health NHS Trust Page 9 of 26

9. Monitoring 9.1 This policy refers to all lone workers within WLMHT. The Quality Committee is responsible for monitoring the effectiveness and implementation of this policy. The Committee will therefore ensure periodic review of the policy. This will occur every 3 years unless emerging evidence indicates. 10. Fraud statement 10.1 Not applicable 11. References (external documents) 11.1 This policy should be read in conjunction with the following: 11.2 The document Not Alone : A guide for better protection for lone workers in the NHS (NHS CFSMS 2009 version 2) provides a comprehensive account and guidance to addressing the problems associated with lone working and should be read in conjunction with this policy in developing local procedures. 11.3 The Management of Health and Safety at Work Regulations 1999. In particular Health and Safety Executive guidance on the risks of lone working: Leaflet INDG73(rev3), published 05/13 11.4 Suzy Lamplugh Trust personal safety advice 12. Supporting documents (trust documents) 12.1 This policy should be read in conjunction with the following trust policies: B3 Bullying & Harassment. H3 Health & Safety. I8 I8A Incident Reporting and Management Policy. M3 Mental Well-Being. V2 Prevention and Management of Aggression and Violence. R1 Risk Management Strategy & Policy. S27 Security Management Policy 13. Glossary of terms / acronyms IM&T Information and Technology LSMS Local Security management System NHS National Health Service PMVA Prevention of Violence and Aggression Training WLMHT West London Mental Health NHS Trust West London Mental Health NHS Trust Page 10 of 26

14 Appendices Appendix 1 Lone Working Procedures Local Services Appendix 2 WLFS09 Procedure for the Management of Lone Worker Devices Appendix 3 Lone worker Risk Assessment Appendix 4 Dynamic Risk Assessment Appendix 5 Home Visiting Checklist Appendix 6 Training Confirmation Form Appendix 7 User Profile Form Appendix 8 Departmental Escalation West London Mental Health NHS Trust Page 11 of 26

Appendix 1 Lone working procedures Lone Working Procedures Local Services 1.0 Every Manager of a service or department will draw up a local protocol that reflects the special nature of their service, local conditions and circumstances. Note: The majority of Trust staff will, at some point during their working week, be classed as lone working. (See Definitions below) 1.1 The local protocol should be in line with the Trust Lone Worker Policy & Procedure & should cover issues of summoning help, employees working alone in the workplace and employee visits outside their work base or between workplaces. Any local arrangements must be agreed with the persons affected and line management. The attached Control Sheet must be completed and will form the basis for the risk assessment and any local procedures. Managers must ensure: Any incident arising out of lone worker situations is reported in accordance with the Trusts Incident reporting procedure. Action is taken to minimise the effects of a recurrence. That staff are fully involved in the risk assessment process including the control measures when being required to work alone Where the risk assessment identifies a training, information or instruction requirement in order to reduce the risks to an acceptable level, such training, information or instruction is provided 2.0 DEFINITIONS Lone workers will include:- Staff employed on people who use services related work whose work may take them away from their base. eg Community Staff, Ward Based nursing staff on escort. Staff employed on service related work whose work may take them away from their base or who are working in remote areas eg. Maintenance staff. Staff employed in an establishment/part of an establishment where for part/all of their hours they are alone eg. Receptionists. Staff employed out of normal hours eg. Domestic/cleaning staff, on call staff, night duty staff. Work undertaken at an individual who use services, normal place of residence in the community, on the street or elsewhere outside of the Trusts control. Those travelling alone between locations on Trust business. 3.0 APPENDICES (As attached in the L3 Lone Worker Policy) Appendix 3 - LONE WORKER RISK ASSESSMENT Appendix 4 - DYNAMIC RISK ASSESSMENT West London Mental Health NHS Trust Page 12 of 26

Appendix 5 - HOME VISITING CHECKLIST 4.0 MONITORING Policy /Procedure Compliance Monitoring Table What will be monitored Required H&S risk assessments are in place and reviewed How/Method MANAGEMENT REVIEW FREQUENCY LEAD REPORTING TO MONTHLY LOCAL MANAGER SENIOR MANAGER Deficiencies / gaps recommendations and actions Monitored at Health and Safety Committee Required H&S risk assessments are in place and risks are adequately controlled QUARTERLY AUDIT INDEPENDENT AUDIT PSR 3 MONTHLY TO PROGRAMME PERIODIC REVIEW SELF AUDIT HEALTH AND SAFETY TEAM PEER SERVICE REVIEW TEAM SENIOR MANAGER SENIOR MANAGER & HEALTH AND SAFETY COMMITTEE SENIOR MANAGER Senior Manager. Monitored at Health and Safety Committee 5.0 AWARENESS 5.1 It is important to remember that management procedures and physical measures, such as the use of technology, cannot work in isolation from each other. They must be seen as integral to and co-dependent on each other. For example, it is pointless for someone visiting a patient/service user in their home to have a mobile phone if there is no one in their base office to answer the phone should they need to make an emergency call. 5.2 Lone Workers need to know that there is a structure in place to help them if they need assistance. Managers and colleagues need to know that Lone Working staff are safe and they have procedures in place so that when something untoward occurs it can be quickly detected and appropriate assistance provided. This may include Doctors on call and/or staff moving between buildings/locations at night. 5.3 Through better and increased reporting by staff, more will become known about the nature, scale and extent of the problem, allowing LSMS to further improve the local procedures in place, minimise the risks that staff face and, nationally, contribute to the further development of guidance. It is important for there to be good reporting processes in place for staff to facilitate this process. Staff must be supported and encouraged to report in the reassurance that it will be investigated and that appropriate action will be taken. 5.4 To ensure that Lone Working security and safety procedures and systems are accepted and put into use, it is necessary to communicate effectively to all relevant staff what their roles and responsibilities are in relation to this, whether they are a manager, a colleague, or a Lone Worker. It is essential that staff, at all levels, are West London Mental Health NHS Trust Page 13 of 26

made aware of their responsibility to be familiar and compliant with Lone Working procedures that are in place for their protection. 5.5 Prior to Working Alone 5.5.1 Analysis of robust risk assessments, reports and operational information may have highlighted identified technology, which if used correctly in conjunction with robust procedures they will enhance the protection of Lone Workers. 5.5.2 It is essential that Lone Workers receive proper training and instruction in the use of such devices and are given sufficient time to become familiar with Lone Worker procedures, systems and devices, before they are expected to use them in their day to day work. 5.5.3 Staff must attend and complete the appropriate level of Prevention and Management of Violence and Aggression (PMVA) Training as part of their primary induction. 5.5.4 Prior to working alone with service users, staff must record the location, approximate time-scales of visits and an agreed time to report back with a nominated individual at a Trust base. 5.5.5 Following completion of visits or any change in arrangements, staff must inform the nominated individual at a Trust base. 5.5.6 If a member of staff does not report back as agreed, the nominated individual at a Trust base should attempt to make contact with them. 5.5.7 If contact cannot be established with the member of staff, contact should be made with their last known location to confirm the visit and time of departure. 5.5.8 If the member of staff can still not be contacted, further action should be taken as identified in local procedures and dependent on the level of risk involved. Such Action may include contacting the Local Security Management Specialist and consideration of police involvement. 5.5.9 Under no circumstances, should staff compromise their safety. If they feel unsafe at any point, while in a Lone Working situation, they should remove themselves from the situation immediately. 5.5.10 Where provided, a mobile telephone should always be kept charged, staff should know how to use it with key numbers on speed dial, it should be used in a sensitive and sensible manner to reduce the risk of escalating a situation. Hands free equipment should be used for driving. Staff should have agreed code words known to all at base which convey the nature of the threat. Mobile telephones alone cannot be wholly relied upon as a means of communication as signal strength can vary. Lone worker devices are in operation in a number of services. The Identicom lone worker device is being rolled out as part of an initiative co-ordinated by NHS Security Management Service and the Local Security Management Specialist. Local procedures for use are in place. 5.5.11 Employees in transit MUST keep colleagues informed of their whereabouts to ensure their own safety in line with departmental procedures. This includes full details of addresses of where they will be working, names and contact details. This may include calling their department to inform someone that they arrived at an West London Mental Health NHS Trust Page 14 of 26

appointment safely and calling again when they leave to say they are on their way back to the department. 5.5.12 Arrangements should be in place to ensure that a colleague with whom details have been left leaves for some reason, they will pass the details on to a colleague who will contact the Lone Worker. 5.5.13 Details of a Lone Worker s vehicle including registration make and model should be recorded at base. 5.5.14 Where genuine concern exists, the manager should use the information in their log to track whether they attended visits. Depending on the circumstances and whether contact through normal means can or cannot be made, the manager or colleague should involve the police, if necessary. If police are involved, they should be provided with all the facts and information promptly. 5.6 Assessing Risk in relation to Lone Working 5.6.1 Risk assessment is carried out to identify the risks to staff and any others affected by their work. The assessment should identify how the risks arise and how they impact on those affected. This information is needed to make decisions on how to manage those risks, so that decisions are made in an informed, rational and structured manner and the appropriate action is taken. 5.6.2 Risk assessments should consider: Work Place Identification in relation to Identification of the Lone Worker staff groups exposed to risk. The requirement of a dynamic risk assessment and Zoning. Assessment of working conditions. Assessment of particular work activities. Assessing the possibility of an increased risk of aggression and violence due to substance use or mental / personality disorder. Assessment of equipment and practical use by Lone Workers. Evaluation of physical capabilities for undertaking Lone Working (e.g. pregnancy / disabilities / experience). Assessment of emergency equipment required (e.g. torch, map of area, telephone numbers, and first aid equipment). Assessment of exit strategy from the location/room if under threat 5.7 Positive Reporting Practices 5.7.1 Lone Workers must always ensure that someone else is aware of their movements (i.e. names / times / addresses / contact details). This can be achieved through completion of a daily / weekly log of activities, this would be further enhanced through a buddy system, where a Lone Worker nominates a buddy, they in turn must be aware of their responsibilities as part of the role, and contingency plans must also be available. 5.7.2 Procedures should be in place to ensure regular contact is maintained with nominated personnel throughout the working day, particularly if delayed or changes occur to the plan of day. 5.7.3 It is vital that as part of induction to a role that includes Lone Working, emphasis is placed on the importance of making contact with the named person at the end of a visit / working day. West London Mental Health NHS Trust Page 15 of 26

5.8 Risk Assessments prior to Visits 5.8.1 Where practicable, a log of known risks should be kept updated and reviewed in respect of the location and details of patients/service users/other people that may be visited by their staff, where a risk may be present. This log should be retained in accordance with the Data Protection Act 1998 and only strictly factual information should be recorded. The log should be available for Lone Workers to inspect before a visit. 5.8.2 Clinicians need to dynamically assess risk and plan visits based on risk zones, this includes a dynamic door step risk assessment of whether it is safe to enter an individuals premises. 5.9.3 Colleagues who have worked in particular areas or with particular personnel should be contacted to help communication about particular risks and action to be taken to minimise them. Such information should, where legally permissible, be communicated with other agencies who may work with the patients/service users, as part of an overall risk management process. 5.9.4 Where known risks exist, it may be necessary to be accompanied on certain visits. Such agreements must be informed by the risk assessment process and planned by the team. 5.9.5 Where animals may be present at a particular address it may be necessary to make contact with the occupants prior to the visit, to request that they are removed or made secure prior to arrival. 5.9.6 The details of action to be taken prior to and during visits, working with high risk patients / service users or whilst escorting patients / service users should be included in local procedures. 5.10 Lone Working and Travelling 5.10.1 Ensure vehicle is safe and capable of carrying out the task required. Items such as bags, cases, CD s should be out of sight preferably where possible stored in the boot, for personal safety having doors locked at slow speeds would be advisable. 5.10.2 Try to park close to the location being visited, in dusk/night and in poor weather conditions park in a well lit area and facing in the direction in which you will leave. Lock the vehicle. 5.10.3 Lone Workers driving alone should not stop for people who may be in distress, rather stop in a safe place as soon as practicable and contact the emergency services. 5.10.4 If followed, or in doubt of being followed, continue to the nearest police station or manned and lit building such as a petrol station to request help, in case of breakdown contact buddy and manager immediately maintain contact throughout. West London Mental Health NHS Trust Page 16 of 26

5.10.5 Signs such as doctor on call, or Nurse on call, shouldn t be displayed as this may encourage thieves to break in to steal drugs for example. 5.10.6 When using public transport, use a timetable, wait at a busy or well lit stop, avoid empty upper decks on buses and where possible sit near the driver, if threatened by another passenger inform the driver immediately. 5.10.7 Taxis should be pre-booked with a reputable company. If not pre-booked, go to a recognised taxi rank to hail a cab, sit in the back, be aware of child locks and central locking (most black cabs will lock the doors whilst in transit) in the cab, avoid giving out personal information. 5.10.8 When walking avoid using a mobile phone overtly in any area, if someone tries to steal what you are carrying relinquish it, try to keep mobile and house keys in different locations, use of a wallet or purse with petty cash and expired credit cards may also be useful, inform the police as soon as possible, make a note of time date and events, contact the LSMS as soon as possible and inform them of the incident. West London Mental Health NHS Trust Page 17 of 26

Appendix 2 WLFS procedure Procedure: WLFS09 Procedure for the Management of Lone Worker Devices Procedure Relates to Primary Policy: L3 Lone Working Policy Version: 6 ISSUED AS A RED ALERT TO LONE WORKERS Approved by: Security Steering Group Date approved: 18 th February 2015 Title of Author: Service Manager, Team Manager & Responsible ED: Responsible Senior Manager Leeanne McGee Paula King Governance Committee Security Steering Group Date of Procedure 30 th January 2015 Date issued: 1 st May 2015 Review date: February 2016 Target audience: All Lone Workers Disclosure Status Not to be disclosed to patients or public West London Mental Health NHS Trust Page 18 of 26

Version Control Sheet Version Date Title of Author Status Comment 1 10.1.2011 FOS Managers Approved Review in 6 months 2 7.6.2011 FOS Managers Approved Review in 1 year 3 7.6.2012 FOS Managers Approved Review in 1 year 4 14.7.2013 FOS Managers Approved Review in 3 mths 5 6.11.2013 FOS Managers Approved Review in 1 year 6 30.1.2015 FOS Managers Approved Review in 1 year West London Mental Health NHS Trust Page 19 of 26

PROCEDURE FOR THE MANAGEMENT OF LONE WORKERS Introduction In order to support the management of lone workers, Lone Worker Devices have been obtained as part of a Government scheme in order to provide additional support to staff seeing patients in a community setting. Dual working / joint visits will be carried out if the staff member or team feel that the risk is such that two (or more) members of the Forensic Outreach Service need to undertake the visit jointly. In addition, due to the risks attached to working the St Bernard s Gymnasium and the Patients Library, a lone worker device has been issued to staff working in these areas. Both services are located on the Ealing site. The lone worker device is a small rectangular unit which is worn around the neck on a safety lanyard. All lone workers are required to complete their training on the use of the device before the device can be activated. It is the responsibility of the lone worker to check the network coverage and battery strength before entering an increased risk environment. Reminders of how to check the battery, set up an Amber Alert and activate a Red Alert can be found in the Easy Reference Guide which was issued with the device. The Functions The Amber Alert: This function is used to pre-record details of the lone worker s location and/or to initiate an alarm timer on the Identicom. The lone worker must speak clearly. They must say their name and the full address and post code of the address they are visiting. For gym or library staff the address of the Ealing site will be given. The Red Alert This function is used at any time when the lone worker feels that their personal safety is being compromised. Procedure when a Red Alert is Activated When a Red Alert is activated, the service provider, Reliance, will be given access to listen to the interaction with the patient. They will make a decision about whether the police should be called or whether the situation is under control. If the service provider feels that the lone worker s personal safety is being compromised, then they will call the police. The Trust s Contact Centre will be called to alert them to an incident and the Contract Centre will, contact the named persons on the list to inform them that a Red Alert has been activated. A decision will then be made on the most appropriate action to take. The named persons would then make immediate arrangements to attend the community site, St Bernard s Gymnasium or Patients Library in order to provide support to the lone worker. Red Alert activation in error On occasion, a Red Alert may be activated by mistake. Again, on activation the service provider, Reliance, will automatically be given access to listen to the interaction with the patient. If it is clear West London Mental Health NHS Trust Page 20 of 26

that personal safely is not being compromised then the police will not be called. In the first instance the service provider would contact the lone worker on their mobile phone to inform them that the Red Alert has been activated and to check that no incident has arisen. If the service provider does not get a response on the mobile phone, they will then contact the Contact Centre, to alert them than a Red Alert has been activated, that the police have not been called but that the lone worker has not responded to a mobile phone call. The Contact Centre would then contact the named persons on the list to inform them of the situation. The named persons on the list would then have to make a decision on the most appropriate action to take. FORENSIC CONTACT LIST If a Red Alert is activated outside of office hours, then the Senior Nurse on call should be contacted in the first instance. If a Red Alert is activated during the hours of 9 am to 5.30 pm then the following persons should be contacted. The contacts are responsible for informing the Contact Centre of any annual or other planned leave. If contact with the following named persons is not successful, then the Duty Senior Nurse should be contacted Contact Centre pleases contact all staff on the list COMMUNITY SERVICE ONLY Name: Title: Contact Number Paula King Head of Community Services 07772872706 Marion Clarke Acting Team Manager 07980 282733 Duty Senior Nurse Bleep 695 Senior Nurse on Call OUTSIDE OFFICE HOURS ONLY 07970 732214 THE ST BERNARD S GYMNASIUM AND THE PATIENTS LIBRARY ONLY : Title: Contact Number Aneesha Jasra Ross Rushton Police Liaison Officers 07891 099983 x8726 Matthew Wilding Head of Security x8151 Kieran Galvin Clinical Security Coordinator 07740 176454 (bleep 765) Site Security Bleep 199 Denise Godleman Head of Administration 07891 061 869 (For Gymnasium and Library) Duty Senior Nurse Bleep 695 Senior Nurse on Call OUTSIDE OFFICE HOURS ONLY 07970 732214 PLEASE NOTE: Lone Worker Devices must not be loaned or reissued to colleagues. The devices are registered against a person s user s profile. For the St Bernard s gym service and the Patients Library it is registered against the premises. If a worker leaves the service, then the device must be returned to the manager in order to be reallocated and registered against a new user profile. In addition to the use of lone worker devices, a process has been introduced for The Forensic Outreach Team (this process excludes the gym and patients library services). The process for Monday to Friday 9am 5pm excluding Bank Holidays There will be one co-ordinator from Forensic Outreach Service for exit calls per working day. This person will take in advance a record of expected exit phone calls for the day. It is each member of West London Mental Health NHS Trust Page 21 of 26

staffs responsibility to contact the co-ordinator for that day to request an exit call from their community visit. This is to include all community locations. It is necessary that staff confirm that they have completed their visits as the co-ordinator is responsible to report that all members of the team have been accounted for by 5.30 each day. If this is not the case and a member of the team is carrying out an out of hours visit they should let the co-ordinator know who will inform the Senior Nurse. By 5.30 each day the person co-ordinating calls, will contact the Senior Nurse on call, via the mobile 07970 732 214 and inform the Senior Nurse of any FOS worker remaining on visits. Out of hours Senior Nurse on call is to be called for any remaining exit calls or to arrange an out of hours exit call. All home visits by people working for FOS will be recorded in the co-ordinators diary held in admin in South West House and should be completed prior to undertaking any visits. This includes staff based outside of South West House and this task can be completed via a telephone call to admin on 0208 354 8503 or 8670. Please do not use leave messages or email for this task as they may not be opened. Risk Assessment and Planning In drawing up and recording an assessment of risk the following issues should be considered, as appropriate to the circumstances: the environment location, security, access, the context nature of the task, any special circumstances, the individuals concerned indicators of potential or actual risk history any previous incidents in similar situations, any other special circumstances. ll available information should be taken into account and checked or updated as necessary Where there is any reasonable doubt about the safety of a lone worker in a given situation, consideration should be given to sending a second worker or making other arrangements to complete the task (this may include liaison with MAPPP and/or JIGSAW) While resource implications cannot be ignored, safety must be the prime concern. Planning Staff should be fully briefed in relation to risk as well as the task itself. Plans for responding to individual service users who present a known risk should be regularly reviewed and discussed with the staff team. Communication, checking-in and fall back arrangements must be in place. The team manager is responsible for agreeing and facilitating these arrangements, which should be tailored to the operating conditions affecting the team. Reporting Should an incident occur, the reporting and de-briefing should follow the guidance in the Support for Service Users, Carers/Relatives and Staff Following a Serious Incident WLMHT policy. The identified person should debrief in the first instance; if this is not the staff member s line manager, that manager should be informed as soon as practicable, and continue the process. West London Mental Health NHS Trust Page 22 of 26

Practice Guidance Personal Safety Reasonable precautions might include: checking directions for the destination, checking whether a person is known to present a risk and the agreed plan for working with them, ensuring your car, if used, is road-worthy and has break-down cover, avoiding where possible poorly lit or deserted areas, taking care when entering or leaving empty buildings, especially at night, ensuring that items such as laptops or mobile phones are carried discreetly. The Pocket Guide prepared by the Suzy Lamplugh Trust gives you further advice and information about personal safety at work. http://www.suzylamplugh.org/home/index.shtml Appendix 1 Appendix 1.docx Appendix 2 Appendix 2.docx Appendix 3 Lone worker risk assessment LONE WORKER RISK ASSESSMENT THE EMBEDDED DOCUMENTS ARE BEING UPLOADED ONTO THE EXCHANGE AND WILL BE REMOVED ON FIMAL APPROFVAL WITH A LINK TO THE DOCUMENTS ON THE EXCHANGE Lone Worker Assessment Sheet.xls West London Mental Health NHS Trust Page 23 of 26

Appendix 4 Dynamic Risk Assessment DYNAMIC RISK ASSESSMENT PET Analysis for Lone Workers and Frontline Staff Interacting With Clients People Consider what is already known about the client and other people you are coming in contact with and behavioural awareness of how individuals are acting at any moment during the interaction: What do I know about the client? What mood are they likely to be in Am I working on my own? Has the client any prejudices Do they have a history of aggression? What is their body language and tone of voice telling me? Is their behaviour changing unexpectedly? How confident and competent do I feel? Environment Consider the environment you will be working in and use your situational awareness to continue to assess the surroundings: What about the environment makes you feel vulnerable What could be used as a weapon against you? Can I get out if I need to? Whose territory is it and how will this affect the dynamics Are you isolated from colleagues? Task Assessing the task will help you identify triggers that may increase the likelihood of aggression: What are you doing that could create a prompt for aggression Are you asking difficult questions or delivering bad news Are you enforcing rules or asking the client to do something they will object to Are you carrying cash or valuables? Are you invading the client s space? Are you assessing for provision or denial of a service West London Mental Health NHS Trust Page 24 of 26

Appendix 5 Home visiting Checklist HOME VISITING CHECKLIST Checklist for managers Are your staff: fully trained in strategies for the prevention of violence? briefed about the area where they work? aware of attitudes, traits or mannerisms which can annoy clients etc? given all available information about the client from all relevant agencies? Have they: understood the importance of previewing cases? left an itinerary? made plans to keep in contact with colleagues? the means to contact you - even when the switchboard may not be in use? got your home telephone number (and have you got theirs)? a sound grasp of your organisation s preventive strategy? authority to arrange an accompanied visit, security escort or use of taxis? Do they: know your attitude to premature termination of interviews? know how to control and defuse potentially violent situations? appreciate their responsibilities for their own safety? understand the provisions for their support by the Trust? Checklist for staff who make home visits Have you: had all the relevant training about violence to staff? a sound grasp of your unit s safety policy for visitors? a clear idea about the area into which you are going? carefully previewed today s cases? asked to double up, take an escort or use a taxi if unsure? made appointment(s)? left your itinerary and expected departure/arrival times? told colleagues, manager, etc about possible changes of plan? arranged for contact if your return is overdue? Do you have: a personal alarm or radio? Does it work? Is it handy? a bag/briefcase, wear an outer uniform or car stickers that suggest you have money or drugs with you? Is this wise where you are going today/tonight? out-of-hours telephone numbers etc to summon help? Can you: be certain your attitudes, body language etc won t cause trouble? defuse potential problems and manage aggression? West London Mental Health NHS Trust Page 25 of 26

Appendix 6 Training confirmation form TRAINING CONFIRMATION FORM THE EMBEDDED DOCUMENTS ARE BEING UPLOADED ONTO THE EXCHANGE AND WILL BE REMOVED ON FIMAL APPROFVAL WITH A LINK TO THE DOCUMENTS ON THE EXCHANGE APPENDIX 4.xlsx Appendix 7 User profile form USER PROFILE FORM THE EMBEDDED DOCUMENTS ARE BEING UPLOADED ONTO THE EXCHANGE AND WILL BE REMOVED ON FIMAL APPROFVAL WITH A LINK TO THE DOCUMENTS ON THE EXCHANGE APPENDIX 5.xls Appendix 8 Departmental escalation DEPARTMENTAL ESCALATION THE EMBEDDED DOCUMENTS ARE BEING UPLOADED ONTO THE EXCHANGE AND WILL BE REMOVED ON FIMAL APPROFVAL WITH A LINK TO THE DOCUMENTS ON THE EXCHANGE APPENDIX 6.xlsx West London Mental Health NHS Trust Page 26 of 26