Leaflet 17 Lone Working Contents 1. Introduction 2. Purpose 3. Definitions 4. Risk Assessment 5. Environment 6. Communication 7. Monitoring & Effectiveness Appendix 1 - Environmental Precautions Appendix 2 - Checklist for local procedure Appendix 3 - Daily management sheets Appendix 4 Aide memoire Appendix 5 Risk Assessment (Lone Worker) 1
1. Introduction The aim of this section is to underline safety issues and contribute to the provision of a safer working environment for staff working alone. Lincolnshire Partnership NHS Foundation Trust (the Trust) has a legal duty as a consequence of Health and Safety legislation to ensure so far as is reasonable and practicable the health and safety of its employees. Staff who work alone are presented with particular issues of risk and personal safety. The Trust recognises its duty to care for its employees and is committed to maintain, as far as is reasonably practicable, a safe working environment for all people working on their own, or with limited support, both within and outside the Trust premises. It is also important that individual staff and their managers act appropriately and play their part in reducing potential risks by following the advice contained within this section and reporting areas of concern either to their manager or appropriate others within the organisation. The Trust is committed to ensure that its staff are safe when carrying out duties on their own. We will ensure protection for all staff irrespective of Age, Disability, Gender re-assignment, Marriage and civil partnership, Pregnancy and maternity, Race including national identity and ethnicity, Religion or belief, Sex (that is, is someone female or male) and Sexual orientation 2. Purpose This section offers an assessment framework for the risks which staff, both clinical and non clinical may face when working alone on behalf of the Trust and provide guidance on the avoidance or reduction of these risks. Staff are not expected to undertake tasks or enter situations where they face serious and unacceptable risks. However, following risk assessment, it may be necessary to take controlled risks but ensuring adequate resources are in place to minimise the risks. Staff should discuss serious safety concerns with their line manager or team manager and expect all reasonable action to be taken to minimise or eradicate the risks. All staff should be concerned about the risks their colleagues face as well as themselves. The Risk Assessment is Appendix 5 3. Definitions For the purpose of this section the term lone worker means: Any member of clinical or non-clinical staff who works on his or her own whilst engaged on Trust business this also includes volunteers who are providing support services on behalf of the Trust. A member of staff who on occasions works in a lone worker setting Note this group of staff must alert their manager to their lone working so that appropriate support can be offered e.g. manager working out of hours/ at weekend in an office 4. Risk Assessment Essential to prevention is the ability to assess each and every situation as you encounter one. Assessment can result in improvement to procedures and identification of correct equipment to support progress. The assessment each member of staff makes must cover 2
environmental, clinical and social factors.an identified risk must be reported to the appropriate manager so that action can be taken following an incident, near miss or environmental risk. The Trust risk register must be used to complete identified non clinical risks. All clinical staff that provides services to service users must complete 3 yearly training in Clinical Risk Assessment and Management. All service users must have a clinical risk assessment completed and an appropriate management plan if required. All staff should remember that their own personal safety is a priority. Whilst using their clinical judgement, if they feel that the risk of violence towards them is increasing, they should remove themselves immediately from the situation. If anyones personal safety is compromised they should: Get out of the situation Summon help Call security or the police Upon return to their base, the individual should complete an incident report (DATIX), inform their Line Manager who will review the incident, take action as appropriate and provide support to the staff involved as necessary. Each service within the organisation is expected to have a local procedure document for lone workers based in their individual areas covering issues pertinent to them. Appendix 2 will aid this. All first appointments/assessments should either take place at team base (or designated community setting) or by two members of staff at the client s home. The Trust recommends that no member of staff works alone in any of its premises which clients reside in or attend. Where this is unavoidable all attempts must be made to minimise these situations and a clear plan of action included within the local procedure document. If the building stores medication special arrangements need to be identified to ensure the safety of staff working alone. An aide memoire is available at Appendix 4. 5. Environment Interview Rooms All rooms that are routinely for Client/family interviews should have an alarm system with appropriate procedures in place (see Appendix 1 for additional information). Support and advice can be obtained through the Trusts security specialist, Health and Safety assessors. Where fitted, building managers must agree a process of testing to ensure that alarm systems are kept in optimum working condition. A procedure must also be agreed on how staff will respond to an alarm call once activated. Details of planned responses should be held in the local procedure document. Reception/Out Patient Areas When members of staff are experiencing difficulty, there must be a system in place to summon assistance. 3
Home Visits/Off-Site Movements It is essential that staff leave a daily diary of visits and movements at your base see Appendix 3 for example local templates are acceptable as long as the same principles are adhered to. Where there is a known or expected risk to personal safety/security staff should attend in pairs. Staff members should be satisfied that they have as much background information as possible, (including risk assessment) on the client before visiting. Priority must be given to any concerns arising from the information before the visit takes place. All staff who provide home visits or regular off site visits, must leave their vehicle details i.e. registration number, make of vehicle, colour of vehicle. A list of these details must be made accessible and left securely at their work base. Managers must make sure that this list is kept up to date and made accessible. If the staff member does not report in after finishing a visit, the senior person in charge must instigate their local procedures, alert relevant parties, e.g. senior managers, police if necessary. See Appendix 4 If a visit is regular, vary the time and day to avoid becoming a target. Organise local procedures for coded messages if in difficulty during a home visit. Details of this should be kept in the local procedure document. Purple Folder is the approved code to be used Any relevant knowledge of a potential risk to staff presented by a service user or any other person who may be at the home should be available to all Trust employees that visit. All staff have a duty to share any known risks with colleagues who may be visiting services users. 6. Communication All mobile phones should always be kept as fully charged as is possible; An employee should ensure they know how to use the mobile phone properly; A mobile phone should never be relied on as the only means of communication. Lone Workers should always check the signal strength before entering into a situation. If there is no signal, the Lone Worker should contact their manager or colleague ahead of a visit, stating their location and the nature of their visit, along with an estimate of the time they think they will need to spend at the visit. Once that visit is completed they should let their manager or colleague know that they are safe; A mobile phone should never be left unattended but should be kept close at hand in case an emergency arises; The use of a mobile phone could potentially escalate an aggressive situation and the Lone Worker should use it in a sensitive and sensible manner; Identicom/Solo Protect. Some areas of the organization have the identicom lone working system. These are effectively a personal alarm managed by an approved recording centre that staff can activate if they feel threatened in any lone working situation. Full training will be given to those areas undertaking the use of identicom. An up to date list of the areas that are using the system will be held by the Local Security Management Specialist 4
7. Monitoring & Effectiveness Systems Monitoring and/or Audit Criteria Systems in place to monitor the safety of lone workers Measurables Lead Officer/Group local lone Building working manager protocols in place Frequency Annual health and safety inspections Reporting to Team leader Action Plan/Monitoring Divisional Management Teams Systems in place to monitor the use of daily management sheets compliance with use of management sheets by teams Building manager daily Team leader Divisional Management Teams 5
Appendix 1 ENVIRONMENTAL PRECAUTIONS ROOM LAYOUT The overall aim in room design should be to make the atmosphere as non-oppressive and conducive to relaxation as possible. At the same time consideration for your personal safety is vital. This includes interview rooms. Awareness of the following points will lessen the risk: STRATEGY Ensure that you can reach an escape route without being obstructed Arrange furniture so that it cannot be used against you Remove objects that can be used as weapons or missiles Prevent any door locks from being activated Direct visitors to a chair in the position of your choice Inform others when you have someone present Have another person present if apprehensive Prepare an urgent call sign in the event of an emergency Whenever possible, prepare adequately for interviews or consultations, the physical design can always be in place as can a contingency plan or procedure. Don t be afraid to move any furniture. Stay alert and avoid complacency. 6
Appendix 2 LOCAL PROCEDURE CHECKLIST The following should be included when setting up a local lone working document 1. Local systems for staff contact and tracking whilst they are absent from the unit for example copies of diaries, daily management sheets (appendix 3) 2. Procedures for checking all staff have completed their work safely at the end of the day. Appendix 4 3. Personal safety advice should be shared with all staff during local induction. 4. Local alert protocols should staff find themselves in difficulties during home visits 5. Alarm response protocols for each building 6. Locking up arrangements for building. 7. Guidelines for staff that maybe working alone in buildings for short periods of time. 8. Budding/pairing up arrangements. 9. Mobile phones and/or identicom instructions 10. Local support arrangements for AMHPS 7
Appendix 3 DAILY MANAGEMENT SHEETS DATE : WORKERS NAME : BASE : VEHICLE DETAILS : REG No. : MAKE : MODEL : COLOUR : TYPE OF ACTIVITY : Client Visits / Meetings / Training Activity (where) Time: (expected start and finish) If visiting Service Users (their address and telephone number Activity (where) Time: (expected start and finish) If visiting Service Users (their address and telephone number Activity (where) Time: (expected start and finish) If visiting Service Users (their address and telephone number If not finishing at base, time telephone call received and time day concluded. 8
Appendix 4 Aide Memoire for Lone Working Appendix 4 Ward/ Service to be amended and adopted locally Safety Health Environment and Fire Policy Section 11 Lone Working Leaflet 17 Appendix 4 Aide memoire for Lone Working 9
Ward/ Service to be amended and adopted locally Date October 2013 1.0 What is the purpose of this Aide Memoire This aide memoire provides guidance to Services and staff who are undertaking lone working; this includes working in isolation on site, and out in the community. This protocol aims to minimise the risk of harm to staff members either from potential violence or from the physical environment. This aide memoire has been developed to assist lone working whereby the risks are managed locally. This aide memoire also aims to ensure that, in the unfortunate circumstance of a member of staff being at risk of, or coming to harm whilst lone working, the situation will be identified rapidly and strategies will be in place to locate and send assistance to that member of staff. This Aide memoire is to be used in conjunction with the Trusts Safety Health Environment and Fire Policy section11, leaflet 17 Failure to comply with the Safety Health Environment and Fire Policy will be taken very seriously as this may cause risk to staff safety and waste of other staff and Police time. 2.0 Definition of Lone Workers The Trust recognises two groups of lone workers Any member of clinical or non-clinical staff who works on his or her own whilst engaged on Trust business this also includes volunteers who are providing support services on behalf of the Trust. A member of staff who on occasions works in a lone worker setting Note this group of staff must alert their manager to their lone working so that appropriate support can be offered e.g. manager working out of hours/ at weekend in an office setting Lone workers are those who work by themselves without close or direct supervision such as: Staff in fixed establishments where: only one member of staff works on the premises staff working separately from others staff working outside normal hours Mobile lone workers working away from their base and when their work may be carried out in: Client's homes Nursing homes The premises of other Trusts or businesses 10
It is recognised that any member of staff may spend a limited amount of their working time 'alone'. 3.0 Local Responsibilities at a Glance All staff are to be aware of and implement these local arrangements. Take reasonable care of themselves and others affected by their actions. Alert line manager if personal circumstances change, e.g. home telephone number, home address, mobile phone contact number, working hours, access to personal transportation Report all incidents that may affect the health and safety of themselves or others and ask for guidance as appropriate. Take part in training designed to meet the requirements of the policy. Use personal safety devices as supplied. Reporting any dangers or potential dangers they identify or any concerns they might have in respect of working alone. Staff must bring the manager s attention to circumstances that may require lone working in different circumstances which can enable further risk assessment. 4.0 What are the Local Arrangements in this area? THIS SECTION IS TO BE AMENDED TO MATCH LOCAL ARRANGEMENTS NOT ALL DEPARTMENTS WILL HAVE ALL THESE MECHANISMS. 4.1 General management of lone worker risks Complete Appendix 5 of the HSWC17 All staff who are undertaking Lone Working outside of NHS premises need to have registered the following information within their department: Mobile phone number Home phone number Buddy name and phone number Personal Contact in the Event of an Emergency/Next of Kin Make/model & registration of car being used Name, address & phone number of person(s) being visited Time of visit(s) and estimated time of return Individual visits should be risk assessed to see if there are any factors to suggest that a visit by a lone worker would be contraindicated e.g.: history of violence, uncontrolled mental illness, potentially hazardous physical environment etc. All staff should ensure that their final visit of the day will be concluded prior to the end of their working day where possible. 11
No visits to new patients should be undertaken at the end of the working day if this can be avoided. All staff undertaking lone working should be carrying a mobile phone and have access to a personal alarm if they wish to carry one. In the clinical environment, chairs and tables should be strategically placed to allow the interviewer the easiest exit route should this become necessary. Know of the existence of any the phone/ Panic Alarm & how to use it. 4.2 Traceability All members of staff working alone should be as traceable as possible. This will include staff members letting others know of their whereabouts. Lone workers should always ensure that someone else, such as their line manager or supervisor or another colleague, is aware of their where they are likely to be operating. 1. A Buddy system will be in place which ensures that all staff takes responsibility for monitoring each other s safe return to the department. Please note that if it is felt necessary to send two members of staff on a visit the second person should not be the first person s buddy, another buddy must be nominated. 2. In the event that a member of staff has not returned to the department, or phoned in, at the expected time the Team Leader should be notified immediately and the following procedure will commence: 3. A phone call is made to the staff member s mobile phone. 4. The staff member will be spoken to directly to ensure that all is well, and a new expected return time to the department will be identified. 5. A phone call will be made to the patient s home that is being visited. 6. If the staff member does not answer their phone on two further attempts over five minutes (to allow them to stop their car and answer the phone safely), a phone call will be made to their home number to see if they have returned home. 7. If the staff member remains un-contactable a phone call will be made to their Personal Contact in Event of Emergency. If the whereabouts of the staff member still cannot be established, and no other useful investigations can be identified, the Team Leader will contact the Police and inform them of the situation. Note It will be the responsibility of the Lone Worker to ensure their Buddy is made aware as soon as possible if they will not be returning to the Department at the expected time due to an unforeseen delay, and they will need to identify a new expected return time. 4.3 The use of pagers, panic and personal alarms Staff are responsible for keeping them charged and for switching them on when they go out on visits. 4.4 Mobile phone contact Staff who go out on home visits should keep a mobile phone with them to be able to summon help in an emergency. Staff are responsible for keeping them charged and within easy reach during home visits. 12
4.5 Occasional Lone Workers Staff who are not lone workers but wish to work alone occasionally (e.g. in offices out of hours) must get agreement from their manager and the arrangements for safety are risk assessed in advance. 5.0 What to do if things go wrong In the event of a violent incident involving a lone worker, the lone worker themselves or the individual identifying that they have not returned should summon help as soon as they are able by phoning their base giving the code PURPLE FOLDER or the Police. The line manager should ensure appropriate written and verbal reporting of any violent incident. The line manager should offer the lone worker a range of the following as appropriate: Debriefing Psychology, Counselling and Welfare services (OASIS) Peer support Access to occupational health Access to a professional or trade union representative. Staff Wellbeing Service (Line Manager or self-referral) The line manager may themselves wish to seek additional support from: Director of Nursing and Operations Senior or General Manager on-call Executive Director on-call Occupational Health(referral by line manager) 6.0 For further information please contact: The Trust s Local Security Management Specialist (LSMS) 01529 222334 or your line manager 7.0 Training Requirements If any local training is required to use the special devices mentioned in this procedure, it will be arranged locally or via the Trust s LSMS. 8.0 References Health and Safety at Work etc Act 1974 Management of Health and Safety at Work Regulations 1999 Working Alone in Safety controlling the risks of solitary work (HSE Books 1998) Violence at Work A guide for employers (HSE Books 1998) Managing Violence in the Community. Lone Working Top 10 Tips (NHS CFSMS) 13
Appendix 5 RISK ASSESSMENT LONE WORKER INDIVIDUAL or TEAM Directorate Department Source of risk (e.g. DATIX) Risk Assessment of Lone Working Team Yes No Individual Yes No Type of Risk Health & Safety Patient Safety Security Location Individual/Team name Risk Assessor Signed Date of Assessment Contact Phone No. Description Of Risk Being Assessed Summary Of Current Control measures What needs to be done by lone worker Overall Risk Grading Consequence (C) Likelihood (L) Risk (C x L) Indicate below whether this risk is department only or for inclusion on directorate or trust risk register? Internal Department Risk Assessment? Yes No Escalate to Risk Register? Yes No Strategic Directorate SEE OVER FOR GRADING TABLE 14
RISK ASSESSMENT LONE WORKER INDIVIDUAL or TEAM Consequence 1 Negligible Minimal injury, none or minor treatment / adverse health outcome / some disruption to service / small financial loss / potential for public concern 2 Low Minor injury / <3 days off work / adverse health outcome / short term disruption to service / financial loss or claim < 10,000 / local media coverage short term 3 Medium Medium injury / 4-14 days off work / adverse health outcome / moderate service disruption / financial loss or claim 10,000-100,00 / local media coverage long term 4 Very high Major injury or disability / closure of a service / financial loss or claim 100,000-1 Million / possible litigation / national media coverage short term 5 Extreme Death(s) / multiple permanent injury or health effects / extended service disruption or closure / financial loss or claim > 1 Million / national media coverage long term Likelihood 1 Rare This will probably never happen / recur (not expected to occur for years) 2 Unlikely Do not expect it to happen / recur but it is possible it may do so (expected to occur annually) 3 Possible Might happen or recur occasionally (Expected to occur monthly) 4 Likely Will probably happen / recur but it is not a persisting issue (Expected to occur weekly) 5 Almost certain Will undoubtedly happen / recur possibly frequently (Expected to occur daily) Extreme 15-25 High 8 12 Moderate 4 6 Low 1-3 Extreme risk, immediate action required High risk, action planned immediately, commenced within one month Moderate risk, action planned within one month, commenced within three months Low risk, action planned within three months, reviewed within 1year 15