Manual Handling Policy

Policy No: RM06 Version: 9.0 Name of Policy: Manual Handling Policy Effective From: 31/05/2016 Date Ratified 12/05/2016 Ratified Health and Safety Committee Review Date 01/05/2018 Sponsor Director of Strategy and Transformation Expiry Date 11/05/2019 Withdrawn Date Unless this copy has been taken directly from the Trust Intranet site (Pandora) there is no assurance that this is the most up to date version This policy supersedes all previous issues. RM06 Manual Handling Policy v9 1

Version control Version Release Author/ Reviewer 1.0 2.0 October 2002 Marian Morrison 3.0 July 2005 Marian Morrison 4.0 5.0 Sept 2006 Marian Morrison Ratified by/authorised by Risk Management Committee Risk Management Committee Risk Management Committee Date October 2002 May 2005 Sept 2006 Changes (Please identify page no.) 6.0 Sept 2009 Aileen Hunter & Deborah Southworth 7.0 02/08/2012 Deborah Southworth 8.0 19/06/2014 Deborah Southworth 9.0 31/05/2016 Deborah Southworth Health and Safety Committee Health and Safety Sub Committee Health and Safety Committee Health and Safety Committee Health and Safety Committee Format and monitoring changes 1-18 Additional Appendices: Training Matrix and Risk Assessment Forms updated 10/07/2012 Review and Format as per OP27 Policy Pg 5-30 Main changes to Risk Assessment section and Training. Monitoring and Appendices reviewed 15/04/2014 Review and Format as per OP27 Policy. Pages 1,4,5,7,9,11,12,13,14, 15,22,23,25,28 Main changes to Risk Assessment section 6.1, minor changes to wording, Updated references. Monitoring and Appendices reviewed 12/05/2016 Review and Format as per OP27 Policy Pages 1, 2, 3, 4, 6, 10,16, 20,23,24 Monitoring reviewed Updated references RM06 Manual Handling Policy v9 2

Contents 1. Introduction... 4 2. Policy Scope... 4 3. Aim of Policy... 5 4. Duties (Roles and responsibilities)... 5 4.1 Trust Board... 5 4.2 Chief Executive... 5 4.3 Executive Directors... 5 4.4 Divisional Directors, Divisional Managers and Heads of Service... 5 4.5 Modern Matrons... 6 4.6 Ward/departmental Managers... 6 4.7 Employee Responsibilities... 7 4.8 Occupational Health Department... 8 4.9 Clinical Ergonomics... 9 4.10 QEF Estates Department... 10 4.11 Health and Safety Advisor... 10 4.12 Procurement Dept... 10 4.13 Tissue Viability Specialist Nurses... 11 5. Definitions... 11 6. Main Body of Policy 6.1 Risk Assessment... 11 6.1.1 Generic risk assessment... 13 6.1.2 Inanimate Objects... 14 6.1.3 Patient Risk Assessment... 14 6.1.4 Rehabilitation Handling... 16 6.1.5 Specialist Services... 16 6.2 Equipment... 17 6.3 Bariatric Patients... 17 7. Training... 17 7.1 Training... 17 7.2 Record Keeping... 19 8. Equality and Diversity... 20 9. Monitoring Compliance with the Policy... 20 10. Consultation and review... 22 11. Implementation of policy (including raising awareness)... 22 12. References... 23 13. Associated documentation (policies)... 24 Page No Appendices Appendix 1 Manual Handling of Loads Risk Assessment Form... 26-27 Appendix 2 Patient Manual Handling Assessment Form... 28-29 Appendix 3 Controversial/Unsafe Practices Handout... 30-41 RM06 Manual Handling Policy v9 3

Gateshead Health NHS Foundation Trust Manual Handling Policy 1 Introduction Musculoskeletal disorders continue to be the most common type of work- related illness reported by general practitioners. Work related musculoskeletal disorders (WRMSDs) can affect muscles, joints and tendons in all parts of the body and the majority of work-related musculoskeletal disorders develop over time. An estimated of 9.5 million working days were lost due to work related musculoskeletal disorders, an average of 17 days lost for each case. (HSE Statistics 2014/2015). On 1 st January 1993 the European Directive 90/269/EEC Manual Handling Operations Regulations 1992 (as amended 2002) under the Health and Safety At Work Act 1974, came into force. The guidance on regulations L23 was reviewed in 2004, with the release of the 3 rd Edition to support the continued risk reduction of handling activities. The regulations require the employer to adopt an ergonomic approach to the removal or reduction of risk from manual handling injuries, also to ensure safe systems of work within a safe working environment. The ergonomic approach requires manual handling to be seen in the context of a wide range of factors, which includes the nature of the task, the load, the working environment, and the individual s capability. Gateshead Health Foundation Trust has prepared this policy in order to meet its statutory obligations and with the aim of reducing the risk, to the lowest level possible, to staff from potential manual handling incidents. Although ideally the need for manual handling of loads (as outlined in the HSE Guidance document L23 on the Manual handling Operations Regulations) should be avoided, it is recognized that due to the nature of the work undertaken by the Trust, staff may have no alternative but to move loads manually. As stated in the policy, managers and staff should follow measures to manage the risk in order to minimize the risk of injury to themselves and others so far as reasonably practicable. The Trust will ensure that the necessary arrangements are in place to facilitate the implementation of this policy, by ensuring they have in place appropriate professionally competent persons with those duties specified in their job brief. The Trust will continue to work towards a safer lifting policy and as part of this process will ensure a current policy of minimal lifting. 2 Policy scope This policy is Trust wide and applies to all members of staff employed/working within Gateshead Health NHS Foundation Trust involved in the manual handling of people and loads. The policy applies to all staff, locums, students, bank staff, and voluntary workers involved in the manual handling of people and loads. The regulations make the self-employed responsible for their own health and safety during handling. They should take the same steps to safeguard themselves as would be expected of an employer in protecting their employees in similar circumstances. RM06 Manual Handling Policy v9 4

The standard of this policy should be the minimum standard expected of other employers when we contract with them for work to be done. 3 Aim of policy The aim of this policy is to: Implement a consistent, safe, and effective approach for managing manual handling risks (in line with the Risk Management Policies). Assist all employees of the Trust to adopt a positive approach to safer manual handling in order to minimise the risks of musculoskeletal injury and achieve a reduction in the number of injuries and disablements caused by manual handling operations. Assist the Trust in implementing the manual handling requirements of Health and Safety legislation in particular the Manual Handling Operations Regulations 1992 (as amended) and relevant associated regulations, arrangements and national guidance. Outline the responsibilities of all staff and the organization with regard to their role in developing and implementing this Policy. 4 Duties (Roles and responsibilities) 4.1 Trust Board The Trust Board is responsible for implementing a robust system of corporate governance and risk management within the organisation. The Director of Strategy and Transformation sponsors this policy and is responsible for its implementation. 4.2 Chief Executive The Chief Executive has overall responsibility for the implementation of this Policy. However day-to-day responsibility for the operational implementation of the policy has been devolved to a local level as described hereafter. 4.3 Executive Directors Are responsible for ensuring that appropriate health and safety management systems are in place within their own area, so that this policy is adhered to, enabling the Trust to meet its duty under current legislation. 4.4 Divisional Directors, Divisional Managers, and Heads of Service Are responsible for: 4.4.1 The implementation of the policy and for ensuring that adequate resources are available for staff to fulfil their duties and responsibilities, in reducing the risk associated with handling tasks. 4.4.2 Implementing the Manual Handling Operations Regulations and the Trust Manual Handling Policy within their work area. RM06 Manual Handling Policy v9 5

4.4.3 Promoting and supporting the Manual Handling Risk Assessment process within their area of responsibility. 4.4.4 Ensuring attendance of all relevant staff at the Trusts Moving and Handling Training Programme in accordance with the training matrix in the Trust Mandatory Training Needs Analysis, this can be found on the Trust Intranet. 4.4.5 Seeking advice from the Clinical Ergonomics team, Control of Infection, Tissue Viability, Medical Devices and/or the QEF Estates Department, before purchasing manual handling equipment and accessories. 4.5 Modern Matrons Are responsible for: 4.5.1 Supporting Divisional and Ward managers in ensuring staff attend training, appropriate and timely records are kept, and risk assessments are carried out. 4.5.2 Implementing the Manual Handling Regulations and the Trusts Manual Handling Policy within their area and developing and implementing safe systems of work. 4.6 Ward / Departmental Managers Local Managers must be aware of the Manual Handling operations undertaken in their area. Local Managers are responsible for: 4.6.1 Implementing the Manual Handling Regulations and the Trust s Manual Handling Policy within their area and developing and implementing safe systems of work. 4.6.2 Avoiding the need for their staff to undertake manual handling tasks, which involve a risk of injury so far as is reasonably practicable. 4.6.3 Carrying out an appropriate risk assessment of any manual handling task, which cannot be avoided but where there is a significant likelihood that an injury may occur. The appointment of Manual Handling Risk Assessors who have undertaken appropriate training will support this process. 4.6.4 Making a clear record of the assessment using the Trust paperwork, communicating its findings to all staff involved and including significant risks in the local risk register. 4.6.5 Ensuring all (generic) manual handling related action plans are addressed with relevant staff at ward/departmental level, prior to forwarding the action plan to the relevant Divisional Manager, and where further advice is required, to the Clinical Ergonomics and/or Health and Safety department. 4.6.6 Introducing appropriate measures to avoid reduce or manage the risks by redesigning the task or the use of mechanical aids. RM06 Manual Handling Policy v9 6

4.6.7 Identifying the training needs of staff and ensuring staff attend the appropriate training in manual handling as outlined in the training matrix guidance in the Trust Mandatory Training Needs Analysis, which can be found on the Trust Intranet. 4.6.8 Ensuring that manual handling requirements are appropriately identified during the recruitment process, in job descriptions and/or risk assessments. 4.6.9 Making reasonable allowances for any known health and ability problems, which might impact on an individual s ability to carry out manual handling tasks safely. 4.6.10 Referring a member of staff to Occupational Health if there is a good reason to suspect that an individual s state of health might significantly increase the risk of injury from manual handling operations. 4.6.11 Documenting, monitoring and reviewing manual handling assessments to reflect any change in working conditions, personnel involved or significant change in the manual handling operations effecting the nature of the task or the load. Risk Assessments should be reviewed annually or if circumstances changes. 4.6.12 Maintaining records of any accident, ill health, and/or training related to manual handling operations. 4.6.13 Ensuring all manual handling accidents, incidents and near misses are reported and investigated via the Trust s Incident Reporting Tool DATIX, to establish if there has been any breach of policy. It is important that findings from such investigation are shared with the local team. 4.6.14 Ensuring a manual handling risk assessment is completed in a timely manner following the return to work of any member of staff suffering from musculoskeletal problems. 4.6.15 Ensuring that manual handling practices used are best practice and that controversial methods are not routine practice within their area. 4.6.16 Ensuring suitable and sufficient manual handling equipment is available to reduce risk and that equipment is easily accessible, properly maintained, cleaned, and used correctly, seeking appropriate specialist advice prior to purchasing any equipment. 4.6.17 Ensuring adequate staffing levels for safe working practice. 4.6.18 Carry out an appropriate risk assessment in relation to pregnant workers to reduce the risk of injury to the individual and others at work. 4.7 Employee Responsibilities The employee must: 4.7.1 Take reasonable care of their own health and safety and that of others who may be affected by their activities when involved in manual handling operations. 4.7.2 Co-operate with their manager in the making of assessments of hazardous manual handling tasks and applying the principles promoted at Trust training. RM06 Manual Handling Policy v9 7

4.7.3 Read and comply with the Trust s Manual Handling Policy and seek advice if anything in the policy is not understood. 4.7.4 Inform their manager of pregnancy, medication, or musculoskeletal conditions, which may affect their ability to handle loads safely. 4.7.5 Present themselves in a suitable mental and physical condition to undertake the work they are contracted to do. 4.7.6 Observe safe systems of work and use of equipment provided to reduce risk, reporting any defects in mechanical aids to their manager. The equipment should be labelled and the faulty equipment withdrawn from use. 4.7.7 Identify and report any change in the nature of the task, work area, personnel involved, or load, which may necessitate a review of the risk assessment. 4.7.8 Report all accidents and near misses arising from manual handling procedures in accordance with Trust Policy. 4.7.9 Seek advice from the manager or appropriate advisor of any situation where they are unsure of the correct procedure to adopt or when they are unsure how to use any manual handling equipment in their work area. 4.7.10 Wear suitable clothing and footwear to facilitate free movement and allow a stable posture. 4.7.11 Participate in training as outlined in the Trust Mandatory Training Needs Analysis and apply the principles of efficient movement, risk assessment and ergonomics to handling tasks in their workplace. 4.7.12 To use the people handling methods that are currently considered to be best practice as routine (as demonstrated and practiced in training sessions) and avoids using controversial methods. Reference: Guide to the Handling of People 5 th Ed 2005 and 6 th Ed 2011 4.7.13 Carry out a full and comprehensive risk assessment of the task/situation in cases where best practice is not possible, contacting the Clinical Ergonomics Team for advice as necessary. 4.8 Occupational Health Department Responsibilities. The Occupational Health Department will: 4.8.1 Ensure that appropriate pre-employment health screening is carried out, which takes into account any manual handling operations necessary, as identified in the prospective employees job description. Managers will be advised as to the outcome of such screening. 4.8.2 Review any musculoskeletal problems arising out of or in connection with work and where necessary the nurse advisor will seek advice from the Clinical Ergonomics Advisor, Physiotherapist or Occupational Health Physician as appropriate. RM06 Manual Handling Policy v9 8

4.8.3 Provide assistance with assessments of work tasks as identified in the job description. 4.8.4 Make arrangements for assessing the staff member s ability to return to work and to full duties when there has been a period of absence from work. When appropriate, a referral will be made to the Clinical Ergonomics team. Refer to Trust Occupational Health Policy PP45 4.9 Clinical Ergonomics The Clinical Ergonomics Service will: 4.9.1 Act as the specialist advisors in manual handling on behalf of the Trust. This service is available Monday Friday and is based within Occupational Health. Out of hours, staff should contact the 1200 bleep holder or their manager for further advice. 4.9.2 Design, develop, and deliver manual handling educational/training programmes for all Trust employees. This also involves the evaluation and monitoring of the training course content. 4.9.3 Provide specialist advice to all managers on measures and equipment to help minimize moving and handling risks within their area of responsibility. 4.9.4 Ensure that staff are notified of their training course details 4.9.5 Record all training on the Trust OLM records database. 4.9.6 Inform staff who fail to attend or who do not complete training. Refer to Trust Mandatory Training Policy PP25. 4.9.7 Carry out an annual audit of compliance on the manual handling risk assessment process in conjunction with the Health and Safety department. An overview will be taken by the department, problem areas and issues identified, and recommendations made. An Annual Report and any required actions will be presented to the Health and Safety Committee. 4.9.8 Work with the Health and Safety Department to review and report annually on manual handling Datix information. 4.9.9 Work with and provide advice to the Occupational Health nursing team in assessing and making arrangements for staff returning to work or being re-deployed when appropriate, particularly in cases covered by the Equality Act 2010. 4.9.10 Lead on the format and verification of all necessary documentation for patient handling and inanimate load handling. Awareness training and training on the use of the documents will be undertaken on the Introduction to Moving and Handling, Manual Handling Risk Assessor, Practical Skills sessions and refresher sessions as appropriate. 4.9.11 Produce a Manual Handling Annual Report for consideration by the Health and Safety Committee. RM06 Manual Handling Policy v9 9

It will include: - compliance with this policy, - updated training statistics, - specific handling related data from incidents reported, - handling linked claims data, - information specifically linked to the interpretation of trust risks. - appropriate Action Plan 4.10 QEF Estates Department Are responsible for: 4.10.1 Maintaining equipment and certification to reduce risks (PUWER and LOLER 1998). 4.10.2 Working with Clinical Ergonomics Team, Medical Devices, Procurement and Trust managers regarding the purchase and location of equipment such as bariatric equipment, mobile and overhead tracking hoists. 4.10.3 Giving specialist advice regarding equipment faults via the Trust call logging system. 4.10.4 When undertaking either a new build or refurbishment, consideration is given to the issue of manual handling. Designs and plans should take account of ergonomics in intended designs, to minimise the risks caused by manual handing and poor postures. Advice from Clinical Ergonomics, and other relevant departments, should be sought where appropriate. 4.11 Health and Safety Advisor The Health and Safety Advisor will work in conjunction with the Clinical Ergonomics Department to provide additional competent advice in relation to the implementation and application of this policy including: - supporting managers to undertake manual handling risk assessments providing support and advice to manual handling risk assessors when requested. the investigation of manual handling incidents 4.12 Procurement Department The Procurement Department will ensure that: 4.12.1 Any equipment purchased is of a suitable standard 4.12.2 The relevant professionals and departments are consulted prior to the purchase of equipment, if appropriate. 4.12.3 Appropriate information accompanies equipment supplied e.g., manufacturer s instructions 4.12.4 The relevant departments are informed e.g., QEF Estates and medical devices department of new equipment purchased so that appropriate service and recertification schedules are drawn up RM06 Manual Handling Policy v9 10

4.13 Tissue Viability Specialist Nurses 5 Definitions Are responsible for: 4.13.1 Advising on specialist beds and pressure relieving equipment and may be contacted by switchboard. 4.13.2 Advising on tissue viability and pressure care issues, which may impact on moving and handling. The following definitions apply to this policy document: Manual Handling refers to the transportation or supporting of a load/person by hand or bodily force including lifting, lowering, pushing, pulling carrying and moving. (MHOR 1992 as amended). Manual Handling includes both transporting of a load and supporting a load in a static posture In the context of this policy a Load is defined as an inanimate object such as equipment or a box, or a person e.g. patient, which needs to be supported, transferred or moved. The level of risk is balanced against any potential movement or any piece of equipment that is moved An injury is any harm to the body arising as a result of carrying out a manual handling task. Risk Assessment: The process whereby hazards and risks are evaluated alongside controls designed to reduce the risk to ensure that risks are eliminated or reduced as far as is reasonably practicable. This may be generic, completed for an area or department, or individual completed as an assessment of any manual handling risks in providing care or rehabilitation for a patient/client. Reasonably Practicable: The process of balancing time, cost, and effort against the reduction in risk achieved. The level of risk is balanced against any potential resource input that is required to remove or reduce the risk. Ergonomics: - Designing the task, workplace, and equipment to fit the individual and reduce the risk of strain and injuries. Oracle Learning Management System (OLM): This is the training section of the NHS Electronic Staff Records Database (ESR) Mandatory Training Needs Analysis (TNA): This document describes all the mandatory training provided within the Trust including manual handling training. 6.0 Risk Assessment 6.1 Risk Assessment The Management of Health & Safety at Work Regulations 1999 require an employer to carry out a suitable and sufficient assessment of the risks to the health and safety of their employees and to anyone else who may be affected by their activity, so that the necessary preventative and protective measures can be identified. RM06 Manual Handling Policy v9 11

The process of risk assessment begins with the identification of hazards and risks. Further guidance on the consistent and comprehensive identification of health and safety hazards can be found in the Health and Safety section of the Trust Intranet. A suitable and sufficient risk assessment should: identify the significant risks arising out of the work; identify and prioritise the measures required to comply with any relevant statutory provisions; remain appropriate to the nature of the work and valid over a reasonable period of time. In order to be suitable and sufficient, the risk assessment should be carried out by an individual (or team), who understands the processes/work concerned, and can identify all relevant risks. It must cover both employees and non-employees affected by the undertaking, and take account of those more vulnerable due to inexperience, disability, or age e.g. Young persons. Risk Assessors will conduct workplace risk assessments as required, including manual handling assessments. Risk assessments should be undertaken as required, and all risk assessments must be reviewed no less than every two years or more frequently especially where: - new technology has been identified - actions have been taken as a result of risk assessment - they have become invalid or can be significantly improved - there has been a substantial change in the work - manual handling incident has been reported - information about the risk changes Risk assessments should be recorded on the trust s documentation and should be passed to the manager for review. A copy of each risk assessment should be stored locally in a risk assessment file. Managers should ensure that all staff are aware of the risk assessments and that they are readily available to all staff. All new staff should be directed to the department/ward risk assessment file. Where risk assessment identifies an issue for which the area/department does not have the resources to eliminate or control the risk, this must be escalated to the divisional director/divisional manager/assistant divisional manager. The health and safety advisor should be notified (Ext 3758) and these risks should be entered onto the risk register for appropriate escalation and management as outlined in the Trust Health and Safety Policy RM02. Guidance for risk assessors and risk assessment templates are available in the Health & Safety section on the trust s Intranet site. A risk assessment is required to be carried out for all handling tasks, both patient and nonpatient which have been identified as being necessary, but where there is a significant risk of an injury occurring. (MHOR 1992 as amended). The risk assessment should be carried out BEFORE the task is undertaken. RM06 Manual Handling Policy v9 12

All paperwork must be dated and signed and should include any associated paperwork on action plans or risk reduction solutions. This is evidence that the process is seen as a cycle of continuous management of risks and improvement. Risk assessments can cover a number of situations in the workplace as follows: - generic situations - movement of inanimate objects - patient movement - rehabilitation - specialist services. Guidance for each of these is covered below in more detail. 6.1.1 Generic Risk Assessment The stages of the Generic Risk Assessment are outlined in the Trust Risk Assessment Guidance, which can be found on the Trust Intranet site and Trust Health and Safety Policy RM02. The same manual handling risk may be apparent in more than one ward or department, therefore, where possible, a generic risk assessment can be adopted which has been checked, adjusted to reflect any local details or changes where necessary and confirmed as applicable to that area. The risk assessment should be dated and signed and should be reviewed according to the normal process. A set of generic risk assessments, including those related to manual handling, have been developed that will cover the main areas of risks. Work will continue to ensure that the number of generic risk assessments available is extended until as many generic risk assessments as necessary are in place. Generic risk assessments are assessments produced only for a given job/task or activity. A generic assessment is undertaken when the activity involved extends to several departments within the organisation and where a core set of precautions should be taken to prevent injury or harm. Generic risk assessments must be edited to ensure that all the risks and controls relevant to the area are included and any details that are not relevant are removed, with a risk rating inserted, completed, signed, and dated so as to ensure that the assessment is suitable and sufficient. Each task is given a risk rating. Tasks/activities with a risk rating of 8 or more, will require a detailed manual handling risk assessment. In the case of manual handling tasks, a specific manual handling risk assessment form must be completed on the appropriate form. (Appendix 1) Copies of generic risk assessments are available to download from the Health and Safety Section on the Trust Intranet A copy of each generic risk assessment should be filed in the Directorate/Dept, health, and safety policy folder, a copy placed in the relevant area where the task or activity is undertaken (as per Trust Guidance). RM06 Manual Handling Policy v9 13

6.1.2 Inanimate Objects Where there is a significant risk of injury a risk assessment MUST be carried out before the job is undertaken. The assessment should be carried out by a nominated risk assessor, who has under gone the necessary training. The assessment should be in suitable and sufficient detail to consider and record all reasonably foreseeable risks, and other factors, including the use of appropriate equipment, that relate to complete handling task. The assessment will identify short term and/or long-term risk reduction methods and specify the safest method of carrying out the task within what is reasonably practicable, taking into account those staff who are at particular risk. The assessment will be reviewed at least annually as part of a management process, or more frequently should there be any significant changes in the handling task or when an incident occurs. (Management of Health and Safety at Work Regulations 1999) The assessment and its outcome must be shared with the team carrying out the tasks. The assessment should be completed on the correct paperwork. The HSE MAC assessment tool is used by some departments e.g., in operational services where this tool may be considered to be the most appropriate method of assessment. (Ref: http://www.hse.gov.uk/msd/mac/index.htm and booklet and score sheets accessed via http://www.hse.gov.uk/pubns/indg383.pdf). 6.1.3 Patient Risk Assessments The Trusts approach to people handling aims to promote the safety of staff while protecting the human rights of patients. The Trust will ensure that manual handling risks, whether clinical or non clinical are reduced, so far as is reasonably practicable. This will be achieved by balancing the safety and human rights of employees and the assessed care needs and human rights of patients. Patient risk assessments should be discussed and completed in consultation with patients and relatives where possible. Staff must take into account the cultural and beliefs of the patient when carrying out manual handling to ensure that no distress is caused and to ensure promotion of independence and privacy of patients in our care. Pre-operative and In-patients Risk Assessments A specific manual handling risk assessment must be completed as appropriate using Trust documentation. RM06 Manual Handling Policy v9 14

Individual patient risk assessments will be undertaken using appropriate Trust documentation, e.g., Pre-Operative and In-Patient Adult Risk Assessment Tool booklet. The assessment should be completed, as appropriate, for all in patients and should be linked to the Mobility/Moving and Handling Care Standard documentation. (Reference to Trust Care Standards documents, which are on the Trust Intranet Site) The risk assessment should be completed appropriately to form an action plan detailing the handling risk level, number of staff and any equipment required to carry out the task safely. The patient risk assessment MUST be reviewed weekly or as the patient s condition changes, e.g. when there is reason to believe the assessment is no longer valid because the patient s condition and ability has changed, circumstances of the task have changed, or there have been significant changes in the environment or the task. In accordance with the Regulations, a review must also take place if an accident or incident occurs. The assessment must consider the patient, and their condition and all other clinical circumstances, which are likely to impact on the handling tasks prior to a final safer system of handling being chosen. All patient risk assessments should be signed (or countersigned) and dated by a qualified health care professional. Other Patient Risk Assessments There are some clinical areas within the Trust where the Pre-Operative and In- Patient Adult Risk Assessment Tool booklet is not appropriate. In these areas, a single individual patient risk assessment form is available for use e.g., Physiotherapy, Day units, some community based acute services (Appendix 2). In some areas, modifications to the single patient risk assessment form have been made to suit individual departmental needs and requirements e.g., Paediatric Physiotherapy. However, any modifications to this form must be discussed with the Clinical Ergonomics Department to ensure that the form contains the required patient risk assessment information. The assessment must consider the patient, and their condition and all other clinical circumstances, which are likely to impact on the handling tasks prior to a final safer system of handling being chosen. The single patient risk assessment should be completed appropriately to form an action plan detailing the handling risk level, number of staff and any equipment required to carry out the task safely. The risk assessment must be kept under constant review and changes made when appropriate e.g. when there is reason to believe the assessment is no longer valid because the patient s condition and ability has changed, circumstances of the task have changed or there have been significant changes in the environment or the task. RM06 Manual Handling Policy v9 15

In accordance with the Regulations, a review must also take place if an accident or incident occurs All patient risk assessments should be signed (or countersigned) and dated by a qualified health care professional. 6.1.4 Rehabilitation Rehabilitation handling is aimed at promoting or maintaining function and independence, in accordance with individual treatment goals (Guide to the Handling of People V5 2005 and V6 2011). A risk assessment must be carried out as part of the overall assessment and treatment plan by the relevant Therapy team. Handling methods must be realistic for all those carrying out the tasks. Less skilled people should not be expected to compromise their safety or that of their patients by working outside of their capabilities in carrying out handling tasks. In accordance with the risk assessment, equipment should be used to complement handling methods. Therapists should not be using controversial handling methods as routine practice. Therapists may have to work from a position in front of the patient, and their greater skill and knowledge may make this less of a risk than for those who are unskilled. However the risk assessment must consider any additional risks. Therapists must, when delegating therapeutic handling to staff, ensure the health and safety and competencies of those involved. Patient handling assessments must be constantly monitored and adjusted, where required, to indicate assessment decisions, which is the responsibility of the assessing clinician. 6.1.5 Specialist Services In areas where there is a rapid through put of patients it may not be practicable to carry out a risk assessment on each patient. In these circumstances a generic risk assessment of handling situations, where there is likely to be a significant risk of injury must be carried out (MHOR as amended). If at a procedure/surgical pre-assessment meeting, a patient is identified as having a specialist handling need, then a full risk assessment must be completed in line with Section 6.1.3 Areas where generic risk assessments may be required include: - Breast Screening - Endoscopy & Colposcopy - A & E including Plaster Room - Out Patient Clinics - ENT - Theatres - Screening Services e.g., AAA screening, ECT - Woman s Health RM06 Manual Handling Policy v9 16

6.2 Equipment. - Mortuary - POD Surgery Centre - Radiology & Medical Physics - Maternity - Day units e.g., Chemo day unit, Woodside, Ellison unit, Chronic Pain service, Jubilee Day Unit This list is not exhaustive. If in doubt, then the Clinical Ergonomics team should be contacted for advice. Equipment shall be provided to assist in the avoidance or reduction of the risk from the handling event. Equipment should be used in accordance with manufacturer s instructions Staff should be trained in the safe use of any equipment used to reduce such risks or for musculoskeletal injury risk reduction. Clinical/departmental managers must establish minimum competencies for using equipment and ensure that their staff are trained accordingly. Records of all training and attainments of competencies must be taken and maintained by line managers (Refer to Trust Medical Devices Policies) Advice should be sought regarding equipment suitability from appropriate trust advisors, e.g. Clinical Ergonomics, Hotel Services, Infection Control, Tissue Viability, Health and Safety Advisor, Medical Devices or QEF Estates Departments. Equipment should be cleaned and decontaminated between uses with different patients as per Manufacturer s instructions and Trust Infection Control Policies. For purchase of equipment refer to Policy for the Procurement Management and Use of Medical Devices RM30 6.3 Bariatric Patients 7 Training Moving and handling very heavy, dependent patients involves a foreseeable risk. In such cases the guidelines and procedures for caring for these patients should be followed. There will be occasions when tasks require adjustments to the process due to changing needs or poor initial assessment. The Guidelines for the Management of the Bariatric Patient can be found on the Trust intranet site. 7.1 Training As manual handling training is mandatory within the Trust, the requirements are detailed within the Trust Mandatory Training Needs Analysis which can be found within the OD& Training section on the Trust Intranet Site. As laid down in the Regulations, the Trust will: RM06 Manual Handling Policy v9 17

7.1.1.1 All newly appointed staff to the Trust will receive Manual Handling Training on the Corporate Induction training, in line with the Trust Induction Policy. This incorporates full manual handling training appropriate to their individual work role requirements on commencement of their employment, in line with Trust Mandatory Training Needs Analysis and Induction Policy PP30. 7.1.1.2 To ensure all new staff attend the appropriate training session(s), the Organisational Development & Training (OD&Training) Department co-ordinate the Induction Training and supply the names of all new starters to the Trust to the Clinical Ergonomics Team 7.1.1.3 All staff should attend manual handling training as required by the Trust as indicated in the Trust Mandatory Training Needs Analysis. The manual handling training programmes include all or some of the following elements depending upon the type of course and training needs: Legislation, local policies and procedures Understanding of the basic principles of biomechanics including mechanics and function of spinal structures Recognise the difference between safe and unsafe/controversial practices and their relationship to Musculoskeletal Injuries. Importance of back care and posture including the risk factors of back pain and musculoskeletal injuries Importance of an ergonomic approach to risk assessment and management and the role of the individual Work place specific handling methods to include inanimate loads and people handling. Promotion of person independence, where appropriate. Work place specific handling equipment The principle of general fitness for handling. Opportunity to practice safer handling methods. Course handouts and further information on manual handling can be located on the Trust Intranet site. Controversial /unsafe Patient handling practices handout can be found in Appendix 3. 7.1.2 Provide training programmes for appropriate groups of staff before any manual handling tasks are undertaken. The level of training each staff group requires is identified in the Trust s Mandatory Training Needs Analysis. 7.1.3 Provide training for groups of staff at all levels, which include skills involved in making ergonomic assessments and a problem solving approach to manual handling operations. 7.1.4 Monitor and review-training programmes to meet the needs of specific occupational groups and develop good practice based on assessment of current training status and the skills required to supervise and monitor established safe practice. 7.1.5 Staff should attend courses relevant to their job role (reference to TNA). If a manager considers this to be unnecessary, then a risk assessment must be carried RM06 Manual Handling Policy v9 18

out indicating how any risks will be managed in the workplace. Copies of the assessment should be sent to Clinical Ergonomics and the relevant Divisional Manager. 7.1.6 Training will be provided on the principles of efficient human movement, and their application to manual handling tasks and on equipment available at the training session. Training will also include skills involved in making an ergonomic assessment and a problem solving approach to manual handling tasks. 7.1.7 The Clinical Ergonomics team will monitor and review all training programmes to ensure that the content is current, meets recognized standards, reflects the needs of the Trust, and addresses issues reported in DATIX as appropriate. 7.1.8 Attendance on training will be monitored by Clinical Ergonomics who will report on attendances. Managers will be made aware of non-attendance and be responsible for ensuring that training is completed. 7.1.9 The frequency of Refresher training is specified in the Trust s Mandatory Training Needs Analysis. 7.1.10 Refresher training for staff returning after absence may be recommended by Occupational Health, where appropriate, as part of their return to work programme. 7.1.11 Where possible the Trust will adhere to the trainer to delegate ratios as recommended by the National Back Exchange: HSE 2007. The recommended number currently stands at 6 8 delegates per trainer. 7.1.12 Customized awareness/refresher training will be provided for all staff where a unique manual handling task has been identified or a piece of equipment e.g. hoist, is used infrequently. 7.1.13 All staff completing the appropriate training programme will receive a Certificate of Attendance to include in the personal/professional development record. 7.2 Record Keeping Training 7.2.1 Records of attendance and non-attendance at Manual Handling Training will be recorded on the Oracle Learning Management (OLM). 7.2.2 It is the responsibility of the OD&Training Department to record all Induction and Mandatory training onto OLM, in line with Mandatory Training Policy PP25 and Induction Policy PP30. 7.2.3 A core course elements document is completed following the main training courses i.e., Induction, Introduction to moving and handling and practical skills courses and is a record of course content, practical elements covered and level of participation during the sessions. For other courses, course documentation is also completed outlining the session content. RM06 Manual Handling Policy v9 19

7.2.4 For the full outline of the process for the Management of Non-Attendance for Mandatory and Statutory Training for directly managed staff, which includes manual handling, refer to Mandatory Training Policy PP25. 7.2.5 Any areas where there is persistent non-attendance, consultation will take place to ascertain the reasons with the relevant line manager. 7.2.6 Manual Handling is classed as Mandatory Training and failure to comply may result in further action being taken. Refer to Mandatory Training Policy PP25 Risk Assessments 8 Equality and diversity 7.2.7 Any risk assessment completed must be accurately recorded using the relevant Trust documentation 7.2.8 Copies of all non clinical risk assessments must be available for inspection in line with health and safety policies by the relevant manager. 7.2.9 The Clinical Ergonomics team, with the Health and Safety Advisor, will monitor and review all manual handling risk assessments to identify trends/risks for further action or follow up, and in addition will develop and monitor the implementation of an appropriate action plans, where required. The Trust is committed to ensuring that, as far as is reasonably practicable, the way we provide services to the public and the way we treat our staff, reflects their individual needs and does not discriminate against individuals or groups on the grounds of any protected characteristic (Equality Act 2010). An equality analysis has been undertaken for this policy, in accordance with the Equality Act (2010) This policy when implemented should reflect anti-discriminatory practice. Any services, interventions or actions must take into account any needs arising from race, gender, age, religion and belief, language, communication, sensory impairment, disability and sexuality. 9 Monitoring compliance with the policy Standard/process/ issue Process for recording Manual Handling Training information. Process for following up those who do not complete training Monitoring and audit Method By Committee Frequency All manual handling For each training records put course onto OLM database Non-compliance - course registers given to OD&Training. Monitoring process ref: Mandatory training Policy and Induction Policy. Clinical Ergonomics/ OD&Training dept Clinical Ergonomics / OD&Training. Health and Safety Committee (HSC) Health and safety Committee HR Committee For each course updates to committee as required RM06 Manual Handling Policy v9 20

Standard/process/ issue Monitoring and audit Monitoring of the above Manual Handling Training Report Method By Committee Frequency Clinical Ergo Health and Annually Safety Committee Standard/process/ Monitoring and audit issue Method By Committee Frequency Moving and Handling managing the risk associated with moving and handling Moving and handling patient risk assessments Ward Audits of patient risk assessments Clinical Ergonomics Health and Safety Committee Annually Generic Moving and Handling clinical and non clinical risk assessments Department and Ward audits Clinical Ergonomics/ Health and Safety Health and Safety Committee Every two years or sooner if assessed necessary How action plans are developed and followed up as a result of risk assessments Audit Clinical Ergonomics/ Health and Safety/Managers Health and Safety Committee As above Monitoring of the above Annual report Clinical Ergonomics/ Health and Safety Health and Safety Committee Annually Compliance with the policy Annual report Clinical Ergonomics/ Health and Safety Health and Safety Committee Annually Incidents Incident statistics Managers/ Health & Safety team Health and Safety Committee Annually The Clinical Ergonomics Team, in conjunction with Health and Safety, will carry out an annual audit on compliance of the manual handling risk assessment process. The findings will be analysed and included in a report, together with recommendations and supporting action plan where appropriate. This will be presented to the Health and Safety Committee. Manual Handling incidents recorded on Datix will be reviewed annually by clinical ergonomics and health and safety. Where trends are identified within the year or where there is a significant increase in accidents or incidents, these will be reported to the Health and Safety Committee. Managers will be provided with a list of staff who have attended manual handling training and a list of non-attendees. This list will be issued as requested, for them to take the appropriate action in accordance with their responsibilities as specified in Section 4 of this policy. RM06 Manual Handling Policy v9 21

For Mandatory training and Corporate Induction training, the OD and Training Department will monitor and report on attendance and non-attendances as per the relevant Trust Polices. To ensure that all relevant issues are addressed an appropriate action plan will be drawn up annually, identifying areas for improvement/change, with leads and timescales clearly specified. Any action plan and updates will be discussed at the Health & Safety (General aspects of Manual Handling including training) and implementation monitored by the Clinical Ergonomics Team. Regular monitoring and audit of health and safety is essential to ensure that the arrangements in place for managing health and safety are effective and compliant with relevant statutory provisions. The Trust will use a variety of mechanisms to monitor and audit the health & safety arrangements. A Manual Handling Annual Report will be produced by the Clinical Ergonomics Service on each financial year (April March), which will be reviewed, by the Health and Safety Committee. 10 Consultation and review This policy has been reviewed and updated and has been circulated for comment and consultation to the following: Clinical Ergonomics and Occupational Health department, Risk Management; Health and Safety Advisor, Internal Audit and Counter Fraud Service and the Equality and Diversity Co-ordinator, staff side health and safety reps, Safer Working Group, Heads of Departments, Medical Devices; Compliance and Assurance, Tissue Viability Specialists; OD&Training, in line with OP27 Trust Policy for the development, management and authorisation of policies and procedures. The policy has been reviewed and approved by the Health and Safety Committee and will be regularly reviewed according to OP27 Policy or more frequently depending on updates in health and safety legislation, guidance or requirements or significant changes in work practices. 11 Implementation of policy (including raising awareness) This policy will be implemented in accordance with OP27 Policy for the development, management, and authorisation of policies and procedures. It is also included in corporate and mandatory training, and relevant staff education/training events. This policy reflects the Trusts stance on the Management of Risk and the provision of good Health and Safety standards. Managers must have named individuals who progress manual handling within each Directorate or Service Area. These named individuals are responsible for ensuring the policy is implemented, in full, in each locality of the trust. They are key in the assessment process and the maintenance of records within their own departments. The Trusts risk assessment process will provide the evidence for each management unit to identify any needs, relating to manual handling compliance, e.g. need for training, equipment etc. This should be conveyed to the Clinical Ergonomics, Health and Safety and Risk Management Teams. The Clinical Ergonomic Service will provide assistance and guidance for managers and staff on any assessments, they feel require specialist knowledge. The service will also provide assistance on solutions requiring changes to work places, changes to the environment and further staff training when managers request such support The Trust Membership Coordinator as detailed within OP27 will circulate this policy. RM06 Manual Handling Policy v9 22