Lone Working Policy Health & Safety Policy HS6 Version 1 Date Issued April 2012 Review Date March 2014 Policy Author Local Security Management Specialist Approved by Quality & Governance Committee Date Approved April 2012
C O N T E N T S Section Subject Page 1. Introduction and purpose of policy 3 2. Aims 3 3. Definition of lone working 3 4. Legislation 4 5. Roles and Responsibilities 5 6. Risk Assessment 8 7. Safe Systems of Work 9 8. Permits to Work 10 9. Emergencies 10 10. What to do if there is genuine concern 11 11. Training 11 12. Review and revision arrangements 11 13. Dissemination and Implementation 11 14. Monitoring 12 15. References 12 Appendix 1. Who is at risk from lone working? 13 Appendix 2. Flow chart Process in the event of an incident 14 Appendix 3. Lone Worker Escalation Contact Form 15 Appendix 4 Staff Procedure 16 Appendix 5. Generic Risk assessment fixed establishment 17 Appendix 6. Generic Risk Assessment away from base 18 2/18
1. Introduction and purpose of this policy 1.1. Wirral Community NHS Trust recognises that there are risks associated with lone working and is committed to ensuring the personal safety of its employees in their working environment. 1.2. This policy explains how Wirral Community NHS Trust will manage lone working situations. It covers a wide and diverse range of situations and employees. 2. Aims 2.1 To ensure that any risks associated with lone working are identified, assessed and measures put in place to maintain safe working practices. 2.2. To provide Heads of Service, managers and lone workers with guidance in managing lone working situations including responsibilities for providing information, instruction and training. 2.3. To ensure effective action can be taken should staff find themselves in a threatening or dangerous environment and need help. Within the context of this policy, each service is required to supplement this by producing their own protocols and procedures based upon risk assessments to assist employees in their local situation. 2.4. To ensure that all staff feel safe and secure, so that they can undertake and perform their duties free from fear and in the full knowledge that there are robust management procedures in place. 2.5. Wirral Community NHS Trust also has a duty to those who undertake lone working on their premises such as maintenance contractors. 3. Definition of lone working 3.1. The Health and Safety Executive define lone working as Those who work by themselves without close or direct supervision. 3.2. NHS Protect defines lone working as Any situation or location in which someone works without a colleague nearby; or when someone is working out of sight or earshot of another colleague. 3.3. Lone Working could refer to those who routinely work in a clinic environment where staff care for patients or service users on their own, without the support of line managers or other colleagues or it could also relate to those who work in the community where care is provided in the patient s home or a non-clinical environment. 3/18
3.4. Lone working is not unique to any particular group of staff, working environment or time of day and may be found in a wide range of situations. Some examples of lone workers in an NHS Community Trust are given in Appendix 1. 4. Legislation 4.1. Although there is no specific legislation in relation to lone working, there are a number of Acts of Parliament and directions that are relevant to lone working. 4.2. Health and safety at Work Act 1974 NHS organisations have responsibilities under the Health and Safety at Work Act 1974, particularly in relation to employers ensuring, as far as is reasonably practicable, the health, safety and welfare of employees at work. 4.3. The Management of Health and Safety at Work Regulations 1999 These Regulations require employers to assess risks to employees and non employees and make arrangements for effective planning, organisation, control, monitoring and review of health and safety risks. Where appropriate, employers must assess the risks of violence to employees and, if necessary, put in place control measures to protect them. 4.4. Safety Representatives and Safety Committees Regulations 1977 (a) and The Health and Safety (Consultation with Employees) Regulations 1996 (b) Employers must inform and consult with employees in good time on matters relating to their health and safety. Employee representatives may make representations to their employer on matters affecting the health and safety of those they represent. 4.5. The Corporate Manslaughter and Corporate Homicide Act 2007 This legislation creates a new offence under which an organisation (rather than any individual) can be prosecuted and face an unlimited fine, particularly if an organisation is in gross breach of health and safety standards and the duty of care owed to the deceased. 4.6. Secretary of State for Health Directions NHS organisations have responsibilities to manage security, including protecting all staff from violence and aggression in accordance with Directions to health bodies on security management measures introduced in 2003 and 2004 and as amended 2006. 4/18
5. Roles and Responsibilities 5.1. Wirral Community NHS Trust Wirral Community NHS Trust Board has a legal duty to ensure the health, safety and welfare of employees who work for the organisation including the protection of lone workers. 5.2. Security Management Director The Security Management Director (SMD) is responsible for ensuring that appropriate security management provisions are made within Wirral Community NHS Trust to protect lone working staff. This includes: Responsibility for raising the profile of security management work at board level and getting their support and backing for important security management strategies and initiatives. Responsibility for the nomination and appointment of a Local Security Management Specialists (LSMS) and through continued liaison to ensure that security management work (including the protection of lone workers) is being undertaken to the highest standard. To ensure that measures to protect lone workers complies with all relevant health and safety legislation, Secretary of State Directions and takes into account NHS Protect guidance. Overall responsibility for the protection of lone workers by gaining assurance that policies, procedures and systems to protect lone workers are implemented. Where there are foreseeable risks, the SMD should gain assurance that all steps have been taken to avoid or control the risks. 5.3. Local Security Management Specialist 5.3.1. The Local Security Management Specialist (LSMS) has responsibility for investigating all breaches of security including incidents involving lone workers and reporting actions taken to the SMD. In conjunction with the Health & Safety Advisor, providing advice, guidance and support in respect of security matters to managers when developing individual local arrangements under this Policy. The LSMS for Wirral Community NHS Trust can be contacted on: Tel No; 0151 514 2888 (internal ext: 1492) Mobile: 07717766162 5/18
5.4. Heads of Service/Heads of Division/Clinical Leads Responsibilities Heads of Service/Leads are responsible for Ensuring that risk assessments are completed within their service area Developing local arrangements to reduce the risks Ensuring processes in place to deal with any emergency situation. For example: in the event that a member of staff cannot be contacted or phones in to report they are in immediate danger (Please see Appendix 2 Process in the Event of Suspicious Event or Missing Lone Worker ) Implementing any necessary remedial action identified by incidents, audits or inspections Allocating sufficient resources/funds for procurement of equipment or changes to working practices where it will reduce the risk of injury or ill health Liaising with the controllers of premises where Wirral Community NHS Trust staff are based to ensure their safety in those premises, including ensuring that lone working has been considered. Where appropriate, for each of the above, the Heads of Service/Leads will consult with the Local Security Management Specialist and / or Health & Safety Advisor as necessary. The Heads of Service/Leads will periodically review and monitor the status of the risk assessments in place. 5.5. Line Manager s responsibilities Line managers have responsibility to: Review operations to identify situations where employees may be exposed to foreseeable risks etc, verbal abuse, physical assault or a work related safety hazard Where appropriate to undertake and record risk assessments and review their effectiveness at intervals not exceeding one year or when significant change in circumstances occurs Involve staff or their representatives when undertaking the required risk assessment. Establish clear procedures to set limits as to what can and cannot be done whilst working alone and, where appropriate, when to stop work and seek advice. Communicate the significant findings of the assessments and monitor compliance with the recommendations and control measures Effectively implement and monitor processes within their service/department to deal with emergency situations and ensure that they are frequently tested Ensure employees receive appropriate training and, where necessary, refresher training. Ensure all untoward incidents are reported in accordance with the Incident Reporting policy GP8. 6/18
Investigate reports of incidents and ensure that corrective actions are put in place Ensure that other agencies are informed of risk assessments as well as any subsequent review or changes to the work plan. Further advice to be obtained by contacting the Clinical Governance/Risk Manager in accordance with Caldicott Principles and Guidance. When planning changes in service provisions to take account of possible risks to safety and make arrangement for their avoidance or control. Ensure that Lone Workers can be contacted and that there is a record kept that will assist in locating them; for example a record of planned visits to patient s homes. (Please see Appendix 3 for a Lone Worker Escalation Contact Form). 5.6. Employees Responsibilities All staff have a responsibility to: Comply with the risk assessment recommendations and any local lone working procedures laid down and to report to their manager any problems encountered whilst working alone. Take reasonable care of themselves and other people affected by their work and to cooperate with their employers in meeting their obligations (Please see Appendix 4 for a staff check list) Comply with any information, instruction and training which are provided to minimise risks to their health and safety. Report to their Line Manager or Occupational Health any personal conditions which may affect their capability to undertake certain activities whilst lone working. Report and document any accidents, incidents, injuries or ill health which may arise. 5.7. Occupational Heath Responsibilities The Occupational Health Service will advise Human Resources (HR) if, on appointment, individuals are unable to work alone for health reasons and will offer support and advice to both Wirral Community NHS Trust staff and any prospective employee. 5.8. Health and Safety Advisor The Health and Safety Advisor is responsible for Providing advice, guidance and support to any employee in connection with lone working. 7/18
Recommending standards of safety to ensure compliance with current legislation regarding personal safety and lone working. Assisting in the development of strategies for the reduction of risks associated with personal safety and lone working. Providing reports to the Health, Safety and Wellbeing Group in respect of Health and Safety issues and incidents involving lone workers. Monitor accidents and incidents in the work place. Regularly reviewing the policy in liaison with the Health, safety and Wellbeing Group, and making appropriate recommendations for amendments necessary to maintain compliance with current legislation and suggested best practice for the personal safety of lone workers. Advising of any training required. 6. Risk Assessment 6.1. The Management of Health and Safety at Work Regulations 1999 require employers to carry out a risk assessment in relation to all significant hazards faced by its employees. (Please note: assessments must be completed in accordance with the Community Trust s General Policy GP45 - Procedure for Risk Identification and Management). 6.2. Having identified the lone workers and lone working situations, managers must determine whether any existing controls are adequate or whether more needs to be done. This should be formally documented. 6.3. The risk assessment should take into account the past, present and future; Past any previous incidents or known history. Present the environment and any existing arrangements in place to manage the hazards faced by lone workers, such as the equipment available, communication systems in place and training. Future the risk inherent in the task to be carried out such as any threats that have been made as to future behavior and the process to be followed in the event of an incident. 6.4. Managers must take account of the extent that existing controls are being followed. 6.5. Information on the outcome of risk assessments must be communicated to staff as part of the risk assessment process. 8/18
6.6. Staff should also be encouraged to seek advice / assistance if they are unsure about a situation or to report any problems / concerns via a line manager. 6.7. Having undertaken the risk assessment, recorded and implemented all necessary controls, it is important that all lone working situations are monitored and reviewed if there are any significant changes or at least once a year. 7. Safe Systems of Work 7.1. Under no circumstances should staff compromise their safety. If they feel unsafe at any point, while in a lone working situation, they should promptly remove themselves from the situation and report the circumstances to a manager immediately. 7.2. Local procedures should ensure, so far as is reasonably practicable, the safety, security and well-being of all staff, including those working alone, and provide information, instructions and advice on issues such as: Staff working alone in isolated areas on NHS premises e.g. a receptionist being confronted by an angry relative, a nurse being trapped in a clinic/treatment/consulting room by an aggressive patient. Safety and security of mobile workers/staff working away from their base locations e.g. staff having to park in poorly lit areas and walk a significant distance away from their vehicle to reach their patient s home. Initial/first visits to patients homes. For example, make sure who (patient/family/friends) will be there, secure pets etc. What to do when a member of staff goes missing. For example, who informs police, relatives, colleagues etc. What should staff do before setting out on a journey? For example, ensure others know where they are going and their route through a buddy system, location boards, telephoning colleagues, planning their route, and have their mobile phones with them. What staff should do on arrival at a patient s home. For example, call a buddy / colleague to say you have arrived, how long you will be there and when you will contact them next. What staff should do in an emergency situation. For example, call base location for assistance or call emergency services. Actions to be taken by staff and managers in the event of suspected / confirmed cases of stalking. For example, informing appropriate agencies, changing routine. 9/18
7.3. Immediately following an incident, the staff members involved should have access to their line manager/team leader for support, supervision, guidance and help with what to do next. As soon as practicable, a meeting should be organised, for the staff involved who may wish to be accompanied and their manager to discuss the incident freely and to ascertain what further support may be needed. Following this meeting the risk assessment will be reviewed and an action plan implemented. 7.4. Within seven days, a formal de-brief should take place. A debrief should be an opportunity for all staff to reflect upon thoughts and feelings evoked by the incident, current working practice, and whether any changes are necessary. 7.5. Lone working systems and devices must only be used for their intended purpose. As well as jeopardising lone workers safety, lack of use could result in monitoring services being withdrawn. In some cases the police may refuse to attend incidents if there has been a history of misuse or false alarms. 7.6. If a lone worker device is misused, then the matter should be referred to the LSMS for investigation. 7.7. Examples of safe working systems can be found in the NHS Protect document entitled Not Alone, (version 2) a copy of which can be found on the Trust intranet. 8. Permits to Work 8.1. There are some high-risk tasks for which a permit-to-work must be issued such as hot work, work in confined spaces, electrical work etc. Only the Estates Department will issue these permits and further information and guidance regarding this issue can be obtained by contacting the Head of Estates or the Health and Safety Advisor. 9. Emergencies 9.1. Heads of Service must ensure that there are suitable provisions for any accident or emergency situation, which a Lone Worker maybe involved in. 9.2. Suitable provisions may include the following: o Access to adequate first aid facilities and mobile workers should carry a first aid kit suitable for treating minor injuries. Occasionally risk assessment may indicate that lone workers require training in first aid. o Provision of communication equipment for use in an emergency or accident situation. o Communication procedure for alerting a central point of an emergency. 10/18
o Provision of specialist equipment which automatically identifies an emergency or accident, e.g. panic alarms connected to a central control point or gravity activated alarms which are activated when an employee remains at a low level for a given amount of time. 10. What to do if there is genuine concern 10.1. Where there is a genuine concern, as a result of a Lone Worker failing to attend a visit, or an arranged meeting, or returning to base within an agreed time, the manager should utilise the information provided in the log to help track the Lone Worker, and ascertain whether or not they turned up for previous appointments that day. 10.2. Depending on the circumstances and whether contact through normal means (mobile phone, pager, etc) can or cannot be made; the manager or colleague should involve the police. 10.3. Where it is thought that the Lone Worker may be at risk after consideration of all the available facts, it is important that matters are dealt with quickly. If Police involvement is needed, they should be given full access to the information held and personnel who might hold it, if that information contains data that might help trace the Lone Worker and provide a fuller assessment of any risks they might be facing. 11. Training 11.1. Heads of Service will ensure that staff receive training in the recognition and management of challenging behaviour (Conflict Resolution Training) as defined in the training needs analysis for the organisation. All core mandatory training is recorded centrally by the Quality and Governance Service. Quarterly monitoring reports are prepared for the Learning and Development Group to monitor attendance rates.. 11.2. Vulnerable Lone Workers have been issued with Lone Worker identicom devices. They are required to attend mandatory training which includes ensuring they are able to use the Safety Device. Managers of Lone Workers will attend training that covers understanding of the risks lone workers are faced with, and aid them to assist their staff to deal with matters effectively. It will also cover the management of lone worker technology systems. 12. Review and revision arrangements 12.1. This policy will be reviewed every 2 years. Review of this policy may be sooner if there are changes to existing legislation, suggested best practice, or the introduction of new legislation or directives prior to any specified review date. 11/18
13. Dissemination and Implementation 13.1. A communication will be sent to all staff on their roles and responsibilities in relation to lone working, making them aware of their responsibility to be familiar and compliant with lone working policies and procedures that are in place for their protection. The NHS Protect website will also be publicised for staff www.nhsbsa.nhs.uk/security. This message will be sent via the following routes: 14. Monitoring The policy will be placed on the Trust intranet site. Notification of any changes to this document will be sent to service leads, who are responsible for passing this information on to staff. Community Trust Staff Communication bulletin The LSMS will inform staff when making on site visits During conflict resolution training 14.1. Health & Safety Performance Assurance reports submitted by services will be used to monitor that risk assessments have been undertaken and action plans implemented in accordance with this policy. 14.2. The Local Security Management Specialist and nominated line manager will monitor monthly Safety Device activity reports and undertake user spot checks to ensure compliance with the policy. 14.3. The Local Security Management Specialist will monitor reports about security incidents involving Lone Working. 15. References 15.1. The Local Security Management Policy and Procedures HS18 (Section 24 Violence and Aggression). 15.2. Incident Reporting Policy GP8 15.3. Procedure for Risk Identification and Management GP45 15.4. NHS Protect document entitled Not Alone (version 2) - A Guide for the better protection of lone workers in the NHS - (www.nhsbsa.nhs.uk/security.) 15.5. NHS Protect template for developing a lone worker policy - (www.nhsbsa.nhs.uk/security.) 15.6. NHS Protect document entitled Non Physical Assault Explanatory Notes A framework for reporting and dealing with non-physical assaults against NHS staff and professionals (www.nhsbsa.nhs.uk/security.) 15.7. Management of health and safety at work. Management of Health and Safety at Work Regulations 1999. Approved Code of Practice and guidance L21 (Second edition) HSE Books 2000 ISBN 978 0 7176 2488 1 15.7. Safer Working in the Community - Royal College of Nursing 1998, ISBN 1873852304 15.8. Secretary of State s Directions in respect of security management 15.9. Working alone in safety - Unison health and safety guide on working alone (INDG73) www.hse.gov.uk/pubns/indg73.pdf 12/18
.Appendix 1 Examples of lone workers People who work in fixed establishments Receptionist working out of sight or earshot of another colleague such as in a clinic reception area. Cleaners working outside normal hours. Staff who see patients, clients or other members of the public on their own. Staff with responsibility for opening up and closing buildings Maintenance and domestic staff who are working alone in an NHS building Staff working in an isolated part of a building People working away from their fixed base Staff visiting service users in their own home Staff who work at home Those who travel between NHS sites and premises. Any employees who attend public events to give presentations on NHS issues. On call staff required to respond to emergencies. How might lone workers be harmed? Working alone need not present any greater risk to staff than working in a team situation or busy environment but some hazards are more significant where staff work alone, for example: Working at height or near unprotected edges or where there is a risk of falling Working on live electrical systems or conductors Working near water Working in confined spaces Working with chemicals or hazardous substances Contact with unknown/potentially violent customers or service users Working with equipment or machinery Working in noisy environments Lifting or carrying loads/setting up equipment In high fire risk areas Undertaking security activities Transporting/collecting cash Working in areas known to suffer anti social problems or with high crime rates or where individuals may be encountered that have a history of violence Exposure to extreme temperatures or weather conditions Employees that have a medical condition, physical or psychological, which may put them at higher risk of harm when working alone The above list is by no means exhaustive. 13/18
Appendix 2 Process in the event of a suspicious incident or missing lone worker Lone worker phones base / colleague / manager to report imminent danger or suspicious incident Staff unable to contact lone worker at end of day Lone worker fails to make contact with base / colleague at allotted time Line Manager is informed immediately Police notified immediately / as appropriate Manager should utilise the information available to help track the lone worker and to ascertain whether or not they turned up for previous appointment that day Head of Service must be informed without delay In the event that a lone worker in the community is assumed missing or is the subject of suspicious circumstances following or during a visit to a patient s home, the Head of Service or their deputy must contact and inform an Executive Director as soon as possible Local investigation undertaken with help of LSMS / H&S as appropriate until concerns resolved NB: If the incident occurs outside normal working hours, contact is via the on-call duty manager who can be contacted via Arrowe Park Hospital switch board on 0151 678 5111 or mobile no: 07810754138 14/18
Appendix 3 C O N F I D E N T I A L Lone Worker Escalation Contact Form The following information is strictly confidential and must not be shared unless for the purposes of protecting the member of staff concerned in the event of an emergency. Any changes to these details must be notified immediately and reviewed at least once a year. Lone Worker details (Please use block capitals): Full name:.. Date of birth:.. Department:... Location:. Tel No: Description: Height:. Hair colour: Any other distinguishing features:.. Description of vehicle used for work: Make / model: Colour:. Registration No: Work mobile phone number: If possible please give a personal mobile phone number: Escalation contact number 1: Dedicated work mobile phone number (if different from above):... Escalation contact number 2: On call duty manager: Escalation contact number 3: Home telephone number:. Next of Kin Mobile Number 15/18
Appendix 4 Staff Procedures The following is a checklist for staff to use when working alone: Have you signed in/out from your location? Do other staff know where you are going? Do staff know how long you will be, your estimated time of return? Is there a contingency plan in place with colleagues if you re overdue? Have you planned your journey? Can you get in contact with others or them with you? Do you need a panic alarm, is one available if required? If the person(s) you are visiting is considered potentially violent or has a recent history of violence, is there reason for seeing them in your office rather than visiting them at home, or alternatively visiting with a colleague? If you are conducting an interview within a client s home, always try and stay located nearest the door, in case you need to make a quick escape. Are you familiar with the risk assessment and controls for the task or activity that you are undertaking? Has your manager explained the measures that are in place to prevent an accident or other type of incident? Have you had training for the work you are undertaking? 16/18
Appendix 5 Generic Risk Assessment Location/Activity: Lone Workers in fixed establishments) February 2012 Ref Hazards Risks People at risk Current Control Measures vary from site to site. The following are examples of what should be considered LW1 Premises where the public has unrestricted or semi restricted access and the lone worker is working out of sight or hearing of colleague Aggressive/ threatening callers Theft of personal property An accident such as trip, slip or fall. Bomb threat Hostage situation Lone Receptionists Clinic based staff who meet members of the public on their own Public Health presenting healthy lifestyle advice Maintenance contractors working alone Access to the building is adequately controlled. A visitor control system is in place (e.g. Visitors book) Confidential system for knowing who staff are interviewing. Effective communications systems in place for lone workers to summon help or raise an alarm. Site watch alert system. Regular contact with lone workers Procedure in place if contact cannot be established Emergency procedures identified and communicated to staff. Staff have received conflict resolution training Telephone access to a manager for advice. Good internal and external lighting. Security guards. CCTV systems. Room layout. 17/18
Appendix 6 Location/Activity: Lone Worker working away from their base. February 2012 Ref Hazards Risks People at risk Current Control Measures vary from site to site. The following are examples of what should be considered LW2 Carrying out lone visits in the Community Aggressive and threatening members of public Theft of personal property and / or NHS medication Road Traffic Accident Firearms / offensive weapon incident Ferocious dog Hostage situation Lone Doctors, Community Nurses and Health Visitors providing treatment / care in patient s homes. Therapies services carrying out lone domiciliary visits. Staff who frequently travel unaccompanied between different work venues Staff who carry medication System for recording sequence of staff visits and locations Lone worker escalation contact form completed and stored in a safe place Telephone access to a manager for support / advice There is regular contact with lone worker Procedures in place if staff cannot be contacted. Emergencies procedures identified and communicated to staff. Staff have received training in conflict resolution Driving at work policy and associated risk assessments 18/18