Lone Worker Policy and Procedure Number: THCCGCG21 Version: 01 This policy sets out the way that Tower Hamlets Clinical Commissioning Group (CCG) will comply with the requirements of the Health and Safety at Work Act 1974 and the relevant statutory provisions. Executive Summary This policy covers everyone that is employed by the Tower Hamlets CCG that are exposed to lone working conditions The CCG is committed to ensuring, so far as is reasonably practicable, the personal safety of its employees. It should be clearly understood by all concerned that in any situation, the reduction of risk and avoidance of untoward incidents is of paramount importance. Where visitors or clients are involved, the emphasis must be on safeguarding them from harm, even in cases where they contribute to the disturbance. Date of ratification Executive Team Committee 20th August 2013 Document Author(s) Collette McQueen Who has been consulted? Archna Mathur 25 th July 2013 Senior Management Team 26 th July 2013 Staff Consultation 26 th July 2013 Executive Team Committee 20th August 2013 Was an Equality Analysis required? Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 1
With what standards does this document demonstrate compliance? - Health and Safety at Work Act (1974) - Management of Health and Safety at Work Regulations (1999) - NHS Security Management Services References and associated CCG documentation Continuous personal and professional development policy Incident reporting and management procedure List of approvals obtained Archna Mathur 25th July 2013 Senior Management Team 26th July 2013 Staff Consultation 26th July 2013 Executive Team Committee 20th August 2013 Recommended review period August 2015 Key words contained in document Is this document fit for the public domain? Y / N Y If No, why? Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 2
Content 1 Purpose and scope... 4 2 Principles... 4 3 Responsibilities... 5 4 Procedure... 6 5 Aims... 6 6 Definition... 6 7 Identifying risks... 7 8 Implementing controls... 8 9 Situation specific guidance... 9 10 Travelling... 10 11 Incidents... 13 12 Training... 13 13 Monitoring, evaluation and audit... 14 14 Records... Error! Bookmark not defined. Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 3
1 Purpose and scope Lone working is an important aspect of the work experience for many staff who work for Tower Hamlets CCG. The CCG recognises that staff working alone may face increased risks that result from the fact that they do not have the immediate support of their colleagues if an incident occurs. This document sets out arrangements intended to reduce the risks associated with lone working for staff within Tower Hamlets CCG, and guidance for dealing effectively with any situations that do arise. This document contributes to the CCG s compliance with the Health and Safety at Work Act (1974) [1] and the Management of Health and Safety at Work Regulations (1999) [2]. It reflects the NHS Security Management Services (SMS) guidelines for protecting lone workers in the NHS (2005) [3]. This document applies to all situations involving lone working which result from the duties and activities of Tower Hamlets CCG staff; this includes temporary and agency staff, volunteers, students and those on work experience. 2 Principles Under the Health and Safety at work Act (1974) [1] and management of Health and Safety at work regulations (1999) [2] risk assessments must be carried out on all work areas where there are perceived risks. All departments / services must have local arrangements in place for lone working. All staff must be aware of the local lone working arrangements that are in place. All new staff will have access to health and safety awareness on induction and receive updates as required. All staff who visit clients in their own homes or who are working alone should have access to a functioning alarm or mobile phone depending on the local circumstances. All departments / services to have as appropriate emergency measures / equipment to raise an alarm of any potential threat to personal safety and all employees to be aware of where these are placed. Staff that are victims of violence will be supported using procedures detailed in the CCG s violence and aggression procedures document. Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 4
3 Responsibilities Party Chief Officer/Deputy Director of Quality and Performance Senior and line managers Lone workers Key responsibilities Making sure that there are arrangements for identifying, evaluating and managing risk associated with lone working. Providing resources for putting the procedure into practice. Ensuring that all staff are aware of the CCG s health and safety policies and procedures, and local arrangements for safe working. Establishment of local safe working arrangements for lone workers designed to eliminate or reduce the risks associated with working alone; Identifying staff who are lone workers, and, monitoring and supervision of lone workers. Ensuring that staff groups and individuals identified as being at risk are given appropriate information, instruction and training, including training at induction, updates and refresher training as necessary; Ensuring risk assessments of the environments and situations relevant to the activities of staff in the service or department are undertaken, recorded, reviewed regularly and shared with all relevant staff. Ensuring that appropriate support is given to staff involved in any incident, and managing the effectiveness of preventative measures through an effective system of reporting, investigating and recording incidents. Taking reasonable care of themselves and other people who may be affected by their actions. Co-operating by following rules and procedures designed for safe working and advising managers of work arrangements. Reporting all incidents that may affect the health and safety of themselves or others and asking for guidance as appropriate. Taking part in training designed to meet the requirements of the policy. Reporting any dangers they identify or any concerns they might have in respect of working alone. Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 5
4 Procedure 5 Aims The Clinical Commissioning Group (CCG) is committed to providing staff with a safe working environment as well as the knowledge and skills to respond to situations as they arise in connection with their duties. This document therefore aims to: 6 Definition raise staff awareness of the safety issues relating to lone working, ensure that risks are identified in a systematic way and action is taken to minimize or remove the risks, ensure appropriate support is available to all staff who engage in lone working, ensure that appropriate training is provided to all staff, encourage reporting of all incidents associated with lone working so that they can be adequately managed, and used to help reduce risks and improve working arrangements, Ensure the CCG s compliance with health and safety legislation and other requirements. For the purpose of this document lone working is defined 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. Examples include: a receptionist working alone in a clinic reception area, community staff including nurses, therapists, support staff, staff who see patients or service users for individual sessions in wards or clinics, staff who provide out-of-hours or on-call services, for example clinicians or estates engineers, staff who travel between NHS sites and premises, staff who open or close NHS buildings either early in the morning or late at night. The CCG recognizes that some staff may spend only a small amount of their time working alone. There are however a number of circumstances where staff are required not to work alone by law. These are: young persons under the age of eighteen years who must be working under the direct supervision of a competent person, people who work in confined spaces, people who work with or near electrical conductors. Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 6
7 Identifying risks In order to be able to adequately manage the safety of staff who are working alone, it is important to identify the risks associated with the environments and situations that they will be working in. This is accomplished using risk assessments. The Risk and governance manager can provide advice on conducting risk assessments for lone workers. Risk assessments must identify lone workers, either by post or individually. Essentially, the hazards associated with the work activity affecting the lone worker are often the same as those if the person were working with others. However, the additional risk control of having others at hand to provide routine assistance, for example to move something or to seek help, is not available. When assessing the risks it is therefore essential to identify how the risks are controlled to take account of the lone working and whether this is adequate. Managers will ensure that risk assessments are undertaken and recorded. Risk assessments should be carried out by someone who is competent in assessing risks, and, who has knowledge of the work activity and the risks it poses to lone workers. Risk assessments can be done in consultation with the staff member(s) who will be working alone, and, the outcome must be communicated to all staff who are affected by the activity. The risk assessment should consider whether CCG staff outside the service who has undertaken the risk assessment could reasonably be affected by the same risks identified, and where appropriate, the lone worker risk assessment should be shared on a need to know basis. The decision making process for sharing information should be documented and made available on request. Support for undertaking this assessment can be obtained from the governance team. Lone workers may be particularly vulnerable to the following hazards, and therefore should be considered as part of risk assessments: Working alone in a health center, clinic, school, surgery, patient s home or office Driving, parking, walking or using public transport alone Being away from base without their whereabouts being known Visiting patients for the first time without adequate referral information Working with aggressive patients and their families (if this is identified as a risk to lone workers, an assessment of the risks associated specifically with violence & aggression may need to also be undertaken Being out of contact with their base for long periods Being in possession of equipment attractive to thieves ipads, laptops, nursing bag, medical equipment, handbag, mobile phone Working at times outside normal office hours early morning, evening and night services, on call Working areas known to have high levels of violence and aggression Being trapped, attacked or injured without being able to summon help Car breaking down Operating machines and equipment. Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 7
8 Implementing controls Once a risk assessment has been completed the information should be used to identify actions or controls that will remove or minimize the risks. Where appropriate, management plans should also be established for responding to realisation of the risk. Advice and support can be sought from the Risk and Governance manager. Control measures might include: Reporting systems to ensure that whereabouts of staff are known. This could include use of team diaries or outlook diaries, which are accessible by team members, to record venue and duration of visits and meetings at bases other than the staff member s main base. Good practice would also include ensuring that team members are aware of the general route and mode of transport to and from the venue. Provision of a means of raising an alarm for example a CCG mobile phone or lone worker alarm device depending on the nature of the risks. Advice regarding lone worker devices can be sought from the Governance teams. Adapting working patterns and hours of work which at certain times of day or night could reduce risks. When possible, and having knowledge of intent to work late, consider arranging to park/move their car as close to the exit point as possible, or, consider arranging for someone, such as security, to meet lone workers and escort them to out of the building. The sharing of information among all persons who may be at risk. Accompanied visits where specific or general information indicates the need. Training to increase staff awareness of risk and the precautions to be taken. Supervision and auditing of work practices. Staff made aware of the CCG s lone working procedures. Where control measures include the establishment of reporting systems to ensure whereabouts of staff are known, managers will ensure that there is a documented process for managing situations where a colleague has not returned as expected. It should be noted that the actions taken if such a situation were to arise will be specific to the situation and the documented process should reflect this. This documented process could include: In the first instance, ask other colleagues whether they have heard from the person, or have been notified of changes to their plans. Ring their mobile number to see if they are safe. If no answer is received or if they answer but sound distressed, consider the following: notify their manager immediately and seek advice regarding notifying others e.g. police. If the manager is not available, notify the most senior person on the premises or the senior manager on call. Consider contacting the police in cases where the person answers but appears to be in distress or where the person does not answer but you are concerned about them. Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 8
If it is not possible to obtain an answer from their mobile phone, the manager should try to contact the person at home or through their next of kin before contacting the police. Useful websites for further information and guidance on principles of good practice for staff and material to aid the development of local departmental risk assessments and procedures include: www.suzylamplugh.org/ and www.unison.org.uk 9 Situation specific guidance When formulating actions or controls that will remove or minimize the risks associated with lone working, managers and staff should consider the following sections. 9.1 Working alone in a building This includes staff working away from their main place of work, working in isolated areas of buildings, and staff that work shifts / who may work late in circumstances which mean that they are alone in the building or at least in their area of the premises. Ensure staff know where the telephones are located. Ensure staff are made aware of local procedures for raising help and alarms. Where this includes use of panic alarms, staff should be made aware of what happens when the alarms is activated (for example will they hear the alarm or is it silent) and what will ensue thereafter. Good practice would dictate that these procedures are practiced with relevant staff. Ensure there are processes in place to minimise the risks associated with the admission of unknown people. Ensure that all windows and doors are appropriately secured to prevent unauthorised access. This may include locking outer doors of the building at higher risk times of the day. Secure all valuables and keys in an appropriate place. Where staff work on a routine or ad hoc basis during hours outside 08.00 to 18.00, Monday to Friday, ensure there are appropriate arrangements in place ensure someone is aware of their presence Staff should not hesitate to contact security or the police if they feel that their safety is at risk. Staff based at Alderney Buildings are to contact Mile End Hospital Security if there are any issues they need to be investigating within the building on: 0208 223 8233 Or Email - Len.Bromley@elc.nhs.uk 9.2 Visiting clients in their own homes In most situations, home visits will pose minimal threat to the safety of staff. However, the purpose of the risk assessment is to anticipate the potential risks of this activity and to implement reasonable steps to manage the identified risks. Managers and staff should consider and agree the appropriateness of the following. Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 9
9.3 Before visits Ensure you have as much information about the client, their home environment, and access details, for example the client s phone number. Review the client s referral and/or record to assess known risks from patients or their families. Documentation reviewed should be clear, up-to-date, comprehensive and accurate. If it is not clear, consider requesting further information from the referrer or other professionals to ascertain whether or not there are any relevant risk factors present, and if there are any reasons why it would be advisable not to visit the client alone. Where little information is available on first time patients, consider the appropriateness of arranging for the first consultation to take place in a clinic rather than the clients home. Where possible, assess the risks to safety associated with the environment external to the client s home. Consider this in conjunction with the time of day the visit is to take place. In certain situations, and where circumstances allow, staff may decide to visit during daylight hours and/or arrange for a colleague to accompany them. Wear shoes and clothes that do not hinder movement or ability to run in case of an emergency. Ensure that your means of communication and any personal alarms are working and accessible. Programme your work base into your mobile telephone so that it can be speed dialled. 9.4 High risk visits Where there is a history of violence or the client s location is considered high risk you must be accompanied by a colleague and/or the police. If there is any doubt over your safety, and it is clinically possible for the client to be seen in a neutral environment such as a clinic or health centre, you should arrange for the consultation to travel to this agreed setting. 9.5 During visits Ensure that you carry a staff ID badge and be prepared to identify yourself. When you arrive and throughout the visit, remain alert to your surroundings. If staff are not comfortable, even if you are not able to articulate exactly why, you should be prepared to use an excuse to negotiate an alternative arrangement. Make sure that when you enter the home you take note of how the door opens and look for potential alternative exit routes this will be useful if you need to leave in an emergency. Wherever practical, avoid being in a situation where the patient, carer or relative is between you and the exit. If violence is threatened leave immediately. Any concerns regarding safety should be documented and shared with appropriate colleagues. 10 Travelling The nature of work for many CCG staff means that they will need to travel between sites and work places. Risk assessments should take into account the risks associated with the mode of transport and implement measures which minimise the risks as far as is reasonably practicable. Managers and staff should consider and Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 10
agree the appropriateness of the following. (Advice on specific modes of transport is given below.) 10.1 By foot Plan your route. As far as reasonably practicable, balance the risks associated with the choice of route and time of travel and choose the one that best suits the circumstances. Do not display staff ID badge en route. Avoid, where possible, displaying CCG and personal items of value. Consider keeping your house keys and mobile phones separate from your handbag or brief case etc. If someone attempts to steal your belongings or CCG property you should relinquish the property immediately without challenge. Avoid, where possible, using mobile phones overtly. Where practicable, consider using your phone or responding to text messages in a safe place such as a shop. If you see someone who appears to be in distress or requiring help consider the risks associated with stopping to offer assistance. If you think you are being followed use your instincts and proceed to a place of increased safety. Cross the street and head for a busy area, or, go to a safe place such as a petrol station or a reputable shop to ask for directions etc. Walk briskly if possible and you are physically able to do so, and avoid stopping in areas that are unknown to you. Avoid stopping at cash machines. Stay in the centre of the footpath facing oncoming traffic. Be aware of your location and be alert to people around you. 10.2 Travelling by Taxis/Minicabs Use a Tower Hamlets CCG contracted company. Sit at the back behind the front passenger seat. Do not give any personal information to the driver (either through conversation with the driver or release sensitive information whilst talking on the mobile phone). 10.3 Travelling by car Items such as bags, CD s or other equipment should never be left visible in the car. Hold the vehicle key in your hand when leaving the premises in order to avoid looking for them outside which could compromise your personal safety. The inside and outside of the vehicle should be checked for possible intruders before entering. Once inside, the vehicle doors should be locked, especially when travelling at slow speed, and when stopped at traffic lights. Always try and park as close as possible to your destination. At night, where possible, park in a well-lit area and facing the direction in which you will be leaving. Use your car horn to attract attention if needed. Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 11
10.4 Travelling by Public Transport 10.5 Cycling Wait for transport at a busy stop or station that is well lit. Try and sit near the driver, preferably in an aisle seat. Familiarise yourself with the safety procedures in the event of an emergency and sit near the emergency alarm. Avoid empty upper decks on buses or empty train compartments (also try to avoid these situations if there is only one other passenger). If threatened by other passengers you should inform the driver or raise the alarm. Secure cycles near premises in a well-lit area if possible. Always hold the bicycle lock key in your hands when leaving the premises in order to avoid looking for them outside which could compromise your personal safety. Fit and use front and rear lights on your bicycle when dark. Avoid making repairs to your bicycle in isolated areas where possible push the bike to the nearest safe place (e.g. petrol station; guarded car park) to make repairs. If someone attempts to steal the bicycle you should relinquish the property immediately without challenge. 10.6 Escorting, patients or service users Where there are known risks concerning a patient, service user, or a location to be visited, you should carry out a full risk assessment before visiting alone. This should include ascertaining the most appropriate means of transportation to be used. If driving, arrange for another member of staff to accompany you so that they can look after the patient whilst you are driving. If escorting a patient by car you should ensure that the patient or service user is seated behind the passenger seat. You should make sure there is valid insurance in place to cover your journey. If conflict arises during your journey you should pull to a safe pace and exit the vehicle. You should not escort a patient or service user by car if there are any doubts about your safety. 10.7 Dealing with animals If you are confronted by an aggressive animal during any visit to a patient or service user you: Should avoid putting yourself or colleagues at risk, If necessary, abandon the visit and report the incident in line with CCG incident reporting policy and procedures. If there is a known problem about animals at a particular location you should contact the occupants of the address to remove the animal before you make the visit. This information should be documented and shared with relevant colleagues. Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 12
11 Incidents If an incident occurs while staff are working alone, where possible, they should: Proceed to a safer place leaving the scene if necessary, Summon assistance, if required, or ask someone to do it for them (this may include: medical, fire, police, or security), Telephone their manager / colleague to report the incident. If the incident involves violence and aggression more detailed advice is available in the Violence and aggression procedure. 11.1 Reporting the incident Staff should ensure that all incidents where they feel threatened or unsafe are reported to their line manager at the earliest appropriate time. The incident must also be reported on an Incident reporting form (obtain from the Governance Team) or via the DatixWeb online incident reporting system [8] as described in the Incident reporting and management procedure 11.2 Post Incident Support Following an incident involving a lone worker and depending on the specific situation, their manager should ensure the worker receives the appropriate support which could include medical treatment and advice. The manager should also be aware of the staff s need to talk about the incident and facilitate a debriefing exercise that explores the following: The need for further counselling /other support Compliance with the CCG s Lone Working procedures The effectiveness of procedures applied by staff Lessons to be learnt from the incident to prevent reoccurrence The circumstances of the incident should be used to review any risk assessments, and where appropriate, these should be up dated and communicated to all relevant staff. 12 Training All staff are provided with basic health and safety training as part of the induction process. The requirements for additional training relating to lone working will vary depending on the nature of the work and work arrangements of the person concerned. A training needs analysis will be conducted for every member of staff as part of the PDP process. Further information about training requirements can be found in the Continuous personal and professional development policy Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 13
13 Monitoring, evaluation and audit Monitoring, evaluation and audit of risk assessments is covered in Risk assessment. Monitoring, evaluation and audit of incident reporting and management is covered in the Incident reporting and management procedure. Monitoring, evaluation and audit of training needs analysis and uptake of training is covered in the Continuous personal and professional development policy. Date ratified: 20th August 2013 THCCGHS21 Lone Worker Policy and Procedure 14