Moving and Handling Policy Responsible Directorate:
Date Approved: Committee:
8 August 2008 Governance Committee
Version Control. Document Title Document number Author Contributors Version Date of Production Review date Postholder responsible revision Primary Circulation List Web address Restrictions
Moving & Handling Policy 1 Chris Bedford Terry Service, Maria Freer 1 March 2008 August 2010 for Chris Bedford PDG None
Standard for Better Health Map. Domain Core Standard Reference Performance Indicators
Domains 1 – Safety, 2 – Clinical & Cost Effectiveness, 3 – Governance, 4 – Patient Focus Core Standard C1, C5(a) C5(c), C7, C11(b), C13a 1. Issue of document to clinical staff 2. Availablity of training for clinical staff. 3. Number of Incident Reports 4. Action plans related to reported incidents (where applicable)
Page Policy Statement Introduction Principles and Legislation Associated Policies and Procedures Aims and Objectives Scope Accountabilities: a Chief Executive b Director of Corporate Services c Health, Safety and Security Manager d Contractors e Department Managers f Manual Handling Advisor g Occupational Health h Staff Risk Assessment Records Equality Impact Assessment Training a Training Strategy b Training for Managers c Training for Staff d Refresher Training Compliance References Stakeholders
1 2 3 4 5 6 6 6 6 6 6 6 6 6 7 8 9 10 10 10 10 10 11 12 13 Appendices A Risk Assessment Guidance B Training Needs Analysis C Equality Assessment Tool
2 3 3-4 4 4 4 4 4-5 5 5 5-6 6 6 6 7 7 8 8 8 8-9 9 9 9 9 10 11-16 17-19 20
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MANUAL HANDLING - GENERAL POLICY STATEMENT NHS Kirklees attaches the greatest importance to the health and safety of its staff and patients, and values the co-operation of management and staff in working together positively to achieve an environment that minimises risk and promotes the health and safety of all staff, patients and any other person affected by their activity. The Trust recognises the risks attached to diverse work activities that involve moving and handling and are committed to assessment of those risks in a systematic way, which enables priorities to be identified and safe systems of work designed. To this end the Trust adopts the principles of the Manual Handling Operations Regulations (1992) wherein the following responsibilities apply: 1. We will AVOID the necessity to carry out MANUAL HANDLING tasks wherever possible. 2. We will ASSESS those tasks where MANUAL HANDLING is unavoidable. 3. Having identified MANUAL HANDLING risks, we will take ACTION to reduce those risks to the lowest possible level. 4. We will undertake to review MANUAL HANDLING assessments as the situation changes. The Trust recognises that safe systems of work are dependent on adequate equipment and facilities and the training and competence of staff. We will take all reasonably practicable steps to ensure that these are available.
Signed: ................................................................. Chief Executive Date..................................................................
Next review due date: ...........................................
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Manual Handling is defined as ‘the movement of a load by means of a bodily force and includes lifting, carrying, putting down, supporting, pushing or pulling’ (HSE 1992). For the purpose of this policy a load will also include the movement of a patient. In the day-to-day activities of work everyone may become involved with aspects of manual handling. The activities can involve different extremes from the trivial, to heavy loads that would be impossible to move without the aid of mechanical lifting equipment. The area between the two extremes is where most difficulties in manual handling occur due to a number of factors including: 1) Shape of the load 2) Position of the load 3) Stability of the load 4) Ability to grasp the load 5) Condition of the person doing the manual handling. 6) Working environment 7) Ergonomics of task Current legislation requires employers to carry out systematic assessments of foreseeable manual handling operations that staff may be expected to perform in order to reduce the risk of injury from manual handling to the lowest level reasonably practical. These assessments can be generic or specific based on the given task. Generic assessments are available on the Trust website. 2.
Principal Legislation and Guidance • The Health and Safety at Work Act 1974 • Management of Health and Safety at Work Regulations 1999 • Workplace Health Safety and Welfare Regulations 1992 • Lifting Operations, Lifting Equipment Regulations 1998 • Provision and Use of Work Equipment Regulations 1998 Page 3 of 20
• The Manual Handling Operations • Human Rights Act 2001 3.
Associated Policies and Procedures.
This Policy should be read in accordance with the Trust’s following policies, procedures and guidance. • • • • 4.
Health and Safety at Work Policy Medical Devices Policy. Incident reporting policy. Procedure for accessing Occupational Health Services. Aims and Objectives.
1. To promote safety awareness as regards to manual handling amongst all staff. 2. To outline the administrative arrangements necessary for effective safety management in respect of moving and handling of patients, plant, equipment, goods and materials etc. 3. To assess the risks associated with moving and handling. 4. To design systems of work to eliminate or reduce these risks wherever possible and reasonably practical. 5.
Scope of the Policy
The legislation and policy covers any transporting or supporting the load, by one or more workers, including lifting, pushing, pulling, carrying or moving a load, which by reason of its characteristics or of unfavourable ergonomic conditions, involves a risk to people. The policy applies to all staff employed by the Trust including temporary, bank or secondments and is provided for contractors for use as necessary. 6.
Accountabilities & Responsibilities
a). Chief Executive The Chief Executive is accountable to the Trust Board of Directors for ensuring compliance with the relevant regulations. The Chief Executive supports this policy and has delegated responsibility for implementation to the Director of Corporate Services. b). Director of Corporate Services. The Director of Corporate Services is responsible for; 1. Implementation, monitoring and evaluation of the policy and for 2. Monitoring of changes in legislative requirements 3. Arrangements are in place to review the policy. Page 4 of 20
4. The Trust provides training and resources to comply with the policy. c).
Health and Safety and Security Manager
The Health, Safety and Security Manager and the Assistant Director of Corporate Services and Risk will assist the Director of Corporate Services in terms of legislative and operational requirements. d). General Practitioners and other Trust contractors All contractors will be aware of their obligations under current legislation and will have systems in place to assess, control and monitor moving and handling activities. Advice and support will also be available to them from the Trustâ€™s Health, Safety and Security Manager, Director of Corporate Services and a Manual Handling Advisor. e). Departmental Managers The Departmental Managers are responsible for ensuring that: 1) They identify manual handling tasks carried out in their area of responsibility. 2) Risk assessments are completed prior to any manual-handling task on Trust premises; Practice premises, in a patientâ€™s homes (where possible although more likely to be retrospective following first visit) or any other location where staff operate in compliance with their duties. These assessments can be generic or localised based on the specific task. 3) Following assessment they take appropriate steps to reduce the risk of injury to staff (seeking advice where necessary) 4) Localised protocols are developed which identify agreed safe working practices, with the emphasis on avoiding/reducing the need for manual handling wherever possible. 5) Advice is sought from the Manual Handling Advisor and Health and Safety Leads before a manual handling aid is purchased or the workplace manual handling environment is altered. 6) Manual handling equipment is fit for purpose, properly maintained, effectively utilised and any damaged equipment is immediately taken out of use and repaired, replaced or disposed of as appropriate. 7) The training needs of staff are identified and met with clear written records being maintained of all manual handling training. 8) Staff members who suffer a musculoskeletal injury (whether at home or at work) are referred to Occupational Health.
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9) All accidents/incidents or near misses are reported, documented and investigated. 10) Risk assessments are reviewed regularly and updated as appropriate (seeking advice where necessary). 11) Protocols for agreed safe working practice are reviewed annually. 12) Staff wear suitable clothing and footwear to allow safe manual handling to take place. f). Manual Handling Advisor The Trust’s Advisor will: 1. Develop a manual handling training strategy (with support from and in consultation with the Head of Training and Staff Development to meet the needs of all staff. 2. Provide appropriate training, and ensure that systems are in place to formally record all manual handling training that has taken place. 3. Provide management information to Directorates on training activity. 4. Provide a specialist advisory function to all Directorates. 5. Provide assessment and problem solving advice for all staff, where specialist knowledge and skills are essentially required. 6. Provide appropriate information on any manual handling issues that may impact upon the annual business planning cycle. g). Occupational Health The Occupational Health Department will: 1. Carry out pre-employment health screening. 2. Provide advice and support to staff who have suffered musculoskeletal injury (not restricted to work related injuries). 3. Provide advice to Managers regarding an individual’s fitness for work following musculoskeletal injury. 4. Liaise with the Trust’s Manual Handling Advisors and responsible Directors to monitor the success of the Trust’s Manual Handling Policy in terms of the incidence of back pain and the prevention of musculoskeletal injury. 5. Provide statistical data to the Trust on reported cases related to manual handling including trends and patterns related to causation and provide recommendations on methodologies to reduce these incidents. Page 6 of 20
All Staff Under current legislation all staff have a responsibility for the health, safety and welfare of themselves, their colleagues, patients and visitors, and must: 1. Ensure that they only manually lift patients or other loads in very exceptional circumstances. 2. Ensure that all patient and non-patient handling is undertaken in line with protocols, handling plans and current accepted safe working practice. 3. Contribute to the risk assessment process and the development of safe working practices. 4. Use equipment provided in a safe and proper manner using and report any defects immediately. 5. Undertake training and education in handling and moving and only use equipment for which they have been provided sufficient training. 6. Report any injury/condition that may affect their ability to safely move or handle patients/goods/equipment. 7. Report via the incident reporting procedure any accident/incident/untoward occurrence or near miss. 8. Adhere to the Trustâ€™s uniform policy at all times. 9. Be committed to the Trustâ€™s manual handling policy.
A key component in the management of manual handling is the use of risk assessments to identify the hazards and the methodologies to remove, reduce or control those hazards. The Trust provides generic risk assessments which are available on the Trust website along with a risk assessment tool for developing localised risk assessments. A copy of a Moving and Handling risk assessment is provided as appendix A. Further guidance is available from the Trust Manual Handling advisor, Health, Safety and Security Advisor, Occupational Health or directly from the Health and Safety Executive at www.hse.gov.uk. 8.
Suitable and sufficient records are to be maintained so that information is available as detailed within the policy. Individual training records will be kept on personal files and administered by the Human Resource Department.
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Equality Impact Assessment.
All public bodies have a statutory duty under the Race Relation (Amendment) Act 2000 to â€œset out arrangements to assess and consult on how their policies and functions impact on race equality.â€? This obligation has been increased to include equality and human rights with regard to disability age and gender. The PCT aims to design and implement services, policies and measures that meet the diverse needs of our service, population and workforce, ensuring that none are placed at a disadvantage over others. In order to meet these requirements, a single equality impact assessment is used to assess all its policies/guidelines and practices. This policy was found to be compliant with this philosophy. 10.
The Trust has in place a training strategy based upon a training needs analysis which acknowledges the commitment to reduce all aspects of manual handling and takes due consideration to other Trust objectives. Manual Handling training has been classified as mandatory for all staff with specific objectives and timescales for each training programme which in turn are related to roles and responsibilities. The training will be provided using a number of appropriate methodologies including formal training and e-learning packages. b). Training for Managers Appropriate training will be provided as required based upon a task/needs analysis, which will support managers in their role. This training may encompass a number of modules including: 1. Legislative requirements 2. Management responsibilities 3. Risk assessment 4. Moving techniques/ safe selection and use of equipment. 5. Investigation of incidents c).
Staff Training 1. All staff involved in moving and handling will undergo training on induction. 2. Manual handling training for staff identified to be at risk will be mandatory. Page 8 of 20
3. The length and content of training to be determined following a task analysis and risk assessment. 4. A suitable venue and equipment will be provided to facilitate moving and handling training. d)
Staff will be provided with regular training updates which are noted within the Trust Training prospectus and advertised through standard communications channels. Individual staff members and managers have a responsibility to ensure that all staff are current with their training requirements related to moving and handling. 11.
Monitoring of Compliance.
The policy will be reviewed on a two year cycle and will be reported to the Governance Committee. Moving and Handling training will be monitored through the Training and Education Group who report to the Governance Committee. Regular training reports will be provided to the Governance Committee detailing attendance numbers against staff groups. The Governance Committee is responsible for ensuring that any identified shortfalls in training are managed and improved. Incident reports related to moving and handling will be reported to the Risk Management Operational Group who in turn report to the Governance Committee. Regular reports on incident trends including moving and handling are tabled to the Governance Committee with actions noted. Occupational Health reports to the Shared Service HR Board and provide statistical data on referrals including patterns and causation. The reports will not contain any identifiable information. The Governance Committee is responsible for ensuring that any identified gaps in systems of work related to moving and handling are noted and action taken to resolve them. 12.
References â€˘ Manual Handling assessment guide HSE http://www.hse.gov.uk/pubns/indg383.pdf. â€˘ Manual Handling Operations Regulations, 1992 â€˘ HSE 1998 guidance to the Manual Handling Operations Regulations 1992
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Key Stakeholders consulted / involved in the development of the policy & procedure.
Terry Service – Assistant Director of Corporate Services and Risk. Chris Bedford – Health, Safety and Security Manager. Liz Butterfield – Head of Training, Education and Staff Development. Policy Development Group.
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MOVING AND HANDLING RISK ASSESSMENT GUIDANCE All staff must be familiar with and adhere to NHS Kirklees Moving and Handling Policy 2008. This guidance applies to all Clinical staff employed by NHS Kirklees. The Manual Handling Operations Regulations, HSE 1992 apply to any manual handling tasks within any work environment. Manual handling refers to the transporting or supporting of a load by hand or bodily force (MHOR 1992, from HSE Guidance on Regulations 1998). These regulations apply equally to the moving and handling of people both in care and therapy situations. Manual Handling Operations Regulations HSE 1992: key requirements I. Avoid hazardous manual handling operations so far as is reasonably practicable II. Make a suitable and sufficient assessment of any hazardous manual handling operations that cannot be avoided III. Reduce the risk of injury from those operation so far as is reasonably practicable Guidance for the completion of a Moving and Handling Risk Assessment 1.1 Before commencing any work-related activity, you must first consider whether any of the component tasks of the intended activity are likely to involve the moving and handling of either a client or other load. 1.2 If the intended work-related activity is likely to involve/require the moving and handling of a client or inanimate load, you must assess the extent of the risk of injury associated with carrying out these tasks. 1.3 If there is a risk of injury associated with any of the tasks of the intended activity, you must assess whether it is reasonably practicable to avoid the need to move/handle the load. 1.4 In relation to the moving/handling of a client, the potential therapeutic benefit of the intervention must be an important consideration in deciding whether it is reasonably practicable to avoid the task. 1.5 If it is not reasonably practicable to avoid the moving and handling task(s) , a detailed moving and handling risk assessment must be completed
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1.6 There are 2 moving and handling risk assessments i) Generic moving and handling risk assessment: can be used to assess the moving/handling of inanimate objects ii) Patient focused moving and handling risk assessment: is applicable to the moving/handling of patients. The HSE 1998 guidance to the Manual Handling Operations Regulations 1992 (schedule one) defined 4 specific aspects that must be evaluated when assessing the risk associated with a particular task: •
Task (what is being done from the start to completion of a task, including all sub components of the task)
Individual capacity (who is carrying out the task, what are her/his skills, competencies and physical capabilities)
Load (what is being moved – person or inanimate object)
Environment (where is the task being carried out, are there any environmental hazards that pose a significant risk of injury)
Both the generic and the patient-focused moving and handling risk assessments have been designed to consider and evaluate these 4 areas. The completion of a moving and handling risk assessment is the first part of the process of risk management, which should lead to sufficient reduction of the risk of injury. 1.7 If any risks are identified during the assessment process, you must complete a Moving and Handling Action Plan to identify what action needs to be taken to reduce the risk of injury to the lowest possible level. The Moving and Handling Action Plan includes the following: • • • •
The tasks (therapeutic, care or other) that need to be completed. The clinical reason for needing to carry out the task e.g. therapeutic, care or other. The minimum skill mix required – refers to the number of assistants and the skills / knowledge required to safely perform the moving and handling task. The handling methods (practical, preventative measures) necessary to reduce the risk of injury to the lowest level reasonably practicable. You are responsible for implementing all practical, preventative measures identified in the Moving and Handling Action Plan. If you encounter any issues that prevent you from implementing the identified preventative action, you must discuss this immediately with your line manager.
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The patient focused Moving and Handling Risk Assessment + Action Plan must be kept in the patientâ€™s record and where appropriate in the medical notes.
Where necessary and appropriate you must be responsible for informing the multidisciplinary team about the outcome of the risk assessment and the resultant action taken (skill mix required, handling methods, handling equipment).
It may not be necessary to complete a Moving and Handling Risk Assessment when: â€˘ An up-to-date risk assessment has already been completed by another member of the multidisciplinary team, that has accurately evaluated all the specific components of the intended moving and handling task(s), the patientâ€™s current abilities and the environment and identified/implemented appropriate measures to reduce the risk of injury to the lowest possible level.
A Moving and Handling re-assessment must be completed if / when any of the factors change from those identified/ evaluated in the original assessment.
If intervention is ongoing, the Moving and Handling Action Plan should be regularly reviewed to determine if any of the assessed factors have changed since the original plan was implemented.
If you are aware of any individual factor (previous injury, current health problems, pregnancy, lack of understanding/knowledge) that may affect your ability to safely participate in any moving and handling tasks, this should immediately be discussed with your line manager. An individual risk assessment should be carried out with your line manager. This should evaluate all workload/caseload operations/tasks.
Specific Moving and Handling guidance for assessment and treatment 2.1
All staff must be responsible for reducing, as far as is reasonably practicable, the risk of injury to themselves and their patients, whilst still facilitating and achieving successful and beneficial rehabilitative progress of a client.
When it is not reasonably practicable to avoid moving and handling a client during care intervention, you must ensure that measures have been taken to make the task/techniques as safe as possible to both yourself and your client. This must be clearly documented in the Moving and Handling Risk Management Action Plan, progress notes and medical / nursing notes.
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Moving and Handling Training 3.1
Annual Moving and Handling training is a mandatory requirement for all Trust staff.
All staff are responsible for ensuring that they have completed Moving and Handling training identified through the training prospectus and KSF programme. If additional Moving and Handling training is required, this development need should be discussed with your line manager.
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MOVING + HANDLING RISK ASSESSMENT FLOW CHART
Does the work-related activity involve moving and/or handling operations?
Is there a risk of injury?
Is it reasonably practicable to avoid moving/handling the load(s)?
Carry out an individual Moving + Handling Assessment. Complete either: i)
Generic risk assessment (inanimate objects) Client focused risk assessment
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Determine action plan to reduce risk of injury to lowest level reasonably practicable
IMPLEMENT action plan (identified risk management measures)
Evaluate action. Is risk of injury is sufficiently reduced
End of initial exercise
Review if conditions change
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Moving and Handling training is mandated for all staff. Who needs to attend?
Occupational Therapists and specialist staff .
Non clinical Staff
How can the training be delivered?
Level 3 Advanced: In-depth for specific staff,
Level 2 Mandated for clinical staff
Level 1 Basic Awareness
External Training providers.
Delivered by qualified and competent trainers
Delivered by qualified and competent trainers
Mandated for non clinical staff
Responsibility for delivery of training Moving and Handling training will be provided by in house or external trainers who are competent to deliver the training. The responsibility for identifying suitably qualified trainers is with the Head of Training.
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Training needs assessment It is estimated that there are approximately 1223 staff in the organisation of which 527 are non clinical who require level one training, 664 are clinical who require level two training and 22 who have specialised roles and who require level three training. The figures include including temporary and bank staff employed by the Trust who may require access to the training. This is broken down as follows: Level 3
The aims and objectives for the 3 levels of training are: Overall Aim: To equip staff at all levels with the information need to enable them to identify and manage manual handling in workplace. Objectives. Level 1 – Basic To provide moving and handling training for staff who are involved in moving and handling in the workplace. 1 hour interactive training session incorporating theory, practical and DVD. • • • •
Legal and professional aspects with regards to moving and handling Understand the structure and function of the spine and the causes and prevention of injury Develop the ability to risk assess and relate to working practice Understand and practice safer moving and handling techniques
Level 2 – Clinical staff To provide moving and handling training for staff who are involved in moving and handling patients. 2 hour interactive training session incorporating theory, practical and DVD. • • • • • •
Legal and professional aspects with regards to moving and handling Understand the structure and function of the spine and the causes and prevention of injury Develop the ability to risk assess and relate to working practice Understand and practice safer moving and handling techniques Demonstrate the ability to carry out appropriate client handling techniques Awareness of moving and handling equipment and how to use these in practice. Page 18 of 20
Level 3– specific identified staff To provide moving and handling training for staff who are involved in moving and handling patients. Four hour interactive training session incorporating theory, practical and DVD. • • • • • •
Legal and professional aspects with regards to moving and handling Understand the structure and function of the spine and the causes and prevention of injury Develop the ability to risk assess and relate to working practice with staff and patients. Understand and practice safer moving and handling techniques for staff and patients. Demonstrate the ability to carry out appropriate client handling techniques including the use of moving and handling aids used by staff and patients. Detailed understanding of moving and handling equipment and how to use these in practice for patients and staff.
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Appendix C Equality Impact Assessment Tool To be completed and attached to any procedural document when submitted to the appropriate committee for consideration and approval. Insert Name of Policy / Procedure 1.
Does the policy/guidance affect one group less or more favourably than another on the basis of: • Race • Ethnic origins travellers)
• Gender • Culture • Religion or belief • Sexual orientation including lesbian, gay and bisexual people • Age • Disability - learning disabilities, physical disability, sensory impairment and mental health problems
4. 5. 6. 7.
Is there any evidence that some groups are affected differently? If you have identified potential discrimination, are any exceptions valid, legal and/or justifiable? Is the impact of the policy/guidance likely to be negative? If so can the impact be avoided? What alternatives are there to achieving the policy/guidance without the impact? Can we reduce the impact by taking different action?
No No No No No No No
No NA No NA NA NA
If you have identified a potential discriminatory impact of this procedural document, please refer it to Health, Safety and Security Manager together with any suggestions as to the action required to avoid/reduce this impact.
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