No-one should routinely manually lift patients. Hoists, sliding aids, electric profiling beds and other specialised equipment are substitutes for manual lifting. Patient moving and handling should only continue in cases which do not involve lifting most or all of a patient’s weight. This rules out for example, the shoulder or Australian lift. Patients often have complex and varying needs. The Health and Safety Executive advise a balanced approach to managing the risks from patient handling. These include:
- Care workers are not required to perform tasks that put them and their clients at risk unreasonably
- Client’s personal wishes on mobility are respected wherever possible
- Client’s independence and autonomy is supported as fully as possible.
Legally, employers are obliged to provide a safe working environment for their staff. Under the Manual Handling Operations Regulations 1992 (as amended) employers are required to:
- Assess the risk of back injury at work
- Reduce the risk to the lowest level reasonably practicable
- Provide training for staff on safe and healthy practice
- Supervise staff to ensure compliance with the regulations.
Risk assessment should be generic and individual. A generic risk assessment would consider the needs of the workplace/environment e.g. the equipment needed, safe staffing levels, emergency procedures and the suitability of the physical environment. Individual risk assessments consider the specific moving and handling needs (e.g. help needed, specific equipment needs and number of staff needed to support the patient) to ensure the safety of staff and the patient/service user.
There is a requirement for a ‘competent person’ to conduct risk assessments. Competency is a mixture of skills, knowledge and qualifications to carry out the role.
Moving and Handling Training and updates
Guidance from the RCN, the College of Occupational Therapy, the Welsh Manual Handling Passport Scheme, the Chartered Society of Physiotherapy, the Care Standards Act 2002 and the Health and Safety Executive recommends that update training in client handling is required at least on an annual basis. The National Back Exchange give more information on what is expected, particularly in relation to both induction training and updates.