OG Status:

Fully Open

Author Section:

Public Services Sector

Target Audience

FOD and LA Inspectors

Summary

This instruction provides guidance for visiting staff on inspecting the management of health and safety in care homes in 2009/2010.

Aim

To improve health and safety outcomes – better identification and management of risks to employees and service users - to reduce injury and ill health incidence in care homes.

Justification

RIDDOR accident statistics have been steadily increasing for employees and the public. In 2007/08 there were a total of 4 503 injuries reported for employees and 1049 to service users. A detailed breakdown can be found in TRIM document 2008/670107.

Poor compliance with key health and safety requirements were found during a series of HSE inspections in 2008/2009. From a sample of 74 inspections undertaken by HSE in England and Wales the following improvement notices were issued:

Improvement notice type	Number issued
Bedside rails	26
Legionella	18
Falls/windows	9
Hot water/surfaces	4
Manual handling/training	2
LOLER	2
Latex	2
Managements of asbestos	2
Total	65

HSE is writing to every care home in England, Scotland and Wales reminding them of their responsibilities under health, safety and care legislation. This follows a major police investigation into alleged cases of neglect in a number of care homes in Wales.

Health and Social Care Services Unit (HSCSU) organised 18 care home seminars in 4 FOD regions between February and March 2009 on the basis that an inspection campaign would follow.

Audience/industry

Care homes in the four regions where the 18 care home seminars were held; Scotland, Yorkshire and the North East, South West, and East and South East. However inspections in other regions and by Local Authorities would be welcome.

Messages

Inspectors will target the management of health and safety in those areas creating the most significant risks to employees and service users as described in the activities section below.

Activities required

Four FOD regions listed above to undertake an inspection campaign in the areas where the seminars were held.  Inspections in other regions would be welcome. 

A complete list of care homes registered in the areas of the seminars can be found in Trim record 2009/87341, together with a list of those who attended in Trim record 2009/87345.  It is anticipated that inspection of a sample of care homes from each list would be undertaken.  Local Authorities can obtain the information for their area by emailing publicservicessector@hse.gsi.gov.uk.

Inspectors may note that the Commission for Social Care Inspection (CSCI – soon to be part of the Care Quality Commission) currently award a quality rating when they undertake an inspection of a care home.  Whilst this along with their report should be taken into consideration it is recommend that a cross section is chosen

Feedback from HSE inspections indicates higher non-compliance in individual or small groups of care homes.   Where inspections are planned to larger/corporate care providers HSE and LA Inspectors should consult SIM 07/2008/06 - HSE national lead for corporate care providers (also produced as LAC 79/10) prior to any visits.

Consideration should be given to releasing a press notice prior to and following the inspection campaign to raise awareness of issues.

In England HSE/LA should inform CSCI of any significant interventions planned in accordance with the principles of the ‘Working arrangements protocol between HSE, LACORS and CSCI’ (will be available on HSE website in due course).   Inspectors in Scotland and Wales should contact the Care Commission in Scotland or the Care and Social Services Inspectorate in Wales.

Visiting inspectors should undertake a full inspection of the care home, but particular attention should be given to those areas covered in the care home seminars, namely:

• Manual Handling (including reviewing individual handling assessments)
• Slips and Trips
• Service user health and safety issues including risks associated with hot water, hot surfaces, bedside rails and falls from windows
• Legionella

Other relevant issues that can be dealt with include:

• Dermatitis, asbestos management, challenging behaviour and migrant workers.

Annex 1 and 2 provide additional guidance for inspectors on these topics.

The sector would welcome a short report following completion of the inspection campaign to include the number of care homes visited a breakdown of enforcement action taken and any general observations that are made.  An optional blank proforma is available Trim document 2009/65277. 

Timing

From April 2009 to March 2010

For information

Annex 1 and 2 provide additional guidance for inspectors on key topics.

Diversity

Inspectors should be aware of who (in terms of diversity e.g. men, women, disabled etc) is the target group in the sector they are dealing with. Give consideration to, and factor into the approach, any issues that may surround this audience such as literacy issues, English as a second language and disability (access needs).

The Diversity pages give more information on these areas.

Contact

Public Services Sector, Health and social care services unit: Lead inspector for social care:  to be announced

Annex 1 Management of health and safety in care homes - guidance for inspection 2009/10

Annex 2 Information sources for inspectors