Annex 1 Management of health and safety in care homes - guidance for inspection 2009/10
SIM 07/2009/03
Manual handling
32% of all employee reported injuries (20% involving people and 12% inanimate objects). The exact figures are not known for service users because injuries are not recorded consistently. Inspectors need to ensure:
- A suitable moving and handling policy is in place and procedures for:
- Providing suitable manual handling training
- Assessing the environment where moving and handling operations will occur and to ensure adequate equipment is available
- Individual handling assessments are completed and updated and that the correct equipment is specified, including the size and type of sling and hoist to be used where appropriate. Particular attention should be paid to this issue because 92 accidents occurred in a recent 3 year period where slings were mentioned in the RIDDOR report; several of these resulted in fatal injuries.
- Undertaking maintenance and examinations as required by PUWER and LOLER for moving and handling equipment
- Accessing competent advice where required
- Lifting equipment is available, is used and is maintained.
- Staff have been trained.
See Annex 2 for additional manual handling references.
Slips and trips
23% of employee and 53% of service user reported injuries. Inspectors need to ensure that:
- Slips and trips are managed through an effective slips and trips policy and procedures that are well understood and implemented.
- The home has an appropriate floor cleaning regime for the kitchen and other high risk slip areas.
Service user health and safety issues
Inspectors should address the key issues that have come to HSE’s attention in recent years following major and fatal accident investigations. These include the need to manage risks associated with bedside rails hot water, hot surfaces, and falls from windows. Inspectors will need to ensure that;
- The nursing home is aware of these risks and has appropriate health and safety policies and arrangements in place to control and manage them.
- Individual risk assessments are undertaken as part of the care planning process and where risks are identified the control measures are documented and implemented. Inspectors are advised to work through the BUPA/HSE Safe use of bed rails interactive training session prior to any inspections and the guidance contained in the relevant SIMs/LACs listed in Annex 2.
Legionella
The care home population is predominantly elderly and often more susceptible to the risks of legionnaire’s disease than the general population. Inspectors should check that the home has:
- Undertaken a full risk assessment of their hot and cold water systems
- Has a written scheme documenting the control measures where risk is identified. This should include eg an up to date plan or schematic diagram of the system, procedures for flushing out dead legs in the system and procedures for monitoring the temperature of the pipe work (where temperature control is the chosen method of managing the risk)
Challenging behaviour
24% of all employee reported injuries. Whilst there is potential for service users to also be injured the figures are not known, The root causes of these incidents has yet to be established and the sector are planning to investigate further. In the meantime the general principles of risk management apply.
Inspectors will need to ensure that the home has completed an assessment of the risks to staff and services users. Where staff are exposed to risks the duty holder will need to produce a suitable policy and supporting procedures to manage the risk of abuse. The key elements to be included in the policy are:
- Recognition of the risks
- A statement of who is responsible for doing what
- Appropriate risk control measures in place including suitable training and the need to undertake individual service user risk assessments where appropriate
- An explanation of what is expected from individual employees
- A commitment to supporting people who have been assaulted or suffered verbal abuse.
Dermatitis
Inspectors need to ensure that appropriate provision is made; in particular that the home understands the risk of dermatitis arising from the use of e.g. hazardous chemicals and the wearing of latex gloves etc and has carried out a suitable COSHH risk assessment.
Asbestos management
Many care homes will be old and often undergo periods of refurbishment. Inspectors should ensure that adequate arrangements are in place to identify and manage any asbestos present.
Migrant workers
A significant proportion of the care sector workforce are migrant workers. Inspectors need to ensure that migrant/vulnerable workers have been considered within the health and safety management systems and that relevant health and safety information is communicated to workers where English may not be the first language.
