LAC 67/2 (rev4.1) - Targeting local authority interventions
Annex E - Example Case Studies
This Annex provides examples of LA interventions that illustrate the principles and philosophy in intervention planning. In each case the LA considered the evidence available for an intervention and then considered the most appropriate intervention type available to achieve its outcome. The numbers in the text (e.g. 1, 2, 3 etc.) relate to the notes at the bottom of the page and indicate where these types of intervention would be recorded on the LAE1.
Intended Outcome – improve standards in legionella management.
Following a Health and Safety Laboratory review of Legionnaires’ disease outbreaks over 10 years and formal HSE enforcement action on legionella risk control over 5 years, HSE developed a programme to cover the range of legionella risk systems, involving stakeholder engagement, promotion of best practice, education, advice, the publication of safety notices and targeted proactive inspection.
The type of intervention(s) undertaken for different systems was dictated by the level of associated risk. Evaporative cooling systems (cooling towers and evaporative condensers) were identified as posing the highest risk and suitable for targeted proactive inspection. Questionnaires were sent to businesses which allowed HSE to provide LAs with lists of premises for visits prioritised by relative risk. The lists were available on a LA accessible database (LEPID) that allowed LAs to record details of their visits.
Other water systems (hot and cold water supplies and spa pools) were classified as medium risk and required intervention strategies other than proactive inspection.
- Undertook targeted inspections at HSE enforced premises with cooling towers/evaporative condensers.
- Worked with the Legionella Control Association (LCA) representing service providers, manufacturers, installers and consultancies that offered products and services associated with the control of legionella in water systems.
- Held events in collaboration with the LCA for duty holders from industries involved in legionella risk systems.
- Targeted trade organisations representing specific industries to provide advice and promote good ways of working.
- Identified national conferences e.g. Royal Society for Public Health conference9 and the Institute for Healthcare Engineers and Estates Management Conference where they provided an update on Legionella-related matters in the healthcare sector.
- Issued safety bulletin to national industry stakeholders.
- Commenced a review of the guidance material on the safe operation of spa pools with Public Health England.
Locally, the LA:
- Checked the LEPID database for details of premises with cooling towers/evaporative condensers, and undertook targeted proactive inspections1 at these LA enforced premises, bringing attention to HSE safety alerts and the guidance available to help manage risks.
- Identified other premises e.g. spa pools (in hotels, private leisure centres, retail premises, at a local spa pool distributor) and hot and cold water systems (in private residential care homes),and undertook intelligence checks on:
- any previous visit record and premises rating;
- the complaint history:
- RIDDOR records;
- HELex prosecution database.
- Checked whether any premises had Primary Authority arrangements with other LAs. Then contacted the PA3 to check what information they held, to help determine a proportionate and consistent response and to check any inspection plan for any proposed actions.
- Used this intelligence, to target comparatively lower risks premises, using a range of interventions to influence the management of risk. Planned to:
- target the supply chain and arrange to discuss legionella management with the local spa pool distributor2;
- run an education and awareness campaign3 using press articles and mail shots which they evaluate;
- run a training day2 for spa pool and/or care home managers on managing legionella risks;
- offer to provide advisory visits2, breakfast briefings2 and ‘toolbox’ talks2 on legionella;
- offer one-off spa pool water quality sampling visits with advice and support based on the result2;
- include spa pool maintenance in a wider ‘safety and health awareness day’3;
- use opportunity to raise education and awareness when doing visits for other reasons e.g. food hygiene, nuisance, licensing9;
- identify other partners to work with to promote the importance of legionella management e.g. Health Protection Agency, County Liaison Groups(2-if visits; 3-if other contacts).
b) Moving and handling in the residential care sector
Intended Outcome – better management of risk to staff within care home sector.
An LA was actively engaged in the wider public health agenda that links with issues around staff musculoskeletal disorders (MSD’s). They noticed a number of RIDDOR notifications reporting MSD’s to staff in care homes within their authority.
- Evaluated the available evidence by:
- working with their local A&E unit to get a better picture of the situation locally(2-if visits; 3-if other contacts);
- assessing other related evidence e.g. from other incidents, interventions and other regulatory visits.
- Found that no individual business was reporting substantially more than the others; this led them to conclude there were no specific poor performers.
- Found the majority of incidents notified were caused by a lack of suitable training.
The LA determined a course of action that included:
- Developing a protocol for the sharing of intelligence between other agencies to best inform each other of relevant concerns on any poor performance in the care setting.
- Undertaking education and awareness to inform care providers on what should and should not be reported under RIDDOR (See RIDDOR in health and social care)(2-if visits; 3-if other contacts).
- Working in partnership with other agencies (County Council social services, Care Quality Commission and NHS) to develop and deliver a training programme on moving and handling and other key health and safety at work topics e.g. Legionella control in their care homes(2-if visits; 3-if other contacts).
c) Gas safety in Indian restaurants
Intended outcome: better gas safety within food sector.
An LA’s food team were reporting a number of ‘Matters of Evident Concern’9 at Indian restaurants that were illegally adapting gas equipment to char chapattis. This practise had also been noted during reactive visits to investigate other health and safety incidents5/complaints6.
- Undertook some training for their food team to cover:
- what the legal requirements were;
- what they should do if they discovered this activity as a matter of evident concern;
- how to identify premises where it may be necessary to combine inspection activity.
- Undertook a programme of education and awareness which included a campaign using appropriate formats for the target audience, working in partnership with local ethnic restaurant groups and Gas Safe Register to deliver the message and working with the supply chain to ensure that there were suitable and sufficient alternatives available(2-if visits; 3-if other contacts).
- Offered new business start-ups an advisory visit3 or7 at the businesses’ convenience to provide advice and support to manage their risks effectively.
- Tested the efficacy of the education/awareness campaign9 using the LA food team during their programmed hygiene inspections.
- Proactively inspected where there was evidence that the business was not managing their gas safety risks effectively1.
d) Working with local supply chain following national safety alert
Intended outcome – better management of risks associated with the installation of stone fireplaces.
There were several instances where heavy stone components forming part of a modern fireplace surround had failed causing damage and injury. These incidents happened because the fireplaces were not securely, mechanically fixed in place. In two separate accidents, this type of incident resulted in the death of two young children. Due to particular local circumstances, this issue was recognised as a local priority for the LA.
- Issued a national safety alert aimed at dutyholders to highlight the risks and what they should do to address the problem.
- Worked with the Stone Federation of Great Britain to revise its guidance on safe installation of fireplace surrounds.
- Alerted relevant stakeholders, including Gas Safe Register so they could pass key messages on to the duty holders they work with.
- Publicised the alert in the local media, and via local trade groups(2-if visits; 3-if other contacts).
- Worked with other Liaison Group colleagues to undertake supply chain research to identify suppliers and retailers within their districts(2-if visits; 3-if other contacts).
- Undertook a number of advisory visits3 to the suppliers to provide material to advise them about the issue, the safety alert and the updated guidance and also encouraged them to use their local supply chain to promulgate this information to dutyholders, retailers and suppliers.
e) Duty to manage asbestos
Intended outcome – the better management of asbestos within retail/wholesale premises.
A Primary Authority reviews their health and safety at work priorities for action with a multi-site retailer and uses this opportunity to discuss the duty to manage asbestos(2-if visits; 3-if other contacts).
They choose this topic for a number of reasons - raising awareness on the duty to manage asbestos is a HSE national priority for LAs; the business had been prosecuted after failing to manage asbestos risks at one site; there was national and local scrutiny on how multi-site retailers dealt with asbestos; and the company understood the effect this might have on their reputation.
During a series of meetings2 it was agreed that:
- The multi-site retailer would, using HSE guidance (www.hse.gov.uk/asbestos/building-owner.htm), review and reissue their guidance to their contractors and store managers to ensure that asbestos was managed safely and effectively in their stores.
- The Primary Authority would build check visits7 within their work programme to assess progress against the reviewed and re-issued guidance.
- The multi-site retailer would use its influence with other retailers and work with the Primary Authority and other LAs to reinforce the key message that when having construction work done in stores, they need to set expectations of the project and provide information and select contractors with the right skills, knowledge and experience.
- The Primary Authority would encourage LAs to arrange briefings2 on the duty to manage asbestos where they were providing SHADs2 to the retail/wholesale industry especially where their multi-site retailer also had a presence within those areas.
This approach had an additional benefit of improving inspector competency. LAs could use the experience gained to raise awareness of this issue when targeting visits e.g. when providing other advice and support2 or when visiting for other regulatory reasons9premises where asbestos was likely to be an issue; when carrying out proactive inspections1 against the high risk activities sectors on the List or where there was evidence that a business was not managing their risks effectively1.
f) Work at height in retail/wholesale sector
Intended outcome – better management of work at height risks associated with fragile roofs in retail/wholesale premises.
During an LA investigation5 in to a high profile incident involving serious injuries to a warehouse worker, who had fallen 3m through a fragile roof whilst cleaning gutters for his employer, the LA became aware that nationally falls through fragile roofs occurred frequently and often led to fatalities or serious injuries. Due to this local/national dimension the LA decided to raise awareness on the control measures required when working at height especially in relation to fragile roofs. They decided to use a range of interventions to raise awareness of this issue including:
- Raising the issue with Primary Authorities3 with multi-site retailers/wholesalers within their area to find out what, if any, advice or guidance had been given on this subject;
- Ensuring that when the LA awarded contracts or undertook similar work in-house this subject was covered adequately9;
- Raising awareness of the issue during proactive inspections1 of work at height at high volume warehousing and industrial retail/wholesale premises; during visits to provide advice and support2 or when visiting for other regulatory reasons premises9 where work at height may be an issue;
- Used HSE and industry guidance to raise awareness with cleaning companies, window cleaners, scaffold and ladder suppliers etc(2-if visits; 3-if other contacts);
- Developed a fragile roof/work at height road show for use around their industrial/trading estates and shared the details with other LAs via HELex2.
g) Swimming pool safety
Intended Outcome – Improvements in swimming pool safety
Over a number of years Liaison groups in a particular region had a number of swimming pool issues. These included two fatalities- one due to insufficient life guard cover/training, the other due to an electrical incident to a worker; public health issues due to poor swimming pool water quality including a Cryptosporidium outbreak; an incident of gas release arising from poor dosing practice and numerous low level slips and trips incidents. A number of these incidents had generated local media interest to such an extent that the Strategic Regional Liaison Group within the region agreed that swimming pools would be a local priority in their region.
Dividing the work load between the Liaison Groups:
- They agreed to develop a training/awareness raising package for swimming pool operators using the latest swimming pool guidance provided by HSE to deal with the health and safety issues as well as covering other wider environmental/public health concerns on water quality9.
- LA regulators used their influence to ensure that LA managed and operated pools acted in such a way that they clearly demonstrated compliance with their legal responsibilities and willingness to share this approach with others9.
- LA regulators developed a regional source of expertise which other LA regulators and pool operators were actively encouraged to use if they had questions or wanted further advice or support on safe swimming pool operations(2-if visits; 3-if other contacts or 7-if invited).
- After a period the Liaison Groups undertook a follow up survey2 with swimming pool operators who had received the training/awareness raising package to determine whether or not key messages had been embedded in practice. Further check visits were targeted where intelligence (incidents5, complaints6, secret shopping(2-if visits; 3-if other contacts), observations during other regulatory visits9, pool water quality checks9 etc) suggested risks were not being effectively managed in order to help develop further interventions in the future.
- Proactive inspections were undertaken where there was evidence that the business was not managing their safety risks effectively1.
h) Work place violence in retail premises
Intended outcome – to reduce the incidence and effects of violence in takeaways.
Crime and anti-social behaviour statistics within an LA indicated that takeaways and takeaway deliveries were increasingly a focus for violence and/or robbery. This picture was confirmed in discussions with the police2 who offered to be a partner in any initiatives to reduce the incidence or effects of violence related to takeaways. Given that premises with vulnerable working conditions (risks are not effectively managed/ lack of suitable security measures) were suitable for proactive inspection (see the List) the LA considered this issue worthy of further investigation. However, the LA, in discussions with the police, thought they would secure longer term improvements if they partnered with the police and the takeaway businesses themselves to deliver an alternative intervention.
The intervention involved working with the police to:
- Set up a scheme whereby takeaways made a pledge and commitment to meet certain essential and desirable criteria e.g. prohibiting customers possessing alcohol from entering the premises and the adoption of sensible money handling procedures. The police and the LA also committed to support the scheme in various ways e.g. providing specific guidance, training, promotion and publicity.
- Develop a takeaway forum to discuss crime etc2 following the introduction of the pledge/commitment to a ‘Business Takeaway Watch Scheme’.
- Link the scheme in with several other related issues/initiatives e.g. safeguarding (posters promoting the scheme had a telephone number for reporting safeguarding concerns); food safety (only premises with a Food Hygiene Rating greater than 3 were eligible to participate); night time economy; licencing; etc.
- Monitor the success of the scheme by check visits2 to see whether or not the takeaways were meeting their pledges and commitments; on the use of the ‘Business Takeaway Watch Scheme’ and forum; and on the changes in reported antisocial behaviour/ violence/robberies statistics.
i) Electrical safety in retail food premises
Intended outcome: better electrical safety in food retail premises.
An LA’s food team were reporting a number of ‘Matters of Evident Concern’9 at food retail premises including damaged electrical sockets (including evidence of overheating), damaged plugs, cables, inappropriate joins, poorly positioned sockets, unprotected cables/poor positioning including trailing etc. Poor practise had also been noted during reactive visits to investigate other health and safety incidents5/complaints6. In addition there had been a number of local incidents connected with poor electrical safety in food premises including a major fire and an electric shock to an employee.
- Trained their food team to cover:
- the legal requirements;
- what they should do if they discovered a matter of evident concern;
- how to identify premises where it may be necessary to combine food safety and health and safety inspection activity;
- Used a programme of education and awareness raising, which included a campaign using appropriate formats for the target audience and links to HSE guidance(2-if visits; 3-if other contacts);
- Offered to visit2 or 7 all new business start-ups, at the businesses’ convenience, to provide advice and support to the businesses in managing their risks effectively;
- Tested the efficacy of the education/awareness campaign during the LA’s food team’s programmed food hygiene inspections9 and during reactive visits to investigate other health and safety incidents5/complaints6.
- Proactive Inspection
- Other visits/face to face contact
- Other contact/interventions
- LPG visits
- Visits to investigate incidents
- Visits to investigate complaints
- Visits following requests from business
- Not recorded