Domiciliary care provided in people's own homes
Increasingly, care is provided within people's homes by Personal Assistants (PAs), care agency staff or local authority homecare services.
The risks to both those being cared for and those providing the care, will vary greatly according to the individual's needs, the environment where care is provided, the type of care being provided and the competence of the carer.
Does the Health and Safety at Work Act 1974 (HSWA) apply to care provided in people's homes?
HSWA does not apply to activities classed exclusively as 'domestic services' carried out in 'private households.'
Personal care provided within someone's own home may be 'domestic service' and therefore may fall within this dis-application.
Whether the HSWA dis-application applies in specific circumstances will need to be considered on a case by case basis (and be subject to careful legal interpretation), but as an indicative guide:
- if the carers work for the NHS, Local Authorities or employment agencies then they are unlikely to be employed exclusively as domestic workers and HSWA may apply,
- if the care involves complex healthcare activities (such as operation of life support or palliative care equipment) then HSWA is likely to apply, and,
- if delivery of the care requires specialist training (for example, people handling and dealing with challenging behaviour) then HSWA is likely to apply.
HSE has developed guidance on the application of HSWA to domestic service.
Will HSE become involved if a serious incident occurs?
If a serious incident occurs, HSE's involvement will be decided in line with its policies and procedures, on a case-by-case basis. HSE will have no involvement where HSWA is dis-applied.
Where equipment is provided by external employers or third party organisations, HSWA duties are likely to apply. Civil or other duties of care might apply, even if HSWA does not.
What are the main health and safety risks?
The most common causes of injury and ill health to carers arise from moving and handling, and dealing with challenging behaviour.
Where HSWA applies, any significant risks to both the carer and service user must be adequately assessed. So far as is reasonably practicable, safe working procedures and appropriate equipment should be provided, and carers should be suitably competent/appropriately trained to carry out the tasks safely. The health and safety of carers working in Great Britain from overseas (migrant workers) may need particular attention – see HSE guidance on this topic.
The following pages contain useful information: