.
MOVING AND HANDLING POLICY
This policy and protocols have been written by the Lincolnshire Inter-Agency
Group for Moving and Handling which comprises the following members:
Adults
Children and Young People
Alyn Blyth
Risk Manager
Lincolnshire Ambulance Service NHS Trust
Tina Craggs
Moving and Handling Specialist
Lincolnshire NHS Shared Services
Wendy Cundy
Head of Workforce Development
East Lincolnshire Primary Care Trust
Alison Gibson
Strategic Back Care Advisor
Lincolnshire Social Services
Alison Gibson
Strategic Back Care Advisor
Lincolnshire Social Services
Mandy Jones
School Nurse, St Francis School
United Lincolnshire Hospitals Trust
Elizabeth Hart
Control Assurance Manager
Lincolnshire South West Primary Care Trust
Abigail Storr
Senior Occupational Therapist
West Lincolnshire Primary Care Trust
Shirley Kaberry
Health and Safety Co-ordinator
Lincolnshire Ambulance Service NHS Trust
Jo Thomas
Senior Practitioner Occupational Therapist
Lincolnshire Social Services
Malcolm King
Specialist Training & Advisory Services Manager
Lincolnshire NHS Shared Services
Gil Vashak
Senior Physiotherapist
West Lincolnshire Primary Care Trust
Sheila Miles
Primary Care Manager
West Lincolnshire Primary Care Trust
Lynn Walters
Senior Occupational Therapist
West Lincolnshire Primary Care Trust
Tobias Payne
Regulation Inspector
Commission for Social Care Inspection
Linda Rhodes
Clinical Advisor Community Healthcare Equipment
East Lincolnshire Primary Care Trust
Carol Stevens
Homecare Manager
Lincolnshire Social Services
The Inter-Agency Group meets regularly and was
originally formed over three years ago with the aim
of promoting a consistent approach to Moving and
Handling across the Lincolnshire Health and
Social Care Community.
Joanne Taylor
Senior Physiotherapist
St Barnabas Hospice
Adi Todd
Moving and Handling Co-ordinator
United Lincolnshire Hospitals Trust
.
1
.
MOVING AND HANDLING POLICY
CONTENTS
Section
Page
1.
Statement of Commitment
4
2.
Definition of Moving and Handling
5
3.
The Costs of Injury and ill-health
5
4.
The Scope of the Policy
5
5.
Policy Values
6.
Organisational Responsibilities
7.
Management Responsibilities
8.
Employee Responsibilities
11
9.
Dress Code for Moving and Handling
12
10.
Training
13-14
11.
Risk Assessments
15-17
12.
Collaborative Working
18
13.
Monitoring
18
14.
Bibliography
19
15.
Glossary of Terms
20
16.
Directory of Specialist Advisors
21
6-7
8
9-10
Appendix 1 – Assessment Forms
22
Risk Assessment Guidance for Managers
23
Person Moving and Handling Assessment (Adults) (Parts 1 & 2)
24-26
Moving & Handling Plan
27
Problems/Deficiencies Sheet
28
Review Sheet
29
Person Moving and Handling Assessment (Children/Young People) (Parts 1 & 2)
30-32
Moving & Handling Plan
33
Problems/Deficiencies Sheet
34
Review Sheet
35
Manual Handling of Loads Risk Assessment Form - Section A (Preliminary)
“
“
36
- Section B (More Detailed Assessment)
37
HSE Risk Assessment Filter Numerical Guidelines
38
.
2
.
MOVING AND HANDLING POLICY
CONTENTS
Page
Appendix 2 – Protocols for Moving and Handling
39
Fallen Person - Protocol A (Uninjured Person)
41
Fallen Person - Protocol B (Injured Person)
42
Protocol for the Moving and Handling of the Bariatric Person in Hospital and the
Community
43
List of Specialist Advisors
44
Section
1.
Definitions
45
2.
Background
45
3.
Risk Assessment for Moving and Handling
46
4.
Weighing Arrangements
47
5.
Admission to Hospital
48
6.
Discharge from Hospital
7.
Equipment
51
8.
Tissue Viability
52
9.
Confidentiality
52
10.
Related Documents
52
49-50
Appendix 3 - Weight Conversion Table
53
.
3
.
MOVING AND HANDLING POLICY
1.
STATEMENT OF COMMITMENT
As member organisations of the Lincolnshire Inter-agency Group for Moving and
Handling we recognise the threat that the risks inherent in moving and handling
pose to individuals, the organisations and the provision of our services.
Working together with our staff, we are committed to addressing these risks in a
proactive way, employing good risk management systems and ergonomic practice.
As far as is reasonably practicable, we aim to eliminate moving and handling
activities where there is a risk of injury. Where this is not possible, we aim to
implement a range of actions to reduce the risks in the workplace to the lowest
possible level.
We also acknowledge the need for tangible investment in taking this policy forward
and will endeavour to ensure that the necessary resources are made available in
line with Risk Management Strategies. This will include the provision of the
necessary equipment and safe systems of work, human resources and a safe
handling environment.
The organisations also accept the responsibility to monitor the implementation of
the policy and to review it on at least an annual basis.
We the Chief Executives and General Manager are committed to the principles of
working through the Lincolnshire Inter-Agency Moving & Handling Group to ensure
a consistent approach to moving and handling across Lincolnshire. Also to work
collaboratively in the development of local procedures and protocols.
This policy is subject to ratification and adoption by the individual member
organisations.
CHRIS SLAVIN
Chief Executive
Lincolnshire Partnership Trust
ROGER PAFFARD
Chief Executive
United Lincolnshire Hospitals Trust
MATT BUKOWSKI
Director
Lincolnshire Social Services
TIM RIDEOUT
Chief Executive
West Lincolnshire Primary Care Trust
DEREK BRAY
Chief Executive
Lincolnshire Southwest Primary Care Trust
JANE FROGGATT
Chief Executive
East Lincolnshire Primary Care Trust
KEN DAVIDSON
General Manager
St Barnabas Hospice
Date: May 2005
The policy is also recognised and supported by the following organisations:
The United Lincolnshire Hospitals NHS Trust
The Lincolnshire Ambulance Services NHS Trust
The Commission for Social Care Inspection
revised 7 July 05
4
.
.
MOVING AND HANDLING POLICY
2.
DEFINITION OF MOVING AND HANDLING
Moving and handling is any action required as part of a person’s job that involves
movement of a person or inanimate object by hands or bodily force. This includes
activities such as lifting, lowering, pushing, pulling, carrying and supporting a load.
It is recognised that in Musculoskeletal Disorders (MSDs) can arise from periods of
being in a static position (eg being seated at a desk for long periods) or repetitive
stooping or bending and that they are often the result of a cumulative effect rather
than being attributable to a specific incident.
It is important therefore, that any injuries or ill-heath related to moving and
handling or working in static positions and poor postures is reported in accordance
with local reporting procedures.
3.
THE COSTS OF INJURY AND ILL-HEALTH
Health and social care workers are among the highest risk occupations with
injuries, caused by their work. This is an increasing trend and 54% of all accidents
in the care sector are associated with moving and handling (Manual Handling
Operations Regulations 1992,1998).
MSDs are by far the most common form of work related ill health in Great Britain,
creating a great deal of suffering and hardship to individual workers, and it is costly
to their employers and health and social care providers. The Health and Safety
Executive has estimated that back problems caused by work cost employers
between £315 – £335 million.
4.
THE SCOPE OF THE POLICY
The policy covers all moving and handling activities undertaken by staff during the
course of their work. It applies to all members of staff and volunteers as well as
the person being moved. It also applies to agency staff, contractors, and visitors.
The policy recognises that the member organisations and their staff have a duty of
care under common law to the person being moved and relatives who may be
involved in the moving and handling tasks.
Organisations will take reasonable steps to ensure that staff from outside agencies
have received the appropriate training in and information on how to perform safer
moving and handling prior to commencement of duties on behalf of the
organisation.
.
revised 7 July 05
5
.
MOVING AND HANDLING POLICY
5.
POLICY VALUES
All the organisations are committed to the implementation of the Moving and
Handling Policy based on the following values.
Handling of People
•
Each person who needs assistance with moving and handling will be
individually assessed by a competent member of staff taking into account their
individuals needs, capabilities and circumstances. A balanced approach will be
followed which considers the person’s human rights as well as the need to
protect staff from injury.
•
As part of the risk assessment the risks and benefits to the person will be
balanced against the need for staff safety. The rehabilitation and developmental
needs of the person will also be considered as part of this process.
•
The person and, where appropriate, those acting on their behalf, will be actively
involved in the moving and handling assessment and decision making process.
•
A problem solving approach will be adopted which considers the use of a variety
of handling methods and equipment to reduce the risk of injury. The
independence of the person will be encouraged at all times.
•
The assessment will identify the number of staff that will be required to safely
move the person. There will be many situations where more than one member
of staff will be required.
•
Following assessment, a written individual handling plan will be produced which
will be reviewed at appropriate intervals or when circumstances change. A copy
of the person’s moving and handling assessment and handling plan should be
available for staff to refer to. This applies to hospital, residential and community
situations.
.
6
.
MOVING AND HANDLING POLICY
Handling of People contd
•
Manual lifting of adult people will be avoided in all but exceptional or life threatening
situations. Hoists, sliding aids and other specialised equipment should be used
whenever possible but in some situations manual lifting may be required.
•
In the case of children it may not be appropriate for all manual lifting to be
eliminated. Methods of avoiding or reducing the risk of injury should be employed
based on a full risk assessment. This should take account of the child's
development needs and manual handling risk factors including the weight of the
child.
•
Moving and handling equipment may not always be required and manual handling
techniques may be used based on an individual risk assessment provided that they
follow safer handling principles.
Load Handling
•
A minimal lifting approach will be applied to load handling situations based on a full
risk assessment, which takes account of factors such as size, shape, weight and
design of the load. Mechanical aids should be utilised whenever possible.
•
Whenever possible the risk of injury from load handling problems should be
reduced by implementing measures at strategic level. Good planning and design at
the workplace will often eliminate hazards at an early stage.
•
Safe systems of transportation will be readily available for the movement of goods,
supplies and equipment.
.
7
.
MOVING AND HANDLING POLICY
6.
ORGANISATIONAL RESPONSIBILITIES
Chief Executives and Chief Officers retain the overall responsibility within their
organisation for the implementation of the policy. This includes for example,
ensuring that sufficient resources are made available for the purchase of moving
and handling equipment, the provision of training for all staff and the availability of
specialist staff to support the risk assessment process.
Each organisation has a legal duty so far as is reasonably practicable to ensure
that:
•
The need for hazardous moving and handling is avoided or, when it cannot be
avoided, an assessment is made of the operation and where there is a risk of
injury, appropriate steps taken to reduce the risk to the lowest possible level.
The assessment must follow the ergonomic approach and take into account
the following factors:
- Characteristics of the load
- Physical capabilities of the individual worker
- The working environment
- The requirements of the task
•
Information and training is provided to staff and managers on risk assessment
and basic ergonomic principles.
•
A safe working environment and safe systems of work are provided including
the necessary aids and equipment.
.
8
.
MOVING AND HANDLING POLICY
7.
MANAGEMENT RESPONSIBILITIES
All managers have the responsibility, so far as is reasonably practicable, for
ensuring that arrangements made under the policy are implemented properly. This
includes:
Safe Working Practices and Systems of Work
•
Being aware of the moving and handling tasks that occur within their areas of
responsibility and avoiding the need for employees to undertake any moving
and handling tasks which involve a risk of injury.
•
The introduction of appropriate risk reduction measures where the handling
task cannot be avoided. This may include the use of mechanical aids,
redesigning the handling task or changing the environment.
•
Supervising staff to ensure that safe working practices are being followed and
that equipment is being used where applicable.
•
Ensuring that adequate staffing levels are maintained to meet moving and
handling requirements.
•
Making sure that staff wear the appropriate clothing and footwear for moving
and handling. In some situations this may include personal protective
equipment eg gloves and special footwear.
Risk Assessments
•
Performing risk assessments of hazardous moving and handling tasks or
situations within the workplace. Specialist support and advice can be
obtained where appropriate from the organisation’s Moving and Handling
Advisor.
•
Making a clear, written record of the assessment and communicate its
findings to all staff involved.
•
Reviewing risk assessments and making arrangements for the risk
assessment to be repeated if they are no longer valid due to changes in the
work situation.
•
Ensuring that in situations where risk assessments are being performed by
frontline staff eg person handling assessments in hospital or community, that
these are being completed and recorded where appropriate in writing. These
assessments must also be available for staff involved in the moving and
handling to refer to.
.
9
.
MOVING AND HANDLING POLICY
MANAGEMENT RESPONSIBILITIES contd
Training
•
Making sure that all staff attend moving and handling training including
updates. All new staff should attend a moving and handling course, as part of
the formal induction programme, before commencement of duties in the
workplace.
•
Attending training and acting as a role model for staff.
Equipment
•
Ensuring that suitable and sufficient mechanical aids are provided and that
these are properly maintained and easily accessible for staff.
•
Making sure that equipment is only used by staff who have been properly
trained in its use.
•
Ensuring that all moving and handling equipment and accessories are
thoroughly examined, serviced and maintained in accordance with The Lifting
Operations and Lifting Equipment Regulations 1998 (LOLER) and The
Provision and Use of Work Equipment Regulations 1998 (PUWER)
Staff Health
•
Ensuring that moving and handling requirements are clearly identified when
recruiting staff so that appropriate medical and Occupational Health advice
can be taken as part of pre-employment health screening.
•
Making allowance for any known health problems which might have a bearing
on an existing employee’s ability to carry out moving and handling tasks in
safety.
•
Referral to Occupational Health Advisors if there is any good reason to
suspect that an individual’s state of health might significantly increase the risk
of injury from moving and handling.
Accident/Incident Reporting
•
Maintaining records of accident and ill-health related to moving and handling
and to investigate the circumstances surrounding the accident or incident.
•
Reporting unresolved problems and deficiencies to senior management such
as lack of equipment, unsafe working conditions or lack of trained staff.
.
10
.
MOVING AND HANDLING POLICY
8.
EMPLOYEE RESPONSIBILITIES
Employees have a legal duty to take reasonable care of their own health and
safety and that of others who may be affected by what they do or do not do. Staff
must therefore:
•
Work within their own limitations and not carry out any activity for which they
are not competent
•
Co-operate with their line manager in performing risk assessments for moving
and handling
•
Look out for hazards
•
Use equipment provided, eg hoists
•
Follow safe working practices
•
Not interfere with or misuse any equipment or aids that have been provided
•
Not use equipment that they have not been trained to use
•
Follow training and instructions provided on moving and handling eg moving
and handling protocols, person handling plans and guidance from training
courses
•
Look out for hazards and report any unsafe situation to the local manager.
This includes things such as:
Faulty equipment – which should be labelled and taken out of use
Unsafe working practices
High risk handling procedures
Environmental problems
•
Attend moving and handling training including updates for their area of work
•
Report pregnancy or any medical conditions, which may affect their ability to
perform moving and handling to their manager
•
Wear suitable work clothing and footwear for moving and handling and
comply with the Dress Code for their area of work
.
11
.
MOVING AND HANDLING POLICY
9.
DRESS CODE FOR MOVING AND HANDLING
The following dress code is strongly recommended for staff who are involved in
hazardous moving and handling tasks:
•
Flat, supportive footwear with a non-slip sole. Open-toed sandals should not
be worn
•
Trousers or culottes for female staff instead of dresses or skirts
•
Tops or tunics should be non-restrictive and allow ease of movement
•
Personal protective equipment eg gloves and protective footwear should also
be worn in accordance with local risk assessments for some groups of staff
•
Fingernails should be short so as not to cause any trauma to the person’s
skin
•
Staff should not wear jewellery, which may cause harm to themselves or the
person being moved. Examples of inappropriate jewellery include:
watches and rings with sharp edges
large hoop earrings
necklaces and bracelets
.
12
.
MOVING AND HANDLING POLICY
10. TRAINING
In order to meet their statutory responsibility each organisation will ensure that
suitable and sufficient training is provided for all staff, managers and senior officers.
Training in risk assessment for moving and handling will be mandatory for relevant
managers.
All new staff will attend moving and handling training as part of their induction
programme prior to the commencement of duties. A two-day foundation course is
recommended for staff involved with moving people.
Each organisation will ensure compliance with relevant training standards.
Training programmes will be based on the ergonomic and problem solving
approach to moving and handling and include the following elements as a
minimum requirement:
•
The human, economic and legal costs of MSDs
•
Relevant health and safety legislation including Human Rights and the need
for balanced decision-making
•
The anatomy and function of the spine and the causes of MSDs
•
24-hour back care
•
Basic ergonomic and manual handling principles
•
Assessment skills and knowledge of the assessment process
•
Current moving and handling techniques
•
Use of relevant mechanical aids and equipment
.
13
.
MOVING AND HANDLING POLICY
TRAINING contd
It is recommended that refresher training be provided every two years for all staff
and managers. More frequent training may be required in some areas depending on
the findings of local risk assessments.
Training must also be provided if new equipment is provided in the workplace or if
there is a change in the work situation, eg changes to the environment or changes in
service delivery.
Accurate training records will be kept for all training courses to include:
•
Signature of trainer
•
Signature of staff attendance
•
Course programme and learning outcomes
•
Course content including details of practical work covered
Each organisation will perform its own training needs analysis to identify the type of
training required. This may be informed by health and safety audits and the findings of
risk assessments and workplace assessments.
Training programmes will be reviewed and monitored regularly to ensure that they
continue to meet the needs of the organisation.
.
14
.
MOVING AND HANDLING POLICY
11. RISK ASSESSMENTS
Risk Assessments for Moving and Handling People
A written moving and handling assessment must be completed for people who
need assistance to move. The assessment should cover the following areas:
•
Assessor’s details and signature, assessment date and review date
•
Personal information of the person, including height and weight
•
The person’s personal wishes on mobility
•
Details of relevant medical diagnosis/problems
•
Handling hazards and constraints
•
Details of any equipment or aids being used
•
A detailed handling plan for all foreseeable handling tasks including
techniques and equipment to be used
•
Numbers of staff required to perform handling tasks
Each organisation will have designated staff who will perform the initial
assessment. Additional advice and support will also be available as appropriate
from other specialist staff, eg Occupational Therapists and the organisation’s
Moving and Handling Advisor.
(Please see sample assessment forms and guidance notes in Appendix 1. These
forms are intended for use mainly in the community, mental health and residential
settings. Other assessment formats may be required in other areas, eg acute
medical wards).
.
15
.
MOVING AND HANDLING POLICY
RISK ASSESSMENTS contd
Each organisation will adopt a collaborative approach to risk assessments in
situations where employees are working within the premise of another employer,
or working in the person’s own home alongside staff from another care provider.
In these situations representatives of each organisation will co-operate to ensure
that a moving and handling assessment and handling plan is completed and that
the information is available for all staff to refer to.
It will usually be the organisation with the most involvement that takes a lead in
completing the assessment and co-ordinating any equipment or aids that are
required.
Some risk assessments will lead to using equipment or adjustments to the
handling environment to reduce handling risks to the carer and/or the person
being moved. The proposed changes are more likely to be acceptable to the
person and their family if they have been fully involved in the assessment process
and understand the purpose for which it has been carried out.
Balanced Decision Making for Moving and Handling People
In a minority of cases the person or their family may be reluctant to accept
changes that have been recommended to address the risks identified. In these
situations the assessor and, where appropriate, the Service Manager will adopt a
balanced approach. They will endeavour to respect the person’s wishes for
mobility and support and, as far as is possible, their independence and autonomy.
It is also recognised however, that under health and safety legislation staff are not
required to perform moving and handling tasks that put them at an unacceptable
level of risk. In these situations it may be necessary to limit the service being
provided or have the service provided in a different way.
Where there is a difference of opinion over methods of moving and handling it is
recommended that a meeting be held with the person, the local manager and all
other relevant people. The meeting should be used to outline the findings of the
risk assessment and to seek a safe solution.
Specialist advice from the organisation’s Moving and Handling Advisor should
also be obtained.
.
16
.
MOVING AND HANDLING POLICY
RISK ASSESSMENTS contd
Limitation of service will be the final option and will only be used after all other possible
solutions have been investigated and discussed with the person and other relevant
people
Householders cannot be required by Health & Safety law to adapt their home or use
equipment provided to reduce risks to visiting care staff. However, with their cooperation, much can be done to eliminate or reduce the risks from moving and
handling, particularly by modifying the home environment to improve working postures
to staff and carers.
Discharge from Hospital
When the person is being discharged from hospital the relevant organisations will
ensure, through forward planning that arrangements have been made for environmental
adaptations, equipment provision and staff training. The person will not be discharged
home unless the necessary equipment is in place and a moving and handling
assessment and handling plan has been completed.
Risk Assessment for Load Handling
Local Managers will perform the initial risk assessment.
Assistance from the
organisations Moving and Handling Advisor or Health and Safety Advisor may be
required for complex handling situations. Staff from the work area should also be
involved in the risk assessment process.
Load handling risk assessments will be performed by using the standardised
assessment form (See sample assessment form and guidance notes in Appendix 1).
More detailed and objective assessments may be performed as necessary using
recognised ergonomic assessment tools. This will normally be done with assistance
from the Moving and Handling Advisor.
.
17
.
MOVING AND HANDLING POLICY
12. COLLABORATIVE WORKING
All organisations will communicate effectively in relation to moving and handling
issues in order to achieve a consistent approach and to reduce the health and
safety risks of all those involved.
Particular consideration should be given to the provision of information to the
Ambulance Service, which is often performing moving and handling tasks in
vulnerable community based situations.
13. MONITORING
Each organisation will monitor the policy to ensure its successful adoption and
implementation. It is recommended that the following monitoring tools be put in
place:
•
Regular audits of people handling assessments and care plans
•
Workplace observations to check that handling methods are consistent with
individual assessments and professional standards for the handling of people
•
Quarterly reports of manual handling accidents and incidents
•
Quarterly reports of sickness absence associated with manual handling
•
Inspection of manual handling accident/incident forms by the Moving and
Handling Advisor or Health and Safety Advisor
•
The reported number of civil claims from employees
•
The reported number of complaints from the person/relatives associated with
moving and handling
•
The results of workplace Health and Safety Inspections and Safety Audits
•
Equipment Audits to check that sufficient equipment is properly maintained
readily and available for staff use.
•
Reports completed as part of the LOLER examination of patient lifting
equipment
•
Quarterly reports of training attendance
•
Workplace supervision by managers/team leaders to ensure that safe working
practices are followed
.
18
.
MOVING AND HANDLING POLICY
14. BIBLIOGRAPHY
The following sources of information have been used in the production of this policy:
•
Health and Safety at Work etc Act 1974
•
Management of Health and Safety at Work Regulations 1999
•
Manual Handling Operations Regulations 1992
•
Human Rights Act 1998
•
Lifting Operations and Lifting Equipment Regulations 1998
•
Provisions and Use of Work Equipment Regulations 1998
•
Manual Handling in the Health Service (Health Services Advisory
Commission 1998)
•
Guide to the Handling of People – revised 5th edition (RCN 2005)
•
Handling Assessment in Hospital and Community (RCN 1999)
•
Introducing a Safer Patient Handling Policy (RCN 1999)
•
RCN Code of Practice for Patient Handling (1999)
•
“Handling Home Care: Achieving safe, efficient and positive outcomes for
care workers and clients” (HSE 2002)
•
Care Handling for People in Hospitals, Community and Educational
Settings –A Code of Practice. Derbyshire Inter-Agency Group
.
19
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MOVING AND HANDLING POLICY
15. GLOSSARY OF TERMS
Person
The patient, service user, client, young person, resident,
child or pupil who requires assistance to be moved
Competent Person
Someone with sufficient training, experience and
knowledge to undertake a particular task eg risk
assessments
Ergonomic approach
Fitting handling tasks to people to make them safer, easier
and more pleasant to perform
Hazard
The capacity for injury, damage or loss
Risk
The likelihood of injury, damage or loss occurring
Moving and Handling
Manual handling, manual handling operations
Moving and Handling
Advisor
Back Care Advisor, Moving and Handling Specialist
.
20
.
MOVING AND HANDLING POLICY
16. DIRECTORY OF SPECIALIST ADVISORS FOR MOVING AND HANDLING
NAME
DESIGNATION
ORGANISATIONS
COVERED
CONTACT TEL
NUMBER
Alison Gibson
Back Care Advisor
Lincolnshire Social
Services
01522 554032
Liz Dirjal
Health & Safety Advisor
Lincolnshire Social
Services
01522 836712
Malcolm King
Specialist Training &
Advisory Services Manager
WLPCT, ELPCT,
LSWPCT, LPT
01522 577010
Tina Craggs
Moving & Handling Specialist
WLPCT, ELPCT,
LSWPCT, LPT
01522 577010
Adi Todd
Moving & Handling
Co-ordinator
ULHT
01522 512512
Phillipa FitzMaurice
Health & Safety Advisor
ULHT
01522 512512
Shirley Kaberry
Health, Safety & Quality
Co-ordinator
Lincolnshire
Ambulance
Services NHS Trust
01522 832615
Joanne Taylor
Senior Physiotherapist
St Barnabas
Hospice
01522 518210
.
21
.
Appendix 1
Assessment Forms
.
22
.
.
revised 7 July 05
23
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
PERSON MOVING AND HANDLING ASSESSMENT (ADULTS)
PART 1 (page 1 of 6)
PERSON’S DETAILS
ASSESSOR DETAILS
Name
NHS/SWIFT/
SOSCIS No
D.O.B.
Location eg Home address/Ward/Day Unit
Name
Designation
Signature
Height
Weight
Assessment Date
Review Date
Details of other professionals involved in the moving and handling assessment
Name
Designation
Signature
PART 1
CHECKLIST OF HANDLING TASKS
TASK
CAN THE PERSON PERFORM THESE TASKS INDEPENDENTLY?
YES
NO
VARIABLE
COMMENTS
ROLLING IN BED
LYING TO SITTING IN BED
REPOSITIONING UP BED
GETTING INTO BED
GETTING OUT OF BED
TURNING IN BED
SITTING TO STANDING (chair/wheelchair)
STANDING TO SITTING (chair/wheelchair)
SITTING TO STANDING (bed)
STANDING TO SITTING (bed)
STANDING
WALKING
LOWERING TO THE FLOOR
RISING FROM THE FLOOR
STAIRS
STEPS
IN BATH/SHOWER
OUT BATH/SHOWER
ON TOILET/COMMODE
OFF TOILET/COMMODE
IN CAR
OUT OF CAR
OTHER TASKS – SPECIFY
IS THERE A HISTORY OF FALLS?
IF YES, PLEASE GIVE DETAILS BELOW INCLUDING CAUSATIVE FACTORS IF KNOWN
YES / NO (PLEASE CIRCLE)
PART 2 OF THE ASSESSMENT MUST NOW BE COMPLETED IF THE PERSON IS NOT INDEPENDENT IN ALL HANDLING TASKS
.
24
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
PERSON MOVING AND HANDLING ASSESSMENT (ADULTS)
PART 2 (page 2 of 6)
Person’s Name: …………………………… DOB: …..………… Assessment Date: ………….…
Details of relevant medical condition/diagnosis
Details of any moving and handling hazards in relation to the person’s physical condition
Details of any mobility equipment, aids and appliances that the person uses eg walking
aids, wheelchair etc
Details of any moving and handling hazards related to communication, comprehension or
behaviour
Person/family wishes and opinions
Do informal carers have physical limitations or medical problems which may affect their
ability to perform moving and handling?
YES / NO / NA (Please circle)
If YES please specify:
Please continue
.
25
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
PERSON MOVING AND HANDLING ASSESSMENT (ADULTS)
PART 2 contd (page 3 of 6)
Identify any problems relating to moving and handling and the environment
Recommendations to improve the environment following the assessment
Is there any equipment required to safely perform any of the tasks?
If YES, give details below.
Equipment needed
Where to be obtained
YES
Date requested & by whom
NO
Equipment received
Sign and date
Assessment Review Date
.
26
Details of movement method to be used including
equipment and techniques
No of
people
DOB: ………………………….
Task duration
& frequency
Assessor’s
signature & date
Sheet No: …………………
.
27
Review Date: …………………
Information on this form should be used as guidance and each situation must still be assessed in case there are changes with
the person or handling situation.
Task Description
Person’s Name: …………………………………….
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
MOVING AND HANDLING PLAN
(page 4 of 6)
Details of Remaining
Problems/Deficiencies
Person
Reported to
DOB: ………………………….
Action/Measures Needed
Person’s Name: …………………………………….
Reported By
(Sign & Date)
Date Resolved
(Sign & Date)
Sheet No: …………………
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
PROBLEMS/DEFICIENCIES SHEET
(page 5 of 6)
.
28
Reviewed By
Outcome of Review Including Details of any
Significant Changes
DOB: ………………………….
Assessor’s
Signature
Sheet No: …………………
In situations where major changes have occurred to the person or handling situation a new assessment/handling plan must be completed
Date of Review
Person’s Name: …………………………………….
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
REVIEW SHEET
(page 6 of 6)
.
29
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
PERSON MOVING AND HANDLING ASSESSMENT
(CHILDREN/YOUNG PEOPLE) - PART 1
(page 1 of 6)
CHILD/YOUNG PERSON’S DETAILS
ASSESSOR DETAILS
NHS/SWIFT/
SOSCIS No
Name
D.O.B.
Location eg Home address/Ward/School/Respite Care
Name
Designation
Signature
Height
Weight
Assessment Date
Review Date
Details of other professionals involved in the moving and handling assessment
Name
Designation
Signature
PART 1
CHECKLIST OF HANDLING TASKS
TASK
CAN THE CHILD/YOUNG PERSON PERFORM THESE TASKS INDEPENDENTLY?
YES
NO
VARIABLE
COMMENTS
ROLLING IN BED
LYING TO SITTING IN BED
REPOSITIONING UP BED
GETTING INTO BED
GETTING OUT OF BED
TURNING IN BED
SITTING TO STANDING (chair/wheelchair)
STANDING TO SITTING (chair/wheelchair)
SITTING TO STANDING (bed)
STANDING TO SITTING (bed)
STANDING
WALKING
IN/OUT STANDER
IN/OUT WALKER
LOWERING TO THE FLOOR
RISING FROM THE FLOOR
STAIRS
STEPS
IN BATH/SHOWER
OUT BATH/SHOWER
ON TOILET/COMMODE
OFF TOILET/COMMODE
IN/OUT CAR
IN/OFF TRANSPORT
IN/OUT OF SENSORY ROOM
OTHER TASKS – SPECIFY
IS THERE A HISTORY OF FALLS?
IF YES, PLEASE GIVE DETAILS BELOW INCLUDING CAUSATIVE FACTORS IF KNOWN
YES / NO (PLEASE CIRCLE)
.
PART 2 OF THE ASSESSMENT MUST NOW BE COMPLETED IF THE CHILD/YOUNG PERSON IS NOT INDEPENDENT IN ALL HANDLING TASKS
30
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
PERSON MOVING AND HANDLING ASSESSMENT - PART 2
(page 2 of 6)
Child/Young Person’s Name: ……………………… DOB: …..… Assessment Date: ………….…
Details of relevant medical condition/diagnosis
Details of any moving and handling hazards in relation to the child/young person’s
physical condition
Details of any mobility equipment, aids and appliances that the child/young person uses
eg walking aids, wheelchair etc
Details of any moving and handling hazards related to communication, comprehension or
behaviour
Child/Young person’s wishes and opinions
Parents’/Carers’ wishes and opinions
Do informal carers have physical limitations or medical problems which may affect their
ability to perform moving and handling?
YES / NO / NA (Please circle)
If YES please specify:
Please continue
.
31
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
PERSON MOVING AND HANDLING ASSESSMENT
PART 2 contd (page 3 of 6)
Identify any problems relating to moving and handling and the environment
Recommendations to improve the environment following the assessment
Is there any equipment required to safely perform any of the tasks?
If YES, give details below.
Equipment needed
Where to be obtained
YES
Date requested & by whom
NO
Equipment received
Sign and date
Assessment Review Date
.
32
Details of movement method to be used including
equipment and techniques
No of
people
DOB: ………………………….
Task duration
& frequency
Assessor’s
signature & date
Sheet No: …………………
.
33
Review Date: …………………
Information on this form should be used as guidance and each situation must still be assessed in case there are changes with
the child/young person or handling situation.
Task Description
Child/Young Person’s Name: ………………………………….
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
MOVING AND HANDLING PLAN
(page 4 of 6)
Details of Remaining
Problems/Deficiencies
Person
Reported to
DOB: ………………………
Action/Measures Needed
Child/Young Person’s Name: …………………………………….
Reported By
(Sign & Date)
Date Resolved
(Sign & Date)
Sheet No: …………………
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
PROBLEMS/DEFICIENCIES SHEET
(page 5 of 6)
.
34
Reviewed By
Outcome of Review Including Details of any
Significant Changes
DOB: ……………….
Assessor’s
Signature
Sheet No: …………………
In situations where major changes have occurred to the child/young person or handling situation a new assessment/handling plan must be
completed
Date of Review
Child/Young Person’s Name: …………………………………….
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
REVIEW SHEET
(page 6 of 6)
.
35
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
MANUAL HANDLING OF LOADS RISK ASSESSMENT FORM
SECTION A – PRELIMINARY (page 1 of 3)
SECTION A – PRELIMINARY
* Circle as appropriate
Job Description:
Is an assessment needed?
(ie is there a potential risk for injury, and are
the factors beyond the limits of the
guidelines?)
Factors beyond the limits of the guidelines?
YES/NO*
If ‘yes’ continue. If ‘no’ the assessment need go no further.
Operations covered by this assessment
(detailed description):
Diagrams (other information):
Locations:
Personnel involved:
Date of assessment:
SECTION B – See over for detailed analysis
SECTION C – Overall assessment of the risk of injury?
Low/Med/High*
SECTION D – Remedial action to be taken:
Remedial steps that should be taken, in order of priority:
1
2
3
4
5
6
Date by which action should be taken:
Date for reassessment:
Assessor’s Name:
Signature:
TAKE ACTION ….. AND CHECK THAT IT HAS THE DESIRED EFFECT
.
36
37
Other factors:
Is movement or posture hindered by
clothing or personal protective
equipment?
Individual capability - does the job:
•Require unusual capability?
•Hazard those with a health problem?
•Hazard those who are pregnant?
•Call for special information/training?
The working environment - are there:
•Constraints on posture?
•Poor floors?
•Variations in levels?
•Hot/cold/humid conditions?
•Strong air movement?
•Poor lighting conditions?
The loads - are they:
•Heavy?
•Bulky/unwieldy?
•Difficult to grasp?
•Unstable/unpredictable?
•Intrinsically harmful (eg sharp/hot)?
The tasks - do they involve:
•Holding loads away from the trunk?
•Twisting?
•Stooping?
•Reaching upwards?
•Large vertical movement?
•Long carrying distances?
•Strenuous pushing or pulling?
•Unpredictable movement of loads?
•Repetitive handling?
•Insufficient rest or recovery?
•A work rate imposed by a process?
Questions to consider:
Yes/No
Low/Med/High
If yes, tick
appropriate
level of risk
Problems occurring from the task. (Make
rough notes in this column in preparation for
the possible remedial action to be taken)
SECTION B – More detailed assessment, where necessary:
Possible remedial action (possible changes
to be made to system/task, load,
workplace/space, environment.
Communication that is needed.
.
LINCOLNSHIRE INTER-AGENCY MOVING AND HANDLING GROUP
MANUAL HANDLING OF LOADS RISK ASSESSMENT FORM
SECTION B – MORE DETAILED ASSESSMENT
(page 2 of 3)
.
.
HSE RISK ASSESSMENT FILTER
NUMERICAL GUIDELINES
(Part 3 of 3)
.
38
.
Appendix 2
Protocols for Moving and Handling
.
39
.
PROTOCOL FOR THE
MANAGEMENT OF THE
FALLEN PERSON
IN THE COMMUNITY
.
40
.
This guidance is intended for Health and Social Services staff working in
the community who may encounter a fallen person
The following action is recommended:
•
First perform a risk assessment of the situation and assess the medical condition of
the person including any injuries.
•
If the person is uninjured and does not need to go to hospital follow Protocol A.
•
If the person is injured or has a medical condition which requires hospital admission
follow Protocol B
PROTOCOL A – UNINJURED PERSON, HOSPITAL ADMISSION NOT REQUIRED
Where possible the person should be encouraged to move themselves, provided this
can be done safely. Staff may give minimal assistance but must avoid lifting or taking
the person’s full weight. Use of a chair or stool for the person to lean on may be
appropriate in some situations.
If the person is unable to get up from the floor they should be left where they are and
made comfortable. Do not attempt to move or manually lift the person from the floor
unless the person is in imminent danger.
If available, mechanical aids such as hoists should be used to lift the person from the
floor onto the bed or chair. This option should only be used if there are a sufficient
number of trained people to use the equipment.
If the person cannot move themselves or be moved safely from the floor, the Ambulance
Service should be contacted for assistance by ringing 999. All relevant information
should be given to the Ambulance Service including:
•
•
•
Name and address of person
Height and weight of person
Any relevant medical conditions
•
Details of any risks associated with the handling situation and environment
AMBULANCE CONTROL MUST ALSO BE INFORMED THAT THE MANGA
EMERGENCY LIFTING CUSHION IS REQUIRED.
.
[This page updated 6.02.06]
41
.
PROTOCOL B – INJURED OR MEDICALLY UNWELL PERSON WHO REQUIRES
ADMISSION TO HOSPITAL
The person should be left in the position found and not moved unless they are in imminent
danger.
Make the person comfortable and give reassurance. Keep the person warm with a blanket if
necessary.
Contact the Ambulance Service immediately by ringing 999.
Stay with the person and give reassurance until the Ambulance Service arrive.
CPR or other first-aid procedures should be commenced as necessary, provided staff have
the appropriate skills and training.
The Ambulance Service will move the person in the most appropriate way once they have
arrived and assessed the situation.
PEOPLE WHO FALL FREQUENTLY
If falls become a regular occurrence the person should be referred to their GP for a full
medical review. Other professional staff including Physiotherapists and Occupational
Therapists should be involved as necessary as part of a falls assessment with the aim of
preventing future falls.
In situations where it is foreseeable that the person may fall again, a written moving and
handling plan must be produced. The plan should include details on what action is to be
taken by staff and details of any equipment to be used. All necessary equipment must be
available.
The Ambulance Service will be very reluctant to respond to on a regular basis unless a risk
assessment has been completed and falls prevention measures have been put in place.
The Ambulance Service will monitor the number of calls to individuals in the community and
problem areas will be reported to the appropriate person, eg GP, District Nurse or Moving
and Handling Advisor.
CARE HOMES
The Ambulance Service will respond to calls from Care Homes where the fallen person is
injured or requires admission to hospital.
If the fallen person is uninjured and does not require admission to hospital, then it is the
Care Home’s responsibility to manage the situation safely. This includes having a written
policy, the provision of suitable aids and equipment and suitably trained staff.
If the Ambulance Service is asked to attend to the uninjured person then a charge will be
made to the individual home.
.
[This page updated 6.02.06]
42
.
PROTOCOL FOR THE
MOVING AND HANDLING OF
THE BARIATRIC PERSON
IN HOSPITAL
AND THE COMMUNITY
.
43
.
PROTOCOL FOR THE MOVING AND HANDLING
OF THE BARIATRIC PERSON
IN HOSPITAL AND THE COMMUNITY
This document has been written and compiled by the Bariatric Sub-group for the
Lincolnshire Inter-agency Group for Moving and Handling.
The group
comprises the following specialist advisors:
Alyn Blyth
Head of Risk and Quality Management
Lincolnshire Ambulance Service NHS Trust
Alison Gibson
Strategic Back Care Advisor
Lincolnshire Social Services
Shirley Kaberry
Health and Safety Co-ordinator
Lincolnshire Ambulance Service NHS Trust
Malcolm King
Specialist Training & Advisory Services Manager
Lincolnshire NHS Shared Services
Tobias Payne
Registration Inspector
Commission for Social Care Inspection
Linda Rhodes
Clinical Advisor Community Healthcare Equipment
East Lincolnshire Primary Care Trust
Adi Todd
Moving and Handling Co-ordinator
United Lincolnshire Hospitals Trust
.
44
.
1.
DEFINITIONS/TERMS
Bariatric
A Bariatric person is defined as a person with a weight over 160kgs (and a body
mass of more than 40).
World Health Organisation 2000.
(See Appendix 1 for weight conversion table)
Person
Is the Bariatric patient, client or service user who requires assistance.
Moving and Handling Advisor
Is the Back Care Advisor, Manual Handling Advisor, Moving and Handling
Co-ordinator or Moving and Handling Specialist.
2.
BACKGROUND
This protocol has been produced by the Lincolnshire Inter-agency Manual
Handling Group in response to the increasing incidence of Bariatric people
requiring health and social care. It is recognised that there is a need for local
organisations to work and communicate effectively together in order to safely meet
the needs of these people particularly where their care includes a transition
between hospital and community.
The protocol is also written in the context of the legislative framework as set out in
the Inter-agency Manual Handling Policy and it also pays due regard to the
Disability Discrimination Act 2002 and the Human Rights Act 1998 including:
•
Article 3 – ‘No one shall be subjected to inhuman or degrading treatment or
punishment’
•
Article 8 – ‘Right to respect for his private and family life, his home and his
correspondence’
.
45
.
3.
RISK ASSESSMENT FOR MOVING AND HANDLING
A risk assessment must be completed for the person who requires assistance to
be moved and where there is risk of injury to staff from manual handling.
Specialist advice will often be required from the organisation’s Moving and
Handling Advisor and it is the responsibility of the named nurse or appropriate
person to make this referral at the earliest possible stage. The Moving and
Handling Advisor will co-ordinate the assessment and equipment provision as
necessary.
Postural Issues
Staff involved with Bariatric people need to be aware that assisting the whole
person to move may be hazardous. In addition their individual limbs can also be
very heavy and that there is risk of injury to staff when performing personal care
and nursing interventions. As part of the Moving and Handling Assessment staff
should consider the working postures they have to adopt whilst performing these
tasks. Wherever possible height adjustable equipment should be used, eg highlow beds and leg supports to help improve working postures. Working at floor
level should be avoided whenever possible. Taking the weight of the person’s limb
may also be avoided by using slide sheets, leg lifters and mechanical aids such as
an inflatable Lifting Cushion. If possible the person should be encouraged to move
or support the limb independently.
Details of the risk reduction measures to be used when moving or supporting limbs
should also be documented in the Moving and Handling Assessment. Further
advice on how to reduce risks in relation to working postures is also available from
the organisation’s Moving and Handling Advisor.
The Fallen Person
The fallen Bariatric person represents a very significant health and safety risk and
everything possible needs to be done to prevent this situation from arising. As part
of the risk assessment, consideration should be given to identifying the factors,
which could cause the person to fall. These may include medical reasons and
environmental hazards such as:
•
Cluttered environment
•
Uneven floor surfaces
•
Loose carpeting
•
Lack of hand-rails or mobility aids
•
Poor fitting footwear
.
46
.
Once the hazards have been identified suitable risk reduction measures need to be put
in place with the aim of preventing a fall. The risk assessment should also include a
handling plan for moving the person up from the floor and this should include, where
appropriate, the utilisation of mechanical aids.
If community staff encounter a fallen Bariatric person then the general Fallen Person
Protocol should be followed. Where possible the Ambulance Service will be notified in
advance of persons who are likely to be at risk. Where appropriate, hoists or inflatable
lifting cushions will be provided by the Integrated Community Equipment Service
(ICES). These will be kept at the home of the person and used where necessary by
ambulance personnel.
Acute hospitals and care homes must ensure that appropriate equipment is available
for staff to safely move the fallen person and that staff have been fully trained in the
use of the equipment.
4.
WEIGHING ARRANGEMENTS
Having an accurate weight of the person is an essential part of the assessment
otherwise it will not be possible to provide the appropriate equipment and transport for
the person. All organisations will ensure that suitable arrangements are in place so
that the person can be weighed in a sensitive and dignified manner. This includes
hospital, community and care homes.
The person should be weighed within 24 hours of initial referral/admission and at
regular intervals thereafter.
United Lincolnshire Hospitals Trust
For work areas within the United Lincolnshire Hospitals Trust (ULHT) staff should
refer to the ULHT Heavier Persons Protocol.
Community
In the community the weighing of the person will take place in the individual’s home
environment. To facilitate this process staff should contact their Moving and Handling
Advisor who will make the necessary arrangements within 5 working days.
Care Homes
In care homes, organisations will ensure that suitable equipment is available so that
the person can be weighed in a dignified and sensitive manner. Care homes should
also make reference to their individual protocol.
.
47
.
5.
ADMISSION TO HOSPITAL
Involvement of the Ambulance Service
In the majority of cases the Ambulance Service will be involved in the admission
of the person. The Ambulance Service will already be aware of some Bariatric
people and their needs. The admission process can be divided into two different
types:
5.1 Emergency Admission (Usually triggered by a 999 call to Ambulance
Control
Ambulance crews will conduct a dynamic risk assessment of the person, which
will determine an appropriate response.
In certain circumstances this
assessment may indicate that this person should be treated in the home
environment rather than being taken to hospital. Ambulance Control will then coordinate the appropriate healthcare response.
If the person is to be taken to hospital the ambulance crew will ensure early
notification to the receiving hospital by the ambulance mobile phone via Control.
The Ambulance Service have an agreed separate protocol with Lincolnshire Fire
and Rescue Service to request assistance where necessary in the moving and
handling of a Bariatric person. A response from Lincolnshire Fire and Rescue
Service will only be activated through Ambulance Control.
5.2 Routine Admission
This is usually arranged by medical or nursing staff and includes outpatient
appointments. Ambulance Control call takers will require a disclosure of the
person’s weight or an estimate from the member of staff requesting the
ambulance journey.
The person’s needs will be categorised using a traffic light system and an
appropriate response will be despatched. For the person assessed in the “Red”
category, transport to hospital for routine appointments, ie blood tests, outpatient
clinics etc, should only be considered as a last resort. Consideration to the
appropriate clinician attending the person in their own home must be given in the
first instance.
Individual Moving and Handling Assessments
For routine admissions a copy of the person’s Moving and Handling
Assessment and Handling Plan in the community or care home should be sent
to the acute hospital. This is to inform the hospital staff of how the person is
normally moved and what equipment is used. This may assist the hospital staff
in making their own assessment and it can also be used as part of discharge
planning.
.
48
.
6.
DISCHARGE FROM HOSPITAL
The discharge process should start on admission of the person and should
include the following steps:
•
Case Conference
The case conference should include representatives from all the relevant
agencies who will be involved in helping to discharge the person back into
the community including:
-
the Person and their family
Community Nursing Staff
Acute Nursing and Medical Staff
Moving and Handling Advisors from the relevant organisations
the Ambulance Service
Social Worker
Occupational Therapist
Homecare Supervisor
Care Home Representative
Input from other specialists may also be required, eg Tissue Viability
Nurse, Clinical Advisor for Community Healthcare Equipment,
Physiotherapist or Dietician.
•
Home Visit
In most cases a home visit will be required to ensure that the person will be
able to manage safely once they are back in their own home and to identify
equipment, aids and services that will be required. Recommendations may
also be made for adaptations to the home environment.
Information gained from the visit will be reported back to the Multi-disciplinary
Team and a further case conference will be organised when necessary.
.
49
.
DISCHARGE FROM HOSPITAL contd
•
Notification of Discharge
All agencies involved in the discharge of the person should be given at
least FIVE WORKING DAYS notification of the proposed discharge date.
This must include notification to the Ambulance Service and the Moving
and Handling Advisor(s) involved in the case.
The person will not be discharged home or to a Care Home on the
proposed date unless there is full agreement by all those involved
that it is safe for the discharge to proceed. Any equipment needed by
the person, eg beds, hoists etc must be in place before the person is
discharged.
Risk Assessment for Moving and Handling
As part of the discharge process a Moving and Handling Assessment of the home
situation must be completed before the person returns home. The assessment
will include details of moving and handling hazards and specific details of how the
person is to be moved and the necessary equipment.
The Moving and Handling Assessment and Handling Plan must be documented
using the Inter-agency Moving and Handling Assessment Forms. (See Interagency Moving and Handling Policy.)
Involvement of the Ambulance Service
The date and time of the discharge must also be agreed in advance with the
Ambulance Service.
The Ambulance Service will undertake its own risk assessment in preparation for
transporting the patient home. This will include an assessment of the home
environment and access into the home. Special transport will be required for
some persons and this may require the use of regional response vehicles.
.
50
.
7.
EQUIPMENT
Community Equipment
A full range of equipment is available for persons living in their own home. Core
equipment from the ICES catalogue will be suitable for persons weighing up to 25
stones. Due to the varying needs of Bariatric people it is not possible for ICES to
keep equipment in stock and so all Bariatric equipment will be provided as
specials. A full risk assessment will need to be completed to identify the
appropriate equipment.
Specialist advice on equipment needs should be obtained from the relevant
specialist advisor. (See Specialist Directory.)
Requests for equipment assessment should be made as soon as the
problem/need has been identified.
Equipment within Hospital
Each organisation must ensure that suitable equipment for the Bariatric person
is readily available. This should include a comprehensive range of equipment
and aids including hoists, beds, commodes and mobility aids. An up-to-date
inventory of all Bariatric equipment should be available for staff reference and
should include as a minimum the following information:
•
•
•
•
Equipment type, make and model
Safe working load
Location
Contact details of person responsible for the equipment
Equipment within Care Homes
Care homes must not admit any person to a care home unless so far as
practicable to do so the person has been fully assessed which includes their
health and welfare by a competent person.
The person must be informed in writing that the home based on this assessment
can meet all their health and welfare needs.
Where a home therefore wishes to provide care for a Bariatric person, the home
must ensure that it can meet all their needs. This includes, providing sufficient
staff, equipment, training of staff, concerning all their needs (physical and
psychological), appropriate skill mix and size of accommodation.
Where equipment is specific to the Bariatric person, then arrangements should be
made with the appropriate Primary Care Trust where an assessment of need will
be carried out.
.
51
.
8.
TISSUE VIABILITY
Community
When a pressure-reducing surface is required for a Bariatric person without
pressure damage, advice should be sought from the relevant PCT Advisor for
Community Healthcare Equipment.
If the person presents with active pressure ulcers, the Tissue Viability Nurse from
the appropriate Primary Care Trust should be contacted for advice.
Hospital
Advice awaited from ULHT Tissue Viability Advisor.
Care Homes
Care homes providing personal care will obtain advice/nursing care from the
Community Nursing Service and/or the Tissue Viability Nurse from the
appropriate Primary Care Trust.
Care homes providing nursing care will use the professional knowledge from
Registered Nurses employed by the home. However where required, either the
home may employ a nurse with additional specialist skills or contact the Tissue
Viability Nurse from the appropriate Primary Care Trust for advice.
9.
CONFIDENTIALITY
Local Health and Social Care services will, in the interests of health and safety,
need to share information about Bariatric persons. Exchange of information will
be in accordance with Caldicott principles and normal medical records, policies
and procedures.
In order to help the Ambulance Service respond quickly and appropriately to calls
for assistance, details of known Bariatric persons will be kept by Ambulance
Control. Local agencies will only provide information to the Ambulance Service
after gaining consent from the person.
10. RELATED DOCUMENTS
This protocol should be read in conjunction with the following documents:
•
•
•
•
•
•
The Lincolnshire Inter-agency Manual Handling Policy
The Lincolnshire Inter-agency Fallen Person Protocol
ULHT Heavier Persons Protocol
Care Homes for Older People National Minimum Standards
Care Homes for Adults (18-65) National Minimum Standards
Care Homes Regulations 2001
.
52
.
WEIGHTS AND MEASURES
CONVERSION TABLE
WEIGHTS
lbs
kilos
Appendix 3
MEASURES
stones
kilos
ins
cms
ins
cms
1
0.45
1
6.4
1
2.54
36
91.44
2
0.91
2
12.7
2
5.08
37
93.98
3
1.36
3
19.1
3
7.62
38
96.52
4
1.81
4
25.4
4
10.16
39
99.06
5
2.27
5
31.8
5
12.70
40
101.60
6
2.72
6
38.1
6
15.24
41
104.14
7
3.18
7
44.5
7
17.78
42
106.68
8
3.63
8
50.8
8
20.32
43
109.22
9
4.08
9
57.2
9
22.86
44
111.76
10
4.54
10
63.5
10
25.40
45
114.30
11
4.99
11
69.9
11
27.94
46
116.84
12
5.44
12
76.2
12
30.48
47
119.38
13
5.9
13
82.6
13
33.02
48
121.92
14
6.35
14
88.9
14
35.56
49
124.46
15
6.8
15
95.3
15
38.10
50
127.00
16
7.26
16
101.6
16
40.64
51
129.54
17
7.71
17
108
17
43.18
52
132.08
18
8.16
18
114.3
18
45.72
53
134.62
19
8.62
19
120.7
19
48.26
54
137.16
20
9.07
20
127.0
20
50.80
55
139.70
21
9.53
21
133.4
21
53.34
56
142.24
22
9.98
22
139.7
22
55.88
57
144.78
23
10.43
23
146.1
23
58.42
58
147.32
24
10.89
24
152.4
24
60.98
59
149.86
25
11.34
25
158.8
25
63.50
60
152.40
26
11.79
26
165.1
26
66.04
61
154.94
27
12.25
27
171.5
27
68.58
62
157.48
28
12.7
28
177.8
28
71.12
63
160.02
29
184.2
29
73.66
64
162.56
30
190.5
30
76.20
31
196.9
31
78.74
32
203.2
32
81.28
33
209.6
33
83.82
34
215.9
34
86.36
35
222.3
35
88.90
.
53