Moving and Handling Policy HSC010

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Moving and Handling Policy – HSC010

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Table of Contents Moving and Handling Policy – HSC010 ................................................................................................... 1

Why we need this Policy ..................................................................................................................... 2

What the Policy is trying to do ............................................................................................................ 3

Which stakeholders have been involved in the creation of this Policy .............................................. 4

Any required definitions/explanations ............................................................................................... 4

Key duties ............................................................................................................................................ 5

Trust Board & Chief Executive ................................................................................................ 5

All Managers ........................................................................................................................... 5

All Employees .......................................................................................................................... 6

Procurement Department....................................................................................................... 7

The Estates Department ......................................................................................................... 7

Specialist Advisors ................................................................................................................... 8

Access to Specialist Advisors ........................................................................................................... 8

Policy detail ......................................................................................................................................... 8

Risk Assessment .............................................................................................................................. 8

Training requirements associated with this Policy ........................................................................... 11

Mandatory Training .............................................................................................................. 11

Specific Training not covered by Mandatory Training .......................................................... 11

How this Policy will be monitored for compliance and effectiveness .............................................. 12

For further information ..................................................................................................................... 12

Equality considerations ..................................................................................................................... 12

Reference Guide ............................................................................................................................... 13

Document control details ................................................................................................................. 13

APPENDIX 1 - PATIENT MOVING AND HANDLING RISK ASSESSMENT .............................................. 14

APPENDIX 2 – PERSONAL MOVING AND HANDLING PLAN............................................................... 16

Why we need this Policy

Manual handling operations form a significant part of the daily work activity within all NHS Trusts, in

particular the moving and handling of service users, stores and supplies which affects nurses,

domestics, porters, estates workers and admin support staff.

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Over half of the accidents reported within the NHS each year are associated with manual handling

causing musculoskeletal injuries.

The Trust has made a clear statement of intent within its Health and Safety Policy to do its

reasonable best to secure the health, safety and welfare at work of all its employees, and to adopt

corporate policies and procedures, which set out safe systems of work to ensure compliance with

relevant statutory provisions, with that duty extending to Manual Handling Operations Regulations

1992.

Additionally, employees are reminded that they have a responsibility to take reasonable care of

themselves and others, and to co-operate with the Trust with regard to the Health and Safety Policy.

The Trust is committed to treating people with dignity and respect in accordance with the Equality

Act 2010 and Human Rights Act 1998. Throughout the production of this policy due regard has been

given to the elimination of unlawful discrimination, harassment and victimisation (as cited in the

Equality Act 2010).

What the Policy is trying to do

This Policy applies to all manual handling tasks, whether involving service users or inanimate loads.

The purpose of the policy is to prevent injury, not only to the back, but any part of the body. It

requires employers, which includes all staff including temporary staff, contracted staff, volunteers

and employees of Northamptonshire Healthcare NHS foundation Trust, students or employees or

other external organisations that provide services to the trust, to take into account the whole

handling operation including the external physical properties of loads which might affect grip or

cause indirect injury.

As well as the potential risk to staff, manual handling incidents can pose risk to the safety and

wellbeing of service users. The Trust is committed to adopting an ergonomic approach in designing

safe systems of working so as to avoid, as far as is reasonably practicable, the need for staff to

undertake moving and handling activities that pose a risk of injury.

The following activities should be considered as a risk:

Any activity that involves transporting or supporting of a load including lifting, putting down, pushing, pulling, carrying or moving thereof, by hand or bodily force.

Any activity that could lead to musculoskeletal strain or injury e.g. activities that include potential long periods of static position, regular stooping, twisting, bending or other poor posture. The risk of injury increases significantly with any combination of the above e.g. bending whilst pushing, twisting whilst lifting etc.

This Policy will apply to all “workplaces” which will be deemed to include:

All Trust premises

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All premises where Trust staff (including bank staff) and contractors are required to work, which are the management responsibility and/or are in the ownership of other organisations or individuals (shared premises).

Moving and handing operations may occur away from the Trust’s premises in situations over which

the employer can exercise little direct control. For example in shared accommodation or in the

service users own home. Where possible there is a need to develop a close liaison with those in

control of such premises. There may sometimes be a limit to the Trust’s ability to influence the

working environments: but the task and perhaps the load will often remain within control as will be

the provision of effective training and the monitoring of effective systems of work. In some cases

special arrangements may need to be made to ensure safe handling of service users in their own

home.

The Trust recognises that there will always be elements of work that require some moving and

handling. Where it is not possible to eliminate such handling, the aim is to make it as safe as is

reasonably practicable to reduce the risk of injury.

A range of actions supporting the continual development of safer handling practices and support

mechanism across the workplace will be implemented, including provision of equipment identified

by risk assessment, and the requirement that employees participate in recognised training.

Which stakeholders have been involved in the creation of this Policy

Health, Safety and Risk Committee

Manual Handling Team

Trust Policy Board

Any required definitions/explanations

NHFT - Northamptonshire Healthcare NHS Foundation Trust

Manual Handling - A common misconception is that manual handling refers only to the lifting of

loads. The Manual Handling Operations Regulations 1992 states: “manual handling operations”

means any transporting or supporting of a load (including the lifting, putting down, pushing, pulling,

carrying or moving thereof) by hand or by bodily force”.

Load - This is any movable object. This includes a service user receiving medical attention or care,

items of equipment, files/records, trolleys, carts, wheelchairs etc.

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Ergonomics - The means by which the working environment and working practices are altered to

more suitably match the individual, thus reducing risk of injury

Minimal Lifting - Minimal lifting techniques are those which employ the use of mechanical lifting

devices. Manual lifting, whilst not banned, should become the last resort when all other options

have been exhausted. If a decision to manually lift is made, managers and staff must be able to

justify their actions.

Minimal Assistance- Guiding a partially sighted or blind service user.

Competent Person - The HSE defines a competent person as someone who has had sufficient

training, experience, knowledge, skills and other qualities to comply with the requirements of the

legislation.

Provision and Use of Work Equipment Regulations (PUWER 1998), HSE: - guidance stating that all

equipment provided and used in the course of your employment should be checked prior to its first

use and on a regular basis. The regularity will depend on the device or piece of equipment being

used.

Lifting Operations and Lifting Equipment Regulations (LOLER 1998), HSE: - guidance stating that all

equipment used for lifting a person whether a hoist, and any material sling used, or lifts in buildings

must be checked by an appropriately qualified person/engineer every 6 months.

Key duties

Trust Board & Chief Executive

Will as far as reasonably practicable, take steps to meet their responsibility by ensuring:

The implementation of this policy

Adequate provision of suitable staffing levels, working conditions and environments

Adequate provision and maintenance of suitable equipment

Trust employees are properly informed and trained

A comprehensive audit process is maintained to measure and review policy compliance and effectiveness

Adequate resources are made available

All Managers

Have the responsibility for the following:

To implement manual handling regulations within their workplace

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To seek additional advice or training on manual handling risk management when necessary

To ensure their staff are aware of, and trained sufficiently, and competent in matters relating to manual handling, posture and ergonomics, records are kept of this training.

To ensure full and sufficient risk assessments of manual handling activities within their departments are carried out. These must be documented and reviewed regularly.

To ensure that only risk assessed patient manual handling practices are used, and that unsafe and high risk techniques are avoided.

To ensure patients manual handling needs are identified, particularly at the time of admission and when referred on to other care providers

To ensure that bank and agency staff are adequately trained before commencing work

To ensure that their departments are sufficiently provisioned with suitable equipment and staffing levels to facilitate safe handling and working postures

To ensure staff use manual handling aids wherever they can to reduce risk of injury, whilst maintaining the needs of the patient

To ensure that any manual handling equipment is in a good state of repair and maintained in accordance with the manufacturer’s instructions, PUWER and LOLER regulations.

To document and report, via risk registers, to their directors any circumstance which prevents them from reducing identified risks, this includes environmental and design issues that have a negative impact on safe working practice.

To ensure that all accidents/incidents regarding manual handling operations are reported, investigated and appropriate remedial action taken.

To ensure when any equipment faults are reported, the equipment is taken out of service and appropriate notification is undertaken.

To contact the manual handling department to complete a training needs analysis when/if their clinical remit/service user needs change.

To nominate a member of the team to complete the quarterly hoist and sling audit as requested by the manual handling team.

To ensure surplus manual handling equipment/stock is identified and returned to the manual handling department to enable other Trust departments to utilise if required.

To ensure condemned or ‘lost’ equipment is reordered in a timely manner to ensure staff and service user safety.

All Employees

Will take reasonable care of their own health and safety and that of others when involved in manual handling.

Are responsible for: o Attending any training and acting upon information provided o Undertaking appropriate risk assessments for the moving and handling of

service users and inanimate loads. The assessment must take account of the task: Task Individual capabilities

Load Working environment Equipment

Ensuring they follow a safe system of work as indicated in documented patient handling risk assessments, and inanimate loads risk assessment documentation, and

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recognize that service users handling needs are ever changing and, as such assessments must be continually updated.

Reporting immediately to their manager any shortcoming in their training, knowledge, skill, competency, ability or experience, which compromises their safe working practice relative to manual handling, working postures and documented risk assessments

Use manual handling aids whenever identified as appropriate via manual handling risk assessment. Please refer to Guidelines for the safe use of electric patient lifting hoists for further information

Promptly reporting any accidents or near misses related to manual handling to their Manager, and complete accident/incident documentation

Reporting to their manager any issues relating to their health or fitness that may have an adverse effect on their manual handling safety or ability (including pregnancy)

Wearing suitable clothing and enclosed flat shoes as a minimum requirement, exact requirements would be indicated by risk assessment. Please refer to Dress code policy for further details.

Ensuring equipment is clean and in visually good condition prior to use.

Employees are advised that they must not cause physical abuse to any patients. Physical abuse is any physical contact, which harms clients or is likely to cause them unnecessary, and unavoidable pain and distress. Examples include handling the client in a rough manner or poor application of manual handling techniques. Physical abuse may cause psychological harm (ref: NMC 2002 Practitioner- client relationships and the prevention of abuse).

Procurement Department

Will ensure that:

Any equipment/furnishings purchased are of suitable standard

Appropriate information accompanies equipment supplied

Prior to purchase of patient manual handling equipment, if required, the appropriate professional i.e. Manual Handling Team, Infection Control Nurse, Tissue Viability Nurse is consulted.

The Estates department is informed of any new equipment purchased so that appropriate servicing schedules are drawn up.

The Estates Department

Will ensure that:

Manual handling equipment, where appropriate is regularly maintained according to manufacturer’s instructions. In particular lifting equipment will be subject to six monthly inspections in accordance with the Lifting Operations and Lifting Equipment Regulations (1998).

Manual handling equipment awaiting repair is given high priority.

When undertaking either a new build or refurbishment, consideration is given to the issue of manual handling. Designers and planners should take account of the ergonomics in intended designs to minimise the risks caused by moving and handling, both in the production process and finished product. Advice from specialist advisors will be sought where appropriate.

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Specialist Advisors

The role of Specialist Advisors is to assist the employer with the risk management of manual handling. This will include identifying, assessing significant risks and reporting on the effectiveness of control measures.

Other duties include: o Design, co-ordination and, where necessary, provision of relevant training

programmes for staff. o Provision of specialist, proactive, reactive or requested advice. o Support/advise in the undertaking of manual handling risk assessments as

requested o Assessment of reported manual handling near misses and incidents with a

view to investigating those where further action may be necessary o Undertaking yearly audits of hoisting and sling equipment o Provision of advice on the selection and use of equipment o Attending meetings seminars, workshops and training courses to ensure

maintenance of knowledge skills and competency o Review of manual handling policy and related guidance on a three yearly cycle

Access to Specialist Advisors

Specialist patient handling advice can be obtained by contacting one of the trainers within the

manual handling team. Other manual handling advice requirements should be directed to the

health and safety risk team.

Contact details of the manual handling and health and safety risk teams are available on the Staff

room.

Policy detail

Risk Assessment

Risk assessment for the moving and handling of service users and objects should be completed by competent staff

Patient Handling Risk Assessments

Patient handling risk assessments should be completed within 24 hours of a service user’s admission, or at a first assessment visit. How to complete a personal moving and handling plan is also available as an ESR e learning package ‘patient handling Risk assessment training for S1’. The Manual Handling Lead can be contacted for specialist advice with regard to the completion of service user moving and handling risk assessments.

Action Plans

Once a risk assessment has been completed any patient identified with moving and handling risks must have a completed action plan as per Appendix 1. This plan must detail how the risk will be reduced.

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Following up risk assessments and action plans

The risk assessment must be reviewed if any of the TILEO factors change, or every six months. All members of the multidisciplinary team must be responsible for updating the risk assessment and corresponding action plan.

Risk Assessment for non-clinical staff who assist patients to and from clinics

A patient attending a clinic will not have had a manual handling risk assessment carried out

therefore their level of mobility will not be known. In this instance only minimal assistance

must be given and where more than minimal assistance is required a wheelchair must be

offered.

When offering a wheelchair ensure that it is safe to use. Carry out the pre-use checks

according to the checklist attached to the wheelchair. Further guidance is available in the

ESR eLearning package ‘safe use of wheelchairs’.

Where the patient is accompanied by a relative or carer, they should be encouraged to assist

the patient when assistance is required.

Object Handling Risk Assessments

A “dynamic” inanimate loads manual handling risk assessment will be carried out prior to all manual handling tasks. Where the manoeuvre of an inanimate load is such as to carry a risk of injury, and handling occurs on a regular basis a written risk assessment should be completed.

The chart on page 10 gives guideline weights for lifting and lowering, of inanimate loads, which assumes that the handling is taking place in reasonable working conditions with a load that is easily grasped with both hands by a reasonably fit, well-trained individual.

No manual handling activity is completely safe. However, using these guidelines as part of a well thought out risk assessment will reduce the risks from manual handling activities. Manual Handling risks identified on the DatixWeb risk assessment form that cannot be eliminated or managed to the lowest reasonably practicable level must be added to the risk register for that department/directorate.

Weights to be lifted may need to be reduced below the guideline values if there are environmental or other factors that could have an adverse effect on the activity or if it involves twisting or bending.

Similarly, if the task is being carried out frequently then weights should be reduced.

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One way to assess manual handling activities is to look at five specific areas – Task, Individual, Load, Environment and Other Factors, (easily remembered by the acronym TILEO). As with any assessment, the workforce should be involved in the process. Key factors to consider in each element are:

The Task

Does the activity involve twisting, stooping, bending, excessive travel, pushing, pulling or precise positioning of the load, sudden movement, inadequate rest or recovery periods, team handling or seated work?

The Individual

Does the individual require unusual strength or height for the activity, are they pregnant, disabled or suffering from a health problem on restricted duties. Is specialist knowledge or training required?

The Load

Is the load heavy, unwieldy, difficult to grasp, sharp, hot, cold, difficult to grip, are the contents likely to move or shift?

The Environment

Are there space constraints, uneven, slippery or unstable floors, variations in floor levels, extremely hot, cold or humid conditions, poor lighting, poor ventilation, gusty winds, clothing or Personal Protective Equipment that restricts movement? Environmental risks must be highlighted on the trusts risk register.

Other Factors

Is the equipment clean and fit for purpose. Are staff that are to use the equipment trained and competent to do so? Are instruction manuals readily accessible in all areas where equipment is to be used? Has equipment been regularly serviced and inspected. Please refer to the Medical Devices Policy for further details.

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Plus size/Bariatric Patient Handling

Bariatric people handling is principally no different from all people handling, however due to the size, weight or body dynamics of this person group, specialist consideration may need to be given to certain aspects of the overall care package. Further advice can be sought from the Manual Handling Lead/team, with regard to patients whose BMI is greater than 35kg/ m², and who staff have identified as having moving and handling risks.

Identification of hazards and risks

The Manual Handling Operations Regulations (1992) establishes a clear hierarchy of measures:

Avoid hazardous manual handling operations so far as is reasonably practicable

Assess any hazardous manual handling operations that cannot be avoided

Reduce the risk of injury so far as is reasonably practicable

Review any assessment if there is reason to suspect that it is no longer valid, if there has been change in the manual handling operations or an injury has occurred.

Within Northamptonshire Healthcare NHS Foundation Trust there are two different forms of moving and handling risk assessment. Appendix 1 details the service users moving and handling risk assessment and action plan. Inanimate loads risk assessments are recorded within the DATIX risk register. See Risk register policy HSC002 for guidance on risk assessment and use of risk registers.

Training requirements associated with this Policy

Mandatory Training

Training required to fulfil this policy will be provided in accordance with the Trust’s Training

Needs Analysis. Management of training will be in accordance with the Trust’s Statutory and

Mandatory Training Policy’.

Techniques to use in the manual handling of service users and use of appropriate equipment are

detailed in A Guide to the Handling of Patients (Edition six). Copies of this guidance are held at the

main hospital sites, Berrywood Library and Manual handling department St Mary’s Hospital. Further

guidance can be obtained on The staff room.

Specific Training not covered by Mandatory Training

Ad hoc training sessions based on an individual’s training needs as defined within their

annual appraisal or job description or service users specific training can be accessed via the

manual handling team .

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How this Policy will be monitored for compliance and effectiveness

The table below outlines the Trusts’ monitoring arrangements for this document. The Trust reserves

the right to commission additional work or change the monitoring arrangements to meet

organisational needs.

Aspect of compliance or effectiveness being monitored

Method of monitoring

Individual responsible for the monitoring

Monitoring frequency

Group or committee who receive the findings or report

Group or committee or individual responsible for completing any actions

Techniques to be used in the moving and handling of service users including the use of appropriate equipment.

Competency assessment of 50 staff using appropriate manual handling within their workplace


Annual

Learning and Development monitor compliance

All staff named within reports

Audit of hoist and slings

All hoists and slings to be inspected and monitored for compliance with regulations.


Annual

Medical devices as requested

Departmental service leads identified in report

For further information

Please contact the Manual Handling and/or the Health, Safety and Risk Team

Equality considerations

The Trust has a duty under the Equality Act and the Public Sector Equality Duty to assess the impact

of Policy changes for different groups within the community. In particular, the Trust is required to

assess the impact (both positive and negative) for a number of ‘protected characteristics’ including:

Age;

Disability;

Gender reassignment;

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Marriage and civil partnership;

Race;

Religion or belief;

Sexual orientation;

Pregnancy and maternity; and

Other excluded groups and/or those with multiple and social deprivation (for example

carers, transient communities, ex-offenders, asylum seekers, sex-workers and homeless

people).

The author has considered the impact on these groups of the adoption of this Policy and these are

incorporated into the overarching health and safety equality analysis.

Reference Guide

MHOR – Manual Handling Operations Regulations 1992.

LOLER- Lifting Operations and Lifting Equipment Regulations 1998.

PUWER –Provision and Use of Work Equipment Regulations 1998.

MHSWR – Management of Health and Safety at Work Regulations 1999.

HSAWA – Health and Safety at Work etc. Act 1974.

Backcare (RCN). The Guide to The Handling Of People 6th Edition 2011 Middlesex,

Document control details

Author: Manual Handling Lead

Approved by and date: Trust Policy Board – 25 June 2019

Responsible Committee: Health, Safety and Risk Committee – 29 May 2019

Any other linked Policies: HSC009 - Policy on the Reporting of Injuries, Diseases and Dangerous Occurrences’ CRM002 - Incident Reporting Policy CLP062 - Falls Management Policy for Service Users HSC011 - Guidelines for the safe use of mobile electric patient lifting hoists HSC002 - Policy and Guidance for the Use of Risk Registers ICP019 – Dress code policy Mandatory Training documentation

Policy number: HSC010

Version control: Version 2

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Version

No.

Date

Ratified/

Amended

Date of

Implementation

Next

Review

Date

Reason for Change (eg. full rewrite,

amendment to reflect new legislation,

updated flowchart, minor amendments, etc.)

1.0 06.07.2016 06.07.2016 01.07.2019 New governance of trust policies

template.

2.0 25.06.2019 26.06.2019 25.06.2022 Reviewed

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APPENDIX 1 - PATIENT MOVING AND HANDLING RISK ASSESSMENT

This risk assessment is to be used within all in patient areas, and must be completed by a named

member of the multidisciplinary team within 24 hours of admission, or transfer from another ward.

Within the community this risk assessment documentation should be used by staff that are required

to assist with the mobility needs of an individual client or patient, or provide a “treatment” that

requires the staff member to carry out manual handling as defined by the Manual Handling

Operations Regulations (1992).

If staff involvement is to offer advice/counselling only this documentation does not need to be

completed, i.e. within community settings.

This assessment must be reviewed if any of the “TILEO” factors change, or every six months. All

members of the multi-disciplinary team must be responsible for updating the risk assessment and

corresponding action plan

All staff must have access to the assessment and action plan at all times.

All staff must check the action plan at the start of their shift. Should the service user’s condition, at

the time they see them, necessitate a change in the safe system of work, then it must be noted.

All staff must understand how to read the assessment, and all staff must follow the safe system of

work laid down in the action plan. (95% of all staff expected to perform the task must be able to do

so)

All services complete the same risk assessment format in system one to identify any moving and

handling risks

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Risk assessment screens from system one

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APPENDIX 2 – PERSONAL MOVING AND HANDLING PLAN

Personal moving and handling care plan (applied to the record following completion of the NHFT

personal moving and handling assessment template, if indicated.

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Holistic Care plan- Community Beds only (applied to all patients and amended/ personalised

according to assessment outcome)

Moving and Handling Policy HSC010

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