Moving and Handling Policy Version 1 – December 2013

Moving and Handling Policy

If being read as a paper copy, please refer to Trust Intranet to ensure this is the current version

Version / 1
Date issued / 04.12.13
Author / Michael Wright
Equality Impact Assessment / Undertaken – no inequalities highlighted
Consultation / Trust Moving and Handling Advisor
Approved by and date / Trust Health and Safety Committee 04.12.13
Ratified by and date / Integrated Governance Committee 17.12.13
Where available / Health and Safety Handbook on Trust Intranet
Target Audience / All managers and staff
Next review due / December 2015
Responsible for review / Executive Director of Knowledge, Governance and Communications

Lewisham and Greenwich NHS TrustPage 1 of 21

Moving and Handling Policy Version 1 – December 2013

Document Version Control

Version / Date / Author / Status (eg: active/archived) / Comment
1 / 04.12.13 / Health and Safety Manager / Active / First Policy of newly formed Trust. Supersedes policy from both Lewisham Healthcare NHS Trust and South London Healthcare NHS Trust.

Lewisham and Greenwich NHS TrustPage 1 of 21

Moving and Handling Policy Version 1 – December 2013

Contents

Section / Title / Page
1 / Introduction / 5
2 / Purpose and Scope / 5
3 / Duties / 5
4 / Definitions / 8
5 / Risk Assessment Process / 8
6 / Treatment Handling / 10
7 / Bariatric Patients / 10
8 / Specialist Advice / 10
9 / Training / 10
10 / Consultation, Approval and Ratification Process / 12
11 / Review and Revision Arrangements including Version Control / 12
12 / Dissemination and Implementation / 12
13 / Document Control including Archiving Arrangements / 13
14 / Monitoring Compliance With and Effectiveness of this document / 14
15 / References / 15
16 / Associated Documentation / 15
Appendix 1 / List of Task Specific Risk Assessments of Approved Techniques for Clinical and Non-clinical staff (including diagrammatic representation of generic lifting technique) / 16
Appendix 2 / Individual Patient Handling Assessment Form / 18
Appendix 3 / Equality Impact Assessment / 21

Lewisham and Greenwich NHS TrustPage 1 of 21

Moving and Handling Policy Version 1 – December 2013

1.0 Introduction

Unsafe moving and handling is a major cause of workplace injury, occupational disability and ill health. Most moving and handling injuries are cumulative, resulting from poor posture and repetitive load bearing movements rather than being caused by a single event. A high priority must be given to reducing the risks inherent in moving and handling.

2.0Purpose and Scope

Lewisham and Greenwich NHS Trust has accepted its legal responsibilities under the Manual Handling Operations Regulations 1992 as amended by the Health and Safety Miscellaneous Amendments Regulations 2002, and will as far as is reasonably practicable, establish, secure and maintain safe working conditions and practices for employees when undertaking manual handling tasks.

Therefore, as far as is reasonably practicable, the Trust will avoid the need for its employees to undertake any moving and handling operations at work, which involve a risk of them being injured. Where it is not reasonably practicable to avoid such handling operations, a suitable and sufficient risk assessment will be made and appropriate steps taken to reduce the risk of injury to its lowest level, by employing ergonomic principles in identifying risks and adopting preventative measures. Such measures will take account of the Trust’s duty to provide services and the need to protect staff and patients’ health and safety. The measures will also consider the rights and expressed views of patients.

3.0Duties

3.1 Chief Executive / Trust Board ensures:

  • The overall implementation, monitoring and effectiveness of the policy
  • The allocation of resources to provide compliance with the policy
  • That managers are aware of their responsibilities and implement the policy

3.2The Executive Director with responsibility for Health & Safety:

  • Has the delegated authority from the Chief Executive for the operation of this policy
  • Ensures that the Trust Board is advised of the effectiveness of this policy and of any shortfalls in meeting the standards set

3.3Divisional Managers ensure:

  • Resources are provided (including time allowance for staff taking on additional roles) to comply with this policy
  • The policy is distributed within their Division and implemented

3.4Departmental Managers will ensure:

  • This policy and the accompanying procedures are fully implemented in their area and staff are aware of its contents and their duties
  • Where appropriate, task specific Moving and Handling Risk Assessments (Appendix 1) are carried out in their areas of responsibility and to keep a record of any such assessments
  • Individual Patient Handling Assessments (Appendix 2) are completed and the actions identified are followed by staff
  • Measures are identified based on the findings of risk assessments to reduce or remove the risk associated with moving and handling (if possible) in their areas of responsibility
  • Liaison with the Occupational Health Department in cases where moving and handling has been a factor in staff sickness absence to ensure that staff return to work in a manner that is not going to cause further harm
  • Liaison with the Moving and Handling Advisor if specialist moving and handling assessment is required
  • Any adverse incidents associated with moving and handling are reported on the Trust Incident Reporting Form and that any such incidents are investigated and assessments are reviewed as a result
  • Staff receive adequate training, information, instruction and advice relevant to their working activities
  • Suitable equipment for moving and handling operations is provided
  • Adequate staffing levels to carry out safer handling tasks
  • All Bank and Agency Staff confirm receipt of updated manual handling training before commencing work in the department
  • Suitable clothing and footwear is worn by members of staff
  • All moving and handling equipment is cleaned in accordance with Trust Infection Control policy.

3.5All Staff must:

  • Avoid “manually handling’’ a load where there is foreseeable risk of injury
  • Attend moving and handling training as indicated and comply with training and relevant Trust guidance on manual handling as issued periodically
  • Make full and proper use of any system of work provided for their use by the Trust, including the use of moving and handling equipment
  • Wear appropriate clothing and footwear for carrying out their work safely
  • Inform their manager of any change in health status that may affect their moving and handling abilities, or of any personal injury caused by moving and handling
  • Liaise with the Occupational Health Department at the earliest opportunity in relation to changes in their health status and injuries
  • Report any accident, incident or near miss involving moving and handling in accordance with the Trust’s Incident Reporting policy
  • Bring to the attention to their managers, any defective equipment and immediately label and take the equipment out of use
  • Bring to the attention of their manager any work area, practices or procedure they believe to be hazardous to staff, patients and/or visitors.

3.5.1In-Patient handling staff must ensure that:

  • They complete, document, sign and follow Individual Patient Handling Assessments. These Assessment Forms are found in the Nursing Documentation booklet. Any changes in the patient’s condition which is likely to affect how that patient is moved or handled must also be documented.
  • They inform patients as to the reasons for using handling equipment or specific moving or handling techniques prior to the procedure taking place.
  • Relatives are made aware of the risks to themselves if they are involved in the handling of the patient. Relatives must be encouraged to use safe-handling techniques at all times and any advice given to them must be documented.
  • Patients are encouraged to move independently where possible. Consideration should be given to the provision of appropriate equipment and furniture to promote their independence, therefore reducing the number of times staff are required to handle patients.
  • Patients are not manually lifted off the floor. A hoist designed for this task must be used.
  • Patients are no longer manually lifted, whatever their weight (lifting means taking the whole or a large part of the weight of a patient). The exceptions are:
  • unforeseeable emergency situations. Managers should have in place procedures which enable staff to respond to foreseeable emergency situations in a safe manner which minimises any moving and handling risks
  • a unit that cares for babies and small children. These areas should concentrate on avoiding or reducing the risk of injury, based on an Ergonomic Risk Assessments and on the guidelines provided in the reference section of this document.
  • Beds/trolleys needing to be moved must be actively transported by 2 members of

staff. In some instances the number of staff required may need to be increased.

  • For those patients weighing in excess of 127kg/20 stone that require treatment within the hospital, refer to Heavy Patients Guidance (available on the Trust Intranet) and contact the Moving and Handling Advisor for further advice if required.
  • Use of appropriate moving and handling equipment and machinery provided by the employer, in accordance with the training and instruction received the Provision and Use of Work Equipment Regulations and Professional Codes of Practice.

3.6 Out-patient handling staff must ensure that:

  • Any specific patient moving and handling need is assessed and acted on
  • Individual or departmental training needs are identified and appropriate training organised with the Moving and Handling Advisor.

3.7 Community-based staff must ensure that:

  • Any specific patient moving and handling need is assessed and acted on
  • Individual or departmental training needs are identified and appropriate training organised with the Moving and Handling Advisor.

3.8 Health and Safety Department will ensure:

  • The publication, content and up-keep of the policy and it’s availability to all staff
  • Managers are supported in carrying out moving and handling risk assessments
  • Advice and support is given to any member of staff seeking information about moving and handling
  • Management of the provision of a competent moving and handling advice and training service
  • An annual training need analysis and delivery plan is produced.
  • A generic non-clinical risk assessment, which includes manual handling, is completed in each clinical department every year and each non-clinical department every two years.

3.7 Moving and Handling Advisor will:

  • Provide competent advice on the safe and effective management of moving and handling within the Trust
  • Maintain the database of task specific manual handling risk assessments and advise on risk assessment of tasks this does not cover as they arise
  • Manage the provision of moving and handling training for the Trust
  • Audit the effectiveness of this policy
  • Upon referral by Occupational Health, conduct moving and handling assessments of staff members to assess functional capacity.

3.8Occupational Health Service will:

  • Assess employees’ fitness and health, in relation to the individual’s capability to perform job specific moving and handling operations. Such assessments will take place prior to employment in the Trust for new staff, prior to entry into a new post for existing staff, and at any subsequent time that staff may be referred to Occupational Health for absence or musculoskeletal injury.
  • Provide advice to staff referred for musculoskeletal injuries occurring at work.
  • Liaise with the Moving and Handling Advisor and managers when a member of staff would benefit from multidisciplinary action in the management of a musculoskeletal injury/problem or changes to the working practice
  • Provide periodic updates to the Trust Health and Safety Committee on patterns of musculoskeletal injuries in the Trust
  • Refer staff attending Occupational Health following a moving and handling related accident or injury for specialist medical advice as appropriate.

3.9Estates Department will ensure:

  • Liaison with the Moving and Handling Advisor for advice on ergonomic design and reduction of moving and handling risks when new buildings or changes in the design of the existing buildings are being considered
  • Annual servicing and six monthly inspections of hoists and other mechanical lifting equipment.
  • Maintenance of a database of hoists and other mechanical lifting equipment including information on maintenance history
  • Line managers are notified of any adverse conditions identified by engineers during inspection/maintenance of lifting equipment
  • Beds and other mechanical patient handling equipment are maintained in accordance with Provision and Use of Work Equipment Regulations (PUWER) 1998

4.0Definitions

Moving and Handling – is the transporting or supporting of a load by hand or bodily force including lifting, putting down, pushing, pulling, carrying and/or moving. For the purpose of this policy the term manual handling may also be used.

Ergonomics – is the study of people in their environment. It aims to fit the job to suit the person by designing tasks, adapting loads and changing the environment.

5.0Risk Assessment Processes

The risk assessment process for the Trust will comprise the:

  • identification of hazards and deciding who might be at risk
  • evaluation of risk and action planning to implement control measures
  • regular review

5.1Task Specific Risk Assessments for Approved techniques for clinical and non-clinical moving and handling

The approved skills and techniques for clinical and non-clinical staff have been identified and are listed in Appendix 1.Task specific risk assessments have been completed for each technique and are accessible via the Health and Safety Handbook on the Trust Intranet.

Diagrammatic representation for the 2 most commonly used load handling techniques is included.

Any technique that is not identified on the list in Appendix 1 must be discussed with the Moving and Handling Advisor and a task specific risk assessment will be developed.

5.1.1Handbook of Transfers

Each ward will hold a physical copy of the ‘Handbook of Transfers.’ This will allow staff to access diagrammatic and written details of the full range of approved techniques for the moving and handling of patients. Further copies of the ‘Handbook of Transfers’ can be obtained by contacting the Health and Safety Department on 6101.

5.1.2Getting to Grips with Manual Handling

Each ward and department will have available the HSE Guidance booklet entitled ‘Getting to Grips with Manual Handling INDG143’. This will be available in the Health and Safety Handbook on the Trust Intranet.

5.2Individual Patient Handling Assessment (IPHA) (Appendix 2)

To protect patient and staff, Individual Patient Handling Assessments must be completed for each patient upon arrival and an action plan recorded. The assessments are designed to allow nursing staff to safely manage the moving and handling requirements of patients during the whole of their time at the hospital.

IPHA’s are include in the Nursing Documentation booklet and should be regularly reviewed and the action plans updated if a patient’s moving and handling needs change.

5.3Generic Non-clinical Risk Assessment

Manual Handling is included as part of the Generic Non-clinical Risk Assessment completed in each clinical department every year and each non-clinical department every two years. This assessment is completed by the Ward/departmental manager in partnership with the health and safety department.

5.4 Evaluation of risk and control measures

Where actual or potential violence and abuse hazards are identified the actions necessary will be identified. This will ensure that, when necessary, moving and handling risks can easily feed the local and corporate risk register and therefore be assessed and analysed in conjunction with the other risks, both clinical and non-clinical highlighted within the Trust.

6.0Treatment handling

6.1Treatment Handling is defined as guiding, facilitating, manipulating, stretching or providing resistance. Thus any treatment where force is applied through any part of the therapist’s body to or from any part of the patient constitutes manual handling. Any manual handling involved in a physiotherapy treatment programme may be defined as treatment handling. (CSP 2008). This definition can apply to other health care professionals in particular Occupational Therapists.

6.2The Trust acknowledges the potential conflict between the objectives of progressing the patients’ rehabilitation programme and minimising manual handling risk, especially to physiotherapy and occupational therapy staff. However, The Trust is committed to reducing the risk to such staff to a minimum. In all events such programmes will be based on risk assessments, which will consider:

  • Use of appropriate equipment to reduce risk of injury
  • Patients’ current abilities/disabilities and rehabilitation potential
  • Benefits of such intervention to the patient
  • Number of therapists required
  • Competence/skill level of staff
  • Stability of the patient’s condition
  • Proximity of the supervising therapist

6.3The Trust agrees in principle that no professional can dictate to members of another profession how they must handle a patient. Therefore manual handling of rehabilitation patients involving multiple occupational groups will be effectively coordinated through a multidisciplinary approach to risk assessment, which recognises the unique competencies of each occupational group.

7.0 Bariatric Patients

An adult patient weighing more than 20 stone (127kgs) may require a bed, chair and other equipment to meet their particular needs. These needs should be identified as soon as possible after admission (or before arrival if able) and the appropriate equipment sourced.

At Lewisham Hospital specialist equipment (beds, hoists, slings, chairs, commode) for heavier patients can be accessed via the Bariatric Equipment Store on the 4th Floor of Riverside. Any staff member removing equipment form this store is responsible for recording on the wall chart where the equipment is being used. The ward or departmental manager is responsible for returning the equipment to the store post-use in a clean and well-maintained state.

At Queen Elizabeth Hospital specialist equipment can be hired from Arjo-Huntleigh.

8.0Specialist advice