POLICY STATEMENT 10076

Domiciliary Care: Requests for Two Carers for Moving and Handling

v1.0 2010-09-10

WARNING ! PLEASE NOTE IF THE REVIEW DATE SHOWN BELOW HAS PASSED THIS

DOCUMENT MAY NO LONGER BE CURRENT AND YOU SHOULD CHECK THE E-LIBRARY FOR THE MOST UP TO DATE VERSION

THIS POLICY STATEMENT APPLIES IN THE FOLLOWING DIRECTORATES/UNIT(S)

• Adult Social Care Including Cumbria Care THIS POLICY STATEMENT AFFECTS THE FOLLOWING GROUPS OF STAFF AND / OR OTHERS:

• Social Workers, Occupational Therapists, Rehabilitation Officers for Visual Impairment

• Cumbria Care Staff • Care Agency Staff

THIS POLICY STATEMENT IS DESIGNED TO ACHIEVE THE FOLLOWING OUTCOMES:

• The Manual Handling Operations Regulations (1992) • Domiciliary Care - National Minimum Standards. (2000)

APPROVAL AND REVIEW

Date of Next Review: 10 March 2011

Last Approved By: (Assistant Director) Judith Whittam

Date Originally Published: 10 September 2010

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RELATED DOCUMENTS

3P POLICY STATEMENT (include document number)

10000 Document Hierarchy

3P PROCEDURES (include document number)

20110 Domiciliary Care: Requests for Two Carers for Moving and Handling

3P PRACTICE GUIDELINES (include document number)

OTHER NON-3P DOCUMENTS (Cumbria CC and external)

LEGISLATION OR OTHER STATUTORY REGULATIONS

APPENDICES ATTACHED (these will be read-only in the E library)

DOCUMENTS SUPERSEDED BY THIS PRACTICE GUIDELINE

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EQUALITY IMPACT ASSESSMENT

Which EIA(s) covers this policy statement? (You will need to double click on the box and select Checked under Default Value)

EIAs for Adult Social Care can be accessed via the Equality Toolkit on the E - Library Home Page

Commissioning Strategy for Older Adults

Community Meals

Prevention

Residential Care / Respite Care / Day Care and Cumbria Care

Self Directed Support

Short Term Interventions

Transforming Community Equipment

Other – please specify: Under Development Please contact your relevant Equality Officer (refer to Section 1.6 of Procedure 20001) if there is no existing relevant EIA or for guidance.

N/A Are any of the existing issues identified in the EIA(s) relevant to this 3P?

If yes, please list the action number(s)

N/A Are there any new equalities issues raised by this 3P? If Yes please notify your relevant Equality Officer so this can

feed into the next EIA review.

CONSULTATION

The following people or groups have been consulted about this Policy Statement

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POLICY STATEMENT The Moving and Handling policy currently in place is documented in Safety Procedure 19, reviewed October 2006. This has been implemented between Adult Social Care, Children’s Services and Cumbria Care. Manual Handling legislation focuses attention on the reduction of and prevention of back pain and lifting related injuries which are important causes of suffering, absence from work and permanent disability. The Manual Handling Operations Regulations (1992) do not prohibit all manual handling. There needs to be a balance in approach to ensure that:

• Care workers are not required to perform tasks that put them and clients at risk unreasonably;

• Clients’ personal wishes on mobility assistance are respected wherever possible; and

• Clients’ independence and autonomy is supported as fully as possible. (*1) Blanket policies around lifting are likely to be unlawful as such policies would pre judge the out come of assessments (A&B, X&Y v East Sussex County Council, 2003). This would rule out policies that insist on two carers for certain tasks or the rigid interpretation of no lifting. The emphasis is to respond to moving and handling situations with an individual assessment that considers risks in relation to the:

• Task • Individual capabilities of the handler • Load • Environment (*2)

This risk assessment should form the basis of a risk management plan. It needs to be user focussed, taking account of dignity, quality of life and lifestyle and built into the design of any care intervention. This approach is also emphasised in the Domiciliary care- National Minimum Care Standards (*3) Standard 2 of the National Minimum Care Standards outlines the requirement for service users to have an assessment of their needs prior to the provision of a domiciliary care service, by a person trained to do so. This would include consideration of their needs in relation to moving and handling. A registered person must make sure that a ‘separate moving and handling risk assessment is undertaken by a member of staff who is trained for the purpose, whenever the staff are required to help a user with any manual handling task…’ (DH, 2000, 12.4). This should take place before the care package commences. A risk management plan must be implemented, documented and reviewed at least annually. Only staff who are both trained to undertake risk assessments and competent to provide the care are to be assigned to emergency situations where pressure of time has not allowed a risk assessment to be completed prior to the provision of care. (DH, 2000, 12.7) As a general principle Local Authorities should avoid laying down health and safety policies of individual DP recipients (*4) however they should consider intervening if serious risks are seen to arise (*2). Self employed people have duty to conduct their undertaking in such a way as to ensure that as far as reasonably practicable, other people who may be affected are not exposed to risk to their health and safety (*5). They must not therefore place themselves, service users or carers at risk.

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Local Authorities have a duty to ensure that a suitable and sufficient assessment of risks to the health and safety of non-employees arising from or connected with the employee’s undertaking is undertaken (*5). This and a duty to consider carers needs means that risk assessments should be undertaken giving consideration to informal carers involved in moving and handling. Situations resulting in requests for two carers: (This is not intended as a complete list but examples of typical examples) Presenting Problem Options to consider Multiple simultaneous tasks- e.g. supporting a person whilst adjusting clothing/ cleansing etc

Task analysis may identify equipment that can be utilised to provide support and hence a safe method of work whilst care is undertaken. This may result in provision of a Stand-aid hoist for toileting or the use of grabrails or positioning rolls to maintain position during care tasks.

Manoeuvring mobile hoists.

The use of mobile hoists should be regarded as a short-term solution pending installation of ceiling track hoists which are less labour intensive and more comfortable for the service user.

Where ceiling track hoist is inappropriate- this may be due to environmental factors or due to provision of palliative care.

Consideration should be given to the use of gantry hoists available through ICES.

Difficulty applying slings. This may be due to issues around:

• Larger people • Moulded seating • Comprehension • Challenging

behaviour • Involuntary

movement

Consider: • Use of appropriate techniques to insert and remove

slings. • Use of slide sheets to apply slings. • Appropriate sling selection: fabric /style/ size. • Provision of appropriate seating i.e. removable arms/

size/ manoeuvrability support. • The need for specialist support i.e. Continuing

Healthcare funding.

Requirement to move someone without the use of equipment due to pain or management of spasms

Risk assessment needs to be completed with Health professionals. It is likely that these care needs would qualify for Continuing Healthcare funding.

Therapeutic handling- i.e. where staff have received training and are monitored by a health professional.

Rehabilitation costs should be met by Health. Continuing Healthcare funding should be sought if carers are undertaking tasks requiring training and monitoring from Health Professionals.

Service user choice i.e. when preference is not to alter the environment or to use equipment

Alternative approaches must be considered with the service users and their families. Clinical reasoning may suggest alternative techniques however overall costs must remain within allocated resources. Resistance to change is no excuse for allowing unsafe working practices.

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*1 HSE. (2001) Handling home care: Achieving safe, efficient and positive outcomes for care workers and clients. HSE Books. *2 Smith; J. (Ed) (2005) The Guide to the Handling of People. 5th Ed. Middlesex: Backcare. *3 DH. (2000) Domiciliary Care- National Minimum Standards. http://www.dh.gov.uk *4 DH. (2003) Direct Payments Guidance. London. DH. *5 Mandelstam, M. (2005) Community Care Practice and the Law. Third Ed. London: JKP.

DOCUMENT CHANGE HISTORY

Version

No Date Issued by Reason for change

v1.0 2010-09-10 Amanda Evans N/A – first 3P issue.

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