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Lone Working Policy

Guidance Document

Reference: H&S/EX MWC

Title: Health & Safety Guidance For Lone Working

Date: December 2017

Version: 5

Approved by: Health and Safety Committee

Author: H&S Manager /Occupational Health Nurse Manager

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CONTENTS

Paragraph Title Page

1. Introduction and Scope

2. Definitions and Terms

3. Hazards Associated With Lone Working

4. Recommended Requirements for Lone Working

5. Requirements for Risk Assessments

6. Reporting Incidents

7. Training Requirements

8. Applicable Legislation and Basic Guidance

Appendix 1 Check List for Managers

Appendix 2 Check List for Staff

Appendix 3 Health and Safety Assessment Template Form for Assessing Lone Working

Appendix 4 Health And Safety Assessment Template For Assessing Lone Working

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1. INTRODUCTION AND SCOPE

1.1 Sherwood Forest Hospitals NHS Foundation Trust (known as the Trust) has statutory obligations under the Health and Safety at Work Act to ensure a safe working environment for its employees as well as a duty of care to minimise the risk of violence and aggression against them by: a) Providing a working environment which, as far as is reasonably practicable, reduces the personal risks of lone working b) Implement a proactive approach to risk assessment to identify where risks need to be controlled c) Provide guidance to management and staff on implementing adequate control measures for lone working d) Provide a system of reporting violent incidents and support for victims 1.2 All staff, whether or not involved in the direct delivery of care, may from time to time find themselves in situations where they are working alone and without the immediate support of colleagues. This may be away from an NHS base, for example in a patient’s home, or within the normal workplace or other healthcare premises. Each team or service should have local arrangements in place to minimise the risk to staff in these circumstances. The purpose of this Guidance is to ensure the safety of lone workers and emphasise the need for appropriate risk assessment, clarify responsibilities and describe some of the steps that can be taken to minimise risk and maximise personal safety. 1.3 This Guidance applies to all staff including temporary and agency staff, contractors, volunteers, students and those on work experience. It forms an integral part of the Trusts Health and Safety policy and applies along with specific local guidance on Lone working.

2 DEFINITIONS OF TERMS USED

2.1The trust’: means the Sherwood Forest Hospitals Trust.

2.2 Staff ‘: means all employees of the trust including those managed by a third party

organisation on behalf of the trust.

2.3 NHS defines lone workers as:

Any situation or location, in which someone works without a colleague nearby; or when

someone is working out of sight or earshot of another colleague.

This could be outside of the hospital or internally, where staff care for patients or service

users on their own including community or outreach workers. Lone Working may be a

constituent part of a person’s usual job or it could occur on an infrequent basis, as and

when circumstances dictate. Lone working is not unique to any particular groups of staff,

working environment or time of day.

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3.4 The Health and Safety Executive (HSE) defines lone workers as:

‘Those who work by themselves without close or direct supervision’.

3. HAZARDS ASSOCIATED WITH LONE WORKING

Some examples of hazards facing lone workers are: Fire Violence and personal safety issues Pets Moving and handling tasks

High risk activities may include:

Undertaking work in isolated areas Undertaking work within known high-risk areas Working/visiting patients in their own home Working alone at base Working alone with people with known risk factors violence or mental health etc. Times when staff are carrying medication, equipment or valuables Times when employees are travelling between site/homes/offices Times when employees are handling cash and/or banking

Managing the risks

The risk which lone workers face should be reduced to the lowest level that is reasonably practicable. Using safe systems of work depends largely on local circumstances, and local procedures or protocols should be in place that provide specific guidance for staff in relation to lone working and associated risk reduction. Issues to consider in developing safe systems of work include:

Joint working with others for high-risk activities; Improvements to security arrangements in buildings; Security lighting in parking areas Using checking-in and monitoring systems; Communication systems for sharing information on risk with colleagues in other

disciplines and agencies’ Using personal protective equipment or mobile phones and personal alarms Having emergency equipment that maybe required, such as, for example, a torch, map

of the local area, telephone numbers for emergences, including “AA recovery”, hospital security and the police, or mobile phone chargers.

4. RECOMMENDED REQUIREMENTS FOR LONE WORKING

The “Buddy System” for all lone working It is essential that Lone Workers keep in contact with colleagues and ensure that they make another colleague aware of their movements. This can be done by implementing a ‘Buddy System’ To operate a ‘Buddy System’ a Lone Worker must nominate a ‘buddy’. This is a person who is nominated contact for the period in which they will be working alone.

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The nominated ‘buddy; will:

Be fully aware of the movements of the Lone Worker. Have all the necessary contact details for the Lone Worker, including personal contact

details, such as next of kin. Have details of the Lone Worker’s known breaks or rest periods. Attempt to contact the Lone Worker, if they do not contact the ‘buddy’ as agreed. Follow the agreed escalation procedure for alerting their senior manager if working on

site or their senior manager and the Police, if the Lone Worker cannot be contacted, or they fail to contact their ‘buddy’ within agreed and reasonable timescales.

Essential to the effective operation of the ‘Buddy System’ are the following factors:

The ‘buddy’ must be made aware that they have been nominated and what the procedures and requirement for their role are

Contingency arrangements should be in place for someone else to take over the role of the ‘buddy’ in case the nominated person is called away to a meeting, for example.

There must be procedures in place to allow someone else to take over the role of the ‘buddy’ if the lone working situation extends past the end of the nominated person’s normal working day or shift.

When working off site reporting/logging of visits

Lone Workers should always ensure that someone else (a Manager or Appropriate Colleague) are aware of their movements. This includes providing them with the full address of where they are working, the details of the person/s with whom they will be working or visiting, telephone numbers if known and indications of how long they expect to be at those locations. (Both arrival and departure time)

Lone Workers should also leave a written visiting list containing these details with their manager and colleague(s). This information must be kept confidential and must not be left in places where those who do not need to have this information, or members of the public can access it.

A visit log that is left with their manager or colleague(s) should be completed and maintained by Lone Workers.

Arrangements should be in place to ensure that if colleague(s), with whom details have been left, leave for some reason, they will pass the details on to another colleague who will check that the Lone Worker arrives back at their office/base or has safely completed their duties.

Details of vehicles used by Lone Workers should also be left with a colleague, for example, registration number, make, model, and colour.

Procedures derived from the risk assessment process should also be in place to ensure that the Lone Worker is in regular contact with their manager or relevant colleague, particularly if they are delayed or have to cancel the appointment.

Where there is a genuine concern, as a result of a Lone Worker failing to attend a visit, or an arranged meeting, within an agreed time, the manager should utilise the information provided in the log to help track the Lone Worker and ascertain whether or not they turned up for previous appointments that day. Depending on the circumstances and whether contact through normal means (mobile phones, pager etc.) can or cannot be made, the manager or colleague should involve the Police if necessary. It is important that matters are dealt with quickly, after consideration of all the available facts, where it is thought that the Lone Worker may be at risk. If Police involvement is

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needed, they should be given full access to information held and personnel who may hold it, if that information contains data that might help trace the Lone Worker and provide a fuller assessment of any risks they may be facing.

It is important that contact and appointment arrangements, once in place, are adhered to. Many procedures, such as this fail simply because staff forget to make the necessary call when they finish their shift. The result is unnecessary escalation and expense, which undermines the integrity of the process.

The log should be developed and implemented by the individual’s relevant department to suit their specific needs.

Risk assessment prior to a visit

Consideration should be given to include, as part of a Lone Workers job description, a requirement that they should inform their manager or ‘buddy’ if they have to make a visit to an address or person on that log;

Such information should, where legally permissible, be communicated with other agencies who may work with the same patients/service users, as part of an overall local risk management process;

Colleagues, who have worked alone in the same location, or with the persons/patients/service users before, should be contacted to help communication about any particular risks and inform action taken to minimise them

If there are known risks with a particular location or patients/service users, Lone Workers and their manager should reschedule this visit to a particular time, place or location where they can be accompanied

The time of day and day of the week for visits should be varied (if visits are frequent) to avoid becoming a target

Lone Workers should remain alert to risks presented from those who are under the influence of drink, drugs, are confused, or where animals may be present.

Being alert to these warning signs will allow the Lone Worker to consider all the facts at their disposal, allowing them to make a personal risk assessment and, therefore, a judgement as to their best possible course of action, for example, to continue with their work, or to withdraw. At no point should the Lone Worker place themselves, their colleagues, or their patients/service users at risk or in actual danger.

If a Lone Worker has been given protective equipment, such as mobile phone or similar device. They must ensure that the mobile phone is in full working order and they have appropriate guidance in the use of the equipment with them, and that they use it before entering into a situation, where they have prior knowledge of risk or, at that point in time, consider themselves to be at risk.

It is essential that Lone Workers remain alert throughout the visit or the work that they undertaking and ensure that they are aware of entrances and exits, in the event of an emergency. If a violent situation develops, then staff should immediately terminate the visit and leave the location.

High risk visits

Where there is a history of violence, including those who are identified through the Violent patient Scheme and/or the patient/service user location is considered high risk, the Lone Worker must be accompanied by: a colleague, or in some cases, by the Police.

Where possible, the visit should take place at a neutral location or within a secure environment.

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In certain cases, a visit may not be appropriate unless there is a clinical need. During visits

Lone Workers should be prepared and fully briefed, having concluded a necessary and appropriate risk assessment with their manager ahead of their visits, where appropriate risks have been identified. They should remove from view ID badges but should carry the ID badge and be prepared to identify themselves.

Lone workers should carry out a “dynamic” risk assessment when they first arrive at the house and the front door is opened. If they feel there is a risk of harm to themselves, they should have an excuse ready not to enter the house and to arrange for an alternative appointment. They should also be aware of animals in the house and ask for them to be removed, prior to entry. (The importance of dynamic assessment is that it enables lone workers to anticipate and recognise the early warning signs of suspected risks and enables safe early interventions to minimise or negate the risk to themselves and others. It recognises that situations change rapidly as do associated risks and that dynamic risk assessment should be an ongoing process).

Lone workers should ensure that, when they enter the house, they shut the front door behind them and make themselves familiar with the door lock, in case they need to make an emergency exit.

Lone Workers should try not to walk in front of a patient/service user. They should not position themselves in a corner or in a situation where it may be difficult to escape.

Lone Workers should remain calm and focused at all times and keep their possessions close to them.

Lone Workers should be aware of their own body language (as well as the body language of the client or patient/service user), as there is the potential risk of exacerbating the situation by sending out the wrong signals, particularly where there may be cultural, gender or physical issues to consider. Body language or other forms of non-verbal communication and mannerisms, plays an important role in how people perceive and behave towards other people. Specific training in non-physical intervention skills, customer service, and de-escalation is essential and Lone Workers must be trained in Conflict Resolution, with additional training provided over and above this, depending on the risks they face and their own personal needs.

Escorting Patients / Service users

Where there are known risks, or identified potentials risks, about a patient/service user or a location to be visited, a full assessment of those risks should be made ahead of the Lone Worker making that visit, along with taking appropriate action to minimise those risks.

Where there are known risks, the patient or service user should be looked after by a member of staff who is not the driver, so that the patient/service user’s needs, can be catered for and the driver is allowed to concentrate on driving the vehicle safely. There have been reported incidents of passengers grabbing at handbrakes and steering wheels while the member of staff is driving.

The Lone Worker should ensure that they are suitably insured for this business purpose, before patients/service users are transported in this manner.

Consideration should be given to the most appropriate mode of transport, based on such risk assessments. It may not be appropriate for the Lone Worker to drive, unless in an emergency, and alternative arrangements may need to be made.

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If escorting a patient/service user by car, Lone Workers should always seat the Patient/Service user behind the passenger seat and ensure that their seat belt is fastened.

Lone Workers should not escort a patient/service user by car if there are any doubts about their safety in doing so, nor should they agree to transport Patient/Service user’s animals.

If a conflict arises (or Patient/Service user becomes aggressive) while the Lone Worker is driving they should pull over into a safe place and exit the vehicle, ensuring that the keys are removed. They should follow local procedures in place, which may involve calling the Police, their Manager, a Colleague, or their ‘buddy’.

Lone working and vehicles (other than escorting Patient/Service users – guidance information)

Before setting out, Lone Workers should ensure that they have adequate fuel for their journey.

They should give themselves enough time for the journey to avoid rushing or taking risks, owing to time pressure.

Items such as bags, cases, CDs, or other equipment, should never be left visible in the car. These should be out of sight, preferably stored in the boot of the vehicle.

Lone Workers should always hold the vehicle keys in their hand when leaving premises, in order to avoid looking for them outside, which could compromise their personal safety.

The inside and outside of the vehicle should be checked for possible intruders before entering.

Once inside the vehicle all doors should be locked, especially when travelling at slow speed, when stopped at traffic lights and when travelling in built-up areas.

Some staff may understandably feel that a Locked door may prevent them from escaping or receiving help in the event of an accident. However, modern vehicles and rescue techniques make this less of a factor than it may seem.

Lone Workers should always try to park close to the location that they are visiting and should never take short cuts to save time. At night or in poor weather conditions, they should park in a well-lit area and facing the direction in which they will leave. They should ensure that all the vehicle’s windows are closed and the doors are locked

Lone Workers should avoid parking on the driveway of the person they are visiting. The Health and Safety Executives safe driver training programmes advise that Lone Workers should reverse into car parking spaces so that, if attacked, the door acts as a barrier.

Lone Workers driving alone: especially after dark, should not stop even for people who may be in distress or requiring help. The Lone Worker should stop in a safe place, as soon as it is practicable to do so, and contact the emergency services as appropriate.

If followed, or if in doubt as to whether they are being followed, Lone Workers should drive to the nearest Police station or manned and lit building, such as a petrol station, to request assistance.

In case of vehicle breakdown, Lone Workers should contact their manager, colleague or ‘buddy’ immediately. If using a mobile phone and the signal is poor, or there is no signal at all, they should put their hazard lights on. If they need to leave the vehicle to use an emergency telephone, they should lock their vehicle and ensure that they are visible to passing traffic.

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They should not display signs such as “Doctor on call” or “Nurse on call” as this may encourage thieves to break in to the vehicle to steal drugs, for example.

Lone Workers should avoid having items in their vehicle that contain personal details, such as their home address.

Lone working - travelling by foot

Lone Workers should walk briskly, if possible and physically able to so, and not stop in areas that are unknown to them, for example, to look at a map or to ask for directions. They should go into a ‘safe’ establishment, such as a Police station, petrol station or reputable shop and ask for directions or, if necessary, to call for assistance from their Manager, Colleague or ‘Buddy’.

They should avoid using mobile phones overtly in any area (they should make a note of the SIM number for the phone in case of theft) and, if carrying equipment, should ensure that this is done using bags or holdalls that do not advertise what they are carrying.

If someone attempts to steal what they are carrying, they should relinquish the property immediately without challenge. They should consider keeping their house keys and mobile phone separately from their handbag or having an old purse/wallet with petty cash and expired credit cards. It is important that any theft, or attempted theft: is reported both internally and to the Police, as soon as is practicable and safe to do so. The Lone Worker should make a note of the date, time and descriptions of events and the attacker(s), as soon as they are in a position to do so and retain it safely until it is requested by the Police or Local Security Management Specialist (Security Manager).

They should stay in the centre of the footpath facing oncoming traffic. They should be aware of the location and remain alert to people around them. They should avoid waste ground, isolated pathways, and subways, particularly at night.

Dealing with animals

If there is a known problem with animals at a particular address or Location, the occupants should be contacted and requested to remove or secure the animals before arrival. Clinical procedures may provoke a reaction from an animal or pet, so it may be prudent to request that it be removed or placed in a different room for the duration of the visit.

If a Lone Worker is confronted by an aggressive animal on a first visit to a Patient/Service user’s address, they should not put themselves at risk. If necessary, they should abandon the visit and report the incident in accordance with local reporting procedures.

If a Lone Worker feels uneasy with animals being present, they should politely request that they be removed, bearing in mind that this could provoke a negative reaction. All possible efforts should be made to ensure that the situation is managed and de-escalated, should hostility become evident. If this is not possible, then alternative arrangements should be made to carry out the visit, such as rescheduling so that the Lone Worker can be accompanied or asking a colleague - more at ease with animals - to assist them.

Handy Hints for Staff to use when travelling

Know where you are going and carry maps to cover your area of travel Make sure that a responsible person at your base knows where you are going and in

what order

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Make sure that a responsible person at your base knows the details of your car – make, registration number and colour

Make sure that a responsible person at your base knows your mobile phone number if you have one

Consider having the following items in your car: a torch (check battery and bulb regularly), a blanket, drinking water (hot flask in extremes of cold weather), a warning triangle, pen and notebook in case of accident

Mobile telephone Allow plenty of time for your journey Drive carefully to avoid road rage incidents Keep doors locked whilst in slow moving traffic, especially if you do not know the area Keep windows and sunroofs closed whilst stationary or in slow moving traffic Do not keep your handbag or any other goods on the passenger seat Do not keep items with your address on in your car Hide all equipment in the boot of your car Remove ID badge from view. Park as near to the premises you are visiting/working at as much as possible Park under a lamp or in a well lit area, preferably facing the direction you will need to

leave in Be aware of the nearest place of safety (e.g. police station, shops, petrol station) If approached by a stranger do not open a window or door. Drive away and sound horn

if threatened or trapped. Beware of those handing out leaflets or asking for directions Glance round before unlocking and opening the car door Lock the car door and make your way to the premises you are attending avoiding

subways, alleys and open land as far as possible If you find the car unlocked or open DO NOT get in. If safe to do so, check if anyone is

in the car, otherwise leave and get help When leaving the premises have your car keys ready in your hand. Keep house and car

keys separate On approaching your car be aware of persons hovering nearby and consider walking on

to a safe area (e.g. a shop) Be alert at petrol stations, car parks road junctions and traffic lights where car jackers

look for targets Allow room to manoeuvre between yourself and the car in front, especially at traffic

lights and road junctions If an unmarked car attempts to stop you and you are unsure whether it is a police

officer, signal that you intend to drive to the local police station or somewhere else where you will feel safe

If someone asks for assistance (e.g. broken down vehicle) do not get out. Go to a safe location and call the police

5. REQUIREMENTS FOR RISK ASSESSMENTS

The key to risk assessment is to identify hazards, understand how and why incidents occur in lone working situations and learn from that understanding to make improvements to controls and systems to reduce the risk to the employee. To achieve this, the following factors should be considered and documented:

type of incident risk (e.g. physical assault/theft of property or equipment)

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frequency/likelihood of incident occurring and having an impact on individuals, resources and delivery of patient care

severity of the incident: cost to the healthcare organisation in human and financial terms confidence that the necessary control measures are in place or improvements are being

made the level of concern and rated risk what action needs to be taken to ensure that improvements are made and risks

reduced. If staff work from a variety of locations, a written log may be difficult to implement and maintain. Where this is in place, consideration should be given to placing it in a secure location that is only accessible to managers and lone workers – for example, on the Trusts intranet.

Dynamic risk assessment During a lone working visit or a site visit, a dynamic risk assessment focuses on reducing the prevalence of a problem. This is done by minimising known or suspected risk factors and by early intervention (when violence is perceived to be imminent, while it is occurring or immediately post-incident). A dynamic risk assessment can be defined as a continuous process of identifying hazards and the risk of them causing harm, and taking steps to eliminate or reduce them in the rapidly changing circumstances of an incident. The dynamic risk assessment involves staff:

being alert to warning signs as covered in conflict resolution training carrying out a ‘10-second risk assessment’; if staff feel there is a risk of harm to

themselves, they should leave immediately placing themselves in a position to make a good escape, i.e. where possible, being the

closest to an exit being aware of all entrances and exits being aware of the positioning of items, including those belonging to the lone worker

(scissors, scalpels, etc), that could be used as a weapon making a judgment as to the best possible course of action – for example, whether to

continue working or withdraw utilising appropriate physical security measures (e.g. triggering panic buttons to call

assistance from staff nearby/security/the police or using a lone worker device to raise an alarm)

ensuring that when they enter a confined area or room, they can operate the door lock in case they need to make an emergency exit

avoiding walking in front of a patient/service user, and not positioning themselves in a corner or in a situation where it may be difficult to escape

remaining calm and focused during an incident in order to make rational judgments being aware of their body language (as well as that of the patient/service user), as there

is a risk of exacerbating the situation.

6. REPORTING INCIDENTS

Staff will be encouraged and supported by the Trust (and in particular by their line manager) to report all incidents of physical and non-physical assault to the LSMS, using the organisation’s incident report form. This will enable the LSMS to conduct a thorough investigation and to ensure that all appropriate cases of physical assault are reported to the police as soon as possible for appropriate action to be taken.

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7. TRAINING REQUIREMENTS

It is essential that staff are given the appropriate training in identifying, preventing, managing and de-escalating potentially violent situations. This must be done within a legal and ethical framework where the rights and needs of the patient/service user are balanced against the rights and safety of lone workers. Lone workers should be given the necessary training and awareness to enable them to carry out their duties in a positive, confident and caring manner. In all situations, they should try to attend to the needs of the individual involved and recognise their particular sensitivities and concerns. As a key preventative measure to tackle violence against NHS staff and to ensure that staff and professionals are given the necessary skills to be able to recognise, de-escalate and manage potentially violent situations, a national syllabus in conflict resolution training for the NHS was introduced in 2004. A separate syllabus, specially adapted for mental health and learning disability settings, was introduced in 2005 and training standards for ambulance settings were introduced in 2007. Conflict resolution training should be delivered to meet the needs of lone workers and should include modules covering risk assessment, de-escalation techniques and post-incident support. The training should also be scenario-based specifically for lone workers. Ensuring that NHS staff and professionals receive appropriate training in risk assessment is a key element in building skills for dealing with lone working. Such training can raise awareness and encourage the sharing of information about identified risks that they and their colleagues may face. Training should be delivered for any specific equipment or devices that may be issued to lone workers. This should include scenarios which are likely to be encountered when lone workers are equipped with devices and with support services fully in place. A training needs analysis (TNA) should be undertaken by the relevant staff. This should determine which lone working staff in the organisation require training, who should be prioritised for training and in which subject, and how often this training is to be refreshed. Subject areas which may be included within the TNA are:

training in disengagement techniques training on health and safety encompassing employee responsibilities cultural awareness, diversity and racial equality training specific equipment training, including lone worker protection devices conducting a risk assessment first aid training.

All lone working staff should be appropriately trained so that they are both aware and mindful of cultural issues (e.g. gender issues) and can manage behaviour before entering a lone working situation. This will ensure that lone workers do not add to or exacerbate the risks faced in a lone working situation.

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8. APPLICABLE LEGISLATION AND BASIC GUIDANCE

Secretary of State Directions NHS healthcare organisations have responsibilities to manage security, which includes the protection of lone workers in accordance with the Directions to health bodies on measures to deal with violence against NHS staff and Directions to health bodies on security management measures, 2003 and 2004 respectively and as amended 2006. Health and Safety at Work Act 1974 NHS healthcare organisations have responsibilities under the Health and Safety at Work Act 1974, particularly in relation to employers ensuring, as far as is reasonably practicable, the health, safety and welfare of employees at work. Employers should have written policies setting out their arrangements for managing health and safety risks. These policies should be publicised and easily accessible to staff. The Management of Health and Safety at Work Regulations 1999 These regulations require employers to assess risks to employees and non-employees and make arrangements for effective planning, organisation, control, monitoring and review of health and safety risks. Where appropriate, employers must assess the risks of violence to employees and, if necessary, put in place control measures to protect them. Safety Representatives and Safety Committees Regulations 1977 (a) and The Health and Safety (Consultation with Employees) Regulations 1996 (b) Employers must inform, and consult with, employees in good time on matters relating to their health and safety. Employee representatives, either appointed by recognised trade unions under (a) or elected under (b) may make representations to their employer on matters affecting the health and safety of those they represent. The Corporate Manslaughter and Corporate Homicide Act 2007 This came into force in April 2008. This legislation creates a new offence under which an organisation (rather than any individual) can be prosecuted and face an unlimited fine, particularly if an organisation is in gross breach of health and safety standards and the duty of care owed to the deceased.

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APPENDIX 1

CHECK LIST FOR MANAGERS

Are your staff – 1. Issued with all relevant policies and procedures relating to lone working staff? 2. Trained in appropriate strategies for the prevention and management of violence (in particular, have they received conflict resolution training)? 3. Given all information about the potential risks for aggression and violence in relation to patients/service users and the appropriate measures needed to control these risks? 4. Issued with appropriate safety equipment and the procedures for maintaining such equipment? 5. Trained to be able to confidently use a device and familiar with the support service systems in place before being issued with it? 6. Aware of how to report an incident and of the need to report all incidents when they occur? 7. Issued with the necessary contacts for post-incident support? Are they – 8. Aware of the importance of doing proper planning before a visit, being aware of the risks and doing all they can to ensure their own safety in advance of a visit? 9. Aware of the importance of leaving an itinerary of movements with their line manager and/or appropriate colleagues? 10. Aware of the need to keep in regular contact with appropriate colleagues and, where relevant, their nominated ‘buddy’? 11. Aware of the need to carry out continual dynamic risk assessments during a visit and take an appropriate course of action? 12. Aware of how to obtain support and advice from management in and outside of normal working hours? 13. Aware that they should never put themselves or colleagues in any danger and if they feel threatened should withdraw immediately? Do they – 14. Appreciate the organisation’s commitment to and support for the protection of lone workers and the measures that have been put in place to protect them? 15. Appreciate that they have their own responsibilities for their own safety? 16. Appreciate the circumstances under which visits should be terminated? 17. Appreciate the requirements for reporting incidents of aggression and violence? 18. Understand the support made available to lone workers by the trust, especially post incident support and the mechanism to access such support?

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APPENDIX 2

CHECK LIST FOR STAFF

Have you received up-to-date training in the prevention and management of violence

(for example conflict resolution and personal safety for lone workers)? Are you aware of policies and local procedures relating to lone working? Have you been given all the information about the risks of aggressive and violent

behaviour by patients/service users and the appropriate measures for controlling these risks?

Do you have access to appropriate safety equipment (for example lone worker alarm devices)?

Do you know how to use and maintain lone worker safety equipment? Do you know how to report an incident? Do you understand the importance of proper planning before a visit and the need to be

aware of the risks and do everything you can in advance to ensure your own safety? Do you always leave an itinerary with your manager or your colleagues? Do you keep in regular contact with your base? Do you carry out dynamic risk assessments during your visits? Are you aware that you should never put yourself or colleagues in danger and that, if

you feel threatened, you should withdraw immediately? Do you understand the circumstances under which a visit can be terminated? Do you know and understand your own responsibilities as well as your manager’s?

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APPENDIX 3 CHECK LIST FOR HOME VISITING

HOME VISITING CHECKLISTS

Home visiting checklist for

Managers

Are your staff who visit:- √

1. Fully trained in dealing with violence situations

2. Briefed about the area(s) where they are to work

3. Given all available information about the client(s)

Have they:- √

1. Understood the importance of previewing cases

2. Left an itinerary

3. Made plans to keep in contact with colleagues

4. The means to contact you – mobile phone

5. Got your home telephone number (and you have theirs)

6. Authority to arrange an accompanied visit, escort or use a taxi

Do they:- √

1. Appreciate the need to report incidents

2. Have easy access to incident report forms

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3. Use the forms

4. Know they have the authority to prematurely terminate a visit

5. Know how to control and defuse potentially violent situations

6. Appreciate their responsibilities for their own safety

7. Understand the provisions for their support

HOME VISITING CHECKLISTS

Home visiting checklist for

Staff

Have you:- √

1. A clear idea about the area into which you are going

2. Carefully previewed today’s cases? Are there any potentially

violent clients/patients?

3. Asked to ‘double up’, take and escort or use a taxi if unsure

4. Made appointments

5. Left your itinerary and expected departure/arrival times

6. Told colleagues or line manager about possible changes of plan

7. Arranged for contact if your return is overdue

NOW – “What else is needed?”

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Do you have:- √

1. A personal alarm and/or mobile phone, does it work, is it at

hand

2. A bag/briefcase, wear a uniform or car sticker that suggests you

have money, drugs or other valuables with you. Is this wise

where you are going today/tonight

3. Out of hours telephone numbers to summon help

Can you:- √

1. Be certain your attitudes, body language etc won’t cause

trouble

2. Defuse potential problems and manage aggression

Remember the three V’s of Visiting

‘Vet’, ‘Verify’, ‘Vigilance’

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RD Health and Safety Policy Issue 3

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APPENDIX 4- Health and Safety Assessment Template Form for Assessing Lone Working

SHERWOOD FOREST HOSPITALS NHS TRUST

HEALTH AND SAFETY RISK ASSESSMENT

Division Department/Ward Date

Work Activity Lone Working

Assessor Review Date

No.

To cover all aspects of Lone Working as applicable

Initial

Risk

Rating

Current and Future

Controls

Target

Risk

Rating

Hazard (the potential to cause

harm)

How harm can occur and

who could be harmed

Control Measures or Safeguards in place

Co

nse

qu

en

ce

(C)

Lik

elih

oo

d (L

)

Ris

k R

atin

g

(C x

L)

Observations and

recommendations to

improve safety

Co

nse

qu

en

ce

(C)

Lik

elih

oo

d (L

)

Ris

k R

atin

g

(C x

L)

1. Personal issues, competencies

and awareness

Define who is at risk If

specific to individual lone

workers then assess

specific hazards, risks and

control measures separately

All lone workers should be competent and

able to undertake appropriate dynamic risk

assessment (see Lone Worker Policy and

Guidance Risk Assessment section).

Control measures should be implemented

to overcome any hazards and risks

identified as a result of training

deficiencies, inexperience, pregnancy,

RD Health and Safety Policy Issue 3

20

No. To cover all aspects of Lone Working as applicable

Initial

Risk

Rating

Current and Future

Controls

Target

Risk

Rating

disability or other issue.

2 Hazards identified through

previous incident history

Define who is at risk Identify previous history and decide control

measures to reduce risk of it reoccurring

3 Communications issues Lone

workers must be able to

communicate effectively at all

times

Define who is at risk Control measures could include measures to communicate movements and a workable escalation system if a problem is reported. Consider use of buddy system, mobile telephones, lone worker devices, alarms, logging systems etc

4 Day to day issues as arising

and requiring immediate

response from individual lone

workers

Define who is at risk Dynamic Risk Assessment and reference

back to Lone Worker risk assessment,

policy and Guidance

5. Patient associated issues in

practice rooms, community

setting etc. taking into

consideration patient history

with regard to alcohol, drugs,

smoking violence etc

Define who is at risk, if there are patient confidentiality issues then assess and refer these specifics separately

Identify agreed control measures for risks

before 1st referral if possible or otherwise

minimise the risks identified. Measures

may include separate reference to patient

notes and care plans, sharing information,

availability of 2nd person at visits / in

practice rooms, no home visits etc

6 Environmental and Geographical Issues, known

Define who is at risk Identify control measures, 2nd person, other routes, assistance from police or

RD Health and Safety Policy Issue 3

21

No. To cover all aspects of Lone Working as applicable

Initial

Risk

Rating

Current and Future

Controls

Target

Risk

Rating

trouble areas, dangerous landscapes or routes / roads, dangerous or difficult access / egress, working environment

security, discussions and agreement with clients for change to room layout etc.

7 Equipment deficiencies, is

other equipment required to

assist the lone worker

Define who is at risk Consider provision of torch, maps, emergency numbers including local police, first aid kit, moving and handling requirements etc.

8 Equipment carried & uniform, does equipment, uniform & resources carried render the worker more liable to be targeted for theft. EG. Prescriptions, medicines, drugs etc

Define who is at risk Consider how equipment and resources

required are best carried / concealed,

uniform options, other options for drugs

dispense

9 Time of visit, night? Start or

end of shift

Define who is at risk Identify control measures for this element alongside other risk assessment issues. Poor lighting, difficult parking opening or closing of premises and safe procedures etc.

10 Conveying bad or sensitive

news or other unwelcome

information

Define who is at risk, if there are patient confidentiality issues then assess and refer these specifics separately

Control measures may include need for additional staff training or 2nd person being present at certain times when news is being transmitted

11 Other persons / pets, clients

family, friends, dogs etc

Define who is at risk, if there

are patient confidentiality

issues then assess and

refer these specifics

Identify control measures to resolve any

risks arising from other influence

RD Health and Safety Policy Issue 3

22

No. To cover all aspects of Lone Working as applicable

Initial

Risk

Rating

Current and Future

Controls

Target

Risk

Rating

separately

12 Clinical / Medical Practices, can

they be carried out safely for

the patient and the carer?

Define who is at risk, if there

are patient confidentiality

issues then assess and

refer these specifics

separately

Control measures for back care and other

issues affecting staff members and clients

13 Other lone working issues

including driving, office related

etc

Define who is at risk Control measures from lone worker policy

and guidance and / or other policies such

as Driving at Work etc.