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Safe Load Movement : Standard Operating Procedure

Document Control Summary

Status: Replacement. Replaces: Safe Load Management Policy

Version: v1.0 Date: January 2016

Author/Title: Owner/Title:

Nick Hulme - Health, Safety and Security Advisor Liz Lockett - Associate Director or Quality and Risk

Approved by: Policy and Procedures Committee Date: 21/01/2016

Ratified: Policy and Procedures Committee Date: 21/01/2016

Related Trust Strategy and/or Strategic Aims

Risk Management Strategy

Implementation Date: February 2016

Review Date: February 2019

Key Words: Safe; Load; Movement; Manual; Handling; Lifting

Associated Policy or Standard Operating Procedures

Health and Safety Policy

Contents

1. Introduction .............................................................................................................. 2

2. Purpose ..................................................................................................................... 2

3. Scope ........................................................................................................................ 3

4. Definitions ................................................................................................................. 3

5. Key Principle............................................................................................................. 3

6. Responsibilities ........................................................................................................ 3

7. Guidance ................................................................................................................... 5

8. Confidentiality .......................................................................................................... 5

9. Access to Specialist/Further Advice ....................................................................... 5

10. Training ..................................................................................................................... 5

11. Process For Monitoring Compliance And Effectiveness ....................................... 6

12. References and Further Guidance .......................................................................... 6

Safe Load Movement SOP/February 2016

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Appendix 1 - Risk Assessment .......................................................................................... 7

Appendix 2 - Moving and Handling Guidelines ............................................................... 10

Appendix 3 - Patient/Client Safe Load Movement Risk Assessment ............................ 13

Appendix 4 - Safe Load Movement Plan for Low Risk Situations ................................. 16

Appendix 5 - Safe Load Movement Plan for Medium Risk Situations ........................... 17

Appendix 6 - Safe Load Movement Plan for High Risk Situations ................................. 18

Appendix 7 - Safe Load Movement Risk Assessment and Movement Plan .................. 19

Appendix 8 - Moving and Handling Techniques ............................................................. 20

Appendix 9 - Generic Process Map for Risk Assessment .............................................. 25

Change Control – Amendment History

Version Dates Amendments

1. Introduction

This Standard Operating Procedure (SOP) is based on the principles set out in the Trusts

Health and Safety Policy. During their work staff may be required to handle loads, either

manually or by mechanical means. The Trust recognises that there is a need to reduce

manual handling so far as is reasonably practicable and that staff work to an overall policy of

minimal handling. This document lays down the measures that should be taken by both

managers and staff to reduce the risk of injuries being incurred. It includes guidelines for the

movement of patients and inanimate loads.

2. Purpose

The objectives of this Safe Load Movement SOP are to ensure that any employee of The

Trust has adequate knowledge of the safe practices for load movement, has adequate

training and access to appropriate equipment so as to minimise the risk to their health and

safety so far as is reasonably practicable.

This SOP describes the procedures which should be followed by all Trust employees when

dealing load movement situations in order to meet these objectives.


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3. Scope

This SOP describes the procedures to be followed to safeguard the health of employees

when using lifting equipment or manual handling. This SOP is intended for use by all

employees and for all employees to have an awareness of this SOP.

4. Definitions

Manual Handling - any activity which involves lifting, lowering, carrying, pulling, pushing or

supporting by hand or bodily force. The use of mechanical aids may reduce, but not always

eliminate the need for manual handling by the member of staff.

Risk assessments - are described as “a process of looking forwards, to anticipate and

prevent harm before it occurs”. The risk assessment process identifies hazards, assesses

the risks to health and safety, prevents the hazards/risks from occurring, or if they cannot be

avoided, controlling the risks so they are reduced to a minimum.

5. Key Principle

Manual handling should be avoided so far as is reasonably practicable.

6. Responsibilities

The Trust Board

The Trust Board has overall responsibility for Health and Safety and ensuring that effective

management systems are in place to achieve high standards of Health, Safety and Welfare

and will call for periodic reports on the effectiveness and implementation of the Safe Load

Movement SOP.

Chief Executive

The Chief Executive has specific responsibility for giving effect to Health and Safety matters

on behalf of the Board and will ensure that this SOP is implemented and that the

effectiveness of the SOP is continually reviewed.

Managers and Supervisors

Managers will identify those staff who will be responsible for the systematic identification and

recorded assessment of all hazardous manual handling tasks (of patient/clients and/or

inanimate objects) using the appropriate risk assessment form(s).

Managers will ensure that those staff identified receive suitable training in safe load

movement including the risk assessment process as per mandatory training policy.


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Managers have the overall responsibility for the selection, purchase, installation,

maintenance and evaluation of manual handling equipment and to ensure that staff are

trained in its correct use. Managers will liaise with the Estates and Supplies departments as

necessary to ensure that technical and safety matters are considered.

Managers will monitor and regularly review their implementation of this SOP. This can be

done in various ways such as supervision, monitoring attendance at training sessions, the

use of risk assessment forms, incidence of injuries, near misses, and sick leave related to

manual handling operations.

Managers will maintain records of handling related accidents and incidents and ensure that

risk assessments are reviewed. Managers will also be responsible for ensuring that such

accidents and incidents are fully investigated and remedial measures implemented, calling

upon expert advice as necessary. (e.g. health and safety lead, manual handling adviser or

other as available)

Managers will identify and review emergency procedures, to ensure that the manual

handling tasks necessary are minimised.

Employees

Staff have responsibility for ensuring that they do not undertake hazardous manual handling

tasks without being aware of the risks involved and the recommended procedures.

Staff are responsible for ensuring that they follow relevant Trust procedures at all times.

Staff should report, label and withdraw from use any handling equipment found to be faulty.

Staff will use the Trusts accident / incident reporting procedure in all cases when manual

handling activities involve injury, suspicion of injury or incidents affecting either staff, patients

or others.

Staff are responsible for co-operating with managers to ensure that they receive initial

training and are updated on safe load movement as required by the mandatory training

policy.

Staff will inform their manager of any condition affecting them personally which might

influence their ability to undertake manual handling tasks safely.

Managers should ensure that staff wear clothing and footwear appropriate to the tasks they

undertake. Staff have a duty to co-operate with their managers in this respect.

Staff should not undertake hazardous lifting operations as a result of patients / clients failing

to co-operate in the use of hoists or other equipment identified as necessary for safe load

movement.

Health & Safety Lead and Manual Handling Advisor

Provide specialist advice where appropriate.


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Ensure that comprehensive documentation including the maintenance of accurate records

are kept, including assessments, workplace advice, recommendations, education and

training, equipment, audits, trials, protocols, standards and procedures.

7. Guidance

The assessment forms, the assessment process map and other guidance is available in the

attached Managers’ Guidance pack.

8. Confidentiality

Where assessments involve details of clients and/or staff of a personal/confidential nature

the information should be as confidential and only made available to ensure safe care and

safety of staff so far as is necessary to achieve the objectives of this SOP. For example an

assessment may identify back health issues with a staff member and require appropriate

adjustments and necessitate the issue to be handled sensitively.

9. Access to Specialist/Further Advice

The Trust has in place arrangements for access to specialist advice. The contact details are

appended to the Health and Safety Policy.

The Health & Safety Lead is also available to give advice for which the contact details are as

follows:

Health & Safety Lead Risk Management Team St. Georges Hospital Corporation Street Stafford ST16 3AG Tel (office): 0300 790 7000 Ext 8696 E-mail: [email protected] Staff side representatives may also be contacted to offer advice and guidance.

10. Training

The Trusts Expectations with regards to moving and handling training is defined within the

Trusts Needs Analysis (TNA). For further details, the TNA can be found on the Trusts

website.

All new staff should be provided with information on safe load movement during the Trust

induction programme.

All staff whose responsibilities include manual handling should receive formal training in safe

load movement as soon as possible after commencement. This training should include the

mailto:[email protected]


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principles of risk assessment and the identification of risk reduction measures. Training

content will vary according to work activity and risk attached. Frequency will be in line with

the Trust’s mandatory training policy. Staff who have not received such training should not

undertake manual handling tasks without the close supervision of an appropriately trained

person.

The need for training should be carefully documented and followed through. Training records

should be kept both by managers and specifically within personal files. (Lack of training

records is a frequent point at issue in compensation claims) Managers are responsible for

maintaining records of staff training which should be accessible to future managers etc. in

event of a claim etc. and implementing a suitable bring up system for refresher training.

11. Process For Monitoring Compliance And Effectiveness

To ensure compliance with this SOP, risk assessments will be carried out by managers

where applicable to safeguard staff from injury. Such assessments will be monitored through

annual audits and through the daily check of incident reporting where such incidents may

occur.

12. References and Further Guidance

Further detailed guidance is also available in the Manual Handling Operations Regulations

1992, the Lifting Operations and Lifting Equipment Regulations (LOLER) 1998 and the latest

edition of the Guide to the Handling of Patients, published by the RCN and NBPA.


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Appendix 1

Risk Assessment

South Staffordshire & Shropshire Healthcare NHS Foundation Trust follows the legislation

laid out in The Management of Health and Safety at Work Regulations 1992 revised 1999,

which require employers to make suitable and sufficient assessments of the risks to their

employees while at work. Where this general assessment indicates the possibility of risks to

employees from manual handling of loads, there should be compliance with the

requirements of the Manual Handling Operations Regulations (MHOR) 1992.

Key Principles

Manual handling should be avoided so far as is reasonably practicable.

Legal Requirements

The Trust will ensure that risk assessments of all but trivial load movement operations will be

made by all appropriate managers, findings will be recorded, control measures implemented

and reviewed periodically or sooner where changes occur.

Reducing Risk

The MHOR set out a hierarchy of measures that should be followed to reduce the risk from

manual handling. The measures are:

Avoid hazardous manual handling operations, so far as is reasonably practicable. Consider whether the operation can be avoided by elimination, automation or mechanisation.

Assess any hazardous manual handling operation that cannot be avoided. Make a suitable and sufficient assessment of all such manual handling operations to be undertaken by employees. Assess with regards to the task, the load, the working environment, individual capability, equipment, other factors (work organisation/psychosocial factors).

Reduce the risk of injury, so far as is reasonably practicable. Give general indications and, where reasonably practicable, precise information on the weight of each load, and the heaviest side of any load whose centre of gravity is not positioned centrally.

Review periodically or if there is any change.

Tasks that may appear to be of low or negligible risk when carried out occasionally may

present a considerable risk if constantly repeated.

The assessments should be reviewed yearly (inanimate loads), six monthly for generic

patient handling assessments, or weekly for specific patient handling assessments. This

may be more often if there are significant changes to the tasks or patient’s condition, to

ensure that the risks inherent are reduced to its lowest level.


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On completion of a risk assessment, it is the manager’s responsibility to ensure that

appropriate actions are taken where a need has been highlighted. The proposed actions

and/or immediate actions taken must be recorded on the moving and handling risk

assessment form for monitoring purposes.

Where the Manual Handling service receives risk assessments that highlight areas of

concern without appropriate actions, the Manual Handling Advisor will take appropriate

action. This arrangement is in place to help ensure that appropriate action is being taken

where needed.

The Manual Handling Advisor will inform the organisation of any risk reduction strategies that

require implementation following review of the assessments.

A Risk Assessment is required of ALL manual handling operations (patient and objects)

except those known to be trivial (though some assessment will be required to determine is

this is the case). Where hazardous handling tasks cannot be avoided a formal risk

assessment should be made taking into account:

a) the nature of the task

b) the individuals capability.

c) the nature of the load

d) the working environment

This risk assessment should be used to identify methods to eliminate or reduce the risk of

injury, from manual handling tasks, so far as is reasonably practicable.

Manual handling equipment will be used to eliminate the need for full body lifts and reduce

the risks associated with other manual handling tasks.

Bank staff, volunteers, work experience personnel and any other people likely to be affected

should be informed of the risks of potentially hazardous manual handling tasks and

managers are equally responsible for these people as for permanent staff in ensuring that

suitable and sufficient risk assessments of tasks and personnel have been carried out, that

the findings have been implemented and adequate aids are available and ensure such

personnel have been trained in the principles of safe load movement and specific techniques

as appropriate.

Managers should ensure that Agency staff have been suitably trained by their employer and

have been advised of any risks associated with their work for the Trust.

Staff should ensure that carers, who assist with any manual handling task, are given

adequate instruction to undertake the task safely.

Dealing With Outstanding Risks

Where risk assessments identify residual/unaddressed risks (e.g. equipment shortage or

unsuitability for task, training needs etc.) these should be forwarded to the Directorate Senior

Team for inclusion into Directorate Risk Registers. If scoring is appropriate they should also

be included within the Trust Risk Register.


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Rehabilitation Of Staff Returning To Work With A Musculo-Skeletal Problem

Any member of staff who suffers a significant injury at work due to a manual handling task

should be assessed by Occupational Health on their ability to continue such tasks and

recommendations made to prevent further injury. Responsibility for referral lies with the

employee’s manager.


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Appendix 2

Moving and Handling Guidelines

The Trust has defined the techniques to be used in the moving and handling of patients and

objects, including the use of appropriate equipment. Further details with regards to these

techniques can be obtained from the Manual Handling adviser & Health & Safety Lead.

1 Guidelines on the Manual Handling of Patients / Clients.

All patients / clients who can safely do so must be encouraged to move themselves.

All patients / clients who require manual handling must be regarded as hazardous.

Therefore, for each of these patients / clients there must be an up-to-date recorded

risk assessment identifying:

patient / clients weight (approximate or specific)

recommended methods of movement

minimum number of staff required to assist

equipment used

relevant risk factors.

The risk assessment must be reviewed annually or if circumstances change

significantly.

Where the risk assessment indicates no alternative but to move a patient / client

manually, a detailed assessment of risk and method must be undertaken and

recorded.

If the risk assessment indicates that the patient / client needs mechanical assistance

to move, the equipment to be used should be identified i.e.,

sliding boards, low friction rollers, handling belts etc.

mechanical aids such as hoists

special mattresses/beds.

Staff should not be expected to take the full weight of an adult patient / client.

2 Guidelines on the Manual Handling of Inanimate Loads

Where reasonably practicable, all hazardous manual handling must be avoided.

Managers are responsible for ensuring that all hazardous load movements are

assessed on the appropriate risk assessment form and reviewed when

circumstances change or at least every year.

Where assessment indicates that manual handling is required to move a load,

methods that minimise the identified risk should be used, e.g. sack trucks, trolleys,

cranes, hoists, block and tackle, skates, rollers etc.


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Staff should not be expected to exceed their personal physical capability when

undertaking manual handling tasks. This ability may be reduced by pregnancy,

illness, injury or other relevant personal factors.

Store rooms and other work areas must be arranged to reduce the risks associated

with manual handling.

3 Work Related Upper Limb Disorders

Such conditions are often referred to as repetitive strain injuries or musculoskeletal

disorders of the upper limbs. These are conditions that can affect the neck,

shoulders, arms, elbows, wrists, hands and fingers. Symptoms include aches and

pains, swelling and difficulty in movement.

Both office and manual jobs can cause WRULD’s, where there are repetitive finger,

hand or arm movements; twisting movements; squeezing; pushing, pulling, lifting or

reaching movements.

Where managers identify staff whose tasks involve the above actions a risk

assessment should be undertaken using the checklist / assessment form contained

within the HSE publication ‘UPPER LIMB DISORDERS, ASSESSING THE RISKS’.

A copy of this publication can be obtained from the HSE website. www.hse.gov.uk

Further to the guidance contained within the aforementioned publication, managers

should consider the following action where risk assessments indicate the need:

1. Alterations to workstations, tools or the work environment. 2. A change of task / work position every 30 minutes. 3. Job rotation or redesign. 4. Provision of a range of tools to alter the forces on the musculoskeletal system. 5. Staff consultation and training.

It is the responsibility of managers to ensure that action is taken in response to risk

assessments which highlight concerns around the moving and handling of patients

and objects.

As with manual handling any member of staff who presents symptoms which may

indicate an upper limb disorder should be assessed by Occupational Health, on their

ability to continue the tasks, and retrained if necessary to prevent further injury.


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4 Using Equipment To Assist With Lifting Operations

All lifting tasks involving the use of a hoist or similar equipment such as a bath lift are

governed by the ‘Lifting Operations and Lifting Equipment Regulations (LOLER)

1998’. The main requirements of these regulations are as follows:

1. New hoists should be selected in such a way as to ensure their suitability and strength for the tasks identified and should come complete with a certificate of conformity from the manufacturer / supplier. New hoists may need to be assembled and tested by a competent person before being used for the first time. Hoist and slings should have the safe working load visibly marked on them. Advice should be sought from both the Facilities and Supplies departments before purchasing such equipment.

2. All hoists should be stored in a suitable place to minimise the risk of damage

and prevent unauthorised use.

3. Staff should be adequately trained in the use of hoists and associated slings and equipment.

4. Hoists and slings should receive a thorough examination by a competent

person every six months. Records of these inspections will be kept by the Facilities department with copies maintained in the same location as the hoist is sited. A suitable label should be attached to each hoist indicating when the next examination is due.


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Appendix 3

Patient/Client Safe Load Movement Risk Assessment

Patient/Client Name...........................................…...Date of assessment................................

Assessors Name (block capitals)....................................Signature..........................................

Assessment must be undertaken on admission and reviewed yearly or if circumstances change

The choice of handling techniques will depend on the condition and capabilities of the patient/client

The appropriate technique must be documented on the patient/client care plan

Assessment

review date

Have there been any significant changes?

If yes a new assessment is required

Name of Assessor

Patient/Client Information

Physical Characteristics

Weight............................................................Height...............................................................

Other Information (please record any condition which may affect handling of patient/client

e.g., scoliosis, amputations, artificial limbs, epilepsy

...................................................................................................................................................

...................................................................................................................................................

Handling Constraints

(Please tick all that apply)

Paralysis


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Further information:

..................................................................................................................................................

...................................................................................................................................................

Behaviour which may affect moving and handling

(Please tick all that apply)

Self inj


.........................................................................………………………..........................................

.........................................................................………………………..........................................

Patient/Client is able to:-

(Please tick relevant box) Unassisted Assisted Details

Yes No Yes No

Walk ........................................

Stand ........................................

Use toilet ........................................

Move in bed ........................................

Transfer to/from seating ........................................

Transfer on/off bed ........................................

Transfer in/out of bath ........................................

Patient/Client comprehension (Please tick all that apply)

ow instruct

Mobility aids used by patient/client (Please tick all that apply)


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Environmental factors (Please tick all that apply)

Staff factors (Please tick all that apply)

Based on this risk assessment is a Safe Load Movement Plan required?

Yes No

If Yes, identify below which plan is required, based on the level of risk and proceed to

complete

Green (low risk) Amber (medium risk) Red (high risk)

NOTE: All tasks involving the use of a hoist are classified as red and should have a

written plan and always be supervised by a competent person.


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Appendix 4

Safe Load Movement Plan (Patients / Clients) Green (Low Risk) Situations

Patient/Client Name...................................................Date.......................................................

Assessors Name (block capitals).......................................Signature........................................

To enable the patient/client to be moved comfortably and safely without causing

injury to themselves or staff the following is required:-

Activity Assistance

a) In / out of bed with the support / presence of................................................................staff

b) On / off toilet with the support / presence of.................................................................staff

c) Moving in bed with the support / presence of................................................................staff

d) In / out of bath with the support / presence of...............................................................staff

e) In / out of chair with the support / presence of..............................................................staff

f) Walking with the support / presence of..........................................................................staff

and the aid of:-

No equipment

Frame

Tripod

Stick

Other


...................................................................................................................................................

...................................................................................................................................................

...................................................................................................................................................

...................................................................................................................................................

...................................................................................................................................................

...................................................................................................................................................


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Appendix 5

Safe Load Movement Plan (Patients/Clients) for Amber (Medium Risk) Situations

Patient/Client Name...................................................Date.......................................................

Assessors Name (block capitals).......................................Signature........................................

To enable the patient/client to be moved comfortably and safely without causing

injury to themselves or staff the following is required:-

Activity Equipment Assistance

a) In / out of bed using...............................................................................and.................staff

b) On / off toilet using................................................................................and.................staff

c) Moving in bed using...............................................................................and.................staff

d) In / out of bath using..............................................................................and.................staff

e) Walking using........................................................................................and.................staff

f) In / out of chair using..............................................................................and.................staff

g) Other................................................................................................…........………...............

.....................................................................................................................………...................


...................................................................................................................................................

...................................................................................................................................................

...................................................................................................................................................

...................................................................................................................................................

...................................................................................................................................................

...................................................................................................................................................

...................................................................................................................................................

...................................................................................................................................................

...................................................................................................................................................

...................................................................................................................................................

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Appendix 6

Safe Load Movement Plan (Patients / Clients) for Red (High Risk) Situations

Patient/Client Name............................................……….....Date....................................................

Assessors Name (block capitals).......................................Signature......................................…..

To enable the patient/client to be moved comfortably and safely without causing injury

to themselves or staff the following is required:-

Activity Equipment Assistance

a) In / out of bed using................................hoist and.............................sling and.............staff

b) On / off toilet using..........................…....hoist and.............................sling and.............staff

c) Moving in bed using..............…...............hoist and.............................sling and.............staff

d) In / out of bath using................…............hoist and.............................sling and.............staff

f) In / out of chair using.................…...........hoist and.............................sling and.............staff

g) Other...................................................................................................................................

................................................................................................................................................

Is lift undertaken by South Staffs & Shropshire Healthcare Trust employee? Yes No

If Yes:

Name of competent person/s supervising lifting

operation.......................................................

If No:

Name of carer trained to use

hoist................................................................................................

Date of last formal thorough examination of

hoist.....................................................................

(If hoist has not had thorough examination for over 6 months-contact maintenance department)


........................................................................................................................................................

........................................................................................................................................................

........................................................................................................................................................

........................................................................................................................................................

........................................................................................................................................................

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Appendix 7

Inanimate Objects: Safe Load Movement Risk Assessment and Movement Plan

Premise........................………....................Room...........….............................Date.…..................

Task Description............................................................................…………...................................

Staff involved..............................................................................…………......................................

Assessors Name (block capitals)..............................…...........Signature.........………....................

Assessment must be reviewed yearly or if circumstances change

Assessment

review date

Have there been any significant changes?

If yes a new assessment is required

Name of Assessor

The choice of handling techniques & equipment will depend on abilities of staff and must be documented on the plan

Risk Factors: Task. Individual. Load. Environment. = T.I.L.E. (tick all that apply)

TASK: does the task involve: Twisting, Lifting and lowering

INDIVIDUAL: are the staff involved:

Suffering from previous Pregnant or nursing mothers

LOAD: is the load: Unstable Dif

If yes: estimated weight................ Any other factors.........................

ENVIRONMENT: is there:

Is there a lift Yes No

Based on this risk assessment is a safe load movement plan required? Yes No

Changes required to the task:……………………………………………………………….……......

Changes required to the environment:…………………………….……………………………........

Recommended techniques and equipment to be used for lifting and handling:

...................................................................................................................................…………......

......................................................................................................................................…………...

Further information / other action to be taken:……………………………………..……………........

....................................................................................................................................………….....

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Appendix 8

Moving and Handling Techniques

Before carrying out any moving and handling, ensure that the persons handling plan has

been read thoroughly.

If a patient requires assistance to transfer, the manager will ensure that a people handling

assessment is carried out within the first 24 hours after the patient has come into the care of the

Trust and recorded. The assessment should be easily accessible to all staff involved in the

patient’s care. Before carrying out any moving and handling, ensure that the persons handling

plan has been read thoroughly.

These risk assessments must be reviewed if there are any changes in the condition of the

patient, or changes to any of the other factors that were taken into consideration when

completing the assessment (Environment, Load, Individual, Task, Equipment). All staff are

responsible for noticing changes and reporting them to their risk assessor to ensure that the

assessment is kept up to date.

Where individuals are being cared for by both therapists and carers, it may be necessary to

have different systems of work recorded on the assessment to reflect the different skill levels

and individual capabilities.

Team handling (tasks involving two or more handlers) should be planned and agreed prior to

commencing the manoeuvre. One person should take charge of the operation ensuring

communication is clear and co-ordinated throughout.

The following techniques are taken from the ‘The Guide to the Handling of People edition 61

and should be used as part of a detailed risk assessment that considers all other significant

factors.

Assisted Sit To Stand

Handling equipment - handling belt Handlers required – 1 or 2

1. Position the handling belt around the persons waist ensuring it is secure.

2. Stand to the side of the person in a ‘step stance’ position with a wide, stable base and

flexible at the knee.

3. Grasp the rear of the handling belt with one hand and positioning the other hand on the

persons shoulder.

4. Utilising a rocking motion and saying ‘ready, steady, stand’ transfer the weight from one leg

to the other whilst supporting the person forward and into a standing position.

5. The handling belt can be used whilst walking the person.

If there is any doubt in the person’s ability to assist by pushing up on their legs it may be

assessed as two persons technique whereby the handlers stand either side of the person and

mirror each other’s actions.

It is important the person is able to maintain a standing balance, if there is any likelihood of

them overbalancing this may knock the carer off their feet.

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Rolling In Bed

Handling equipment needed – nil Handlers requires - 1 or 2

This technique can be used for personal care tasks, changing of clothing and bed linen or

positioning of sling prior to hoisting.

1. It is assumed the person is lying on their back.

2. Stand by the bedside facing the person.

3. Ask/assist them to position the arm nearest to you so they will not roll onto it.

4. Ask/assist them to bend the leg furthest away from you so that their foot rests flat on the

bed or cross that ankle over the nearest one.

5. Ask/assist them to turn their head to face the direction they are going in and bring the arm

furthest away across the body.

6. Adopt a wide stable base, feet apart corresponding approximately to the hip and shoulder

level of the service user, toes turned out at approximately 45 degrees (if the bed is very low

you may need to put one knee on the bed approximately in line with their waist). Lean

forward with the upper body maintaining the natural curves of the spine.

7. Place the palm of one hand on their hip the other under the shoulder, utilising a rocking

motion state ready, steady, roll bringing the service user towards you ensuring they are

secure by maintaining your position.

Always roll a person towards you. If you need to roll them in both directions then you must have

access to both sides of the bed. If the person is in a double bed or on the floor this technique is

modified by the handler adopting the wide base whilst kneeling. NB. This reduces the handler’s

physical strength.

Moving Up In Bed

Handlers requires – 2 Handling equipment – sliding sheet

1. Adjust the bed to a comfortable height for both carers.

2. Using the roll technique position the sliding sheet so that it covers the person from head to

foot.

3. Handlers stand either side of the bed facing one another, with feet shoulder width apart

and flexible at the knee.

4. Grasp the top part of the slide sheet at hip and shoulder level, using a rocking motion and

saying ready, steady, slide ant then slide the person up the bed. Remember to coordinate

this action.

5. It is sufficient to slide the person until their head is comfortably on the pillows.

6. Remove the slide sheet from under the feet then pull up towards the head.

Turning In Bed

Handling equipment needed – sliding sheet,

Handlers needed – 1 to carry out manoeuvre 1 to support.

This technique is useful for individuals who remain in bed and require turning as part of a

pressure sore prevention measure.

1. Adjust the bed to a comfortable height for both carers.

2. Using the roll technique position the slide sheet so that it covers the trunk area.

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3. Position yourself with one leg in front of the other adopting a stable position with flexible

knees.

4. Grasp the sides of the sheet close to the persons body, using a rocking motion and saying

ready, steady, turn, gently transfer weight from front leg to back leg whist pulling on the

slide sheet.

5. Remove the slide sheet and make the individual comfortable.

6. Pillows can be used as support either behind the person or under the mattress to prevent

rolling back.

Sitting Up In Bed

Handling equipment needed – nil Handlers required – 1 or 2

1. Stand to the side of the bed (low bed) facing the headboard, place the nearest knee on the

bed in a ‘high kneel position (space between buttocks and heel) close to the person below

their waist height (it is important to place the foot on the bed as well).

2. Grasp the pillow/ bed sheet at shoulder level. (If using the bed sheet ensure it is not tucked

in first!)

3. Using the instructions ready, steady, sit, the handler sits back whilst grasping the

pillow/bed sheet using their body weight to bring the person into a sitting position.

4. To assist the person to maintain this position in bed extra pillows a backrest support or

chair could be utilised.

If the individual is very flaccid and unable to assist in a sitting position two carers may

be required, each standing either side of the bed.

Principles Of Hoisting

Prior to commencing any hoisting procedure it is important to ensure:

1. You have received training from a designated moving and handling trainer, and feel

competent to utilise the equipment.

2. Equipment and sling are appropriate to the hoist, task and person being lifted

3. The environment is suitable for the manoeuvring of the equipment as well as the task

required.

4. Any obstacles are removed from the environment if possible.

5. The furniture is arranged such as to facilitate easier manoeuvrability of the hoisting

equipment.

6. The dignity of the individual is maintained throughout the whole of the procedure.

7. Principles of safer handling are observed throughout.

Hoisting equipment is not designed for the transportation of people, you must only

utilise them in order to raise and lower an individual. Guidelines state transportation of

people in hoists should be no more than 10 metres. There are more appropriate ways in

which to move people from room to room e.g. Wheelchair, commode etc.

The number of handlers required during the hoisting procedure should be stipulated on

the Moving and Handling risk assessment form and based on the environment, task and

both the handlers and persons capabilities.

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Hoisting

Before using a hoist the following operator checks must be undertaken:

There is sufficient battery power to undertake the necessary manoeuvre.

The handset is fully operational. If this does not appear to be working please check the emergency stop button has not been pressed and the connection leads are secure.

The wheels are able to move freely and the brakes work sufficiently

Check the wear and tear, ensure all four castors are on the floor.

The leg opening mechanism works

The sling should be clean and free from any tears or holes. If there are any small tears in the body of the sling it should be withdrawn from use immediately, since it could enlarge once the patient’s weight is added.

To Position A Sling On A Person In Bed

1. Fold the sling in half and position it alongside person’s trunk.

2. Log roll person, position the sling so that the bottom seam is in line with the coccyx.

3. Slide the bottom of the sling out from the persons back.

4. Bring the top leg piece up and tuck the leg strap under the person’s neck.

5. Fold the shoulder strap in and roll the top of the sling into the persons back.

6. Re sit the person on their back.

7. Take the strap from the person’s neck and pull out and down to release.

8. Ensure the sling is positioned correctly by sliding the trunk section into position.

NB: If you are concerned about the person’s skin use the alternative of log rolling the person in

both directions to position sling. In order to remove the sling in bed, log roll technique in both

directions must be utilised.

To Position A Sling On A Person Whilst Sitting

1. Encourage the person to sit forward, if not able to assist by positioning hand on shoulder

blade and bringing forward.

2. Slide the sling down the persons back ensuring the bottom seam is in contact with the

chair.

3. Ensure legs straps are not twisted and slide down person’s leg. To ensure a good position

hold the leg strap and apply tension towards you, this helps the sling to slide into position.

4. Kneel in front of the person and bring their foot onto your thigh in order to position the leg

straps. Ensure both leg straps are even in length.

5. In order to remove leg straps avoid lifting the legs as this may cause the person to slide

forward. Roll the leg strap under and slide it from under the thigh.

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Hoisting From Floor Level

When hoisting from floor the basic principles are the same as for any hoisting activity but

following is additional guidance.

1. First consider if it is appropriate to move person, i.e. have they sustained an injury?

2. Ensure sufficient staff. This should be done with the minimum of two persons.

3. Reassure person and maintain their dignity as much as possible, i.e. use of screens.

4. Log roll to position the sling on person, remember capabilities are less when kneeling.

5. Using an appropriate technique, assist to sit forward and support using an upturned chair

or member of staff kneeling behind person. Do not hoist the person whilst lying flat even if

the hoist is capable of this as it is uncomfortable and can cause the person to be dragged

across the floor.

6. Approach person with hoist from the side where possible.

7. If the person has fallen in a confined space, an appropriate size sliding sheet may be

required to move to a more accessible area. Hoisting from the floor is not a lengthy

process, allow the person time to recover from event.

Rehabilitation

During rehabilitation; a competent assessor must assess the individual’s capabilities and

determine how the individual staff members are to handle them. Frequently during rehabilitation

different members of the staff team utilise different moving and handling techniques.

Physiotherapists/Occupational Therapists may use techniques that are not suitable for other

team members because of highly developed skills that are required. Individuals who are trained

by these therapists and are deemed able, may also perform these specialised techniques.

It is important during rehabilitation to tailor the techniques to the individual’s current condition

and capabilities, as strength and ability improve these techniques can be adjusted accordingly.

Therefore hoisting equipment may be appropriate at the early stage of treatment (both standing

and walking hoists are available) these have the advantage of reducing risks if injury to the

carer and promoting confidence to the individual.

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For work-related stress - 3 monthly verbal and 6 monthly written reports are required to be made to the

Health and Safety Committee by Directorate representatives identifying that up to date assessments are in

place for the Directorate, all constituent wards/teams and if required for affected individuals and action plans

are in place and being progressed where issues have been identified

For a specific topic

e.g. Safe Lifting,

Pregnancy &

Parenthood, Work-

related Stress etc.

Identified issues are noted and solutions i.e. Control

Measures sought.

If there are multiple issues a specific action plan may be

also be required cross-referenced to the risk assessment.

Retain copies of risk assessments and any action plans as

documented evidence of assessment, action and progress

If no issues are identified (unlikely to

be so) - but if so, document what

was reviewed and schedule a further

review at 12 months max – or sooner

if changes occur or are planned

All assessments require annual review - however this should

be sooner if there are known or suspected concerns or there

have been incidents. Also review if changes have occurred

(or are planned) which are relevant to the assessment.

Note That Some Issues Require Much More Frequent

Review

For any risk assessments pertaining to individuals, follow the same process however, a more frequent review

is likely to be appropriate & a re-assessment would normally be required sooner than 6 months.

Action plans – keep under review to

monitor progress (typically monthly

but sooner if appropriate) Update

action plans

(Keep previous versions for the

record) Action plans to be reviewed

with re-assessments

Implement the control measures identified - this includes

communicating it to the staff concerned, supplying the right

equipment, substances etc. AND any PPE specified which

must also be used / worn.

Ensure any training needed is provided (& recorded)

Supervise to ensure compliance with the risk assessment –

monitor for changes – review if indicated

Generic Process Map for Risk Assessments Appendix 9

The

assessment

required is

either…

For a general

activity or situation

OR

Use specific assessment

form from relevant policy or

standard operating

procedure

Use the general

assessment form from non-

clinical risk assessment &

management SOP

Identify the ‘hazards’

as appropriate to the

topic or the general

approach. Note that

specific topics may

also have wider

issues requiring

consideration

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