Scenario 1

Tim is 23 years old with a diagnosis of cerebral palsy and epilepsy. He has

severe physical disability with poor muscle tone and has frequent muscle

spasms which he finds painful and distressing. Tim has a mild learning

disability and uses non verbal methods of communication. Tim has a specially

adapted and moulded wheelchair, which gives him maximum support and

reduces his muscle spasms , this gives him use of his right hand.

Tim lives at home with his parents who are both in their late seventies. He

attends day services daily and travels in a mini bus which is able to

accommodate his specially adapted wheelchair. Tim participates in the many

sessions that the day service offers. Tim has a good relationship with his key

worker. Tim likes to go swimming as this gives him freedom of movement, but

the local pool does not have a pool hoist, which means two members of staff

lift him from his chair into the pool, having to come down four steps to get into

the pool. They do have disabled changing facilities but the room is very small

and leaves little room for manoeuvre.

At meal times, Tim is lifted from his wheelchair onto a dinning chair with arms

as his wheelchair is unable to fit under the table. Tim is able to feed himself

without much support, but because of time pressures, his key worker will feed

him his pudding.

After lunch Tim is lifted back into his chair and taken to the clinical room,

which doubles up as a laundry room. Tim is lifted onto a fixed height table,

which has to be up against the wall due to lack if space, so his keyworker can

carry out personal care tasks.

Staff have received training to use the hoist available, however this was two

years. Any new staff do not receive hoist training. As a result it is rarely used

and is stored in a locked cupboard to prevent other service users using it. It

has been suggested by some staff that they should use the hoist to move Tim

as he has a tracking system at home and finds it comfortable. However most

of the team say that they find it quicker to continue to lift Tim themselves.

Using L.I.T.E.E. identify all the hazards and risks

LOAD

INDIVIDUAL

TASK

ENVIRONMENT

EQUIPMENT

What control measures would you put in place?

Scenario 2

Mr John Smith is an 84 year old widower who has been discharged home

from hospital following a left sided stroke. The assessment prior to discharge

noted that John is anxious and lacks confidence in both his ability to cope

alone and particularly in walking with his walking frame.

His home is a small one bed roomed warden controlled flat on the first floor.

There is a lift in good working order most of the time. Mr Smith has retained

much of his furniture from his previous larger house; consequently the floor

space is limited. There are rugs on the floor in the hallway, lounge and

bedroom. His double bed is positioned under the window and against the

wall, requiring him to get out of bed on his right side. The bathroom is

compact with a toilet, bath and hand basin and the doors in the building are of

average width and have door thresholds.

On return home, Mr Smith is delighted to find his usual slippers and

immediately puts these on in place of his shoes which he was using in

hospital. He is disappointed to find that his carer has changed and the

morning visit is provided by a new and inexperienced member of the home

care team. On one visit soon after his return home Mr Smith explains that he

always had a bath on Thursdays before his accident and the carer agrees to

support him with this activity even though it is not on the care/handling plan.

Using L.I.T.E.E. identify all risk and hazards.

LOAD

INDIVIDUAL

TASK

ENVIRONMENT

EQUIPMENT

What control measures would you put in place?

Scenario 3

Sally has been a resident in a home for the past four years and has a

diagnosis of Parkinson’s disease. Sally has now reached the point where she

needs assistance to get up in the morning as she finds this very difficult as

her balance skills are limited. She is in quite a lot of pain and does not have

her medication until breakfast because they are required to be taken with

food. Her room is a single room with a low divan bed up against the wall.

She has her own furniture and the space in the room is small.

You observe a carer in the lounge assisting Sally out of the chair by placing

Sally’s walking frame in front of her. The carer then places one foot on the

front of the frame and reaches over to hold Sally’s arm, the carer is

supporting herself on one leg only. Sally and the carer are having a joke and

laughing at the same time. As Sally rises the carer twists.

Using L.I.T.E.E. identify all risk and hazards.

LOAD

INDIVIDUAL

TASK

ENVIRONMENT

EQUIPMENT

What control measures would you put in place?

Scenario 4

Emma is 86 years old who and has lived in a residential home for 2 years.

She was initially admitted with progressive Alzheimer dementia and is

urinary and faecally incontinent. Her condition has steadily deteriorated,

she no longer communicates verbally. Her weight has decreased to 42Kgs

as her appetite is decreased, she is immobile and spends most of the day

on her bed. She has severe contractures and is at high risk of developing

pressure sores.

To be transferred into her chair she uses a support sling and an overhead

hoist. She can only tolerate being in her chair for a maximum of 90 minutes

before showing signs of distress, but this time spent up is when she is

more likely to eat and drink. Her husband is happy to assist her eating and

drinking during his daily visits.

Using L.I.T.E.E. identify all risk and hazards.

LOAD

INDIVIDUAL

TASK

ENVIRONMENT

EQUIPMENT

What control measures would you put in place?