Health, Safety & Welfare Learning Guidance

Health, Safety & Welfare

Learning Guidance

1. Introduction & Definitions

2. Health & Safety Law

3. Workplace Hazards

4. Health and Safety Arrangements

Welcome to the Health, Safety and Welfare Learning Guide .This guide covers the training for health, safety and welfare. This learning guidance covers the following topics

Working together to improve health and safety

Health and safety is important for moral, financial and legal reasons.

The Health and Safety Executive (HSE) 2017 statistics report advise :

• 1.3 million work related ill health cases (new or long standing)

• 0.5 million work-related musculoskeletal disorder cases (new or long standing)

• 70,116 non-fatal injuries to employees reported by employer (RIDDOR)

• 31.2 million working days lost due to work-related ill health and non fatal workplace injuries.

1. Introduction

• The Trust regards its responsibility for the health, safety and welfare of all its employees, clients, patients, students, contractors, visitors, neighbours and members of the public as a matter of prime importance.

• The Trust has a signed health and safety policy general statement of intent, which staff should access through the Trust’s health and safety intranet page.

• You have an important role and responsibilities to ensure health and safety in the Trust during your day to day work, by working in ways that are consistent with legislation, policies and procedures and for maintaining your own and others’ health and safety.

• The Trust has a dedicated Health, Safety and Fire Department to support the Trust, its staff, managers, users and visitors and provide competent advice in Health and Safety and fire. The Department is located in the Trust Headquarters, but covers Trustwide. Their contact details are available on the Trust health and safety intranet page.

1. Introduction continued …….

Health, Safety and Fire Department Contacts • [email protected] • [email protected]

Below are some health and safety terms/definitions that will be referred to in this learning guide. A comprehensive list of health and safety definitions are available in the Trust’s Health and Safety Policy which can be accessed through the Trust’s intranet via policies and documents:-

• Hazard: Defined by the HSE as something (e.g. an object, a property of a substance, a phenomenon or an activity) that has the potential to cause harm, loss or damage or cause other adverse effects.

• Risk: is the likelihood that a hazard will actually result in causing harm, loss or damage; the risk also takes the consequences of an adverse incident into account.

• Risk Assessment: Defined by the HSE as a careful examination of work activities and procedures so that the employer can weigh up whether they have taken adequate precautions to prevent harm to any person, loss or damage. The law does not expect an organisation to eliminate all risk, but requires organisations to take reasonable steps to protect people “so far as is reasonably practicable”.

• Incident An event or circumstance which could have resulted, or did result, in unnecessary damage, loss or harm to patients, staff, visitors or members of the public.

• Near Miss is defined as any unexpected or unintended incident which was prevented either by intervention or by luck.

1. Introduction continued……

• The Health and Safety at Work Act etc. Act 1974 (HASAWA) is an enabling Act which allows for further laws (known as regulations) to be passed.

• The Trust, as an employer, and you, as an employee, both have responsibilities for health and safety under the Act and health and safety regulations.

2. Health and Safety Law continued …

Section 2 HASAWA places general duties on the Trust to its employees

“It shall be the duty of every employer to ensure, as far as is reasonably practicable, the health, safety and welfare at work of all his employees”

• The Trust as an employer must:-

• Maintain safe plant and systems of work

• Provide information, instruction and training

• Provide a safe place of work

• Provide a safe working environment

• Consult its employees in health and safety

• Have a Health and Safety Policy

Section 3 of the HASAWA places general duties on the Trust to Persons (such as our patients and visitors, etc)

“It shall be the duty of every employer to conduct his general duties undertaking in such a way as to ensure, so far as is reasonably practicable, that persons not in his employment who may be affected thereby are not thereby exposed to risks to their health and safety”

2. Health and Safety Law continued …..

Section 7 & 8 HASAWA places duties on you as an employee • to take reasonable care for the health and safety of yourself and of other persons who may

be affected your acts or omissions at work.

• to co-operate with the Trust so far as is necessary to enable the Trust’s duty or requirement to be performed or complied with.

• Not to intentionally or recklessly interfere with or misuse anything provided in the interests of health, safety or welfare in pursuance of any of the relevant statutory provisions.

The Management of Health and Safety at Work Regulations 1999 also require you as an employee to:- • use any machinery, equipment, dangerous substance, transport equipment, means of

production or safety device provided to you by the Trust in accordance both with any training in the use of the equipment and the instructions respecting that use which have been provided by the Trust.

• inform the Trust of any work situation you would reasonably consider represented a serious and immediate danger to health and safety.

• inform the Trust of any matter which you would reasonably consider represented a shortcoming in the employer’s protection arrangements for health and safety.

2. Health and Safety Law continued ……

Information to Staff

The Trust has a legal duty under the Health and Safety Information for Employees Regulations to display an approved health and safety law poster in a prominent position in each workplace or provide each worker with a copy of the approved leaflet health and safety law: What you need to know that outlines British health and safety law.

The Trust policy is to display the poster at entrances to its premises. It also provides each worker with a copy of the approved leaflet, through the Trust’s health and safety intranet page.

It is your responsibility to access this from the Trust’s intranet health and safety page.

2. Health and Safety Law continued ….

Risk Assessment:

It is a legal requirement to make an assessment of the health and safety risks arising out of the Trust’s work. The purpose of the assessment is to identify what needs to be done to control health and safety risks. (Regulation 3 of the Management of Health and Safety at Work Regulations 1999).

To do a risk assessment, there is a need to understood what might cause harm to people and decide whether enough is being done to prevent that harm. Once decided the next step is to identify and prioritise putting in place, appropriate and sensible control measures.

• identifying what can harm people in the Trust’s workplace

• identifying who might be harmed and how

• evaluating the risks and deciding on the appropriate controls, taking into account the controls you already have in place

• recording the risk assessment

• reviewing and updating the assessment

You must follow the controls/precautions that are recorded in the risk assessments for your work area provided to you by your manager.

The Trust has a dedicated policy for risk assessment – managers need to follow this policy to undertake risk assessments for their area and share with their staff.

2. Health and Safety Law

Consultation with Staff & Corporate Health & Safety Group

• The Trust has a duty to consult with their employees, or their representatives, on health and safety matters. Consultation involves the Trust giving information to employees and listening to them, taking account of what they say before making any health and safety decisions.

• The Trust has a Corporate Health and Safety Group which fulfils the requirements of a Health and Safety Committee as required by health and safety law. The Trust works in partnership with Trade Union appointed health and safety representatives who are members of this Group and are consulted on in matters of health and safety.

• It is Trust Policy that all team meetings have health and safety as a standard agenda item to facilitate local consultation with staff and discuss and share information with staff on matters of health and safety. In addition to Datix reporting and other routes such as reporting directly to line managers, and following appropriate Trust policies it facilities health and safety concerns to be discussed by staff.

Managers and staff are responsible for ensuring that health and safety is an agenda item and discussed in team meetings.


Corporate Heath and Safety Group

Healthcare Estate & Environment Health and

Safety Group

• Water Management Group • Fire Safety Group • Asbestos Safety Group • Medical Gas Group • Security Group • Sharps Safety Group • Health & Wellbeing Group

Trustwide Health & Safety Groups • Estates & Facilities Health, Safety & Fire Group • Divisional Clinical Governance Groups • All Team Meetings Health & Safety Standard Agenda Item

Health and Safety Team & Trade

Union Health & Safety

Representatives Partnership

Operational Group

Trade Union Meetings

The Corporate Health and Safety Group reports through the Trust’s committee structure to the Trust Board

HTM Estates & Compliance Group

Health and Safety Policies


• The Trust is required by health and safety law to have health and safety policies

• All staff must have access to the Trust’s health and safety policies and procedures and know their responsibilities under these policies

• The Trust’s main health and safety policy contains details of associated health and safety policies – you are responsible for ensuring you know which policies are in place and are aware of your responsibilities under these policies.

• All policies are available on the Trust’s intranet policies and documents page.

• All departments should have local health and safety guidelines, which are specific to each area. These should be shared with all staff, volunteers, bank , agency staff to the department as part of their local induction to the Department.

The Health and Safety (Display Screen Equipment) Regulations 1992, as amended by the Health and Safety (Miscellaneous Amendments) Regulations 2002 aim to protect the health of people who work with Display Screen Equipment. The Regulations were introduced because DSE has become one of the most common kinds of work equipment.

Display Screen Equipment (DSE) is any work equipment having a screen that displays information including conventional equipment, laptops, tablets, smart phones etc.

It may be that other devices found in the Trust are classed as display screen equipment depending on how they are used, for example:-

• Ultrasound machines

• Microfiche Machines

• Security Screens

• Handheld devices

• Equipment in laboratories

3. Working with Display Screen Equipment

Under the DSE Regulations the Trust must:

• Identify DSE Users

• Analyse workstations to assess and reduce risks

• Make sure controls are in place

• Provide information, instruction and training

• Provide eye and eyesight tests on request, and special spectacles if needed

• Review the assessment when the user or DSE changes

3. Working with Display Screen Equipment

What is Display Screen Equipment (DSE)? • DSE are devices or equipment that have an alphanumeric or graphic display screen, this includes laptops,

touch screens, medical equipment or graphic displays. • A fixed DSE is one that is not portable. • Portable DSE includes laptops , notebooks, smart phones, etc.

What is a User?

• A user is defined as being a person who works for the Trust as an employee, (including bank) that uses a computer on average for more than one hour in a working day (continuous).

• If time spent is less than 1 hour in a working day, the person should still be classed as a user if their work involves one or both of the following: - Use of a computer on most days per week for continuous or near continuous periods of an hour or more. - Computer tasks that require a high degree of attention and accuracy by the user e.g when the work is fast paced or numerical data entry.

• Trust, bank, temporary agency staff and home workers are all included.

Definitions

3. The Law on Display Screen Equipment

• Visual Problems (including dry eyes from reduced blinking, and headaches from eye strain) • Stress and Fatigue (including headaches and migraines) • Musculoskeletal disorders also known as Repetitive Strain Injury (RSI)

• Work Related Upper Limb Disorders (such as Carpel Tunnel Syndrome) • Back/Neck Pain • Leg/Foot Pain • Skin disorders (e.g rashes which can be caused by static)

What you can do • Report any ill health to your line manager and or local DSE Assessor • Ensure that your line manager has arranged for you to have a personal DSE risk assessment

including training from the assessor on how to safely and correctly use your DSE. • Ensure you are aware of the Trust’s application form for reimbursement of eye sight tests and

corrective glasses for display screen equipment users , available on the Trust Intranet. • Set up your DSE in accordance with the Workstation Ergonomics Layout Poster and 12 Point

Improving Posture Plan available on the Trust health and safety intranet page • Take regular breaks, including micro-breaks • Keep screens clean to prevent static on screen, and allow air flow to prevent static • Follow policies associated to health risks (for example Stress Policy, etc)

3. Possible Health Effects from Using Display Screen Equipment

• The Trust has a specific policy for DSE available on the Trust’s intranet - Display Screen Equipment (DSE) Management of Computer Workstations Policy, Procedure and Guidance.

• This policy addresses specifically administration type work activities for DSE for clinical use (e.g undertaking an ultrasound) and non-clinical use. For staff undertaking patient clinical use of DSE, for example undertaking an ultrasound reference should be made to the Policy and Procedures for Managing Upper Limb Disorders in Sonographers/Radiographers, etc.

• The principals of correct workstation set up and ergonomics to prevent musculoskeletal disorders apply to all workstations you use whether for administration type work activities or clinical use.

3. Trust Policy

By collaborating with employees, potential health problems associated with DSE can be addressed in a practical way. The following steps are taken, once a DSE user is identified within the Trust:

Step Action By Who

1 Self Assessment Questionnaire issued. Line Manager

2 Self Assessment to be completed and returned to Manager. The User

3 Priority assessed (low risks to local DSE Risk Assessor, if necessary referred for medium/high risks to Health, Safety and Fire Department or Moving and Handling Service).

Line Manager

4 DSE Risk Assessment undertaken – where appropriate actions to reduce risks identified are given in writing to Manger in the form of the risk assessment.

DSE Assessor

5 Risk Assessment actions taken forward by manager. Line Manager

Risk assessments are undertaken by trained competent DSE risk assessors who will review the paper self assessments and undertake a suitable and sufficient risk assessment. Risk Assessment must be reviewed regularly as detailed within the Trust DSE and Management of Workstations Policy.

3. How are DSE risks identified

1. Chair Height

Adjust the seat height so that your elbows are approximately level with the desk. The wrists should be in a relaxed, neutral position. Ensure armrests do not prevent you getting close enough to the desk / keyboard or obstruct your elbows whilst typing. Pelvis should be slightly higher than knees.

2. Footrest

Use a footrest to support your feet if they do not reach the floor and ensure that there is no undue pressure on the bottom and/or thighs. Thighs should be approximately horizontal (thigh angle should be slightly tilted from the pelvis to knee by no more than 10 degrees)

3. Chair Back

Adjust the chair back to give support to the small of your back. Adjust the chair back angle for comfort and support; this should be fairly upright when typing.

4. Keyboard

There should be space in front of the keyboard to rest your hands / arms when not typing. The keyboard should be a comfortable distance from (depending on typing style) and parallel with the front edge of desk. There should be space in front of the keyboard to rest your hands/arms when typing. You should adopt a neutral position of the wrists when using the keyboard.

5. Mouse

There should be room in front of the mouse so that your hand/forearm is not obstructed when using it. You should create enough space so that the mouse and mouse mat if used can be moved close enough to prevent you over-stretching. Move your hand away from the mouse when not in use. Use keyboard shortcuts as an alternative to the mouse.

6. Monitor

As a rough guide, touch typists’ eyes should be about level with the top of the display screen and with hunt & peck typists’ slightly lower, staff with vari-focal glasses will need to adjust the monitor to suit their glasses and the screen should be at approximately arm’s length. Adjust the viewing distance and screen height to suit but ensure a slightly downward viewing angle to the screen.

3. Reducing Risks when using DSE Improving Posture 12 Point DSE Workstation Set Up Plan

including, so far as is reasonably practicable, laptops/Mobile DSE in prolonged use (more than 30 minutes)

7. Screen

It should be possible to avoid glare and reflections by adjusting the screen tilt, and it should not be necessary to work with the screen angled down in order to avoid reflections. The correct viewing position is with the screen at right angles to the line of sight. Blinds may be used if available.

8. User Position Your body position should be ‘squared-up’ to the desk. Users should not work at odd angles if it can be avoided. Shoulders should be in line with your hips. Drawers, CPUs, waste bins, etc should not obstruct legs. Therefore, if you are working with the computer the screen should be directly in front of you.

9. Documents

Use a document holder whenever possible if working from a hard copy. Where possible you should position documents at the same viewing distance as the screen, but if it is not possible to use a document holder consider placing the document between the screen and keyboard. However, never place documents on your desk in front of the keyboard so that you have to lean forward to type.

10. Equipment Position & Working Environment

The positioning of other equipment should be thought about, especially any items that are frequently used. Users should not have to stretch excessively for the telephone, or regularly used items. Nothing should be stored under the user’s desk. Do not cradle telephones between shoulder and chin – hold the handset. If you use a telephone and p.c. for long periods together it may be necessary to use a headset dependent on the results of your risk assessment. Lighting should be sufficient for the task. Draughts should be reported and thermal comfort maintained by local means and layers of clothing. Noise that affects or distracts concentration should be reported.



11. Breaks

Organise your work so that you take regular short breaks away from the screen e.g. collecting documents from the printer, filing, making coffee, etc. When not engaged in sustained keyboard work – change your workstation and/or chair set-up so that through the day you adopt a variety of postures. If possible after every 45 minutes continuous DSE use, do 15 minutes non DSE related work, however, as a minimum after every 55 minutes continuous DSE use, 5 minutes of non-DSE work must be undertaken – this must not be accumulated.

12. Other issues/any problems?

If you experience any problems whilst using your workstation or have any health and safety related concerns you should contact your line manager in the first instance. Health and safety advice can be obtained from the Health, Safety and Fire Department, manual handling advice through the Moving and Handling Team. Staff (work place) injury advice can be obtained from the Occupational Health Department. Ensure you are aware of your entitlement to eye and eyesight testing and follow the Trust’s eyesight procedure to get information on how to obtain this entitlement which is a reimbursement scheme. Have regular eye tests as directed by your optician (standard adult advice is an eye test every two years). Software should be suitable for the tasks being performed and you should understand how to use the software issue – speak to your manager if there are any problems. Do bear in mind that the correct set up might not feel right straight away. The principles of correct work station set up apply to all workstations you use including those at home.



3. Summary of Prevention of Health Effects

From DSE - Workstation Ergonomics

A Workstation Ergonomics Poster is available on the Trust health and safety intranet page for you to print off and keep by your workstation to help you set up your equipment correctly.

Portable DSE such as laptop and note book computers are subject to the DSE regulations if in prolonged use, they must be set up as close as possible to fixed DSE, following the Improving Posture 12 Point Plan and Workstation Ergonomics Poster. The Trust defines prolonged use as 30 minutes continuous/near continuous when using a laptop.

When not in prolonged use:

• Aim to use the laptop for short periods only

• Try to find a good position whenever you use a laptop – as a minimum you must always sit at a desk/table with a chair

• Make sure you chair supports your back

• Avoid sitting too high or low, to achieve this always attempt to sit on adjustable chairs

• Do not use your laptop sitting on a sofa or similar chair

• Never use your laptop in a car

• Report promptly any symptoms of discomfort

• Take regular breaks

• Avoid unnecessary Manual Handling

• Minimise risks from theft or mugging

3. Laptops/Note books

3. iPads and Tablets

An iPad or tablet is a great portable device to use for short periods of time but for longer periods or for work requiring the input of information, a correctly set up workstation is the best option. Make sure you use the right tool for the job to ensure you are productive and working without compromising your health. Health and safety advice for using tablets and ipads is located on the Trust’s health and safety intranet page – it is your responsibility to read this if you are using one of these devices for the Trust

3. Portable Communications

Portable input devices including smart phones can lead to pain and discomfort due to the posture needed to use them. Health and safety advice for using portable communications are located on the Trust health and safety intranet page – it is your responsibility to read this if you are using one of these devices for the Trust

Slips, trips and falls can have a serious impact on the lives of employees and those being cared for. The Health and Safety Executive report that they account for around half of all reported major injuries to employees. Possible sources for slips, trips and falls are:

• Spills from containers, bags, tables, food and drinks carts etc

• Leaks from equipment, appliances, pipes, roofs, etc

• Wet mopping of shiny floors

• Rubbish on floors

• Entrances during bad weather

• Footwear wearing inappropriate footwear

3. Slips, Trips and Falls

Slips, trips and falls can be caused by:

• Broken or uneven flooring or loose carpet

• Leads and cables across walkways and corridors

• Obstacles left in walkways and corridors, e.g. wheelchairs, medical equipment, meal trolleys and cleaning equipment

• Equipment using ladders and kick step or stools incorrectly such as over stretching, and using inappropriate equipment to reach heights

• Environmental levels of lighting, contrast between floors, walls and doors

The Trust has a Slips, Trips and Falls Policy and Procedure (excluding patients) and a Slips, Trips and Fall Policy for in patients.

There is a Working at Heights Policy. These are accessible through the Trust’s intranet policies and documents page. You should read these and ensure you understand the policies and

your responsibilities.

3. Slips, Trips and Falls

3. Buildings Safety

• In Trust buildings, there may be hidden hazards, such as water pipes, electrical cables and asbestos, etc. These hazards do not pose a risk unless they are damaged or disturbed. To protect our patients, and ensure a safe environment for all users of Trust premises, staff must not disturb the infrastructure of buildings for any reason, for example do not put drawing pins into walls, do not hammer/penetrate/disturb or damage any of the walls, floors or ceiling of the buildings.

• If departments require any items to be affixed to the buildings, for example securing items to the floor, or walls, putting

up a clock, putting up a notice board, pictures, etc, then a call must be logged with the Trust’s Estates helpdesk only the Estates department must undertake such works within the Trust.

3. Building Safety Continued...

• Traffic routes: To ensure your safety staff must use pedestrian dedicated walkways provided, this may be a dedicated pavement, yellow zoned area on a floor, road, trolleyway or carpark.

• Access/Egress: All corridors and walkways must be kept clear of hazards and obstructions to enable persons , including wheelchair users , hospital beds and equipment to move freely and safely. Do not obstruct doors, fire doors, corridors or fire exits. Arrange furniture to ensure safety and free movement of persons and equipment.

• Welfare: Health and safety law requires the Trust to provide ‘so far as is reasonably practicable’, adequate and appropriate welfare facilities for Trust staff whilst they are at work. Welfare facilities are those that are necessary for the well-being of the staff, such as washing, toilet, rest and changing facilities (where required), and somewhere clean to eat and drink during breaks.

• Workplace Risk Assessment: For each area the manager responsible must complete a workplace risk assessment. A guideline generic template is available on the health and safety intranet site for managers to adapt and make suitable and sufficient for their area(s). This must be shared with all staff and all staff must follow the controls identified.

3. Buildings Safety – Safe Water

The Trust is committed to providing a safe environment for patients, visitors and staff

We all should expect to receive safe healthy water

The water systems are looked after and checked by the Trust to make sure the hot and cold water is suitable for you to use

Is that the end of the story? NO

The Trust needs YOUR help in making sure that the water remains safe at all times

When water stops moving for long periods bacteria can grow which can make the water and water systems unsafe

When basins are used not just for hand washing – this can

introduce harmful bacteria into the water system making the water unsafe

Rooms used as stores with basins/showers in them will increase the risk of bacterial growth

Empty patient rooms/unused en-suites stop water use and increase the potential for bacteria growth

Broken taps, showers and blocked drains will prevent taps/showers from being used

Using basins to hold used medical devices increases risk of

contamination to the water systems and the medical devices

Disposing of waste/fluids down the ward basins increases risk of contamination

WHAT MUST YOU DO TO HELP?

Taps in ALL areas should be used every day – play your part make

sure the hot and cold is run

Report issues to the Estates Help Desk immediately

Follow good clinical practices If in doubt ask

Make sure basins/showers are clean

Report to the Domestic help desk

Poor cleanliness on basins/showers increases risk of contamination

3. Waste

• Waste management is the generic term given to the range of activities associated with waste - generation, handling, storage and transportation from point of production or source (ward/department) to final place of disposal (recycling/landfill/incineration). The Trust produces waste as part of the daily activities.

• Correct waste management is essential for the following reasons:

• To reduce health and safety risks from waste to staff, patients and visitors (e.g. spread of infection from waste, prevent needle-stick injury).

• To protect the environment (e.g. from escape of waste into a river/fly tipping)

• To minimise waste disposal costs

• To comply with environmental law and avoid fines or enforcement action.

• All those who produce or handle waste (i.e. the Trust and all its employees) have a legal Duty of Care to ensure correct handling and disposal procedures for waste are followed and that wastes are managed responsibly from point of source to final place of disposal.

• This Trust has a dedicated policy which outlines the correct procedures all staff must follow. It is your responsibility to read and understand this policy and comply with the requirements.

• The “Trust Waste Policy” is available on the Trust’s intranet policies and document page.

Pressure is part and parcel of all work and helps to keep us motivated. However, excessive pressure can lead to stress which undermines performance, is costly to employers and can make people ill.

The need to tackle stress is also recognised in law. Under the Health & Safety at Work etc. Act 1974 and the Management of Health and Safety at Work Regulations 1999, employers are obliged to undertake a risk assessment for health hazards at work – including stress – and to take action to control that risk.

The Trust is committed to protecting the health, safety and welfare of its employees and recognises that workplace stress is a health and safety issue. It acknowledges the importance of identifying and reducing workplace stressors.

3. Managing Stress

The Health and Safety Executive (HSE) estimates that 12.5 million working days were lost to stress, depression and anxiety in 2016/17.

The HSE’s Definition of Stress

The HSE define stress as "the adverse reaction people have to excessive pressures or other types of demand placed on them". Recent research shows that this 'adverse reaction' can seriously undermine the quality of people's working lives and, in turn, the effectiveness of the workplace.

3. Managing Stress Introduction

Physical Health Risks :

Stress takes many forms. It can lead to:

• Anxiety and depression

• A Significant impact on physical health

• Headaches

• High blood pressure

• Blurred vision

• Disturbed sleep

• Rashes, allergies

• Excessive sweating

• Back pain

• A link to heart disease

• Gastrointestinal disturbances

• Alcohol and drug dependency

Psychological symptoms:

It can lead to feelings of:

• Anxiety

• Depression

• De-motivation

• Lack of concentration

• Poor recollection

• Loss of creativity

• Inability to make decisions

• Fatigue

• Being misunderstood

• Powerless

• Irritation

• Inability to cope

3. Signs of Stress

Life changing events can cause stress and effect us such as:

• Marital problems

• New baby

• Financial worries

• Loss of a loved one

• New job/job changes

• Moving house

• Health worries

• Divorce

• Holidays

• Shift work

Workplace stressors include:

• Being unclear of work expected from you

• Having unachievable deadlines

• Different groups at work demanding things from you that are hard to combine

• Friction or anger between colleagues or service users

• Strained working relationships

• Being subject to bullying

• Being unable to take sufficient breaks

• Under pressure to work long hours

• Having to work fast

• Not being consulted about work place changes

3. Causes of Stress

Stress should not be seen as an inevitable part of modern life nor as a sign of weakness.

The Trust’s Stress Policy applies to all staff (including bank staff, agency staff, contractors, students, trainees and volunteers).

The Management Standards approach has been developed by the HSE to help reduce the levels of work-related stress. The overall aim is to bring about a reduction in the number of employees who go off sick, or cannot perform well at work because of stress.

The management standards approach gives managers the help they need to achieve these aims.

The Trust Stress Policy requires managers to undertake Stress Risk Assessments.

3. The Trust’s Duty Tackling Stress

The Trust can help me through:

• Adequate and achievable demands

• Employees skills and abilities are matched to demands

• Where possible, employees have control over their work

• Employees are consulted over work patterns and any

changes

• Employees are made aware of policies and procedures to prevent or resolve unacceptable behaviour

• Requirements placed upon employees are clear

3. How the Trust can help me

Put yourself first

• Eat and drink healthily, take regular exercise that you find enjoyable

Manage your time

• Choose your top 3 most urgent tasks each morning and make them a priority. Try to delegate commitments that you don’t have time to do yourself.

Have Fun!

• Spend a few minutes each day appreciating what you have got and the good things in life. Try and take time out to enjoy yourself

Relax and Unwind

• Take some time to learn breathing and relaxation exercises – they are proven to be of use in reducing

stress and anxiety.

How can I help myself?

• Try to identify the cause and what you can do to make things better

• Tell your line manager as soon as you are able that you are having problems (personal or work related)

• If you perceive the source of pressure involves your line manager and you are finding it difficult to share this with them, find out what procedures are in place to help you with this. Talk to a Union or Employee Representative. Refer the Trust’s Stress Policy.

• You can speak to the Counselling Service in Occupational Health.

• Remember stress is not a weakness and can happen to anyone.

3. How can I help myself?

The Control of Substances Hazardous to Health Regulations (COSHH) (as amended) cover the presence and use of

substances in the workplace that are ‘hazardous to health’. The risks of using such substances must be assessed

and controlled and employees must be given information, instruction and training on the required control measures. Hazardous substances need to be controlled and managed safely. COSHH substances take many forms in the healthcare environment including: • Products containing chemicals; hand soaps, sanitisers, cleaning products, decontamination products • mists, aerosols, dusts, fumes and sprays; disinfectant sprays, air fresheners, toner cartridges for printers/photocopiers • gases and asphyxiating gases; nitrous oxide, other theatre anesthetic gases, liquid nitrogen • biological agents such as blood borne infections These hazardous substances can potentially enter the body through: • the skin or eye by absorption • inhalation as you breathe • ingestion from being on your fingers • injection directly into the body through needle stick injuries

3. (CoSHH)

Control of Substances Hazardous to Health – (CoSHH)

Control of Substances Hazardous to Health

Both employers and employees have responsibilities under COSHH. Employees must:

• co-operate with their employer, e.g by attending/participating in training courses

• always use control measures designed to reduce exposure

• correctly use the Personal Protective Equipment (PPE) provided

• report any problems with PPE or other equipment

• report non-compliance with safe systems of work

• attend occupational health checks where required

• cooperate with the risk assessment process

3. CoSHH continued …

• Managers must ensure that departments must have up to date CoSHH assessments of CoSHH items (includes items such as cleaning products, hand soaps, toners, skin products, etc).

• The health and safety intranet page contains CoSHH assessment templates for commonly used CoSHH items throughout the

Trust. Managers can download these and complete the relevant uncompleted fields to turn these templates in to departmental specific CoSHH assessments – these should be shared and communicated along with the accompanying Material Safety Data Sheet to relevant staff. Instructions on how to find the relevant CoSHH template are given on the Intranet page.

• The health and safety intranet page for CoSHH includes a short PowerPoint presentation that will guide you through how to use the

database and provides you with additional information and guidance.

• Staff across the Trust have the potential to be exposed to substances that are potentially hazardous to their health, such as printer and photocopier toner, hand soap, hand sanitiser, air freshener etc, so every ward and department should have a CoSHH file. If you are a member of staff you should be shown and have access to the CoSHH assessment(s) before you use these products. You must ensure that you understand them and follow the controls in them at all times when using the products. If you are unsure or need clarification of the CoSHH assessment(s) you should discuss this with your line manager and ensure you fully understand what you are required to do before using the products.

• Staff should be aware that not all hazardous substances – such as bodily fluids may have a safety data sheet, but an assessment will still be required to be completed, for example Blood Borne Viruses (BBV) risk assessment if applicable to your Department.

3.CoSHH continued …

• Dermatitis is a condition where the skin becomes dry, itchy with redness, this can develop into flaking, scaling, swelling and blisters. It often occurs on the hands but can affect any part of the skin. It can affect those people whose job requires frequent hand immersion in water, such as healthcare workers. Causes include repeated hand washing, not rinsing and drying your hands properly, cold weather and atopic eczema in childhood. To cut down the risk of dermatitis at work make sure you have a good hand washing technique, dry your hands properly and moisturise regularly. Check your hands regularly.

Your annual appraisal must cover if you are experiencing any work related skin conditions (such as dermatitis, etc) which must be recorded. If you think you may have dermatitis report it to your line manager who will need to refer you to Occupational Health. You can also seek help and advice from your G.P.

3. Dermatitis

• Violence and aggression to staff, whether verbal or physical, from patients or their friends and relatives, is not tolerated by the Trust. Staff should report any incidences to their line manager at the earliest opportunity and also on Datix. If it is deemed appropriate, and with the consent of the staff member concerned, further action may be taken. This may be the issuing of red or yellow cards, a verbal waring or involving the police.

• Security: You should not bring in any valuables to work, put your possessions (handbags, clothes etc) in either a locked drawer, a secure locker or a locked room. You should challenge any strangers you see in your ward or department. If you see anything suspicious you should call the Security Department (in the acute sites) or the police (clinics etc).

• The Security Department are available 24 hours a day by contacting ext. 3888 or 3999 at Northwick Park & Central Middlesex Hospitals or bleeping 199 at Ealing Hospital. Security should be called for all emergency incidents, thefts, fire responses or for general security advice.

• Policies: The Trust has a Violence and Aggression Policy and a Security Policy which can be accessed though the Trust’s Intranet Policies and Documents Pages.

3.Violence & Aggression and Security

• Lone workers are staff that work by themselves with or without close supervision. This includes staff from all disciplines who may find themselves alone in Trust or Health and Social Care premises, patients’ homes, their own homes (when working on Trust business ‘at home’) or who are expected to be mobile and regularly work away from their main operational bases.

• If you are a loan worker, your manager must carry out a lone worker risk assessment for you detailing any risks you face as a lone worker and what the controls that are being put in place as a result of the risk assessment for your safety.

• The Trust has a Lone Worker Policy which can be accessed though the Trust’s intranet policies and documents pages.

3. Lone Workers

3. Health and Safety Signage

Health and Safety is communicated in a number of ways one of them being through signage .

Ensure that you understand the signage meaning used for health and safety communication and what the different signs mean in these pictures

Provision and Use of Work Equipment

We all use equipment to carry out our jobs. This equipment must be fit for purpose and safe to use. Where necessary it should be serviced and maintained in line with manufacturers‘ instructions.

Instructions for the use of equipment should be clear. All equipment produced in the EU should have a CE mark on it.

Staff must be trained in the use of all equipment relevant to their role.

Whenever you use any equipment you should undertake a visual check to ensure there are no hazards, for example on electrical items there could be hazards such as a frayed cable which could cause electric shock, broken casing on the plugs which could be a fire hazard or cause personal injury. You should ensure that the PAT testing label is in date and when you use equipment do not create a trip hazard by trailing cables, etc.

If you notice that there is a defect you must not use the equipment. You must ensure that no-one else can use the equipment (take out of use, put on a sign, etc) and immediately report it to your manager.

The Trust has a Provision and Use of Work Equipment Policy available on the intranet policies and documents pages. You must read this and understand your responsibilities for work equipment.

3. Work Equipment

Personal Protective Equipment (PPE)

Some roles within the Trust requires staff to wear personal protective equipment (PPE) such as gloves, aprons, eye protection, etc. The risk assessment undertaken by your manager will determine if you are required to wear PPE to protect yourself.

This equipment is there for our protection and to keep us safe, so must always be worn when required. You must wear PPE if the risk assessment or local procedures state you must, which must be provided by the Trust/your line manager.

Single use PPE must be disposed of after use and non-disposable PPE kept clean.

If non-disposable PPE breaks, ask your line manager for a replacement.

You must not be charged for any PPE required to carry out your role in the Trust.

The Trust has a Non-Clinical Personal Protective Equipment Policy available on the Trust intranet policies and documents page. You must read this policy and understand your responsibilities for PPE. Infection control policies detail PPE required for clinical work and is available on the Trust policies and documents pages.

3. Personal Protective Equipment

Sharps, Needle Stick Injuries and Body Fluid Splashes

Needle stick injuries can result in the transfer of blood-borne infections like HIV and Hepatitis B and C. To try and prevent these the Trust has introduced safer sharps. You will need to be trained in their use – there is specific training for the use of safer sharps.

Make sure that you activate the safety device and always dispose of the used sharp immediately in a sharps box. Never leave a dirty sharp lying around for someone else to be injured by it. Never dispose of used sharps in a waste bag.

If you sustain a sharps injury (incl. body fluid splashes) ensure that you follow the emergency procedure as detailed in the Occupational Health policies. You and your manager should ensure that you are aware of the relevant procedure to follow.

3. Sharps, Needle Stick Injuries and Body Fluid Splashes

• We are all responsible and accountable for health and safety whilst we are at work, and must incorporate the Trust’s HEART Values to all that we do.

• To help you in your role for health and safety the Trust has developed a Health and Safety Intranet Page, this is dedicated to health and safety – you should ensure that you are familiar with this resource.

• Health and safety champions within your department support your manager to ensure a safe place to work. If you are interested in becoming a health and safety champion please discuss this with your manager. The Health, Safety and Fire Department provide additional face to face training to health and safety champions and managers.

4. Health and Safety Arrangements

• All departments/wards must have health and safety risk assessments in place, which is the responsibility of the departmental manager to complete these.

• The Trust’s health and safety intranet page has generic health and safety risk assessments that your manager would have reviewed and made specific to your department and the risks to you.

• All managers must ensure their departments/ wards have in place a health and safety folder that contain the departmental/ward risk assessments, safe operating procedures, and are accompanied by a sign off sheet to acknowledge staff have read and understood these.

• Health and safety risk assessments must be shared with you by your line manager – ask to see these if you have not seen them and ensure you are clear about the responsibilities you have and what controls you must follow to keep yourself and others safe. You must complete the sign off sheet to acknowledge you have read and understood these.

• Health and safety risks for your department may also be included in your Divisional risk register – health and safety risks are recorded on the Trust’s Datix risk system.

4. Health and Safety Risk Assessments

To ensure your safety the Trust has processes in place that your manager must ensure are being undertaken in your department. If you are a manager you must ensure that these are being undertaken. Refer to the health and safety intranet page for guidance, below are examples:-

• Annual Health and Safety Departmental Checklist and Action Plan.

• Completion of monthly health and safety prompt lists and Fire Safety Checklist and dissemination to all staff of the Health and Safety and Fire Bulletin.

• Regular Health and Safety Inspections (recorded).

• Health and Safety as a standard agenda item in all team meetings.

• Safe operational procedures, health and safety risk assessments, CoSHH Assessments and CoSHH inventory.

• Annual Appraisals which include dermatitis checks and specific health and safety responsibilities and training.

• Core Skills training.

• Annual Health and Safety Audits.

• Local health and safety induction using the Departmental Health and Safety Template Document.

4. Local Health and Safety Management

First Aid

As people can have accidents or be taken ill at work, it is necessary that some staff know about first aid and what to do in an emergency and how to call for an ambulance.

A first aid needs assessment (refer to the First Aid Policy on the Trust’s intranet policies and document page) helps managers decide what level of first aid cover is required in their ward/department.

As a minimum there must be an appointed person in your department and a first aid box or container (this can be a clinical store).

Your manager must let you know on your first day of work what your first aid provision is and this should also be on display in your department.

Fire Wardens

Your department should have Fire Wardens in place. However, you must ensure you know what to do in the event of a fire – full training is given as part of the fire safety core skills training.

4. Emergency Arrangements

Datix is the incident reporting system that is accessed via the intranet and is used across the Trust for both clinical, non-clinical incidents and near miss incidents. Whether you work in one of our four hospitals or in the community you must report all incidents and near misses you are involved in through Datix.

All non-clinical and health and safety incidents are reviewed by your manager and the Health, Safety and Fire Department.

If you put your email address in you will get feedback when the incident is signed off by the nominated handler (manager).

4. Incident Reporting

Health and safety incidents include:

• slips, trips and falls (to patients, staff & visitors)

• verbal abuse and physical assault

• incidents involving lone workers

• needle stick injuries and body fluid splashes

• fires and false fire alarms

• chemical spills

• manual handling

• missing equipment or equipment failures

If in doubt, report it!

4. Incident Reporting continued ….

Certain types of accident have to be reported to the Health and Safety Executive (HSE).

These are only reported by the Health, Safety and Fire Department. To enable these to be reported it is important that Datix reports are detailed and clear so that it can be identified that there is an incident that is RIDDOR reportable.

Including the following:

• Fractures (to patients, staff and visitors)

• Over 7 consecutive day off sick following an accident at work (includes weekends, holiday and days off duty)

• Light or modified duties for more than 7 consecutive days following an accident at work

• Being admitted to hospital for more than 24 hours following an accident in a place of work

• Certain work related diseases such as occupational dermatitis and occupational asthma.

• Dangerous occurrences including some needle stick injuries.

Notify the Health, Safety and Fire Department as soon as it is identified that there is a RIDDOR reportable incident – follow the Trusts RIDDOR Reporting policy.

4. Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013