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Page 1 of 19
Moving and Handling Policy – HSC010
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Table of Contents Moving and Handling Policy – HSC010 ................................................................................................... 1
Why we need this Policy ..................................................................................................................... 2
What the Policy is trying to do ............................................................................................................ 3
Which stakeholders have been involved in the creation of this Policy .............................................. 4
Any required definitions/explanations ............................................................................................... 4
Key duties ............................................................................................................................................ 5
Trust Board & Chief Executive ................................................................................................ 5
All Managers ........................................................................................................................... 5
All Employees .......................................................................................................................... 6
Procurement Department....................................................................................................... 7
The Estates Department ......................................................................................................... 7
Specialist Advisors ................................................................................................................... 8
Access to Specialist Advisors ........................................................................................................... 8
Policy detail ......................................................................................................................................... 8
Risk Assessment .............................................................................................................................. 8
Training requirements associated with this Policy ........................................................................... 11
Mandatory Training .............................................................................................................. 11
Specific Training not covered by Mandatory Training .......................................................... 11
How this Policy will be monitored for compliance and effectiveness .............................................. 12
For further information ..................................................................................................................... 12
Equality considerations ..................................................................................................................... 12
Reference Guide ............................................................................................................................... 13
Document control details ................................................................................................................. 13
APPENDIX 1 - PATIENT MOVING AND HANDLING RISK ASSESSMENT .............................................. 14
APPENDIX 2 – PERSONAL MOVING AND HANDLING PLAN............................................................... 16
Why we need this Policy
Manual handling operations form a significant part of the daily work activity within all NHS Trusts, in
particular the moving and handling of service users, stores and supplies which affects nurses,
domestics, porters, estates workers and admin support staff.
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Over half of the accidents reported within the NHS each year are associated with manual handling
causing musculoskeletal injuries.
The Trust has made a clear statement of intent within its Health and Safety Policy to do its
reasonable best to secure the health, safety and welfare at work of all its employees, and to adopt
corporate policies and procedures, which set out safe systems of work to ensure compliance with
relevant statutory provisions, with that duty extending to Manual Handling Operations Regulations
1992.
Additionally, employees are reminded that they have a responsibility to take reasonable care of
themselves and others, and to co-operate with the Trust with regard to the Health and Safety Policy.
The Trust is committed to treating people with dignity and respect in accordance with the Equality
Act 2010 and Human Rights Act 1998. Throughout the production of this policy due regard has been
given to the elimination of unlawful discrimination, harassment and victimisation (as cited in the
Equality Act 2010).
What the Policy is trying to do
This Policy applies to all manual handling tasks, whether involving service users or inanimate loads.
The purpose of the policy is to prevent injury, not only to the back, but any part of the body. It
requires employers, which includes all staff including temporary staff, contracted staff, volunteers
and employees of Northamptonshire Healthcare NHS foundation Trust, students or employees or
other external organisations that provide services to the trust, to take into account the whole
handling operation including the external physical properties of loads which might affect grip or
cause indirect injury.
As well as the potential risk to staff, manual handling incidents can pose risk to the safety and
wellbeing of service users. The Trust is committed to adopting an ergonomic approach in designing
safe systems of working so as to avoid, as far as is reasonably practicable, the need for staff to
undertake moving and handling activities that pose a risk of injury.
The following activities should be considered as a risk:
Any activity that involves transporting or supporting of a load including lifting, putting down, pushing, pulling, carrying or moving thereof, by hand or bodily force.
Any activity that could lead to musculoskeletal strain or injury e.g. activities that include potential long periods of static position, regular stooping, twisting, bending or other poor posture. The risk of injury increases significantly with any combination of the above e.g. bending whilst pushing, twisting whilst lifting etc.
This Policy will apply to all “workplaces” which will be deemed to include:
All Trust premises
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All premises where Trust staff (including bank staff) and contractors are required to work, which are the management responsibility and/or are in the ownership of other organisations or individuals (shared premises).
Moving and handing operations may occur away from the Trust’s premises in situations over which
the employer can exercise little direct control. For example in shared accommodation or in the
service users own home. Where possible there is a need to develop a close liaison with those in
control of such premises. There may sometimes be a limit to the Trust’s ability to influence the
working environments: but the task and perhaps the load will often remain within control as will be
the provision of effective training and the monitoring of effective systems of work. In some cases
special arrangements may need to be made to ensure safe handling of service users in their own
home.
The Trust recognises that there will always be elements of work that require some moving and
handling. Where it is not possible to eliminate such handling, the aim is to make it as safe as is
reasonably practicable to reduce the risk of injury.
A range of actions supporting the continual development of safer handling practices and support
mechanism across the workplace will be implemented, including provision of equipment identified
by risk assessment, and the requirement that employees participate in recognised training.
Which stakeholders have been involved in the creation of this Policy
Health, Safety and Risk Committee
Manual Handling Team
Trust Policy Board
Any required definitions/explanations
NHFT - Northamptonshire Healthcare NHS Foundation Trust
Manual Handling - A common misconception is that manual handling refers only to the lifting of
loads. The Manual Handling Operations Regulations 1992 states: “manual handling operations”
means any transporting or supporting of a load (including the lifting, putting down, pushing, pulling,
carrying or moving thereof) by hand or by bodily force”.
Load - This is any movable object. This includes a service user receiving medical attention or care,
items of equipment, files/records, trolleys, carts, wheelchairs etc.
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Ergonomics - The means by which the working environment and working practices are altered to
more suitably match the individual, thus reducing risk of injury
Minimal Lifting - Minimal lifting techniques are those which employ the use of mechanical lifting
devices. Manual lifting, whilst not banned, should become the last resort when all other options
have been exhausted. If a decision to manually lift is made, managers and staff must be able to
justify their actions.
Minimal Assistance- Guiding a partially sighted or blind service user.
Competent Person - The HSE defines a competent person as someone who has had sufficient
training, experience, knowledge, skills and other qualities to comply with the requirements of the
legislation.
Provision and Use of Work Equipment Regulations (PUWER 1998), HSE: - guidance stating that all
equipment provided and used in the course of your employment should be checked prior to its first
use and on a regular basis. The regularity will depend on the device or piece of equipment being
used.
Lifting Operations and Lifting Equipment Regulations (LOLER 1998), HSE: - guidance stating that all
equipment used for lifting a person whether a hoist, and any material sling used, or lifts in buildings
must be checked by an appropriately qualified person/engineer every 6 months.
Key duties
Trust Board & Chief Executive
Will as far as reasonably practicable, take steps to meet their responsibility by ensuring:
The implementation of this policy
Adequate provision of suitable staffing levels, working conditions and environments
Adequate provision and maintenance of suitable equipment
Trust employees are properly informed and trained
A comprehensive audit process is maintained to measure and review policy compliance and effectiveness
Adequate resources are made available
All Managers
Have the responsibility for the following:
To implement manual handling regulations within their workplace
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To seek additional advice or training on manual handling risk management when necessary
To ensure their staff are aware of, and trained sufficiently, and competent in matters relating to manual handling, posture and ergonomics, records are kept of this training.
To ensure full and sufficient risk assessments of manual handling activities within their departments are carried out. These must be documented and reviewed regularly.
To ensure that only risk assessed patient manual handling practices are used, and that unsafe and high risk techniques are avoided.
To ensure patients manual handling needs are identified, particularly at the time of admission and when referred on to other care providers
To ensure that bank and agency staff are adequately trained before commencing work
To ensure that their departments are sufficiently provisioned with suitable equipment and staffing levels to facilitate safe handling and working postures
To ensure staff use manual handling aids wherever they can to reduce risk of injury, whilst maintaining the needs of the patient
To ensure that any manual handling equipment is in a good state of repair and maintained in accordance with the manufacturer’s instructions, PUWER and LOLER regulations.
To document and report, via risk registers, to their directors any circumstance which prevents them from reducing identified risks, this includes environmental and design issues that have a negative impact on safe working practice.
To ensure that all accidents/incidents regarding manual handling operations are reported, investigated and appropriate remedial action taken.
To ensure when any equipment faults are reported, the equipment is taken out of service and appropriate notification is undertaken.
To contact the manual handling department to complete a training needs analysis when/if their clinical remit/service user needs change.
To nominate a member of the team to complete the quarterly hoist and sling audit as requested by the manual handling team.
To ensure surplus manual handling equipment/stock is identified and returned to the manual handling department to enable other Trust departments to utilise if required.
To ensure condemned or ‘lost’ equipment is reordered in a timely manner to ensure staff and service user safety.
All Employees
Will take reasonable care of their own health and safety and that of others when involved in manual handling.
Are responsible for: o Attending any training and acting upon information provided o Undertaking appropriate risk assessments for the moving and handling of
service users and inanimate loads. The assessment must take account of the task: Task Individual capabilities
Load Working environment Equipment
Ensuring they follow a safe system of work as indicated in documented patient handling risk assessments, and inanimate loads risk assessment documentation, and
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recognize that service users handling needs are ever changing and, as such assessments must be continually updated.
Reporting immediately to their manager any shortcoming in their training, knowledge, skill, competency, ability or experience, which compromises their safe working practice relative to manual handling, working postures and documented risk assessments
Use manual handling aids whenever identified as appropriate via manual handling risk assessment. Please refer to Guidelines for the safe use of electric patient lifting hoists for further information
Promptly reporting any accidents or near misses related to manual handling to their Manager, and complete accident/incident documentation
Reporting to their manager any issues relating to their health or fitness that may have an adverse effect on their manual handling safety or ability (including pregnancy)
Wearing suitable clothing and enclosed flat shoes as a minimum requirement, exact requirements would be indicated by risk assessment. Please refer to Dress code policy for further details.
Ensuring equipment is clean and in visually good condition prior to use.
Employees are advised that they must not cause physical abuse to any patients. Physical abuse is any physical contact, which harms clients or is likely to cause them unnecessary, and unavoidable pain and distress. Examples include handling the client in a rough manner or poor application of manual handling techniques. Physical abuse may cause psychological harm (ref: NMC 2002 Practitioner- client relationships and the prevention of abuse).
Procurement Department
Will ensure that:
Any equipment/furnishings purchased are of suitable standard
Appropriate information accompanies equipment supplied
Prior to purchase of patient manual handling equipment, if required, the appropriate professional i.e. Manual Handling Team, Infection Control Nurse, Tissue Viability Nurse is consulted.
The Estates department is informed of any new equipment purchased so that appropriate servicing schedules are drawn up.
The Estates Department
Will ensure that:
Manual handling equipment, where appropriate is regularly maintained according to manufacturer’s instructions. In particular lifting equipment will be subject to six monthly inspections in accordance with the Lifting Operations and Lifting Equipment Regulations (1998).
Manual handling equipment awaiting repair is given high priority.
When undertaking either a new build or refurbishment, consideration is given to the issue of manual handling. Designers and planners should take account of the ergonomics in intended designs to minimise the risks caused by moving and handling, both in the production process and finished product. Advice from specialist advisors will be sought where appropriate.
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Specialist Advisors
The role of Specialist Advisors is to assist the employer with the risk management of manual handling. This will include identifying, assessing significant risks and reporting on the effectiveness of control measures.
Other duties include: o Design, co-ordination and, where necessary, provision of relevant training
programmes for staff. o Provision of specialist, proactive, reactive or requested advice. o Support/advise in the undertaking of manual handling risk assessments as
requested o Assessment of reported manual handling near misses and incidents with a
view to investigating those where further action may be necessary o Undertaking yearly audits of hoisting and sling equipment o Provision of advice on the selection and use of equipment o Attending meetings seminars, workshops and training courses to ensure
maintenance of knowledge skills and competency o Review of manual handling policy and related guidance on a three yearly cycle
Access to Specialist Advisors
Specialist patient handling advice can be obtained by contacting one of the trainers within the
manual handling team. Other manual handling advice requirements should be directed to the
health and safety risk team.
Contact details of the manual handling and health and safety risk teams are available on the Staff
room.
Policy detail
Risk Assessment
Risk assessment for the moving and handling of service users and objects should be completed by competent staff
Patient Handling Risk Assessments
Patient handling risk assessments should be completed within 24 hours of a service user’s admission, or at a first assessment visit. How to complete a personal moving and handling plan is also available as an ESR e learning package ‘patient handling Risk assessment training for S1’. The Manual Handling Lead can be contacted for specialist advice with regard to the completion of service user moving and handling risk assessments.
Action Plans
Once a risk assessment has been completed any patient identified with moving and handling risks must have a completed action plan as per Appendix 1. This plan must detail how the risk will be reduced.
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Following up risk assessments and action plans
The risk assessment must be reviewed if any of the TILEO factors change, or every six months. All members of the multidisciplinary team must be responsible for updating the risk assessment and corresponding action plan.
Risk Assessment for non-clinical staff who assist patients to and from clinics
A patient attending a clinic will not have had a manual handling risk assessment carried out
therefore their level of mobility will not be known. In this instance only minimal assistance
must be given and where more than minimal assistance is required a wheelchair must be
offered.
When offering a wheelchair ensure that it is safe to use. Carry out the pre-use checks
according to the checklist attached to the wheelchair. Further guidance is available in the
ESR eLearning package ‘safe use of wheelchairs’.
Where the patient is accompanied by a relative or carer, they should be encouraged to assist
the patient when assistance is required.
Object Handling Risk Assessments
A “dynamic” inanimate loads manual handling risk assessment will be carried out prior to all manual handling tasks. Where the manoeuvre of an inanimate load is such as to carry a risk of injury, and handling occurs on a regular basis a written risk assessment should be completed.
The chart on page 10 gives guideline weights for lifting and lowering, of inanimate loads, which assumes that the handling is taking place in reasonable working conditions with a load that is easily grasped with both hands by a reasonably fit, well-trained individual.
No manual handling activity is completely safe. However, using these guidelines as part of a well thought out risk assessment will reduce the risks from manual handling activities. Manual Handling risks identified on the DatixWeb risk assessment form that cannot be eliminated or managed to the lowest reasonably practicable level must be added to the risk register for that department/directorate.
Weights to be lifted may need to be reduced below the guideline values if there are environmental or other factors that could have an adverse effect on the activity or if it involves twisting or bending.
Similarly, if the task is being carried out frequently then weights should be reduced.
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One way to assess manual handling activities is to look at five specific areas – Task, Individual, Load, Environment and Other Factors, (easily remembered by the acronym TILEO). As with any assessment, the workforce should be involved in the process. Key factors to consider in each element are:
The Task
Does the activity involve twisting, stooping, bending, excessive travel, pushing, pulling or precise positioning of the load, sudden movement, inadequate rest or recovery periods, team handling or seated work?
The Individual
Does the individual require unusual strength or height for the activity, are they pregnant, disabled or suffering from a health problem on restricted duties. Is specialist knowledge or training required?
The Load
Is the load heavy, unwieldy, difficult to grasp, sharp, hot, cold, difficult to grip, are the contents likely to move or shift?
The Environment
Are there space constraints, uneven, slippery or unstable floors, variations in floor levels, extremely hot, cold or humid conditions, poor lighting, poor ventilation, gusty winds, clothing or Personal Protective Equipment that restricts movement? Environmental risks must be highlighted on the trusts risk register.
Other Factors
Is the equipment clean and fit for purpose. Are staff that are to use the equipment trained and competent to do so? Are instruction manuals readily accessible in all areas where equipment is to be used? Has equipment been regularly serviced and inspected. Please refer to the Medical Devices Policy for further details.
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Plus size/Bariatric Patient Handling
Bariatric people handling is principally no different from all people handling, however due to the size, weight or body dynamics of this person group, specialist consideration may need to be given to certain aspects of the overall care package. Further advice can be sought from the Manual Handling Lead/team, with regard to patients whose BMI is greater than 35kg/ m², and who staff have identified as having moving and handling risks.
Identification of hazards and risks
The Manual Handling Operations Regulations (1992) establishes a clear hierarchy of measures:
Avoid hazardous manual handling operations so far as is reasonably practicable
Assess any hazardous manual handling operations that cannot be avoided
Reduce the risk of injury so far as is reasonably practicable
Review any assessment if there is reason to suspect that it is no longer valid, if there has been change in the manual handling operations or an injury has occurred.
Within Northamptonshire Healthcare NHS Foundation Trust there are two different forms of moving and handling risk assessment. Appendix 1 details the service users moving and handling risk assessment and action plan. Inanimate loads risk assessments are recorded within the DATIX risk register. See Risk register policy HSC002 for guidance on risk assessment and use of risk registers.
Training requirements associated with this Policy
Mandatory Training
Training required to fulfil this policy will be provided in accordance with the Trust’s Training
Needs Analysis. Management of training will be in accordance with the Trust’s Statutory and
Mandatory Training Policy’.
Techniques to use in the manual handling of service users and use of appropriate equipment are
detailed in A Guide to the Handling of Patients (Edition six). Copies of this guidance are held at the
main hospital sites, Berrywood Library and Manual handling department St Mary’s Hospital. Further
guidance can be obtained on The staff room.
Specific Training not covered by Mandatory Training
Ad hoc training sessions based on an individual’s training needs as defined within their
annual appraisal or job description or service users specific training can be accessed via the
manual handling team .
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How this Policy will be monitored for compliance and effectiveness
The table below outlines the Trusts’ monitoring arrangements for this document. The Trust reserves
the right to commission additional work or change the monitoring arrangements to meet
organisational needs.
Aspect of compliance or effectiveness being monitored
Method of monitoring
Individual responsible for the monitoring
Monitoring frequency
Group or committee who receive the findings or report
Group or committee or individual responsible for completing any actions
Techniques to be used in the moving and handling of service users including the use of appropriate equipment.
Competency assessment of 50 staff using appropriate manual handling within their workplace
Manual Handling Team
Annual
Learning and Development monitor compliance
All staff named within reports
Audit of hoist and slings
All hoists and slings to be inspected and monitored for compliance with regulations.
Manual Handling Team
Annual
Medical devices as requested
Departmental service leads identified in report
For further information
Please contact the Manual Handling and/or the Health, Safety and Risk Team
Equality considerations
The Trust has a duty under the Equality Act and the Public Sector Equality Duty to assess the impact
of Policy changes for different groups within the community. In particular, the Trust is required to
assess the impact (both positive and negative) for a number of ‘protected characteristics’ including:
Age;
Disability;
Gender reassignment;
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Marriage and civil partnership;
Race;
Religion or belief;
Sexual orientation;
Pregnancy and maternity; and
Other excluded groups and/or those with multiple and social deprivation (for example
carers, transient communities, ex-offenders, asylum seekers, sex-workers and homeless
people).
The author has considered the impact on these groups of the adoption of this Policy and these are
incorporated into the overarching health and safety equality analysis.
Reference Guide
MHOR – Manual Handling Operations Regulations 1992.
LOLER- Lifting Operations and Lifting Equipment Regulations 1998.
PUWER –Provision and Use of Work Equipment Regulations 1998.
MHSWR – Management of Health and Safety at Work Regulations 1999.
HSAWA – Health and Safety at Work etc. Act 1974.
Backcare (RCN). The Guide to The Handling Of People 6th Edition 2011 Middlesex,
Document control details
Author: Manual Handling Lead
Approved by and date: Trust Policy Board – 25 June 2019
Responsible Committee: Health, Safety and Risk Committee – 29 May 2019
Any other linked Policies: HSC009 - Policy on the Reporting of Injuries, Diseases and Dangerous Occurrences’ CRM002 - Incident Reporting Policy CLP062 - Falls Management Policy for Service Users HSC011 - Guidelines for the safe use of mobile electric patient lifting hoists HSC002 - Policy and Guidance for the Use of Risk Registers ICP019 – Dress code policy Mandatory Training documentation
Policy number: HSC010
Version control: Version 2
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Version
No.
Date
Ratified/
Amended
Date of
Implementation
Next
Review
Date
Reason for Change (eg. full rewrite,
amendment to reflect new legislation,
updated flowchart, minor amendments, etc.)
1.0 06.07.2016 06.07.2016 01.07.2019 New governance of trust policies
template.
2.0 25.06.2019 26.06.2019 25.06.2022 Reviewed
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APPENDIX 1 - PATIENT MOVING AND HANDLING RISK ASSESSMENT
This risk assessment is to be used within all in patient areas, and must be completed by a named
member of the multidisciplinary team within 24 hours of admission, or transfer from another ward.
Within the community this risk assessment documentation should be used by staff that are required
to assist with the mobility needs of an individual client or patient, or provide a “treatment” that
requires the staff member to carry out manual handling as defined by the Manual Handling
Operations Regulations (1992).
If staff involvement is to offer advice/counselling only this documentation does not need to be
completed, i.e. within community settings.
This assessment must be reviewed if any of the “TILEO” factors change, or every six months. All
members of the multi-disciplinary team must be responsible for updating the risk assessment and
corresponding action plan
All staff must have access to the assessment and action plan at all times.
All staff must check the action plan at the start of their shift. Should the service user’s condition, at
the time they see them, necessitate a change in the safe system of work, then it must be noted.
All staff must understand how to read the assessment, and all staff must follow the safe system of
work laid down in the action plan. (95% of all staff expected to perform the task must be able to do
so)
All services complete the same risk assessment format in system one to identify any moving and
handling risks
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Risk assessment screens from system one
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APPENDIX 2 – PERSONAL MOVING AND HANDLING PLAN
Personal moving and handling care plan (applied to the record following completion of the NHFT
personal moving and handling assessment template, if indicated.
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Holistic Care plan- Community Beds only (applied to all patients and amended/ personalised
according to assessment outcome)