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In this issue:

• Avoid winter slip ups.

• Care home fire safety.

• Foodborne illness prevention.

• Sensible risk assessments in care homes.

Autumn 2014 Avoid winter slip-ups

Winter months present additional hazards that are typically not factors for employees during warmer weather – specifically, slip and fall concerns. With snowy and icy conditions, you run the risk of taking major falls, which can lead to serious injuries.

Prevention

Education is essential in preventing winter weather related injuries. Consider the following recommendations to prevent slip and fall injuries during the winter months:

• Wear the proper footwear that provides traction on snow and ice. Footwear should be made of anti-slip material; avoid plastic and leather-soled shoes or boots.

• Exercise caution when entering and exiting vehicles, and use the vehicle for balance and support.

• Try to walk only in designated areas that are safe for foot traffic. If you notice that a walkway is covered in ice, walk on the grass next to the pavement, which will have more traction.

• Avoid inclines that are typically difficult to walk up or down as they may be more treacherous in winter conditions.

• Take small steps to maintain your centre of balance, walk slowly and never run. When possible, walk with your hands free to maintain your balance. And despite the cold temperatures, avoid putting your hands in your pockets. This will help you to better maintain your balance and allow you to break a fall should you slip.

• Use handrails, walls or anything stationary to assist in steadying your feet.

• Look ahead to the path in front of you to avoid hazards.

Latest news on issues affecting healthcare businesses

Injuries resulting from slips and falls can be devastating. And colder temperatures bring especially hazardous conditions.

• Seek shelter immediately in the event of severe weather conditions.

If you begin to slip…

• Twist your body and roll backwards to avoid falling forward and injuring your face.

• Try to relax your body when you start to feel your legs give way.

• If you are carrying a load, throw it off to the side so it does not land on you when you fall. This will also free your arms to help break your fall.

Avoid winter slip-ups (continued)

The health and safety of your residents should be your top priority, so it is important that your facility is proactive in ensuring that proper fire safety precautions are in place. Without a sufficient fire safety programme, you are exposing your organisation to huge losses and legal actions that could potentially bankrupt your business.

Creating a fire safety programme

There are two key measures a care home can take to establish a fire safety programme: installing a sprinkler system and establishing a fire safety programme.

Sprinklers are essential because many residents cannot move quickly or unassisted because they are dependent on ventilators, IVs and feeding tubes. Though the equipment is costly, it is worth the extra expense. Sprinklers diffuse a fire more quickly, allowing residents and staff more time to exit the building safely.

However, a facility cannot rely on sprinklers alone to cover their risk of fire; it is also critical to have a solid fire prevention programme in place. To establish a plan, consider the following three steps.

Step 1: Evaluate the building

First, examine the structure of the facility.

• Your plan will depend on whether the building has a sprinkler system. If it does not, your evacuation will need to be faster and more efficient, so your plan should take that into consideration.

• Evaluate the heating, ventilation and air conditioning system (HVAC) to determine if the vent system will disperse smoke. Additionally, determine if the HVAC has an automatic shut-off in place for the air handlers should the fire alarm sound.

• Inspect the lift to determine if it has fire-resistant gaskets, if pressurisation has been used to prevent smoke from entering the lift shaft and if the vertical utility shafts have adequate sealing.

Care home fire safety

• Evaluate whether the facility has enough smoke detectors and determine if it has an automatic fire service notification system in place.

• Determine if the facility has smoke barriers that will trap the fire in a certain area until the fire service can put it out.

• Inspect the doors of the residents’ rooms. Doors that are 4.5 centimetres thick provide 20 minutes of fire protection. Also, door latches installed outside of the door prevent the door from opening even under the pressure of fire.

Step 2: Create evacuation procedures

You should provide employees with specific instructions in the event that they discover a fire or hear a fire alarm. This information should be clearly posted for staff members and should also be part of your employee handbook. The procedural information should include the following:

• Appropriate actions when discovering a fire.

• Guidelines for removing residents from the area affected by the fire.

• Explanations for how to activate the alarm.

• Guidelines for how to exit the building while assisting residents.

• Test a potentially slippery area before stepping on it by tapping your foot on the surface first.

• Remove debris, water and ice from all working walkways.

• Steer clear of roof edges, floor openings and other drop-offs to avoid slipping hazards.

• Sand or salt surfaces covered by ice or snow to provide traction.

• Dry your shoes or boots on floor mats when entering a building.

• Report trip and fall hazards immediately to your supervisor.

• Instructions for how to greet fire service staff.

• Directions for where to take fire fighters in the building while residents are being evacuated.

• Instructions for how to safely remove feeding tubes, IVs, catheter drains and ventilators before evacuating residents and how to continue these functions in another designated area.

Step 3: Staff training and drills

In order for staff members to understand the proper procedures and have the ability to perform them quickly, the facility must conduct thorough staff training and periodic fire drills.

On a frequent basis, supervisors — such as department heads and charge nurses — should conduct fire drills with their staff. While doing so, each department can determine how well the employees are prepared in the

event of an actual fire. From there, each department can conduct additional training in areas that need improving.

Protect your residents and your facility

A solid fire prevention plan eliminates your risk of penalties from the government, lowers your risk of negligence legal actions, protects your building and your business, keeps your residents safe and is a major selling point for prospective residents and their families. With the appropriate technology and procedures in place, your facility can be prepared in the event of a fire and avoid a potentially catastrophic situation.

Care home fire safety (contnued)

A successful fire safety programme at your facility will involve evaluating the building, creating procedures and training your staff.

Preventing foodborne illness is important for everyone. But when cooking for others, especially senior citizens and those who are ill, you must exercise extreme caution.

Food contamination may seem very difficult to prevent; however, by following these safety tips, you can ensure food safety and prevent foodborne illness at your facility.

Safety steps

Safe steps in food handling, cooking and storage are essential in preventing foodborne illness. You typically cannot see, smell or taste harmful bacteria that have the potential to cause illness. Keep food safe in every step of preparation.

• Wash hands and surfaces often.

• Separate foods to avoid cross-contamination.

• Cook foods to the proper temperatures.

• Refrigerate and store leftovers promptly.

Food handling guidelines

• Refrigerate or freeze all perishable food items. The refrigerator should be set at 4°C or less and the freezer set at -17°C or less. Check the temperatures with a thermometer designated for these appliances.

• Always thaw food in the refrigerator or under cold water, never sitting out at room temperature.

• Wash chopping boards and cooking utensils immediately with soap and hot water after contact with raw meats to prevent bacterial contamination.

• Do not leave perishable foods sitting out for more than two hours.

If room temperature is above 32°C, do not leave foods

out for more than one hour.

• If food is cooked, but will not be served for more than two hours, keep it in the oven at 60 °C and cover with foil.

• Discard tinned foods that are dented, seeping or bulging.

• Do not use food if packaging is torn or open.

• Poultry and meat is only good in the refrigerator for one to two days.

• Keep seafood in the refrigerator or freezer until right before use.

• Throw out foods with any sign of mould growth.

• Never store food near cleaning products or chemicals.

• Store condiments such as ketchup and mayonnaise in the refrigerator after opening.

Cook with care

The most common contributions to foodborne illness outbreaks, such as salmonella or E. coli, are improper cooking, storage techniques and mishandling. Follow these guidelines to prevent illness in your facility.

Foodborne illness prevention

People who work in care homes constitute a large and diverse workforce looking after a predominantly vulnerable population. Employees have the right to work in a healthy and safe workplace, and the people using services are entitled to care and support that is safe and takes their needs, freedom and dignity into account.

Managing these different needs can sometimes present unique and complex situations which can, if not effectively managed, result in serious harm to employees, people using care services and others. Common care home hazards include slips and trips, moving and handling, violent or aggressive behaviour, falls, diseases and much more.

A risk assessment (a process required by law) is not about creating huge amounts of paperwork; it is about identifying and taking sensible and proportionate measures to control the risks. You may already be taking steps to control the risks, but the assessment process will help you decide whether you should be doing more. You may need to consider different elements of risk when producing your assessment, including:

• The common risks to everyone on the premises, for example, risks from legionella, asbestos, electrical equipment and transport.

• The common risks to people using services, for example, risks from falls from height or scalding. Whilst you may have some individuals who are not at risk, you must implement measures to prevent harm to the most vulnerable individuals.

• The individual risks to particular staff, for example, expectant mothers and young workers.

• The individual risks to particular people using services, for example, the risk of an individual falling out of bed or needing help to safely mobilise.

Making sensible risk assessment decisions

The provision of care and support should be tailored to meet the needs of individual residents and should encourage them to do what they can for themselves. Often when assessing the care and support needs, everyday activities are identified that will benefit the resident, but also put him or her at some level of risk.

This requires a balanced decision to be made between the needs, freedom and dignity of the individual and his or her safety.

Care assessments should enable people to live fulfilled lives safely, rather than be a mechanism for restricting their reasonable freedoms. Many care providers find it hard not to slip towards a risk-adverse approach for a multitude of reasons, for example, resources, bad experiences and a fear of the consequences if things go wrong.

Consider the following points when balancing risks:

• Concentrating on real risks where there is a realistic risk of harm.

• Communicating with the individual, caregiver and family when carrying out risk assessments in order to achieve outcomes that matter to them.

• Determining how risks that emerge from an individual’s choice can best be reduced, so far as is reasonably practicable, by putting in place sensible controls.

Care home safety precautions:Ergonomic tips for staffSensible risk assessments in care homes

A risk assessment is not about creating huge amounts of paperwork; it is about identifying and taking sensible and proportionate measures to control the risks.

The content of this newsletter is of general interest and is not intended to apply to specific circumstances. It does not purport to be a comprehensive analysis of all matters relevant to its subject matter. The content should not, therefore, be regarded as constituting legal advice and not be relied upon as such. In relation to any particular problem which they may have, readers are advised to seek specific advice. Further, the law may have changed since first publication and the reader is cautioned accordingly.

© 2014 Zywave, Inc. All rights reserved.

bluefingroup.co.ukBluefin Insurance Services Limited is authorised and regulated by the Financial Conduct Authority.

• Analysing how the most vulnerable can be protected when organising group activities, without unnecessarily restricting the freedoms of the most capable.

Examples of sensible risk management

Use the following examples to help implement sensible risk management in your care home.

• Individual risks when walking to the local shop

A resident who walked to the local shop on a daily basis to collect the newspaper developed Alzheimer’s. He became confused and started to forget how to get back to the care home. Having considered different possibilities, the shop owner agreed to give a gentle reminder of the route home every time the resident visited. This, coupled with checks by the home, allowed the resident to continue with his daily routine – subject to regular review. Other control measures may be appropriate, dependent on the individual.

• Individual risks when making a cup of tea

A resident with learning disabilities was vulnerable to the risk of scalding but benefitted from being able to make his own cup of tea. Proper risk assessment identified that the size, weight and volume of water in a standard kettle put the resident at risk of serious

harm. However, using a single cup hot water dispenser was a reasonably practicable solution. Owing to the resident’s physical condition and tendency to shake, a cup with a limited opening (spill resistant) was also provided.

• Individual risks when a person with dementia is wandering from the care setting

A resident with dementia developed a tendency to wander away from the care setting. The resident was formerly employed in a job where they walked long distances on a daily basis. Assessment indicated that the main risk was from getting lost. The care staff, family and resident all agreed to the use of a tracking and personal alarm system, which alerted the care home if the resident became lost.

• Individual risks when helping to cook in a care home

A resident wished to help in the kitchen at a home. The individual had dementia but was able to carry out certain activities without much support, and helping in the kitchen provided great benefits to the individual and reduced boredom. An assessment of the kitchen identified that some of the equipment presented a significant risk. However, it was decided that the individual could undertake certain tasks under supervision.

• Individual risks for outdoor activities

A resident with Down syndrome wanted to ride a horse on a group outing. If allowed, the resident was then vulnerable to the risk of falling and may not have had the capacity to appreciate the potential danger. However, caregivers decided that the benefits and enjoyment he gained from carrying out the activity outweighed the risks. An assessment identified suitable measures that reduced the risk, including the selection of a reputable leisure provider, use of protective clothing, safe supportive seating, the selection of a suitable horse and close supervision.

Residents can enjoy many different activities if risks are properly assessed and practical solutions are implemented.

Source: The Health and Safety Executive (www.hse.gov.uk).

Care home safety precautions:Ergonomic tips for staffSensible risk assessments in care homes (continued)