Unit 06

Promote health, safety and wellbeing in care settings

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Unit purpose and aims

This unit introduces knowledge and understanding of health and safety requirements when

working in a care setting.

The learner will:

1. Understand own responsibilities and the responsibilities of others, relating to health

and safety

2. Be able to carry out own responsibilities for health and safety

3. Understand procedures for responding to accidents and sudden illness

4. Be able to reduce the spread of infection

5. Be able to move and handle equipment and other objects safely

6. Be able to handle hazardous substances and materials

7. Be able to promote fire safety in the work setting

8. Be able to implement security measures in the work setting

9. Know how to manage stress

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1.1 Legislation relating to general health and safety in a social care setting

The framework of legislation is based on Acts of Parliament being passed and Regulations,

Codes of Practice and Guidance being made under these to explain, in greater detail, the

requirements of the Act itself:

The Health and Safety at Work Act 1974(HASWA)

Manual Handling Operations Regulations (1992)

Management of Health & Safety at Work Regulations1999

The Provision of Workplace Equipment Regulations

The Management Welfare Regulations

The Personal Protective Equipment Regulations

Health and Safety (First Aid) Regulations(1981)

The Electricity at Work regulations1989

Working Time Regulations1998

Care Standard Act2000

Food Safety Act 1990 and Food Hygiene Regulations2005

Personal Protective Equipment Regulations.

The employer has a duty to carry out an assessment and to provide suitable first aid

equipment and procedures. Employees should be informed of these arrangements. Your

workplace will have either first aiders or appointed persons. Their names and location

should be displayed on the notice board.

Food Hygiene Act (1995)

The purpose of this legislation is to prevent food poisoning by ensuring that the food we eat

has been prepared and handled safely.

Environmental Protection Act (1990)

This Act governs how and where waste is disposed of, in order to protect the environment.

RIDDOR - The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations

(2013)

The Public Health (Control of Disease Act 1984) as amended by the Health and

Social Care Act2008

The Public Health (infectious Diseases) Regulations1998

Lifting Operations and Lifting Equipment Regulations (1998)(LOLER)

Health & Safety (Display Screen Equipment) Regulations1992

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The Medicines Act 1968

The Misuse of Drugs Act1971.

Control of Substances Hazardous to Health (COSHH)

The Control of Substances Hazardous to Health Regulations place a responsibility on the

employer to ensure that all substances used in their place of work are safe and correctly

handled

Hazardous Waste Regulations 2005

These regulations were introduced to control the storage, transport and disposal of

hazardous waste to ensure it is appropriately managed and that any risks are limited.

Communicable diseases

Any disease that can be transmitted from one person to another. This may occur by direct

physical contact, by common handling of an object that has picked up infective micro-

organisms, through a disease carrier or by the spread of infected droplets coughed or

exhaled into the air.

The most dangerous communicable diseases are on the list of notifiable diseases e.g.

Meningococal meningitis.

The Fundamental Standards state that ‘You must not be given unsafe care or treatment or

be put at risk of harm that could be avoided. Providers must assess the risks to your health

and safety during any care or treatment and make sure their staff have the qualifications,

competence, skills and experience to keep you safe. You can view this at - www.cqc.org.uk

According to your code of conduct you must ‘Work in collaboration with your colleagues to

ensure the delivery of high quality, safe and compassionate healthcare, care and support.’ -

www.skillsforhealth.org.uk and www.skillsforcare.org.uk

You can view these and other relevant legislations at - www.hse.gov.uk

The Public Health (Control of Disease Act 1984) - doctors must report any notifiable disease to Public Health officials.

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1.2 The main points of health and safety policies and procedures agreed

with the employer

Organisational safety and security procedures

In order to keep the workplace safe and secure, employers write policies and develop

procedures to be followed by their employees. The Health and Safety at Work Act (1974)

requires employees to draw up a Statement of Health and Safety Policy, to review and

revise it as often as necessary and to ensure that all employees are aware of it. This

applies to all employers who have five or more employees.

Health and Safety Policy Statement

‘An employer (of 5 or more people) should prepare (and revise when necessary) a general

statement of policy with respect to health and safety at work and, in particular, outline the

organisation and arrangements which have been implemented to ensure that the policy is

being carried out’.

This means a company should write down the arrangements in place for ensuring that the

health and safety of its employees are taken into account in the day-to-day running of the

business.

The policy should include:

All significant risks

All controlled measures assessed for hazards

Methods for reporting hazards or health problems

Procedures for first aid, fire and emergencies

All reporting procedures.

The policy should be in writing and brought to the attention of all employees. It should

clearly define the roles and responsibilities of individuals and managers for health and

safety. It should be signed by the most senior manager within the company, in order to

show commitment.

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1.3 The main health and safety responsibilities

The Health and Safety at Work Act 1974 places responsibilities on both employers and

employees to ensure compliance with health and safety.

Duties of care worker (employee)

Employees should:

Take reasonable care of their own health and safety, and that of others who may be

affected by their acts or omissions

Co-operate with the employer on matters of health and safety, and follow work place

procedures

Correctly use, and not misuse or interfere with anything provided for health, safety or

welfare. Procedures have been developed to ensure that equipment and materials

are used safely, to prevent injury to the worker, individual or visitor. The

manufacturers also provide information on the equipment and documentation

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Visually check any electrical equipment, prior to use - Is the plug cracked or

damaged, are there any loose parts and is the cable intact so that wires cannot be

accidentally touched

Portable electrical equipment [PAT] has to be checked annually to ensure functioning

correctly, that the wiring is intact, and safe and correct fuses installed

Take part in Health and safety training

Report any potential hazards and risks

Understand and comply with health and safety procedures

Report any accident or incident that may occur, whether or not anyone sustained

injury

Work in a safe manner.

Duties of the employer

An employer should ensure, so far as it is reasonably practicable, the health, safety and

welfare of all employees. In particular, this section requires the employer to:

Provide and maintain plant and systems of work that are safe and without risk to

health

Make arrangements to ensure that substances (e.g. solvents) can be used, handled,

stored and transported safely

Provide information, instruction, training and supervision to ensure health, safety and

welfare of employees

Maintain the place of work in a safe condition and without risk to health, and to

ensure that means of access to and from the place of work are provided and

maintained in a safe condition

Provide adequate welfare facilities and maintain a safe and healthy working

environment

Provide plant, equipment and premises that are safe to use

Provide first aid facilities

Train and supervise on all health and safety

Outlining procedures for dealing with fires

Make adequate provision for the safe storage of goods

Provide protective clothing when necessary

Make regular audits and assessments of work place activities

Provide a written statement of Health and Safety, if 5 or more people are employed

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Arrange adequate insurance cover for employees and the public

Provide a safe environment for all.

Duties of the individual (someone requiring care or support)

To comply with health and safety instructions and procedures

To take reasonable care of their own health and safety and the safety of others.

Duties of others in the work setting

In health and social care settings ‘others’ may be relatives, visiting professionals or trades

people who are on the premises temporarily. They have a duty to comply with health and

safety instructions and procedures and report any concerns about hazards to staff.

1.4 Tasks relating to health and safety that require specialist training

Tasks that the learner should not carry out without special training may include those

relating to:

Use of equipment

First aid

Medication

Assisting and moving

Emergency procedures

Food handling and preparation.

Under the Management of Health and Safety at Work Regulations - regulation 13 states:

‘The employer must ensure individuals are appropriately trained to carry out their duties’.

Many pieces of legislation require an employer to ensure that staff have received

appropriate training.

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Induction training

Induction training should be carried out when a person joins a company for the first time.

Health and Safety should form an integral part of any existing induction training package.

Topics to be covered should include emergency procedures, such as fire precautions and

evacuation, first aid arrangements, accident reporting, all procedures and the company

safety policy.

Job specific

The extent and complexity of training will depend upon the job being carried out. It is

important to consider a period of supervision, especially if the employee is a young person

or has any learning difficulties.

Ongoing training

It is a requirement to introduce a periodic refresher or update of skills (e.g. moving and

handling techniques) to ensure that employees continue to practice safely.

A programme of regular health and safety training can be used to advise employees about:

Any new hazards and risks

The results of risk assessments

Control measures to reduce risks.

Specialised training

Some jobs require individuals to be highly skilled and ‘competent’. A competent person is

defined as a person who has specialised knowledge of the issues concerned, who may

have a recognised qualification and experience, but above all who knows their own

limitations. Within this area are included medication training, food handling and preparation,

and first aid.

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A first aider is someone who has undergone a training course in first aid at work and holds

a current first aid at work certificate. An appointed person is someone who looks after first

aid equipment and takes charge when somebody is injured or is taken ill in the workplace.

Training records

It is important to have a formal way of recording any training that employees receive during

their employment. This will not only assist in ensuring that persons are appropriately trained

to carry out their relevant tasks, but may be of use should an incident occur, or worse still a

compensation claim is made. If an accident occurs in your place of work, the Health &

Safety Executive (HSE) or Environmental Health Officer (EHO) may ask for training records

to verify if the injured person received appropriate training, or whether lack of training was a

contributory cause of the accident.

2.1 Use policies and procedures or other agreed ways of working that

relate to health and safety

It is imperative that you are aware of, and have access to, policies and procedures and

other agreed ways of working. It is your responsibility to adhere to and use these in order to

maintain the health and safety of yourself and others whilst carrying out your work

practices. You must use agreed ways of working when providing all aspects of care to

individuals. This may include:

Prevention and control of infection

Moving and handling safely

Handling medication and other hazardous substances safely

Ensuring the risk of fires starting is minimised.

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2.2 Support others’ understanding of health and safety to undertake and

follow agreed safe practices

You, as a care worker, can encourage and support others to understand and follow safe

practices. You can act as a role model, teaching by example and passing on your

knowledge, practical skills and abilities to colleagues. You can provide support by ensuring

an environment is created where people feel confident and able to follow safe practices.

They should feel they can rely on you for advice, guidance and support and you will

respond to any concerns about their ability to understand and follow safe practices. They

must also be aware that you will not support unsafe practices and will report any concerns

you have.

2.3 Monitor and report potential health and safety risks

It is essential that you know when and how to report potential health and safety risks that

have been identified. It is the responsibility of all employees to report risks, even if that

employee is in a junior position. Reporting a risk will ensure that the health and safety

officer and/or manager/employer is aware and is able to assess the risk. Even if a written

risk assessment is in place, you must report any risks that develop due to any hazards

identified, changes that occur, or if control measures are inadequate.

Your workplace will have policies and procedures which detail the processes required to

report potential or actual risks to health and safety. Your role within the organisation will

determine who you report this risk to and how you do it. It is likely that if you are new to

care, or in a junior position, you will report the risk to a designated senior colleague e.g.

your manager, a trained nurse, or the health and safety officer.

It is good practice for you to make a written record of the potential/actual risk identified and

when and to whom you reported this. Indeed, it is likely your care organisation will require

this.

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Faulty equipment should be removed from use, clearly labelled and a written report made.

Any environmental risks (e.g. loose tiles, rugs etc.) should be reported, the hazard removed

if possible, and all those within the care setting protected from the risk. This may be done

by the use of signage, cordoning off the area and requesting urgent repairs or replacement.

The manager, or health and safety officer, will then follow legal and organisation processes

to report the risk.

It is important that you appreciate that reports must be clear and accurate. There is little to

be gained from a report that is not understood, gives a false impression of the situation or

has vital details omitted.

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

These regulations insist that workplaces keep a note of any injuries, diseases and

dangerous occurrences so that they can be monitored and, if necessary, investigated.

Organisations must have an accident reporting system and any incident that results in an

employee needing seven or more days off work has to be reported to the Health and Safety

Executive.

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2.4 Use risk assessment in relation to health and safety

Defining hazard and risk

Hazard - something with the potential to cause harm, death, ill health, injury, loss of

production or damage to plant or property.

Risk - entails the likelihood of injury, damage or harm arising, taking into account any

preventative measures already in place.

For instance, a sharp knife left in a washing up bowl is a hazard; receiving a cut from

putting your hand in is the risk; a control measure is not to leave sharp knives in the bowl.

Risk assessment

A risk assessment may be defined as an identification of the hazards present and an

assessment of the extent of the risk involved, taking into account whatever precautions are

already in place.

Where five or more persons are employed that assessment must be written down. There

are “Five Steps to Risk Assessment”:

1 Identify all the hazards

2 Decide who could be harmed

3 Evaluate the risks and decide if existing control measures are adequate

4 Record the findings

5 Review the assessments at regular intervals.

The format for recording the assessment may be one that suits your organisation.

In order to achieve a suitable and sufficient risk assessment, it is essential to identify all the

hazards associated with the activity.

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The following list is a guide to some of the hazards which need to be considered when

identifying these for the purpose of risk assessment:

Slipping/tripping

Fire

Loose or trailing cables

Storage of boxes and files

Manual handling

Noise

Poor lighting

Electricity

Housekeeping

Chemicals.

This is not a comprehensive list, but is given to illustrate the extensive nature of hazards

which may need to be taken into account.

Evaluation

Evaluate the risks arising from the hazards and decide whether existing precautions are

adequate, or more should be done.

For each activity, a risk assessment has to be carried out. To estimate the extent of the risk,

use guidance material (e.g. a manufacturer’s hand book supplied with a machine will tell

you of potential hazards), information and your own experience.

Risk is a combination of three factors:

The numbers of people who could be affected

The severity of likely injuries that persons could suffer

The likelihood of harm actually occurring.

The overall risk score is calculated using the following formula:

Risk rating = numbers x severity x likelihood

Assessing risk should be systematic, ensuring all aspects are covered, addressing what

actually happens and taking into account existing, preventative (control) measures.

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The following questions should be asked: Do the precautions

Meet the standards set by a legal requirement?

Comply with recognised industry standard?

Represent good practice?

Reduce risks as far as is reasonably practicable?

If it is found that something needs to be done, ask:

Can the hazard be removed altogether?

If not, how can the risks be controlled so that harm is unlikely?

2.5 Ways to minimise potential risks and hazards

Once the risk has been assessed, it must then be decided how to eliminate, reduce or

control it.

If your organisation has fewer than five employees, you do not need to write anything down,

but you still need to assess the risk. Five or more employees means that you must record

the significant findings of your assessment. This means writing down the more significant

hazards and recording the most important conclusions.

Risk assessment in the workplace

A risk assessment is simply a careful examination of what, in your work, could cause harm

to people, so that you can weigh up whether you have taken enough precautions, or should

do more to prevent harm.

Risk assessments are conducted in the workplace as a means to:

Identify the hazards that exist

Consider the risks created by the hazards

Identify actions that will eliminate or reduce the risks

Make sure that no one is injured or becomes ill as a result of work activities.

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Risk assessment should include a careful examination of:

The things in the workplace that could cause harm

The precautions to prevent harm occurring.

Before we consider the process of risk assessment, it is important that you understand the

terminology that is used, in particular the meanings of the words ‘hazard’ and ‘risk’.

Hazards

To keep safe, healthy and out of danger at work, we must avoid hazards.

The word hazard is used to describe something that can cause harm, something that is

dangerous, or something that is potentially harmful.

Here are some examples of hazards and illustrations of the harm they can cause:

Hazard Harm

Water Drowning

Damage to property

Fire

Burns, Death Smoke inhalation Damage to

property

Noise Damage to hearing Loss of concentration

Electricity

Electric shock, Death Burns

Fire

Chemicals

Death

Damage to health Damage to skin or lungs

Fire or explosion

Falling objects

Injuries Death

Damage to property

Fall of a person(from a height) Injuries Death

Manual handling Injuries

Reduced mobility

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You will be able to see from this table that some hazards create other hazards, as well as

causing direct harm themselves. For example:

Electricity can cause a fire which is a further hazard

A fire can cause structural damage and make a building unsafe

Excessive noise can lead to a lack of concentration which causes workers to work in

unsafe ways.

Other hazards include:

Untidy work areas

Poorly maintained floors

Inadequate lighting

Extreme temperatures (both high and low)

Severe weather conditions.

Every workplace contains hazards; there are things in even the safest-looking environment

that could cause harm.

Danger

The word ‘danger’ is used to describe exposure to a hazard and it is often shown to draw

people’s attention to hazards. If you are in danger, you are at risk of being harmed by a

hazard, and if something is dangerous, it is a hazard.

Risks

The word ‘risk’ is used to describe:

The chance or probability that someone will be harmed by a hazard

The likelihood that a hazard will lead to personal injury.

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The extent of the risk

Risks are often described as being low or high: Low risks

In situations where a hazard is present in the workplace, but is well-controlled and unlikely

to cause harm, it can be described as a low risk.

This does not mean that the hazard has gone away, but that everyone should remain safe,

as long as control measures are maintained.

Example:

As we have already identified, electricity is a hazard. Most workplaces contain a variety of

electrical appliances. If these appliances are adequately earthed, kept in good working

order, regularly checked, operated by trained employees, and used following the

manufacturers’ instructions, the risk should be low.

High risks

A high risk occurs when a hazard is uncontrolled or inadequately controlled, and the chance

that someone will be harmed is great. The more likely it becomes that someone will be

harmed and the more serious (injury, ill health, or even death) that harm is likely to be, the

higher the risk becomes.

If there is a possibility that a process or a piece of equipment may injure someone, but the

injury is likely to be negligible (minor cuts or bruising, for example), this risk would be lower

than one in which the likelihood of harm occurring was less, but the seriousness of potential

injury could be far worse (loss of limb or sight, for example).

Some usually low risk hazards can become high risk because one of the control measures

fails. A good example of this would be a hair dryer in the home.

When in good condition and used as instructed, a hair dryer presents a low risk of causing

harm. If the user ignores the instructions and uses the hairdryer in the damp atmosphere of

the bathroom, the risk immediately becomes much higher.

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It is likely that many of the hazards that you identified in your workplace only present a low

risk of causing harm because of the control measures that your employer has already

implemented to keep everyone safe.

Now you know what hazards and risks are, we can get back to risk assessment.

A variety of approaches to risk assessment can be considered. In some workplaces, an

individual inspection of every activity which could result in harm, is conducted. The

advantage of this method can be that it is less likely that any risks will be missed, but the

disadvantages could be that the risk assessment is an enormous task in large workplaces

and those with many hazards.

In other places, the hazards associated with each department or section of the work area

are assessed independently. The advantage of this method is that the risk assessment of

the whole workplace is split into manageable activities. The disadvantage could be areas

that fall between two departments may be overlooked.

Another approach is to examine hazards in clusters, such as:

Manual handling activities

Equipment and machinery

The use of substances.

The advantages of this method are that each type of hazard will be considered in detail and

can be conducted by a specialist in each area. The disadvantages could be that some

hazards are overlooked, as they do not fall into the chosen categories, or that there is a lot

of repetition because some tasks involve a combination of hazards.

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Whatever approach is adopted, those responsible for health and safety in every workplace

must ensure that all hazards and risks have been considered.

The Health and Safety Executive (HSE) have produced a valuable guide to risk assessment

entitled ‘5 Steps to Risk Assessment’.

The HSE consider that the process of risk assessment should go through five stages. The

five stages are:

Step 1- Look for the hazards

Step 2- Decide who may be harmed and how

Step 3- Evaluate the risks and decide whether existing precautions are adequate or

more should be done

Step 4- Document your findings

Step 5- Review the assessment and revise, if necessary.

We will now examine each step of this process in detail.

The Identification of Hazards

You will remember that the first step of the ‘5 Steps to Risk Assessment’ is to look for the

hazards.

Hazards can be identified by:

Checking the workplace for things that could be harmful

Examining work activities

Asking other people in the workplace about any hazards they have noticed

Checking instructions to find the hazards associated with machinery and equipment

Checking information about hazardous substances

Looking for evidence of accidents and ill health.

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Take a walk around the place where you work and look for things that could reasonably be

expected to cause harm. As you go around the workplace, examine:

The working environment

The work activities

The equipment that is used

The materials and substances that are used.

As you conduct this careful examination, you will begin to identify the hazards that exist,

and can then consider the precautions that have already been taken to prevent harm.

You may already have ideas about what the hazards are. When you perform your

examination, try to keep an open mind and take a fresh look for anything that may be

harmful.

The people you work with may have noticed things that are not immediately obvious to you.

Inform your colleagues about what you are doing and ask them to tell you about any

hazards that they have become aware of.

There may be other people such as safety representatives, who can help you to make sure

that you have not overlooked any hazards.

Health and Safety (First Aid) Regulations 1981

These regulations lay down a minimum standard which means that settings will need to

have at least one qualified first aider on site at all times to be responsible in the event of an

accident, and to keep a first aid box.

There are no legal requirements as to what a first aid box should contain, as this will

depend on the individual needs of the setting.

The needs, wishes and preferences of individuals should be taken into account whilst you

ensure your own safety, the safety of individuals and key people such as:

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Family

Friends

Carers

Others who provide support.

Conflict

There may occasionally be a conflict of interest with regard to health and safety issues. This

may occur between team members, individuals, key people, care workers and others.

Resolving this conflict must never compromise health and safety. It is essential that you

explain the reasons for, and the process of, risk assessment and involve those concerned

in its development in order to promote understanding and encourage co-operation.

There may be areas of conflict that you have encountered. For example, an immobile

individual and their carers may decide they do not wish to use recommended moving and

handling equipment such as a hoist. This may result in the individual being lifted manually,

as colleagues may feel this is quicker. You must remind colleagues of their responsibilities

under current legislation, they may face disciplinary action if they persist, and that you will

record and report unsafe practices. Discussion and re-education may be sufficient to

resolve this conflict.

In the case of the individual and informal carers, the potential risks and dangers of their

action, and the possible consequences to all concerned, must be discussed and related to

the risk assessment. The use and benefits of equipment should be clearly explained and

reassurances given. Resolution may be reached if the individuals concerned agree to use

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the equipment, or the use of suitable alternative equipment is agreed. However, you must

not agree to do anything you know is unsafe and must also discourage others from doing

so. Reporting this conflict, seeking advice and making a record is vital. Each person has the

right to choose to accept the consequences of their actions, but no-one has the right to

compromise the health and safety of others.

It is worth noting that legal challenges to moving and handling legislation have been made

and you, as a care worker, must keep yourself up-to-date with how this may affect your

practice, now and in the future.

2.6 Access additional support or information relating to health and safety

It is important you know when and how to access support in relation to health and safety. If

you are unsure of the procedure for this in your care setting speak to your manager, so you

are prepared should the need arise. Information or support can be accessed from a number

of sources:

Manager

Other health care professionals

Health and safety representatives/specialists

Infection control team

Outside agencies (e.g. environmental health)

Training courses

Health and safety information, leaflets etc.

Internet - check sources of information are reliable (e.g. Government or NHS sites).

3.1 The different types of accidents and sudden illness that may occur in

a care setting

Emergencies can be described as situations involving an immediate and threatening

danger to individuals and others.

Incidents are defined as occurrences that require immediate attention to avoid possible

danger and harm to people, goods and/or the environment. When emergencies and

incidents take place, it is essential that you know what to do, and that you are able to take

immediate and appropriate action.

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Emergencies situations include:

Explosion

Fire

Flood

Serious damage to the building

Health emergencies.

Incidents could be:

Intruders

Chemical spillages

Lost keys, purses

etc.

Missing individuals

Individuals locked out

Contamination risk

Aggressive and dangerous encounters

Bomb scare.

Possible accidents and sudden illnesses could be:

Slips, trips and falls

Burns and scalds

Inhalation and swallowing of hazardous substances

Stroke

Breathing difficulties

Hypoglycaemia

Seizures

Loss of consciousness/fainting

Food poisoning

Cardiac arrest

Sudden and severe chest pain.

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3.2 Procedures to be followed if emergencies or sudden illness occur

The urgent nature of emergencies and many incidents means it is essential that the action

you take is provided without delay. Because of this, you must be prepared to deal with

these situations, so that you do not waste valuable time if they occur. Fire drills and practice

emergency evacuations will help you to be ready to deal with some of the emergencies and

incidents that may occur.

Training and a good understanding of organisational policies and procedures will prepare

you to respond to other situations.

Provide support and assistance and make the area safe

When health emergencies or illnesses occur, care workers may provide complete first aid

care or call for help and follow the instructions of a more qualified person. The care you

provide will vary according to the type of emergency or illness and your training, knowledge

and experience in dealing with emergencies and illness. The more experienced person, or

ambulance crew, may take a few minutes to reach the scene, so you will need to provide

the casualty with reassurance and any immediate help or first aid that you feel confident in

providing.

First aid terms

A - Airway

B - Breathing

C - Circulation

B - Basic

L - Life

S - Support

Cardiac arrest (the person is unconscious and you are unable to detect a pulse or

breathing)

This is a life - threatening situation. Failure to commence basic life support (BLS) within 3

minutes will cause severe oxygen deprivation and death may be the inevitable result.

Assess safety – remove hazards

Speak to, shout at and shake the casualty - if no response, check A.B.C. – summon

help

If no A B C - dial 999 immediately

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Check and clear airway - head tilt/chin lift or jaw thrust - give 2 rescue breaths

Check carotid pulse - no pulse - commence BLS - 15 chest compressions: 2breaths

Continue BLS until help arrives OR the patient shows signs of life OR you are too

exhausted to continue

Do not interrupt BLS unless you are told to by someone in authority.

Other health emergencies may include:

Shock

Epileptic seizure

Choking and breathing

difficulty

Poisoning

Electrocution

Faints or loss of consciousness

Burns and scalds

Severe bleeding

Fractures, actual or suspected.

When professional help arrives you should give information to the paramedic, doctor or

nurse about the circumstances of the injury or illness and the treatment that has been given

already. It is also important that you think about the safety and privacy of the person with

the emergency.

Safety

You should always assess the situation that the casualty is found in and pay particular

attention to the safety of yourself, the person and other people in the area.

You should take charge of the situation in a calm way, ensuring that the cause of the injury

does not create further harm. This can be done by:

Switching of the current, in the case of electric shock

Moving the casualty to safety, if there is a risk from fire or the collapse of the building

Removing furniture or equipment that is in the way.

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Privacy

The casualty’s privacy should be protected as much as possible. When someone has been

taken ill, they do not want to be looked at by others who have no need to be around. It can

add to the distress and anxiety felt by casualties when they are the focus of unnecessary

attention. You can protect the privacy of the person with the emergency by asking

bystanders to leave the area and restricting entrance to the surroundings until the casualty

can be moved.

Supervision

When a number of people respond to an incident or emergency, it is vital that they work

together as a team and that they understand their individual roles. The key to this is the use

of appropriate supervision. The person in charge of the situation can ensure that:

Someone calls for any assistance required

The most appropriate individual(s) administers first aid

The safety and privacy of the area is maintained

Changes in the situation are responded to

The handover to the emergency services is effective.

When the casualty has received appropriate help, others (individuals, staff and visitors) may

also need support because they helped to deal with the emergency, witnessed the incident

or they may have been ‘close’ to the person.

Being involved in an emergency situation and being concerned about the wellbeing of a

casualty can be both stressful and distressing. You should be as supportive as possible to

everyone involved and remember that the incident may have an emotional effect on you

too. If you, or others involved in the incident, require extra support to manage stress and

prevent distress, you should seek the advice of your manager.

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Report and record incidents, accidents and emergencies

All incidents and emergencies, whether they involve staff, individuals or visitors, must be

reported immediately to the manager. Reports made must be accurate and complete, so

that those who receive them have a clear understanding of the incident or emergency, any

injury that was caused and the action that was taken in response to it. It is a legal

requirement that all accidents are reported and investigated.

All employers are required to keep an accident book. Accidents books are designed in a

loose- leaf format so that completed pages, containing personal information about

casualties, can be removed and filed securely for data protection purposes.

The accident book should be used to record:

Details about the person who had the accident in the workplace, suchas:

Name

Address

Occupation

Details of the accident, such as:

The date and time of the accident

The place and circumstances of the accident

Location of others involved (staff, individuals, visitors)

The type of injury

The treatment that was given

Details about the entry:

Who made the entry in the accident book

The date the entry was made.

All records and reports should respect confidentiality, be accurate, legible and complete,

and conform to organisational and legal requirements. Details of any incident, accident or

emergency involving am individual should also be recorded in their care plan.

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Accident reports and employer responsibilities

Records in accident books should be used as part of the risk assessment process, to

identify the types of accidents that occur in the workplace and to help employers recognise

risks and take action to reduce them. An accident investigation must be completed at the

earliest opportunity. The purpose of this is to establish what caused the accident and what

caused the injury. By completing a full accident investigation, it can be possible to remove

the risk of the same accident happening again by changing the procedures, working

practices or instigating repairs to the machinery or the fabric of the building.

The legal requirement to report incidents and emergencies is identified in RIDDOR - The

Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013. Under

these regulations, the ‘responsible person’ in the workplace must notify the relevant

authority about:

The death of any person as a result of an accident

Major injuries sustained by people

Injuries that result in the casualty being taken to hospital.

Employers must report any listed injury, dangerous occurrence or disease to the Health and

Safety Executive (HSE) or local authority. The preferred method of reporting is by telephone

to the Incident Contact Centre (ICC) 0845 300 9923. Reports made in this way will be

recorded and a copy of the report sent to the employer.

It is important that only qualified first aiders carry out first aid because:

It will comply with health and safety regulations and will meet organisational policies and

procedures

Treating illness and injuries effectively will reduce the consequences and preserve

life.

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The aims of first aid are to:

Preserve life

Prevent deterioration

Promote recovery.

It is essential you know your capabilities for dealing with an emergency. If you are unsure of

what is expected of you, or are unsure of first aid procedures, discuss this with your

manager immediately.

It is very important you understand the aims of first aid, in order to be aware of the reasons

why emergency first aid tasks are only carried out by qualified first aiders. Failure to

administer first aid immediately and effectively can lead to poor recovery, deterioration, or

even death. Others involved may be exposed to unnecessary risk, if procedures are carried

out incorrectly, or mistakes or omissions occur. A care worker may also find themselves the

subject of a complaint and/or legal proceedings.

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4.1 Your role in supporting others to follow practices that reduce the

spread of infection

As a senior/experienced care worker it may be part of your role to support other to follow

practices to reduce the spread of infection. In order to do this you must know, and be able

to, implement these practices yourself. You will be a role model and can guide and inform

others by passing on your knowledge, training and experience. You must ensure that others

are given any aids and equipment they require and that they understand their use and

purposes.

They should feel they can rely on you for guidance, advice and support and will respond to

any concerns they express. You must ensure that others are clear that you will not support

unsafe practices and will act on and report any concerns you may have.

4.2 The causes and spread of infection

Routes by which infection can enter the body

There are 5 ways in which infection can get into the body. These are:

Direct contact - physical contact with an infected person, a carrier, hand to hand, oral

or sexual contact

Indirect contact - some infections are airborne and can be inhaled from someone

coughing or sneezing

In blood - needle stick injuries, animals or insect bites, injection or inoculation, sexual

contact and mother to unborn baby

Urine, saliva and body fluids - directly, via contact with an individual and indirectly,

via contaminated equipment

Faecal - oral route - via unwashed or inadequately washed hands, ingesting

contaminated food or water and using contaminated equipment.

Infections are caused by microbes (germs) which may be bacteria, viruses, fungi and

occasionally prions. Parasites can also enter the body which you may hear referred to as an

infection or infestation. The human body is a very good environment for most microbes to

live and multiply.

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Some bacteria can be helpful (such as ‘good’ gut bacteria) but most microbes can be

harmful if they multiply enough. Even a mild infection can affect a person’s wellbeing. The

infected person is likely to feel unwell. Some mild infections get better without treatment as

the body’s immune system helps remove or kill the microbes. Without treatment, some mild

infections can become more serious and the person may become seriously ill. Some

infections can be hard to treat, particularly if the individual has other illnesses or lowered

immunity. You may know that there are bacteria which have developed resistance to

antibiotics. Severe infections can trigger sepsis (a serious immune over-reaction to an

infection) which is life threatening. In the worst cases infections can be fatal.

Care settings are high risk areas for infections so preventing the spread of infection is very

important for everyone’s health, safety and wellbeing. Infections in these settings can be

spread by:

The close proximity of many people meaning that microbes (germs) can easily be

passed by air or by physical contact between them

Individuals who already have significant infections being present increases the

likelihood that others will become infected

Staff moving from one person to the next, often having physical contact with them as

part of their work increases the chances of microbes being carried from person to

person

Staff handle high risk bodily fluids; without proper infection control measures, this

can lead to the spread of infection

Some individuals in care settings will be particularly at risk of infections. They may

have a weakened immune system, have breaks in their skin such as surgical wounds

or equipment attached such as a catheter which can enable microbes to get in the

body

Individuals who have invasive procedures such as blood tests can get infections

unless sterile equipment and correct procedures are followed.

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4.3 The use of Personal Protective Equipment (PPE)

In order to prevent the spread of infection care workers often need to create a barrier

between themselves and any microbes (germs) which may be present. This protects them

from infections and helps to prevent them from spreading infection to service users. The

barrier is in the form of Personal Protective Equipment (PPE). You may be familiar with

wearing disposable gloves, aprons and masks and gowns depending on your work setting.

Personal Protective Equipment (PPE) is all equipment or clothing which is to be worn at

work and which affords protection against one or more risks to health and safety. It also

includes clothing designed to protect against adverse weather conditions. Personal

Protective Equipment should not be confused with a works uniform e.g. nurses uniform or

shop assistant’s overalls. These are provided as part of the company’s ‘image’ and are not

covered under the PPE regulations.

The use of PPE to protect people is the last line of defence. Other measures to control the

hazards and risks involved should be considered first. All too often there is not enough

effort put into reducing or eliminating hazards and too much reliance is placed on the use of

personal protection to prevent the hazards causing injury or ill health.

The employer has a duty to ensure that if PPE is provided for protection against a known

hazard that the ‘user’ actually wears this. Regular supervision is important and if necessary

a disciplinary procedure should be introduced for people who refuse to wear the agreed

protection. As individuals have a duty to comply with the employer’s health and safety

arrangements, it would be considered a breach of health and safety law if the employee

refused to wear specified PPE.

Apron - protect the wearer from being contaminated; for example, waste matter. Also

protects individual from contaminants present in uniforms and clothes

Gloves - prevent the wearer from contaminating sterile areas, or protect wearer and

others from contamination

Masks - protect the wearer and others from airborne pathogens, or splashes from

contaminated matter

Hairnets - prevents hair, dandruff and grease from contaminating food and open

wounds.

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4.4 The recommended method for handwashing

The single most important and neglected aspect for the control of infection is attention to

the basic rule of frequent and thorough hand washing.

Best Practice for handwashing - Using dedicated hand wash sink

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Step 1 Wash hands thoroughly under

warm running water using liquid soap

(anti- bacterial best). Squirt soap into

middle of one palm.

Step 3 Rub palm of one hand against

back and fingers of your other hand.

Repeat with other hand

Step 5 Rinse off soap in clear, warm

water

Step 2 Rub palms together to make a lather

Step 4 Interlock fingers and wash thoroughly

between fingers. Rub around thumbs on each

hand than then rub fingertips of hands against

your palms

Step 6 Dry with clean towel (using disposable

paper towel from a dispenser is best practice

and an essential control in high risk areas)

Safety Tip: Turn off the tap with a disposable towel before throwing away to prevent re- contaminating hands

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4.5 Ways to ensure own health or hygiene do not pose a risk to an

individual or others at work

Care worker health and hygiene

When working in a health care environment, it is essential that you are fit to perform your

role safely and effectively without risk to your own or other people’s health and safety.

Therefore, it is important that workplace policies and guidelines on staff infection and work

restrictions are adhered to. Should you, or your family, be suffering from any kind of

infection, advice should be sought from your GP and/or manager with regard to returning to

work. Many employers recommend that you stay away from work for a further 48 hours

after illness has ended to ensure that you are free from infection. Some employers will ask

for further health checks before allowing you back to work in areas where your illness could

put patients at increased risk. Infection can be carried in the body for weeks after symptoms

disappear, so it is important that these infections are not passed to vulnerable people.

Other diseases that care workers should be aware of include German measles, chicken pox

and mumps. You should seek advice if you know you have been in contact with someone

who has any of these diseases.

Care workers who have pain or injury to the back and joints, any infection or are pregnant,

must seek the advice of their manager, as their health and safety and that of others may be

affected.

Care workers should also ensure that:

Long hair is tied back or covered

Jewellery apart from wedding rings is not worn (there may be specific guidelines in

your workplace about this)

Always clean any equipment used

Always follow food safety and hygiene procedures.

Frail, ill individuals are particularly vulnerable to infections transmitted by poor hygiene and

contagious diseases. Colleagues and others may also transmit infections following

exposure to a care worker’s poor health and hygiene.

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You, as a care worker, will be handling and disposing of waste contaminated with bodily

fluids during the course of your work. It is important that you protect yourself, your service

users and colleagues from transmitting infection this way.

5.1 Legislation that relates to moving and handling

Health and Safety at Work Act1974

Manual Handling Operations Regulations 1992 (amended2002)

Provision and Use of Work Equipment Regulations1998

Lifting Operations and Lifting Equipment Regulations1998.

These regulations concern the moving of objects during activities carried out at work. This

includes any type of physical movement such as:

Pulling

Pushing

Lowering

Lifting.

The employer is expected to avoid the need for manual lifting, wherever this is possible. A

risk assessment should be carried out, efforts made to minimise the risk of injury and the

need for equipment should be identified. All care staff should be fully trained to move and

handle and use equipment safely. This will reduce the risk of injury to staff, individuals and

others. In addition, these regulations include numerical guidelines to help determine when

assessment is required. No statement is given as a limit below which handling may be

considered safe.

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Guidelines advise that all individual handling should be assessed, taking into consideration

all aspects, not just weight. Lifting of people manually is definitely NOT RECOMMENDED.

Advice will include using alternatives such as slide sheets to move individuals, rather than

turning or rolling, and hoists for lifting.

The message is clear - DO NOT LIFT PEOPLE MANUALLY!

Local and organisational policy

Every care organisation should have an organisational policy and procedures based on the

Manual Handling Regulations and local guidelines. All staff should be aware of this and

know where to locate the information. Your organisation should supply you with a copy of

the policy in order for you to have a clear understanding of your and your employer’s

responsibilities.

5.2 Principles for safe moving and handling

Moving and handling

You must use, and support others to use, safe procedures and techniques for moving and

handling. Moving and handling activities may be conducted manually or by using

equipment:

Materials

Other items

People.

Employers are required by The Manual Handling Operations Regulations 1992 to carry out

risk assessments for all moving and handling activities; this includes the laundry, kitchen

and office, as well as for individual individuals.

The result of these assessments should provide information which ensures that lifting and

moving of heavy loads is avoided. Employees are required to read and follow these

assessments.

This risk assessment should include the following areas:

L Load - this includes weight, centre of gravity, the temperature, any attachments

such as catheters, the shape and size of the load, how co - operative the loadis

I Individual - includes the height, weight, age, fitness, gender, training, attitude,

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ability, capability, clothing and shoes of the person undertaking the task

T Task - how often do you do the task, look at the distance, speed and positioning,

do you have to twist, stretch or reach, what equipment do you have to help you

E Environment - look at space, noise, stairs, obstacles, ventilation, humidity, floor

surface and whether the task is inside or outside.

The following points are important and should be observed at all times:

Before any load is moved or handled, a full assessment of the risks involved must be

undertaken

Do not lift manually, if the load appears too heavy. This will include the people you

care for who should not be lifted manually unless in exceptional circumstances (e.g.

falls in places inaccessible to a hoist or certain life-threatening emergencies). You

should have received training in safe techniques and summon the help of as many

people as possible

Following training, always use the equipment provided, where this is advised

Always check that any equipment you use is clean and in good working order

If you are unsure, you must seek advice from your manager before attempting the

task

Do not attempt any moving and handling task you feel may result in injury to yourself

or others

Always bend your knees when lifting and keep your back straight

Stay close to the load; don’t stretch to reach it

Feet should be slightly apart with one foot slightly in front of the other. This will

spread the weight of the load

Hold the load firmly - if dropped it could injure your feet and cause damage to the

item

When putting a load down, bend the knees and keep your back straight.

Remember to practice this at home as well as at work!

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If you need to reach items beyond your normal height, always use stepladders or purpose-

built equipment. Never use a chair or stand on boxes, shelves etc.

There are 10 basic principles for safe lifting and handling. These are:

Good foot position - is your balance and stabilitygood

Face in linewith movement - this will reduce twisting which can injure your back

Back straight- reduces lumbar pressures

Avoid twisting- move your feet - prevent lower disc stress

Bend your knees- this ensures you use the large muscles in the tops of your legs

Firm grip- will give you more control

Hold close- this lowers the pressure on the spine

Raise your head- so you can see where you are going and helps to keep your back

straight

Lift in stages, if necessary - your muscles will work better with rest

Lower carefully - this will prevent ‘whiplash’ type injuries when you release.

5.3 Move and handle equipment or other objects safely

It is important that moving and handling tasks are carried out only after having specialist

training because:

It is the law

It helps to prevent back injuries

Promotes the safety of individuals, yourselves and your colleagues

Limits possible compensation claims for back injuries.

All staff should be provided with training appropriate to their needs i.e. all staff should be

fully trained in moving and handling objects. In addition, care workers require further

training in working with people.

Anyone who needs to use equipment to lift, move or handle objects or people must be

given appropriate training to use the equipment safely. There may be a variety of moving

and handling aids and equipment in a care setting. It is essential that you are fully aware of

their purpose and use.

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It is vital that you understand your role and responsibilities regarding moving and handling.

You must be clear about what you are responsible for and whom you are accountable to.

You must always operate within the limits of your role and responsibilities. Undertaking

tasks or using equipment you are not trained for could have disastrous consequences. You

are accountable to the individual, colleagues and the care organisation and may face

disciplinary procedures, or even civil or criminal proceedings, if you fail in your

responsibilities.

6.1 Types of hazardous substances that may be found in the work setting

Hazardous substances are used in many workplaces and may lead to a range of conditions

including dermatitis, asthma and infections. Visitors and members of the public can also be

placed at risk from their use, not just the person using the substance.

Hazardous substances come in many forms including:

Liquids, such as cleaning chemicals

Dusts, such as lead or asbestos

Fumes, such as soldering fumes

Gases, such as carbon monoxide

Living organisms, such as fungal spores

Bodily fluids

Medication.

It is important that you know what types of substances you may come into contact with or are already using. The supplier of the substance should provide a hazard data sheet (Material Safety Data Sheet - MSDS) containing all relevant information for that substance. It will indicate if it has any hazards.

You can also check the container or packaging for warning labels.

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6.2 Safe practices for storing, using and disposing of hazardous

substances and materials

The legislation covering chemicals is the Control of Substances Hazardous to Health

regulations - called COSHH and pronounced ‘cosh’. It states that every chemical must have

advice on safe storage, use and what to do in the event of an emergency.

Chemicals and cleaning fluids often come in large bottles and must not be transferred to

other containers, as information on the use, safe storage and emergency procedures are

clearly written on these bottles, and are paramount to the health and safety of the individual.

All hazardous substances must be locked away in a cupboard designated for this purpose.

Access to these substances should be restricted to authorised personnel.

Material Safety Data Sheets

MSDS are documents describing the known hazards associated with a material, indicating

safe handling procedures and recommending responses to accidents and are thus

invaluable sources of safety information. They are prepared by the chemical suppliers and

by UK law must be sent to you if you buy a chemical, but can be requested even if you are

only thinking of buying. If you already have the chemical, but the MSDS is lost or the

material is so old that none came with it, most manufacturers are happy to fax a relevant

MSDS on request. Many even make compilations of their data sheets available free of

charge.

Hazard symbols

The following are the symbols that appear on hazardous substances, such as cleaning

fluids and other chemicals.

Explosive Corrosive Oxidising Flammable

Toxic Irritant Harmful Biohazard

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Storage and safe use of substances

The following checklist is provided to help you use or handle substances safely. You must

always remember to follow your employer’s advice or procedure, and report to the

appropriate person, if any problems arise:

Never mix different chemicals together

Never decant chemicals into unmarked or incorrectly labeled containers

Never use chemicals you are not trained or authorised to use

Always follow the correct procedures

Always store chemicals in their designated areas

Always report any problems or health effects immediately

Allow access only to authorized personnel

Always use any PPE indicated.

Disposal of hazardous substances

Wear gloves and apron. Use only once and change between service users

Dispose of in accordance with COSHH recommendations and manufacturer’s

instructions

Dispose of contaminated waste properly. This should be disposed of in bags used for

the purpose and collected by approved companies for disposal

Contaminated clothing and linen should be boil-washed separately. This is often

done after linen is placed into bags which dissolve in hot water

Waste containers should be stored in the appropriate area

The environment and waste containers should be kept clean and hygienic at all

times, consistent with COSHH, and policies and procedures

Spillages should be cleaned and removed using appropriate materials. There will be

a policy and procedure set down by your organisation. You must make sure you are

aware of this. Any spillage must be reported immediately and a warning sign put

inplace.

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Bags for the disposal of waste are coded using the following colours:

BLACK - Non -hazardous waste

BLUE - Unbroken bottles and cans

RED - Contaminated linen (bags which dissolve when placed in a hot wash)

YELLOW - Contaminated/hazardous refuse.

The Hazardous Waste (England and Wales) Regulations 2005 impact on the disposal of

clinical care settings waste and the disposal of unused medicines.

7.1 Practices that prevent fires from starting or spreading &

7.2 Measures that prevent fires from starting

Most fire safety legislation comes under the Regulatory Reform (Fire Safety) Order 2005

which gives those with responsibility for premises a duty to:

Take reasonable steps to reduce the risk from fire

Make sure that people can escape safely, if there is a fire.

To do this, employers must:

Carry out risk assessments

Provide detection and warning systems to alert people to fire

Provide fire – fighting equipment

Provide emergency routes and a means of escape

Develop procedures to be followed in case of danger

Provide fire safety information and training.

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Training for all staff

Staff should receive training in fire safety and the agreed procedure for evacuation as soon

as possible after commencing work (i.e. at induction) and, ideally, this should be updated on

an annual basis.

Fire prevention checklist

Ensureallescaperoutesandexitdoorsarefreeofobstructions,anddoorsareeasytoopen

Extinguishers should preferably be wall-mounted and form part of a fire point. They

should not be used to wedge open doors or used as a coat stand!

Extinguishers should be inspected by fire wardens on a regular basis, ideally weekly,

but no less frequently than monthly. Findings should be recorded in the fire logbook

and any discrepancies brought to the attention of the manager

Fire resisting self-closing doors should never be held in the open position, unless

fitted with an automatic release mechanism linked to the fire alarm system

Fire alarm call points should be readily available for use, tested on a weekly basis

from a different call point each time (not the main fire panel). All testing should be

recorded in the fire logbook

If smoke alarms are fitted, these should be regularly checked. Some smoke alarms

are linked to the fire alarm systems, whilst others are battery operated. If your smoke

alarms are battery operated, the batteries should be checked regularly and changed

when necessary

It is particularly important to have smoke alarms fitted where people may work in

various parts of a building, so that they can be alerted to a fire before it spreads

Consider fitting smoke alarms in areas where items are stored, but not regularly

inspected or visited e.g. basement store rooms

A competent person should test all electrical appliances.

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7.3 Emergency procedures to be followed in the event of a fire

In the event of a fire you should:

Raise the alarm

Dial999

Go to the assembly point

Move yourself and others from the danger area, if safe to do so

Inform the manager/fire safety officer

Do not use lifts.

Disabled evacuation procedure

Every building should have arrangements for evacuating the disabled and less able

occupants. Arrangements should also be made for staff, visitors, members of the public etc.

Disabled persons should not slow down or hinder other persons evacuating the building.

They should be escorted immediately to an agreed (with the fire and rescue authorities)

safe refuge (e.g. staircase enclosure) or a dedicated fire lift. After other occupants have

vacated that area, the disabled person should then be assisted to safety.

7.4 Ensuring clear evacuation routes are maintained at all times

'The Regulatory Reform (Fire Safety) Order (RRFSO) 2005, which came into force in

October 2006, charges the responsible person(s) in control of non-domestic premises with

the safety of everyone, whether employed in or visiting the building. Under Article 14 of the

RRFSO, this duty of care includes ensuring that “routes to emergency exits from premises

and the exits themselves are kept clear at all times” (14: 1) and that these “emergency

routes and exits must lead as directly as possible to a place of safety” (14: 2: a). In other

words, the entire escape route up to and including the final exit from a building must remain

unobstructed at all times, while the distance people have to go to escape (the travel

distance) must be as short as possible.

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8.1 The use of agreed procedures for checking the identity of anyone

requesting access to premises and/or information

Property should be protected and key codes limited to those on a need-to-know basis.

Access to the premises, and areas within it, should be restricted. Security should be

assured, especially at night and for those individuals who have rooms on the ground floor.

Valuables should be locked away and access limited. Records should be kept. All visitors

should politely be asked for identification and the purpose of the visit checked. If you are

unsure, ask the advice of your manager.

Those who appear to be under the influence of alcohol or drugs should not be allowed

entry. Do not tackle these situations alone. If you feel threatened, call for assistance

immediately. Always maintain a calm and polite manner. The identity of anyone requesting

confidential information should be established as to whether they have a right to access this

information.

You should always work within agreed boundaries and seek advice from management

before confidential information is shared. If an individual is unable to give consent, advice

must be taken from management who will act on guidance contained in legislation and

organisational policies and procedures.

Even though you can legitimately disclose information with the person’s consent, you must

ensure you are aware of your responsibilities and the possible limitation of your role.

It can be difficult to refuse information to someone who requests it, but has no right to it; this

person could be a colleague, or another person who is known to you. Remember that the

law is on your side; you have the best interests of the service user in mind and you must be

polite, but firm. Seek assistance from your manager.

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8.2 Measures to protect own security and the security of others in the

work setting

Intruder/security breach action

In the event of an intruder/security breach, you should:

Dial 999 - you should report any intruders, or those trespassing in the workplace or

grounds, immediately to the police

Remove yourself and others to a safe area

Report to your manager/safety officer

Record the incident.

8.3 Importance of ensuring that others are aware of your own

whereabouts

People will need to know your whereabouts at all times, especially your line manager or

supervisor. This is for a number of reasons. If you are needed for anything they know where

to find you. It also protects you if you are in any danger and especially if there was either a

security incident or fire as everyone will need to be accounted for promptly. Valuable time

will be lost if your whereabouts are not known.

9.1 Common signs and indicators of stress in self and others

At some point in our lives we may all have complained about feeling ‘stressed’. Stress

arises when we feel that there are too many demands placed upon us and we feel unable to

meet these demands.

The Health and Safety Executive (2004) defines stress as ‘the adverse reaction people have to

excessive pressure or other types of demand placed on them.’

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Signs and symptoms include:

Feelings of anxiety, apprehension, tension, nervousness, helplessness, feelings of

being alienated

Physical feelings of tiredness and lacking enthusiasm

Mood swings

Tendency to worry more

Irritability

Loss of confidence and low self-esteem

Inability to concentrate, daydreaming

Becoming more withdrawn.

When we are under excessive, or prolonged, stress the range of effects may include:

Physical effects - such as increased heart rate which may cause palpitations, aches

and pains caused by tense muscles (including headaches), difficulty breathing,

numbness or tingling sensations due to over-breathing, frequent visits to the toilet,

‘butterflies’ or even indigestion, sleep disturbance

Emotional and behavioural effects - such as feeling tearful, tense, guilty, moody,

worried, low self-esteem, weighed down by demands, agitated, angry, more likely to

smoke or drink, more likely to take sick leave from work, or make mistakes in daily

tasks

Mental and organisational effects - such as difficulty in concentrating, being more

critical of yourself or others, poor decision-making and poor time management,

feeling more sensitive to other people’s behaviour and comments

Health effects - prolonged stress may trigger health problems, or make existing

health concerns worse. This can include asthma and hay fever/allergies, rashes and

skin conditions such as eczema, headaches and migraines, stomach ulcers and

diarrhoea. Heart disease is a possible effect of long-term stress. Irritable bowel

syndrome (IBS) is one of the most common physical health effects of stress. Existing

conditions such as diabetes and high blood pressure may become less well

controlled with the effects of stress. Although this may sound worrying, these health

effects can be managed and some may be reversed, with appropriate advice from

your GP.

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9.2 Factors that can trigger stress

The source of stress may be different for each of us, as we are all individual. Stress can

affect any person at any time in their life and is not limited to people in demanding jobs, or

those with busy lives.

Each of us may be able to identify areas of our life that we find personally stressful. These

can include:

Relationship concerns - family demands, juggling a job and childcare, problems in

relationships, disagreements with spouse or partner, in-laws, parents, friends or

neighbours

The role that we have in life - other people have expectations of what we will do. If

we feel that we must always meet these expectations, this can lead to feelings of

stress

Financial worries

Health worries - for our own health or those around us

Work problems - unemployment, demands at work, problems with a colleague or

manager, threat of redundancy, an excessive workload

Housing problems - threat of homelessness, stress of buying a house or moving

home, demands of maintaining a home

Feeling isolated or lonely

Experiencing abuse or harassment.

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Within the workplace, there may be factors such as:

Feeling undervalued by other team members

Inadequate training

Lack of job satisfaction

Inadequate staffing levels and/or skill mix

Threat of unemployment/redundancy

Conflict

Inadequate management systems

Inadequate communication within the workplace

Long working hours and demanding shift patterns

Inexperience

Excessive workload.

Demands may be internal, coming from the person themselves and may include:

The person’s own personality - perfectionist who makes excessive demands on

themselves

Self-critical

High expectations of self and others

Unachievable or unrealistic goal setting

Guilt feelings, either reasonable or unreasonable.

9.3 Compare strategies for managing stress in self and others

Ways to manage stress

One of the first steps is to recognise that you are experiencing stress symptoms, and then

to try and organise a manageable way of dealing with the demands in your life.

We need to accept that we cannot control everything in our lives. Getting a balance is

important; knowing what stressful situations we can change and accepting those we cannot.

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Internal demands:

You can start by being less demanding of yourself, if your life is busy and causing

feelings of stress

Set reasonable time-scales to complete all the things you want to do. Are there any

things that can reasonably be put off for a day or two? Which things are most

important?

There may be situations where stress is ongoing, but it may help for you to reduce

stress in another area of your life. This might be through listening to some music,

enjoying the company of friends or family, or just a relaxing bath and an early night at

the end of a hard day

Take some time for yourself, to redress the balance

Don’t feel guilty for taking some time off to manage the demands effectively.

External demands:

This is any stress that comes to us from someone or somewhere else, such as needs of

family or work demands. Not all demands made of you will be reasonable.

Consider ways that you may be able to address the demands that are placed upon

you

Learn to say ‘no’ when you feel too much is being expected of you

Don’t feel guilty for sometimes refusing requests from others.

This will help you continue to manage everyday demands more effectively.

It is important that we recognise that different people manage stress in different ways. The

way in which individuals manage stress may directly affect whether stress is relieved or

worsened.

Managing stress in other members of staff can be a challenge. Colleagues can provide

emotional support but senior staff may be required to step in with practical solutions such as

making reasonable adjustments to working hours or arranging support from an occupational

health department if available.

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9.4 How to access sources of support

Communicate your feelings and concerns to your manager. They have a

responsibility to support you and assist you to access additional support, if this is

necessary

Many people seek advice from their General Practitioner (GP) who will probably ask

you some questions about your general health, offer health advice and may

prescribe a short course of medication. Physical tests may be carried out (such as

blood pressure checks) to rule out other health problems. Your GP may refer you/or

advise you to speak to a counsellor

Family and friends can be supportive in your efforts to manage your stress, by

learning to be reasonable with their demands on your time. You will also need to

make your needs known, and if you feel unable to manage a request, then say so.

There are many ways to manage stress and it is important that you compare and evaluate

the various strategies in order to choose a strategy or strategies most appropriate for

managing yours or other stress, taking into consideration needs, preferences and individual

circumstances.

In care settings you may observe signs of stress in others. Offering support to colleagues,

relatives or others who may need it is important. However, this needs to be appropriate to

your job role as it may be that a more senior person needs to be consulted.

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Conclusion

The information you have read within this unit should increase your knowledge and

understanding which will benefit you, the individuals you care for, key people and others.

Now complete the assessment questions for this unit in the workbook section.