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Home Care - Nursing Home - Retirement Home - Hospitals
Thursday, May 16, 2013 at 2:18:54 PM

Home Care - Nursing Home - Retirment Home - Hospitals

1. Workplace Hazards and Controls

Listed below are key work related hazards which can occur in residential care facilities and some of the control measures to avoid or reduce the risk. This will assist the employer and employees in the preparation of risk assessments and identification of controls for their workplace and work activities. There is more information on each topic on the HSA website at

2. Manual Handling

The Safety, Health and Welfare at Work (General Application) Regulations 2007, Chapter 4 of Part 2, also known as the Manual Handling of Loads Regulations, outline the requirements that much be fulfilled for manual handling. The term manual handling includes lifting, putting down, pushing, pulling, carrying or moving a load, which due to characteristics of the load or unfavorable ergonomic conditions, involves a risk of injury to workers, (particularly to the back).

The Regulations relating to manual handling of loads require an employer to avoid manual handling of loads where there is a risk of injury and if this is not possible to access the risk and reduce the risk of injury to create a safe working environment.

The term manual handling is used here to mean both the manual handling of inanimate loads, such as laundry cages and catering trolleys, and people handling involving residents with restricted mobility.

3. Employers must ensure that there are procedures in place to manage the risk from manual handling at work, taking account of the following:

∑ The avoidance of manual handling where possible, by changing the work design or by the use of technology;

∑ The minimization of manual handling tasks to the greatest extent possible: for example, introducing manual handling aids such as trolleys, patient hoists and sliding sheets;

∑ The identification of roles and responsibilities with regard to ensuring safe manual handling at work;

∑ The risk management process and need to undertake manual handling risk assessments and the means of communicating this information;

∑ The need for a balanced approach that considers the wishes and needs of the resident and the provision of quality care, while providing a safe working environment;

∑ The arrangements in place to ensure employees have the information and training required;

∑ The arrangements in place for the procurement and maintenance of suitable equipment and furniture;

∑ The resources and competence required to ensure safe manual handling;

∑ The arrangements in place for reporting and follow up on work related incidents and near misses;

∑ The arrangements in place for absence management and rehabilitation of employees;

∑ The process of review of the controls implemented to ensure they are effective.

4. Risk Assessment

Identify the activities which involve manual handling and the risk of injury. Consult with employees when doing so. Collect technical details on the activity.
Take account of:

∑ The Task;
∑ The individual (i.e. person carrying out the manual handling activity);
∑ The Load; and
∑ The Environment

Analyze any accident report data and take account of the findings when carrying out the risk assessment.

The Task

Collect information on how the task is carried out and identify the key stages of the task: describe how the task is carried out for example, the number of lifts required.


Take the individualís capabilities into account. Does the task require unusual strength, height or other characteristics or put those who are or were recently pregnant at risk? Does the employee have the knowledge and training required to carry out the task safely?


Loads can consist of:

∑ Inanimate objects such as boxes, bags, laundry bundles or equipment; or
∑ Residents.

When dealing with inanimate objects, consider the load weight, size and dimensions, and modify where possible to reduce the risk.


The environment can affect manual handling activities, for example:

∑ Space constraints or the physical dimensions of the work area;
∑ Uneven, slippery or obstructed floors;
∑ Inadequate lighting-too dim or causing glare;
∑ Non-adjustable beds and trolleys; or
ē The presence of residentís attachments such as drips or catheters which can restrict movements or access.

5. People Handling

Residents should initially be assessed to see if they are capable of independent movement. Where manual handling is required to assist the resident a more detailed risk assessment is required.

6. People Handling Risk Assessment

In carrying out the detailed people handling risk assessment consider:

∑ How much help does the resident need? Is the residentís inability to move independently short term (e.g., post-surgery), medium term (e.g., orthopedic injury) or is it a permanent physical disability?

∑ What is the weight and height of the resident?

∑ Does the resident have any condition which may affect the people handling activity such as poor eyesight, skin conditions, seizures, pain, etc?

∑ What level of ability does the resident have to understand instruction and communicate?

∑ Does the resident manifest any behavior which may affect the moving and handling activity? (E.g., is the resident anxious or unco-operative?)

∑ Any medication which may affect the moving and handling activity.

∑ History of falls: does a falls risk assessment need to be carried out?

∑ Does the method used encourage independence

∑ What type of handling equipment was used before admission?

∑ What therapy plan if any is in place for the resident?

Identify what improvements are required to avoid or reduce the risk form the activity. Where the task cannot be avoided, can the work activity be organized to allow the use of mechanical aids to avoid or reduce the need for manual handling?

7. Controlling the Risk

Controls indentified will be based on the results of the risk assessment. Controls may include the following:

∑ Avoiding manual handling if possible:

∑ Minimizing manual handling: encourage residents to move themselves (where appropriate); use handling aids; reorganize or redesign the task; change the system of work (e.g., take the treatment to the resident). Seek to address the root cause of the residentís immobility (e.g., referral of resident to physiotherapist for assessment);

∑ Reducing the risk; use mechanical aids;

∑ Distributing unavoidable manual handling tasks throughout the working period;

∑ Ensuring employees have the information, training and supervision required to perform the task safely.

The introduction of control measures such as a handling aid or a new work layout means the introduction of a new work activity. So each new work activity will need to be assessed to ensure that any new hazards are identified and controlled.

Document the risk assessment including the controls required and ensure that the relevant and appropriate information is communicated to the employees who undertake the manual handling or people handling activity.

Lifting and handling needs should be included in residentís care plans. Care plans should include details of:

∑ The recommended method of movement for the relevant task such as bathing, sitting, and so on;

∑ The equipment to be used;

∑ Any factors such as weakness, pain, challenging behavior or dementia that may impact on the effective manual handling techniques; and

∑ The minimum number of employees required to assist.

Care plans should also allow for changes in the residentís condition and mobility.

8. Instructions, Training and Supervision

Employees involved in manual handling must be appropriately trained in safe techniques and be advised of the correct use of manual handling aids.

There should be a system in place to manage the training requirements of employees, to ensure that their training is kept up to date.

Training should be specific to the work tasks of the healthcare worker and informed by the manual handling risk assessments. Supervision in necessary to ensure that the lessons learned are being applied in the work setting.

Records of employee training should be kept.

Consider training a number of employees as manual handling and people handling instructions so that there is expertise on site. Additional expertise may be required for difficult situations.

Instructors should have a FETAC level 6 Award for Manual Handling or People Handling Instruction.

Home Care Ė Nursing Home Ė Retirement Home Ė Hospitals
Thursday, May 2, 2013 at 12:49:07 PM


Health and Safety information is not only for the Health Care Industry, Home Care Industry, it is for all industries to study Culture Control committing to safe and healthy workplaces and the safe and sustainable management of unsafe conditions and chemicals.

Hazards in health care may be considered under the headings - Physical - Chemicals - Biological - Psychosocial Hazards.

Hazards include Manual Handling activities involving heavy, awkward or hard to reach loads which is a risk of injury.

Vehicle movements whether in the workplace or on the road which could cause serious injury or death to people who come in contact with them.

Slipping and tripping hazards such as wet or poorly maintained floors, sidewalks, stairs, roads and cross walks.

Chemical hazards - These include cleaning, disinfecting or sterilizing agents.

Biological Hazards - These include any virus and/or bacteria that can cause infection, allergies or toxic effects. Harmful exposure to blood and body fluids or exposure to air borne pathogens such as tuberculosis and legionnaires disease, psychosocial hazards, bullying at work, dealing with aggressive behavior which can affect psychological health and its result in work related to stress.

Next Part to be Continued May 6, 2013