Pamela Simpson MCSP Moving And Handling Consultant

What and How? Person Centred decision making Legal and good practice guidance as tools The process The practicalities

Risk Management RISK MANAGEMENT: To act to control and minimise the risks to which a person or an organisation may be exposed.

Risk Management Balanced decision making, considering all relevant aspects Best practice happens when your policy, your training content and what happens with the service user everyday matches.

The Balanced Approach Increased safety for service users Increased safety for all staff groups, volunteers and informal carers Enhanced rehabilitation opportunities The right to choice and dignity for all concerned

Common Law Employers must ensure they provide: Safe place of work Safe systems of work Safe equipment Competent employees who understand basic safety instructions and systems

Health and Safety The legal system provides us with: Health and Safety at Work Act 1974 Management of Health and Safety at Work Regs 1999 Manual Handling Operations Regulations 1992 Provision and Use of Work Equipment Regulations 1998 Lifting Operations Lifting Equipment Regulations 1998 ALL REQUIRE RISK ASSESSMENTS TO BE COMPLETED AND ACTION TO BE TAKEN FOR SAFETY

Other Legal Considerations Human Rights legislation 1998 Mental Capacity Act 2003 Equality Act 210 Care Standards Act 2010 Care Act 2014 In individual circumstances and when assessing children there will be other legal considerations

Professional Guidelines & Advice RCN Guidance 1996 “Manual lifting of patients is eliminated in all but exceptional or life threatening situations” HSE Guidance 2002 “Implementation of policy & practice on lifting & handling should not place any unreasonable restriction on clients rights to autonomy, privacy or dignity”

More Professional Guidance Chartered Society of Physiotherapy Guidance on Manual Handling 2002, 2008 and 2014 setting out responsibilities for advice and delegation. College of Occupational Therapists Manual Handling guidance April 2006 National Back Exchange series of publications, e.g. Standards in Manual Handling

February 2005 Agreed Standard that is as up to date as possible THE GUIDE TO THE HANDLING OF PEOPLE 5 th edition Balanced decision making and evidence based tools

February 2011 Agreed Standard that is as up to date as possible THE GUIDE TO THE HANDLING OF PEOPLE 6 th edition A Systems Approach ‘ advice must have come from the most accepted body of thought at the time of the occurrence’

Moving and Handling Policy Continuum

Risk Assessment Tools Task REBA measuring, Borg scales Load FIM scores, comfort scales Environment Turning angles and space Individual Capability Benner scales

How do we make decisions? Involve everyone especially the service user Talk to the people who know the service user the best Proactively listen! Try the solutions for yourself Be prepared to compromise and be flexible Consider all 4 areas of decision making Involve other professionals where necessary Write it down together CONCENSUS DECISION MAKING

What should we try to avoid? Making decisions from a distance Being prescriptive and dogmatic The words allowed, not allowed, illegal, condemned Confrontation Quoting from the “rules” Focussing solely on staff safety

It Depends…….. Hoists should always be used by 2 people

It Depends…….. Training makes people competent

It Depends………. If the hoist isn’t working we must leave someone in bed

It Depends…... Risk assessments and handling plans are always carried out by senior staff and must be followed

What is Competency? Having sufficient skill Having knowledge and understanding Having the ability to do something well Communicating well with others Must be measurable and observable

Stages of Learning Unconscious incompetence Conscious incompetence Conscious competence Unconscious competence

Best practice happens when your policy, your training content and what happens with the service user everyday matches.

Documentation Generic risk assessments Patient specific risk assessment Specific Handling plans Do they say enough? How often are they reviewed ARE THEY EFFECTIVE?

“Success consists of going from failure to failure without a loss of enthusiasm” Winston Churchill