1. Use of Hoists in a Care Home Setting
A Basic Introduction
This presentation is intended as an introductory session to the use of person-lifting hoists in a care home setting, eg in supporting basic induction. For staff who have roles which involve moving and handling skills, such as those who have to move service users, additional training will be required which includes hands-on practice, and should be provided by an appropriately qualified manual handling trainer.

2. Manual Handling and Service Users
Service users in the care sector have a range of mobility needs and will typically require different levels of assistance
Where individual service users need assistance with their mobility a full assessment of their needs should be completed
The assessment should identify if moving and handling aids are required to move the service user safely in any situation – this may include use of a hoist
There always needs to be a balance in approach to ensure that:
care workers are not required to perform tasks that put them or their residents at unreasonable risk
residents' personal wishes on mobility assistance are respected wherever possible
residents' independence and autonomy is supported as fully as possible.

3. What are Hoists?
Hoists are devices used for lifting or lowering a load
Person-lifting hoists are commonly used in social care settings to help service users with limited mobility to move
Most hoists are electrically powered
Hoists can be mobile (on wheels) or fixed, usually to the ceiling
Hoists come in different sizes and can lift different loads
The most common type of hoist takes the form of a mechanical arm, usually called the “spreader bar”, which can rise and lower with the person suspended below in a sling. Such hoists are usually mobile and are wheeled into position. Most hoists are electric and have their own battery, which must be kept charged. The lifting arm is operated with a button or with a remote control.

4. Lifting Operations Using Hoists Basic Principles
A hoist should be used only for the moving and handling of a service user by staff who are trained and competent in its use
A resident being lifted in a hoist is vulnerable and relies on the operator of the hoist for their safety
Unsafe use of the hoist, poor maintenance, or the use of inappropriate or defective hoists or slings can be the cause of potentially fatal accidents
Here the home can introduce the main elements of its policy on the use of hoists.

5. Manual Handling Aids and Equipment
A hoist is a form of lifting equipment according to the law
Hoists are designed to make manual handling tasks easier or safer, reducing the risk of accidents or injury
Care home managers should ensure that sufficient numbers of suitable hoists are available
An appropriate form of hoist should be used wherever indicated in a manual handling risk assessment
Care home managers should ensure that sufficient numbers of suitable hoists are available in the home. The type and quantity of hoists should be dictated by assessments of the needs of each service user and by manual handling risk assessments.

6. What Does the Law Say about Hoists?
The Manual Handling Operations Regulations 1992 place a duty on employers to use safe working practices, including safe use of hoists
All hoists should comply with the Lifting Operations and Lifting Equipment Regulations 1998 (LOLER)
The Care Quality Commission requires services to provide safe care using properly maintained and appropriate equipment
Remind the group that the need for safe manual handling is not only covered by health and safety law but is also an important factor in registration with the CQC.

7. What Are the Risks Involved with a Hoist?
The unsafe use of a hoist can cause serious or even fatal injuries to service users
Service users can fall or be struck against walls or furniture
Manual handling accidents involving hoists can also cause injuries to staff
Common injuries involve back pain or what are commonly referred to as musculoskeletal disorders
Ask the group what they think the risks of unsafe hoist use might be.
In the case of manual handling activities that involve the use of a hoist to lift service users, risks will include possible injury to the service user being handled. In the care sector there is a history of incidents where service users have been dropped, injured and even killed as a result of poor or inappropriate manual handling techniques or the use of defective or inappropriate equipment. Such incidents not only have the potential to cause human tragedy and injury but also can result in costly litigation and damages.

8. Manual Handling Risk Assessments
According to the Manual Handling Operations Regulations 1992 all manual handling tasks that have the potential for injury should be fully assessed
Assessments should be person-centred and, where possible, involve the service user or their family in decisions about how their needs are met
The risk assessment should be used to inform a suitable moving and handling plan
This slide presents an opportunity for the home to expand on its risk assessment policy and tools.
The Health and Safety Executive has developed a tool called the Manual Handling Assessment Chart (MAC) which can be used to help assess the most common risk factors in lifting, carrying and team handling. Care home managers may find the MAC useful to help identify high-risk manual handling operations and to help complete detailed risk assessments.

9. Safe Use of Hoists - General
All care homes where hoists are used should have a policy which covers their use
Use of hoists should be restricted for authorised use by trained staff only
Refer to the risk assessment/manual handling plan for details of each manouvre
Ensure sufficient numbers of trained staff according to the plan and adequate supervision
All hoists should be used in accordance with the operating instructions supplied by the manufacturer
Staff should ensure that a thorough manual handling risk assessment has been conducted prior to the use of the hoist and ensure that they consult and follow the relevant service user or manual handling plan. The operation should always be explained to the service user, whose consent should be obtained.
Risk assessments/manual handling plans should indicate exactly how each manouvre should be performed and how many staff will be required to operate equipment and perform each manouvre safely.

10. Safe Use of Hoists – the Hoist
Carry out appropriate safety checks prior to use
Does the hoist look clean and in good condition?
Is the battery charged?
Check that any emergency features/back-ups work?
Check the service record – is it in date?
Do not use a hoist you have not been trained to use
Always ensure that the right hoist is being used for the job, including weight tolerance
Never exceed the safe working load
Avoid wheeling a fully laden hoist from one room to another
Follow the manufacturer’s instructions for use
Hoists are complicated pieces of equipment and must be properly maintained and checked to ensure that they are serviceable at all times. Any staff using a hoist must be fully trained in its use and appropriately supervised. All hoists should be used in accordance with the operating instructions supplied by the manufacturer.
This slide does not constitute full training in the safe use of a hoist as it is only a general introduction. It should be supported with more in-depth training and hands-on experience in using a hoist safely. There are many different types of hoist and each one will have specific safety points that need to be included in hoist specific training.
Hoists are only designed for transferring people from, for example, a bed to a wheelchair. They must never be used for transporting people between places, for example, from a bedroom to a bathroom. This is very unsafe and undignified for the service user.

11. Safe Use of Hoists – the Sling
Slings are just as important as the actual lifting mechanism
Slings come in different sizes and types
Using an inappropriate, broken or ill-fitting sling can be very dangerous
The choice of the right sling depends upon the type of support required, the task to be accomplished, the comfort of the resident and their size, condition, strength, muscle tone, dexterity and comprehension
Slings are often neglected when the safety of hoists is considered but they are just as important as the actual lifting mechanism.
Slings are usually made of reinforced fabric and contain strengtheners. They are placed under and around the person being lifted and are then connected to the hoist’s spreader bar via a number of attachment points. It is thus the sling that actually takes the weight of the person being lifted and ensures their comfort and positioning.

12. Safe Use of Hoists - The Environment
Lighting: is there adequate lighting, natural or artificial?
Space: do space constraints affect or compromise use of the hoist? Wheeled mobile electric hoists need room to work in safely
Flooring: are floors uneven, slippery or unstable?
Housekeeping: is the environment free from clutter?
Ask the group what aspects of the task might affect the use of a hoist. Click to display the slide suggestions. These are not exclusive but provide an idea of the sort of questions that should be asked in an assessment.

13. Defective Hoists or Slings
In cases of concern about the safety of a hoist or sling ALWAYS REPORT CONCERNS IMMEDIATELY AND DO NOT USE THE EQUIPMENT
Report to a manager/supervisor and withdraw the equipment from use
Make sure the equipment is labelled clearly that it should not be used
Arrange for the equipment to be checked, serviced, repaired or replaced
Complete adverse incident form and incident reporting as required
Care staff should be trained to report any defects or suspected faults in hoists or slings as soon as they are noticed, removing the hoist or sling from use immediately. A hoist with a suspected defect should never be used; it should be withdrawn from use and marked clearly “NOT FOR USE” until inspected, serviced or repaired.
An adverse incident involving medical equipment is defined as an event that has the potential to cause unexpected or unwanted effects involving the safety or wellbeing of service users or other persons. Care home managers should ensure that all such equipment failures involving hoists are recorded as an untoward incident and an investigation held to look at possible ramifications, pointers for the future and lessons for procurement.
Incidents involving medical devices that threaten the health of employees or service users should be reported to the Medicines and Healthcare Products Regulatory Agency (MHRA).

14. Independence and Dignity
Being moved in a hoist can be undignified and uncomfortable for service users
Respect service users’ preferences and obtain consent for any procedure
Always consider the service user’s feelings, privacy and dignity at every stage of the lift
Take every opportunity to encourage the independence and mobility of service users
Never leave a service user in a hoist for too long
Never use a hoist to transfer service users from room to room or over distances
Hoists are only designed for transferring people from, for example, a bed to a wheelchair. They must never be used for transporting people between places, for example, from a bedroom to a bathroom. This is very unsafe and undignified for the service user.

15. Manual Handling Training
In this home all staff will be given adequate training and information on the manual handling risks relevant to their work area and how to avoid them
All new staff should read the relevant policies
Where they are expected to use a hoist, full hands-on training will be provided
Manual handling/use of hoist training is mandatory for care staff and should be repeated as required
Full records of staff training should be kept
This slide gives an opportunity for a home to present their training policy. It should be adapted as required.
Adequate training is an essential element in the safe use of hoists. A lack of adequate training is often cited as the main or contributory cause in the majority of accidents involving hoists.

16. Procurement, Maintenance, Advice and Support
Hoists should always be procured from a reputable supplier and conform to industry recognised standards
Hoists should have warranties, service contracts and bear a CE quality mark
Advice on types of hoists should be obtained from a specialist source, such as a manual handling or back care advisor
Maintenance and service records should be kept for each piece of equipment
The manufacturer of each hoist should advise on use, maintenance and servicing
The maintenance of hoists and slings is a vital element in ensuring the safety of service users. Like all mechanical equipment, hoists suffer wear and tear during prolonged use and can malfunction or just wear out. Faults and breakdowns involving hoists, and a failure to repair or maintain them, are the most common causes of accidents and prosecutions.

17. Summary Read the home’s manual handling policy
Remember that the unsafe or untrained use of hoists can cause injuries to staff and service users
Assess all manual handling operations using a hoist for risk
Refer to the resident’s individual manual handling plan before you use a hoist
Make sure the hoist is safe to use, clean and well maintained
If you are concerned about a hoist do not use it!
Only use a hoist if you are appropriately trained and familiar with its use
Click to present each point as a reminder of the content of the session.