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Training for Carers; The Risk Management Approach

Carers and Training ConferenceCarers Research Partnership

The Robert Gordon UniversityTuesday 7th November 2006

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Contents

• Legislation

• Duty of Care

• Professional Guidance

• Putting all this into Practice!

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Legislation

• Health and Safety at Work Act etc 1974

• Manual Handling Operations Regulations 1992

• Management of Health and Safety at Work Regulations 1999

• Human Rights Act 1998

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Health and Safety Legislation

• Criminal Law

• Enforced by Health and Safety Executive

• Includes NHS Boards and local authorities

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Health and Safety at Work Act

Employers must;

• Ensure the Health and Safety so far as is reasonably practicable (SFARP) of his employees …................................

…………and those not in his employment that may be affected by their acts or omissions

• Provide their employees with adequate information, instruction, training and supervision

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Management of H&S Regs 1999

Employers have a duty to conduct suitable and sufficient risk assessments of the tasks that provide risk of injury to staff or others

Employees must use equipment provided for their safety in accordance with training provided

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Manual Handling Operations Regs ‘92

Employers must;

• Avoid Manual Handling operations SFARP• Assess risks• Reduce risks SFARP• Review the risk assessment• Provide information on the load

Employees must follow Safe Systems of Work provided for their safety

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Duty of Care

• Common law (i.e. judge made law) states that a duty exists where one person (or organisation) can reasonably foresee that his/her actions and/or omissions could cause reasonably foreseeable harm to another person.

• Breaches are known in Scotland as Delict of Negligence

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Negligence

A breach of the duty of care may give rise to a claim for negligence in civil law. To succeed a claimant must show that:

• The defendant owed the person harmed a duty of care

• The defendant was in breach of that duty• The harm caused was a direct breach of that

foreseeable risk

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Professional Guidance - CSP

Delegation and Guidance

• Importance is placed on differentiating between the above

• Delegation infers the entrustment of a physiotherapy task to another person

• Guidance is the professional verbal or written input given by the treating physiotherapist in his/her role as a part of the care team, to the overall rehabilitation and/or management of a patient

• Both require a risk assessment process

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Summary

• Employers must conduct risk assessments of risky tasks

• The detail of the RA (incl. methods of reducing the risk) must be communicated to employees/others that may be affected

• Organisations (this will include NHS Grampian, the local authority and charities) owe a duty of care to those employed by them as well as those affected by their operations – e.g. patients and carers

• This duty can be satisfied by;– Conducting risk assessments and communicating the results to all

relevant groups– Provision of adequate training or guidance as appropriate

NB – need to be able to evidence this to satisfy internal audits and to defend claims

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Falls Guidelines

• 1st November – Launch of Falls Strategy for NHS Grampian

• Publication of Falls Guidelines including;

“Guidelines for Handling the Falling/Fallen Patient in the Community”

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TRAINING CARERS CHECKLIST

Clients Name Date Of Birth / Unit Number

Carers Name / Relationship

Type Of Transfer

Risk assessment form completed including each transfer Reasons for assisting with transfer as discussed with carer and client Risks associated with carrying out transfer discussed Carer able to discuss reasons for modifying or when not to carry

out the technique

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Number of training sessions carried out Carer competent to demonstrate technique independently

(specific environment and date) Written copies of technique provided and copy filed in client’s notes Additional comments Carers signature: ____________________ Date: _____________ Therapists signature: ___________________ Date: _____________

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Transferring Patient X with the turner xx.11.06

Before standing please ensure that xxxxx feet are on the turner. The carer should steady the turner with their foot. Ask xxxxx to stand up by pulling up with his right arm on the turner. Before turning make sure that xxxxxx has his balance. This is better carried out by 2 carers but can on occasion be done with one. 2 carers – one to go in front of the turner and one stay beside xxxxxx 1 carer – start beside xxxx as shown. Once xxxxx balanced move to front of tuner to turn it round, and move back beside xxxxxx before he sits down. Only family and carers that have been taught by a physiotherapist are advised to do this. Should you have any problems please contact the physiotherapy team.

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Transferring Patient X with the Turner xx.11.06

Before standing please ensure that xxxxx feet are on the turner. The carer should steady the turner with their foot.

Ask xxxxx to stand up by pulling up with his right arm on the turner.

Before turning make sure that xxxxxx has his balance.

This is better carried out by 2 carers but can on occasion be done with one.

2 carers – one to go in front of the turner and one stay beside xxxxxx

1 carer – start beside xxxx as shown. Once xxxxx balanced move to front of tuner to turn it round, and move back beside xxxxxx before he sits down.

Only family and carers that have been taught by a physiotherapist are advised to do this.

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Jason Nicol MCSP, SRPRisk Management Advisor (Moving and Handling), NHS GrampianJason.nicol@nhs.net; 01224 554333

Fiona Douglas MCSP, SRPSenior I Physiotherapist, Stroke Rehabilitation Centre, Woodend Hospital