Occupational Safety and Health and Home Care 2017 2017 · Introduction 2 Objective 2 Occupational...
Transcript of Occupational Safety and Health and Home Care 2017 2017 · Introduction 2 Objective 2 Occupational...
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Occupational Safety and Healthand Home Care
2017 2017
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Guidance on the Safety, Health and Welfare at Work (Reporting of Accidents and Dangerous Occurrences)
Regulations 2016
Occupational Safety and Healthand Home Care
2017 2017
Our Vision:healthy, safe and productive lives
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Introduction 2
Objective 2
Occupationalsafetyandhealthinthecontextofhomecare 2
Managing occupational safety and health 3
Planning, delivery and review of home care services 4
Planninghomecareservices 4
Deliveryofhomecareservices 7
Stafftraininganddevelopment 7
Supervisionofstaff 7
Riskprofileandriskassessment 7
Review of home care services 11
Published in 2017 by the Health and Safety Authority, The Metropolitan Building, James Joyce Street, Dublin 1. ©All rights reserved.
Contents
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Occupational Safety and Health and Home Care
IntroductionObjective
Thisinformationsheetisaimedatemployersandemployeesprovidingformalcareforolderandvulnerablepeopleintheirownhome.InIreland,homecareservicesareprovidedbytheHSE,thevoluntarysectorandprivateproviders.
Definition
Home care: support provided (both short and long term) to people who require assistance to continue to live independently, outside of a hospital or residential care setting.
Homecareclientstendtobeolderpersons,personswithdisabilities,personswithchronichealthconditionsandanyonewhosequalityoflifecanbeimprovedbyhavingatrainedandsupervisedcareworkerintheirhome.
Thetypesofworkingenvironmentandworkingarrangementinvolvedintheprovisionofhomecareservicespresenttheirownuniquehazardsandrisks,whichmustbeidentifiedandmanaged.Thisinformationsheethighlightstheoccupationalsafetyandhealthissuesassociatedwiththeprovisionofhomecareandindicatescontrolmeasurestomitigaterisk.Itisnotintendedtocoverhomemaintenance,deliveredmealsortravelandescortingclients.
Occupational safety and health in the context of home care
Whileahomecareworkerisworkinginaclient’shomethathomebecomesaplaceofworkandtherelevantoccupationalsafetyandhealthlegislativerequirementsmustbemet.Meetingtheseobligations,however,shouldbedoneinasensitivewaythatrespectsthewaytheclientorganisesandwantstoliveintheirhome.
TheSafety,HealthandWelfareatWorkAct2005emphasisestheneedforemployerstomanagesafetyandhealthatworkinordertopreventworkplaceinjuriesandillhealth.Thisinvolvesaninitialreviewofthearrangementsinplacetosecuresafetyandhealth,identificationofstandardstobeachieved,settingoutthemethodofachievingthosestandardsandmonitoringandreviewingofperformance.
Thefoundationofthemanagementofsafetyandhealthisthewrittensafetystatement.Itwillreflectthesysteminplaceformanagingsafetyandhealthatwork.Thesafetystatementmustbebasedontheidentificationofhazardsandtheassessmentofrisk.
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Cyan 100%Magenta 76%Yellow 0Black 27%Managing occupational safety and health
Thekeyelementsofasafetyandhealthmanagementsystemareshownbelow.Safetyandhealthmanagementsystemsshouldbetailoredtosuittheneedsoftheorganisation.
Step 1 PLAN
n Saywhatyouwanttoachieve,whowillberesponsible,howwillyouraimsbeachievedandhowwillsuccessbe measured.Youmayneedtowritedownthispolicyandaplantodeliverit.
n Decidehowyouwillmeasureperformance.Thinkaboutwaystodothisthatgobeyondlookingataccident figures.Lookforleadingindicatorsaswellaslaggingindicators(e.g.competentoccupationalsafetyandhealth adviceavailable[employedorcontracted],writtenriskassessmentscompletedandimplemented,trainingplan anddelivery,staffconsultationandfeedback,resultsof[internaland/orexternal]audits).
n Remembertoplanforchangesandidentifyanyspecificlegalrequirementsthatapplytoyou.
Step 2 DO
n Identifyyourriskprofile
Assesstherisks:identifywhatcouldcauseharmintheworkplace,whoitcouldharmandhow,andwhatyouwill dotomanagetherisk.Decidewhattheprioritiesareandidentifythebiggestrisks.
n Organiseyouractivitiestodeliveryourplan
Inparticular,aimto:
n involveandcommunicatewithworkers,sothateveryoneisclearonwhatisneededandcandiscuss issues,andtodeveloppositiveattitudesandbehaviours;and
n provideadequateresources,includingcompetentadvicewhereneeded.
n Implementyourplan:
n decideonthepreventiveandprotectivemeasuresneededandputtheminplace;
n providetherighttoolsandequipmenttodothejobandmaintainthem;
n providetrainingandinstructiontoensureemployees’safety,healthandwelfareatwork;and
n supervisetomakesurethatarrangementsarefollowed.
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Occupational Safety and Health and Home Care
Step 3 CHECK
n Measureyourperformance:
n makesurethatyourplanhasbeenimplemented–theevidencetoprovethatwhatissaidin documentationisactuallyachievedinreality;and
n assesshowwelltherisksarebeingcontrolledandifyouareachievingyouraims.Insome circumstancesformalauditsmaybeuseful.
n Investigatetherootcausesofanyaccidents,incidentsornearmisses.
Step 4 ACT
Reviewyourperformance.
Learnfromaccidentsandincidents,ill-healthdata,errorsandrelevantexperience,includingfromotherorganisations.
Revisitplans,policydocumentsandriskassessmentstoseeiftheyarestillfitforpurpose.
Takeactiononlessonslearned,includingfromauditandinspectionreports.
Planning, delivery and review of home care servicesPlanning home care services
Planninghomecareserviceswilltypicallyincludeanassessmentoftheclient’seligibilityfortheserviceandtheclient’sneeds.Occupationalsafetyandhealthissuesneedtobeconsideredatvariousstagesofplanning:
n atthereferralstage(thefitbetweentheneedsoftheclientandtheserviceofferedbytheprovider);
n attheclient’scareneedsassessmentstage(impactsofwhichinputintothe‘careplan’);
n whenassessingtheriskswithinthehomeenvironment(i.e.thesuitabilityofthedwellingasaplaceofwork),as partoftheoverallmulti-disciplinarySingleAssessmentTool(SAT);and
n whenidentifyingtheequipmentrequiredtomeetcareneeds.
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Organisationsthatprovidehomecareservicesshouldestablishreferralpoliciesandprocedurestotakeintoaccountrelevantoccupationalsafetyandhealthissueswherepracticable.
Theassessmentofaclient’seligibilityandneedforsupportservicesistheinitialcareplanningstepandisdesignedtoensureclientsreceiveappropriatetypesandlevelsofservicestoenablethemtomaximisetheirindependentlivingcapacity.Relevantinformationmayinclude:
n personaldetailsandcircumstances,
n currentcommunity/home-supportservicesused,
n Currentdiagnosisandmedical/mentalhealthsummary,
n multi-disciplinaryassessments(SAT),and
n homeenvironmentinformation(e.g.pets,geographicallocation,livingarrangements,family/friends/ neighbours).
Asoundassessmentprocesswillnotonlyresultinthedeliveryofappropriateservicesbutalsoidentifyanyoccupationalsafetyandhealthissuesthatmayneedtobemanaged(e.g.patientmovingandhandlingneeds,challengingbehaviours).
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Occupational Safety and Health and Home Care
Inadditiontoplanningforthesafedeliveryofservices,thehomeenvironmentinformationservestobeginarelationshipwiththeclientaboutbuildingasafeandhealthyenvironmentforbothworkerandclient.Thekeyitemscontainedwithinthehomeenvironmentassessmentinclude:
n general(visualinspection);
n accesstothehome–parking,pathways,steps,lighting,gates,pets,entrydoor,etc;
n internalconditions(general)–firesafety,stairs,floorsurfaces,electricity,equipment,housekeepingand hygiene;
n bathroom/toilet–accessibilityand ergonomicsuitability,availabilityof showeringfacilities;
n bedroom–accessibility,heightofbed, spaceandergonomicsuitability;
n clientaidsandequipment–wheelchair, showerseat,liftingequipment(including maintenance)withadequate accessibilityandergonomicdesign;and
n other–smoking,potentialweapons, etc.
Equallyimportantistheprovisionandmaintenanceofsuitableequipmenttomeetcareneeds.Therangeofequipmentincludesliftingandmobilityaids,healthcareriskwastebags/bins,cleaningequipmentusedbythehomecareworker,vehiclesfortransportationofclients,etc.Equipment,whetherprovidedbytheclientorthehomecareorganisation,mustbesuitablefortheneedsoftheclientandtheprotectionofthehomecareworker.Rolesandresponsibilitieswithregardtotheprovision,maintenanceandrepairofequipmentneedtobeclarifiedbetweentheclientandthehomecareprovider.
Occupational Safety and Health and Home Care
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Delivery of home care services
Centraltotheemployer’sdutyistheneedtoensurethataworkplaceundertheemployer’scontrolandmanagementismaintained,sofarasisreasonablypracticable,inaconditionthatissafeandwithoutriskstohealth.TheSafety,HealthandWelfareatWorkActdefinesaplaceofworkasany,oranypartofany,buildingorstructureinwhichworkiscarriedonwhetheroccasionallyorotherwise.Therefore,aprivatehomeinwhichanemployeeisworkingisthatemployee’sworkplaceandtherequirementsofparts2,3and4ofthe2005Actapply.
Staff training and development
Tocomplywiththelaw,employeesneedtohavetheskills,knowledgeandexperiencetocarryouttheirdutiessafely.Organisationsthatprovidehomecareservicesmusttakeintoaccounteachemployee’scapabilitiestoensurethatthedemandsofthejobdonotexceedtheirabilitytodotheworkwithoutrisktothemselvesorothers.
Traininghelpspeoplegaintheskillsandknowledge,andultimatelythecompetence,tocarryouttheirworksafelyandwithoutrisktotheirhealth.Inductiontrainingshouldcoverthekeyelementsofthesafetystatement,includingthesafesystemsofworkrelevanttotheemployee’stasks.Jobanalysisandwrittenriskassessmentsshallidentifyallspecifictrainingrequired(e.g.patienthandling,managingchallengingbehaviours,careoftheolderperson,loneworking,sharpsawareness).Updateandrefreshertrainingmayberequiredatintervals.Trainingrecordsshouldbemaintained.
Supervision of staff
Directsupervisionisdifficultwheretheworkplaceissomeoneelse’shomeandwhereemployeesareoftenworkinginisolation.Itisessential,therefore,thathomecareworkers’activitiesaresupportedbyasystemofworkthatclearlyallocatesresponsibilitiesformanagingthehazardsandthewaytheworkisdone.Suchasystemshouldinclude:
n communicationarrangements,particularlyforemergencycontacts;and
n arrangementstofacilitateregularcontactbetweenstaffandsupervisors.
Risk profile and risk assessment
Section19ofthe2005Actrequiresemployerstoidentifyhazardsinworkplacesundertheircontrol,assesstheriskspresentedand,takingaccountofthefindingsoftheriskassessment,takestepstoimplementimprovementsconsiderednecessary.
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Occupational Safety and Health and Home Care
Listedbelowaresomeofthekeyoccupationalhazardsthatcanoccurinhomecareandsomeofthecontrolmeasurestoavoidorreducetherisk.MoredetailedinformationisavailableontheAuthority’swebsite (www.hsa.ie).
Manual and people handling
Theterm‘manualhandling’isusedheretomeanboththemanualhandlingofinanimateloadsandpeoplehandlinginvolvingclientswithrestrictedmobility.Employersmustensurethatthereareproceduresinplacetomanagetheriskfrommanualhandlingatwork.Safetyandhealthlegislationrequiresthatwheremanualhandlingofloadsinvolvingariskofinjury(particularlytotheback)ispresent,theemployermusttakemeasurestoavoidorreducetheriskofinjury.
Whenundertakingamanualhandlingriskassessment,considerthefollowingriskfactors:
n thetask–therequirementsoftheactivitysuchasnumberoflifts,carryingdistances;
n theindividual–theemployee’sphysicalsuitability,trainingandknowledge;
n theload–thecharacteristicsoftheloadsuchasweight,sizeanddimensions;and
n theenvironment–availablespace,unevenorslipperyfloors,etc.
Whenpeoplehandlingactivitiesarebeingassessed,theriskassessmentshouldalsoinclude:
n thetypeofhandlingactivitiesthatarelikelytoberequiredandtheclient’sabilitywithregardtoeach (e.g.repositioninginthebed,toileting,walking);and
n peoplehandlingriskfactorsrelatingtotheclientforexampletheclient’sabilitytounderstand instructionandcommunicate,historyoffalls,weightandheightetc.
Basedontheriskassessment,identifycontrolstoavoidorreducetherisk.Controlmeasuresmayincludetheuseofequipmentsuchasmobilityaids,hoists,showerchairs,grabrails,etc.Aclienthandling/mobilitycareplancanbedevelopedfollowingriskassessment.Riskassessmentsandcareplansmustbereviewedandrevisedifnecessary.
Challenging behaviours and potential for work-related violence and aggression
Forthepurposesofthisguidance,work-relatedaggressionandviolenceisconsideredtobeanyincidentwherestaffareverballyabused,threatenedorassaultedincircumstancesrelatingtotheirwork,involvinganexplicitorimplicitchallengetotheirsafety,well-beingorhealth.
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Wherework-relatedviolenceandaggressionisidentifiedasahazard,theassociatedriskmustbeassessedandmanagedtoensurethatthecontrolsinplaceareeffectiveandtoidentifyanyfurthercontrolsthatmayberequired.
Whenidentifyingthepotentialforviolenceandaggression,considerthetriggers,situationsandworkactivitiesthatmakeaggressivebehaviourmorelikely.Withregardtoclientswhohaveaggressivebehaviour,theassessmentofriskmayincludeaclinicalassessmentofaclient’sbehaviourandtheidentificationofappropriateinterventionstohelpreducetherisk.
Thepotentialforchallengingbehavioursandwork-relatedviolenceandaggressionfromfamilymembers,friendsandotherscanalsoexistandshouldalsobeassessedwhereappropriate.
Lone working
Manyemployeesinthissectorareloneworkers(forthepurposeofthisguidance,loneworkersaredefinedaspeoplewhoworkbythemselveswithoutcloseordirectsupervision).Loneworkerscanbeatincreasedriskandthismustbetakenintoaccountbytheemployerintheriskassessment.Clienthistorywillbeimportantinassessingtherisk.
Controlmeasurestobeconsideredinclude:
n ensuringloneworkershaveameansofcommunication(e.g.mobilephone)andsupportifrequired;
n Informationandtrainingforloneworkerstoensurethattheyareawareofthehazardsandcontrolsto mitigatetherisksassociatedwithloneworking;
n havingplansinplaceintheeventofanemergency;and
n planninginadvancethesystemofcommunicationbetweentheemployerandemployee.
Slips, trips and falls
Slips,tripsandfallsareoneofthemaincausesofinjuryreportedfromthehealthandsocialcaresector.Safetyandhealthlegislationrequiresthatthereissafeentryandexitintotheworkplace.Floorsmustbeingoodconditionand,asfarasisreasonablypracticable,notslippery.Placesofworkmustbekeptinacleanstate.Accumulationsofdirt,refuseandwastemustbefrequentlyremovedbyasuitablemethodtomaintainanappropriatelevelofsafetyandhealth.
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Occupational Safety and Health and Home Care
Considerthefollowingcontributingfactorswhenmanagingtheriskofslips,tripsandfallsatwork:
n stairsandlevelchanges;
n floorsurfacecondition(wet,uneven,clutteredfloorsincreasetherisk);
n environmentalaspects(e.g.poorlighting,wetandicyconditions);
n personalbehaviour(e.g.lackofconcentration,riskybehaviour);and
n footwear(wearingsuitablefootwearfortheenvironmentandworkactivitiescanhelpreducetherisk).
Biological hazards
Thereisthepotentialforhomecareworkerstocomeintocontactwithanumberofsourcesofinfectioneitherthroughdirectcontactwithclientsorwithcontaminatedmaterials,includingwaste,laundry,contaminatedsurfacesandsoon.Identifyingthespecificinfectiousagent(ifknown),itssource(e.g.blood,healthcareriskwaste)androutesoftransmissionwillfacilitatetheselectionofappropriatecontrols.
Thecontrolmeasuresrequiredbysafetyandhealthlegislationmayalreadylargelybeinplaceaspartofinfectionpreventionandcontrolpolicies.Infectionpreventionandcontrolpoliciesshouldbeinkeepingwithnationalguidelinesandshouldtakeaccountofstandardprecautionsandtransmission-basedprecautionswherenecessary.
Controlmeasuresmayinclude:
n hygienemeasuresthatpreventorreducetransferoftheagent(e.g.handwashing);
n maintainingtheworkenvironmentinacleanandhygieniccondition;
n havingplansinplacetodealwithaccidentsinvolvingbiologicalagents(e.g.needlestickinjuries, cleaningofbloodspills);
n useofpersonalprotectiveequipment(e.g.gloves,aprons);and
n safehandlingofinfectiousspecimens,sharps,waste,contaminatedlinenandothermaterial.
HealthcareriskwastemustbestoredinappropriateUN-approvedcontainers(bagsorbinsdependingonthenatureofthewaste).Thesecontainersaredesignedtopreventleakageandarepermanentlymarkedwithahazardandspecificcontentlabel(maximumexemptedquantityis333kgs).
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Review of home care services
Aneffectiveoccupationalsafetyandhealthsystemmustdealwithchangesintheworkingenvironmentthatmaycreatenewrisks.Forexample:
n changesinclient’shealthandassociatedneedsassessmentandcareplan,
n changesinthelevelofserviceprovided,
n changestothehomeenvironment,and
n learningoutcomesfromanyincidentsoremergencies.
Ineachcaseasuitableresponsetomeettheclient’sneedsandtoreassessoccupationalsafetyandhealthriskswillberequired.
Reviewingoccupationalsafetyandhealthperformanceinvolvessettingupaneffectivemonitoringsystem,backedupwithsensibleperformancemeasures(i.e.thefeedbackloop),theaimofwhichmustbecontinualimprovementandlearninglessonssoastopreventthereoccurrenceofnegativeoutcomes.
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Occupational Safety and Health and Home Care
Notes
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healthy, safe and
productive lives
Health and SafetyAuthority
978-1-84496-239-6 HSA0460