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
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
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
healthy, safe and
productive lives
Health and SafetyAuthority
978-1-84496-239-6 HSA0460