Elderly Care in PenrithMoving & Handling Guide for Home Carers in Cumbria
Manual handling training is crucial for ensuring the safety of both clients and staff. This training is not only a legal requirement but is also fundamental to maintaining a secure and efficient care environment.
Each person's care needs are distinct and as varied as their personality. Even people who share a similar medical condition can have different needs and requirements when it comes to moving & handling.
Some clients require support for fundamental aspects of their care including assistance with moving and handling their bodies regularly. People with conditions like Huntington’s Disease, Cerebral Palsy, or Myasthenia Gravis, can have very different needs depending on their condition. The varying circumstances of individuals with these conditions call for tailored approaches to ensure their specific needs are met with the utmost consideration and expertise.
Relevant Legislation and Regulations
Health and Safety at Work Act (1974): The Health and Safety at Work Act establishes the legal framework for ensuring the health, safety, and welfare of all employees in the workplace. In the context of moving and handling, this act emphasises the responsibility of employers to provide a safe working environment, including proper training and equipment to minimise the risk of injury during manual handling tasks.
Manual Handling Operations Regulations (1992): These regulations specifically address the risks associated with manual handling activities at work. They require employers to conduct risk assessments for manual handling tasks, implement measures to reduce the risk of injury and provide training to employees involved in such activities. The goal is to prevent musculoskeletal disorders and injuries related to manual handling.
Lifting Operations and Lifting Equipment Regulations (1998): The Lifting Operations and Lifting Equipment Regulations focus on the safe use of lifting equipment in the workplace. In the context of moving and handling, this regulation ensures that lifting equipment is properly maintained, inspected, and used by trained personnel. It covers various lifting equipment, including hoists and slings used in care settings.
Provision and Use of Work Equipment Regulations (1998): These regulations aim to ensure the safety of work equipment, including machinery and tools. In the context of moving and handling, it mandates that equipment used for lifting and transporting individuals is suitable for the task, well-maintained, and used by trained personnel. Employers are required to assess risks, provide information and training, and ensure the proper use of work equipment.
Principles of Safer Handling
Kinetic Lifting Principles: Understanding the principles of kinetic lifting involves using the body's natural movements and mechanics to minimise strain during lifting and handling tasks. This includes utilizing the legs for lifting, keeping the load close to the body, and maintaining a smooth and controlled motion.
Levers: Applying the concept of levers involves using the body's leverage points effectively. For example, when lifting, bending the knees and using leg muscles provides better leverage than relying solely on back muscles. Proper lever usage reduces the risk of back injuries.
Posture: Maintaining a correct posture is crucial for preventing injuries during moving and handling. This includes keeping the spine straight, bending at the knees, and avoiding twisting movements. Good posture ensures that the load is distributed evenly across the body.
Grips: Choosing the right grip when handling objects or assisting individuals is essential. Using a wide grip can distribute the load more evenly and reduce strain on the hands and wrists. Proper grip techniques help maintain control and stability during handling tasks.
Team Lifting: Team lifting involves collaboration between multiple individuals to share the load during heavier lifting tasks. Effective communication and coordination are key to ensuring that everyone lifts simultaneously and in unison, reducing the risk of uneven weight distribution and injuries.
Communication: Clear communication is fundamental during moving and handling activities. Team members should communicate effectively to coordinate movements, signal readiness, and ensure a synchronised approach. Verbal and non-verbal communication helps prevent accidents and ensures the safety of everyone involved.
Equipment Use: Proper use of handling equipment, such as hoists, slings, and transfer aids, is crucial for preventing injuries. Training on equipment operation, regular maintenance checks, and adherence to manufacturer guidelines contribute to safe and effective equipment use.
Risk Assessment: Conducting thorough risk assessments before any moving and handling task is essential. This involves identifying potential hazards, evaluating the environment, and determining the most appropriate techniques and equipment to mitigate risks.
Risk Assessments in Moving and Handling
Risk assessments play a vital role in ensuring the safety of both carers and clients during moving and handling tasks. Identifying potential hazards is a critical step, encompassing various elements such as obstacles, stairs, and spill risks.
Home carers need to be aware of the risks identified and recorded in the care plan. You should be aware of the risk mitigations that have been established and risk assess every moving & handling situation before supporting the client. This is because a client's condition can change and new risks may be present.
Key Components of Risk Assessments:
Identification of Hazards: Risk assessments involve assessing the environment and the specific task at hand. Hazards can range from physical obstacles in the surroundings to the complexity of the client's mobility or health condition.
Obstacle Recognition: Carers need to be vigilant in recognising potential obstacles that might impede the smooth execution of moving and handling tasks. This includes ensuring clear pathways, identifying tripping hazards, and addressing any environmental challenges.
Stair Risks: Stairs present a unique set of challenges during moving and handling. Assessments should focus on the presence of handrails, the condition of steps, and the overall feasibility of navigating stairs with the client. Appropriate techniques and equipment should be determined based on the assessment.
Spill Risks: Spills pose a risk to both carers and clients, especially when coupled with the need for swift and coordinated movements. Risk assessments should consider the likelihood of spills and establish preventive measures to maintain a safe environment.
- Dynamic Assessment: Each client is unique so carers should conduct on-the-spot assessments. This includes evaluating the client's current condition, the immediate environment, and any factors that may have changed since the last interaction.
Continuous Vigilance: Carers should maintain continuous vigilance throughout the support process, adapting their approach based on evolving circumstances. This ensures that any emerging risks are promptly identified and addressed.
Adaptability and Flexibility: Risk assessments are not static documents but dynamic guides that inform real-time decision-making. Carerrs must be adaptable and flexible, adjusting their strategies based on the specific needs and challenges presented by each client.
Planning and Preparation
Reviewing Care Plans: Initiate the process by thoroughly reviewing care plans, ensuring an understanding of the specific needs and requirements of each client.
Consulting with Therapists: Collaborate with healthcare professionals, including therapists, to gain insights into the client's physical condition, limitations, and recommended handling techniques tailored to their unique circumstances.
Staff Briefing: Ensure you're up to date with any information from the manager or office team about changes to the client's condition or whether temporary or permanent changes to moving & handling.
Equipment Verification: Prior to any moving and handling tasks, rigorously check and verify the functionality and appropriateness of the equipment to be used. This step is crucial for preventing equipment-related incidents.
Assessing Patient Abilities: Gauge the specific abilities and limitations of the client, considering factors such as mobility, strength, and any relevant medical conditions. This information guides the development of a tailored approach to handling.
Groundwork for Safer Handling: Undertake comprehensive groundwork by considering various elements, including the physical environment, potential challenges, and any specific requirements that contribute to creating a safe and controlled handling environment.
Ergonomics and Body Mechanics
Proper Stance: Adopting a balanced and stable position to support the body's weight and maintain control during moving and handling tasks.
Foot Placement: Strategically positioning the feet to provide a solid base, ensuring balance and preventing slips or accidents.
Core Activation: Engaging and activating the core muscles to provide strength and stability to the spine and torso.
Bent Knees: Maintaining a slight bend in the knees to lower the body's centre of gravity and reduce strain on the back.
Tight Back: Keeping the back muscles engaged and tight to provide support and protect against unnecessary stress.
Alignment: Ensuring the body is aligned correctly to promote efficient movement and reduce the risk of injuries.
Assistive Equipment Use
- Weight Capacity: Ensure the hoist's weight capacity exceeds the client's weight.
- Proper Sling Attachment: Verify the correct attachment of slings to distribute weight evenly.
- Battery Status: Regularly check and charge the hoist's battery to prevent unexpected failures.
- Patient's Ability: Assess the client's ability to use the stand aid safely.
- Secure Positioning: Ensure the stand aid is securely positioned before use.
- Clear Path: Clear the path of any obstacles to facilitate smooth movement.
- Skin Inspection: Regularly inspect patient skin for signs of shearing or abrasion.
- Friction Reduction: Confirm proper placement and use to minimise friction during transfers.
- Patient Comfort: Prioritise client comfort during repositioning.
- Proper Placement: Secure the belt snugly around the client's waist for effective support.
- Communication: Establish clear communication with the client during sling use.
- Regular Checks: Regularly check for wear and tear to ensure continued reliability.
- Correct Positioning: Position the transfer board securely for a smooth transfer.
- Patient Cooperation: Ensure client cooperation and understanding during the transfer.
- Smooth Surface: Confirm the board's surface is smooth to prevent friction
Practical Handling Techniques
Controlled Wheelchair Transfers:
- Wheelchair Brakes: Ensure wheelchair brakes are engaged during transfers.
- Patient's Stability: Assess the client's stability before initiating the transfer.
- Clear Path: Maintain a clear path to prevent obstacles during the transfer.
Standing Hoist Transfers:
- Patient's Weight-Bearing Capacity: Evaluate the client's ability to bear weight on their legs.
- Correct Sling Attachment: Ensure the sling is correctly attached to the hoist and positioned for stability.
- Smooth Movement: Coordinate movements with the client and other carers for smooth transfers.
- Risk Assessment: Assess the floor for any potential hazards or obstacles.
- Proper Lifting Technique: Use proper lifting techniques to prevent back strain.
- Patient Cooperation: Coordinate with the client for a safe and comfortable transfer.
Repositioning in Bed:
- Frequency: Regularly reposition the patient to prevent pressure sores.
- Use of Slide Sheets: Employ slide sheets for easier and smoother repositioning.
- Adequate Support: Ensure pillows and supports are used to maintain proper body alignment.
- Patient's Mobility: Assess the patient's mobility and adjust guidance accordingly.
- Clear Instructions: Provide clear and concise instructions during ambulant guiding.
- Safety Precautions: Be aware of the environment for potential trip hazards.
- Assessment of Patient's Ability: Assess the client's ability to navigate stairs safely.
- Assistance: Provide appropriate assistance based on the client's needs.
- Use of Handrails: Encourage the use of handrails for added stability.
Client Comfort, Dignity, and Safety
Effective moving and handling practices go beyond the physical aspect; they encompass the overall well-being and experience of the client. Carers play a crucial role in ensuring the following key aspects:
- Encourage Independence: Whenever possible, encourage and support clients to participate in their own movement and transfers, promoting a sense of autonomy.
- Assistive Devices: Utilize appropriate assistive devices to facilitate patient independence, considering their abilities and preferences.
- Communication: Maintain open communication with the client, explaining procedures and respecting their preferences.
- Privacy: Prioritise privacy during moving and handling tasks, using curtains or screens when necessary.
- Regular Position Changes: Implement a schedule for position changes to prevent discomfort and pressure ulcers, especially for patients with limited mobility.
- Proper Use of Equipment: Ensure that any equipment used is adjusted for comfort and doesn't cause unnecessary strain or discomfort.
- Risk Assessment: Conduct thorough risk assessments before any moving and handling activity, identifying potential hazards and taking preventive measures.
- Teamwork: Utilize a team approach when needed to ensure the safety of both the client and the carers.
- Patient Involvement: Involve the client in discussions about their care plan and preferences, fostering a sense of control and involvement.
- Team Collaboration: Maintain clear communication within the caregiving team to coordinate movements and transfers effectively.
Carers should approach moving and handling tasks with a holistic perspective, considering not only the physical aspects but also the emotional and psychological well-being of the patient. This approach contributes to a positive care experience, promoting dignity, safety, and overall patient satisfaction.
How to Support a Non-Weight-Bearing Client
If a client is unable to weight-bear, the recommended practice is:
- Leave them in bed or the chair, ensuring comfort and coverage with a blanket/quilt.
- Contact the office to explain the inability to stand safely at this call and take direction from the office staff.
By adhering to these guidelines, home carers can ensure a safe and person-centred approach to manual handling, promoting the well-being of both clients and staff.