Risk Assessment & Hoist FAQ

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Moving and handling risk assessment

Avoid manual handling where possible

Risk assessment - choosing a hoistClearly, it is not possible to avoid moving a person who is unable to move independently, but it is possible to make the procedure safer with the right equipment.

For this reason, risk assessment is extremely important.

If you employ five or more people, you are legally obliged to keep a record of all your risk assessments.

It is good practice for all organisations to keep such records, and communicate them with any relevant staff, in order to help with managing risks effectively.

There are two types of risk assessment required; generic and individual

Generic risk assessment considers the workplace/environment in general, including the equipment needed; safe staffing levels; emergency procedures; and any risks associated with the physical environment.

Individual risk assessments look at the specific moving and handling needs of a person, to ensure the safety of both care staff and patient/service user. This will include assessing the degree of help needed; any specific equipment requirements; the number of staff needed to complete the task safely.
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Competent person to carry out assessments

All risk assessments must be carried out by a ‘competent person’, who is most likely somebody within the organisation, as they are best placed to understand the services provided and tasks carried out. They will probably require specialist training in risk assessment.

Risk assessments form part of a care plan, and should be person-centred, ensuring that the dignity and well-being of the individual is respected.

They and/or their family should be involved in the process as far as possible, so that they understand the equipment being used, and how it will protect everyone involved in the transfer from injury and discomfort.

Specialist advice on helping users with specific moving and handling needs can be useful.

For example, some people can become agitated or upset when they are moved. Others may be able to cooperate with a transfer initially, but become too tired subsequently. Some needs change depending on the time of day.
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There are numerous issues to take into account when assessing – here is a hoist FAQ:
The Tasks

• Activities – is the hoist needed for one particular task / transfer or several e.g. in and out of bed, on and off a chair?

• Is it for one transfer in a specific area or is flexibility important so that transfers can take place anywhere in a room?

• Frequency – is the hoist for emergency use only, e.g. lifting from the floor after a fall, or is it for daily use?
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The Home Environment

• Space – is there enough space to manoeuvre the hoist and user safely and easily?

• Furniture – will a mobile hoist base go around or under furniture?

• Floor surfaces – are these suitable to move a mobile hoist across?

Note: If these factors cause repeated difficulties, consider an overhead hoist that runs on a straight or curved ceiling-fixed track.
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The Hoist User

• Type of disability – what is the person’s diagnosis and prognosis? Is their condition stable or likely to fluctuate or deteriorate?

• Size – check that the hoist and sling is suitable for the user’s size and weight.

• Confidence – is the carer confident in the use of specialist equipment such as hoists?

• Physical strength – consider the size and strength of the carer. It requires quite a lot of effort to turn and move a mobile hoist

If the person needs to be carried over a distance, it is advisable to use an overhead track hoist or specifically designed wheeled equipment (e.g. wheelchairs or shower/commode chairs).
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Sources of advice on manual handling include:

• occupational therapists

• physiotherapists

• manual handling advisers

• ergonomists with experience in health and social care

• professional bodies such as the National Back Exchange or Chartered Society for Physiotherapists

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How far to reduce risks?

It is impossible to eliminate risk entirely, but paying attention to the environment, appropriate equipment and training can reduce risk to a minimum.

The needs of both the person being moved and the carer must be considered.
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Double handed care

The idea that there should be “two people for every lift” is a misconception, but still widespread. It is possible that the original source is the following paragraph in the National Minimum Standards Regulations for Domiciliary Care 2003, which states:

“12.8 Two people fully trained in current safe handling techniques and the equipment to be used are always involved in the provision of care when the need is identified from the manual handling risk assessment.”

Note the final third of that statement, when the need is identified from the manual handling risk assessment.

What managers should take from this is that a moving and handling risk assessment is necessary, not that two carers should be involved in every lift.

Equally, there have been significant developments in the design of transfer equipment in recent years.

Very often, it is intended to be used by one person, and is quite safe without the need for an extra pair of hands.
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With thanks to Matthew Box of Inclusion.Me for hoist selection FAQs.

You can read more on the debate about safe transfers and the requirement for double handed care here
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