Care Professional | 36 Comments |
Risk Assessment & Hoist FAQ
Moving and handling risk assessment
With thanks to Inclusion.Me for the hoist selection FAQ below
Avoid manual handling where possible
Clearly, 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.
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.
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?
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.
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).
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
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.
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.
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
Matthew Box and Linda Agnew have reviewed double-handed care packages in Thurrock
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36 Replies to “Risk Assessment & Hoist FAQ”
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Hi,I work I a dimensia care home and we have a lady who now requires the hoist she is able to weight bear but the reason for it is her legs are ulcerated , this lady hates that we hoist her she kicks screams cry out loud abuses staff it’s very distressing for her all while in company of other residents which get distressed seeing her upset an screaming , she does have capacity to make her own choices , just wanted to check are we allowed to force her to use the hoist if she chooses not to and also are we as carers in the care home allowed to refuse to use it on her or do we risk losing our job thank you
Hello Michaela
This sounds a really difficult situation all round. Forcing someone to use a hoist can’t possibly be a good solution. A risk assessment should have been undertaken which considers the person, the equipment and the environment. What does that say?
There is guidance from the Health & Safety Executive about using hoists to transfer people – you can read it here: https://www.hse.gov.uk/pubns/hsis3.pdf (external link will open in a new browser tab or window)
I hope you get the situation resolved soon.
Best wishes,
Frances
Hi we have a service user who we assisted via a overhead hoist rail . My workplace got a sensory room refurbished and fitted . Which included a water bed . Now this is approx my knee height . And is only assessable to hoist on one side it is basically on a fitted wooden block with the water mattress . Against the wall . Now I have been taught how to stand when assisting P.c this stance is not possible as the bed so low . Main concern is not having full access to two sides of the bed . It’s is a 2 person lift . Recently we have had concerns considering our safety on both parties . The service user is of heavy build . And very active while on the bed which means the position of the sling h has moved leaving us to try and find the loops handles for the overhead procedure . Sometimes I have to kneel on my hat SU the bed itself . Now this has been a concern for me & my colleges but lately has gotten harder to transfer in to out off the bed . I approached my manager he reply he wanted the said SU to stay on the bed and put him more to the end of the mattress . I totally think this is very bad practice . But before I go back in . I want to make sure . The SU has not been asses by a OT and the water mattress was not solely ment for that SU . Can you help me please . Thank you
Hello Vronne
Any lift must be risk assessed by a suitably qualified person. They should look at the environment generally and the specific moving and handling needs of the service user, 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.
If your employer employs more than five people, they are legally required to keep records of all risk assessments carried out.
I hope this helps.
Best wishes,
Frances
If a patient doesn’t roll for personal care but legs have to be lifted is it safe for one person to do. Their faeces can be quite runny
Hello Jacqueline
Any lift or transfer should be risk assessed by a suitably qualified person, to decide how it can be carried out safely. This isn’t something that I can advise on, I’m afraid.
Best wishes,
Frances
If when using a sit to stand hoist and the belt on the person keeps slipping up does this mean we are using wrong size belt
Hello Sally
There is obviously an issue, if the belt is not holding the person safely. Someone who is suitably trained in using the equipment should be making sure that it is the correct belt, and is fitted and used correctly.
Best wishes,
Frances
Hi can you help please if a hoists service is out of date by a few days can you still use the hoist?
Hello Anne
You really need to be sure that equipment used to transfer a person is safe and reliable, so I wouldn’t recommend using a hoist that is overdue for service.
However – COVID restrictions have meant that in some cases it is difficult to get service visits undertaken in time. So it is a question of balancing risks. If there is another way of safely transferring the person you should do that. There is full guidance on the HSE website: https://www.hse.gov.uk/coronavirus/equipment-and-machinery/work-equipment.htm (external link will open in a new browser window)
Best wishes,
Frances
Hi , we currently have an elderly lady who is very weak. We were using the hoist to transfer her from her bed to any easy chair. After transfers we noticed this was causing her slight marking that eventually became small bruising. Is there any other way that we could transfer her , that will cause her no discomfort,as she may end up spending her last bit of time lay in her bed otherwise and I feel this will be detrimental to her health ?
Hello Nicola
For someone who is unable to weight bear, a hoist is the recommended way to transfer from bed to chair. Maybe the sling is not the right size or style, if it is pressing into her skin?
I think it would be a good idea to get an assessment from a moving and handling expert who can recommend the best equipment and technique to keep this lady as comfortable as possible during transfers.
It would be a shame if she couldn’t benefit from spending some time sitting in a chair rather than always being in bed.
Best wishes,
Frances
Hi I am currently studying cert III in Individual support and disability and I am just wondering if someone could give me a hand with something?
If I arrived at the home of a client and their sling that they use daily to go to the bathroom is broken what policies and procedures would I need to follow?
Hello Teegan
The first and most important thing is that you should never use transfer equipment, including slings, that show any sign of damage. They could cause a serious accident.
Beyond that, your employer should have given you alternative procedures to follow in a situation like this.
Best wishes,
Frances
Hi can you help we have a client who is struggling to use her zimner frame so we were told to use a hoist the clint was panicking crying I was not comfortable with the task I looked in her care plan and she has not been assesed for a hoist can I refuse to hoist the client
Hello Ann
Your client absolutely needs to be assessed for a hoist. This is part of the manual handling risk assessment that must be carried out before any assisted transfer takes place.
Perhaps she could be helped to use her walking frame better? It would be a great pity to lose what mobility she has, and she is clearly experiencing considerable distress with the attempts to use a hoist.
i am struggling to compose a risk assessment for a person new to a ceiling hoist with full body sling and a mobile standing hoist , can you help please? many thanks
Hello Miriam
Thank you for contacting Independent Living. First, I must stress that this is just general information about risk assessments for moving and handling, and if you are being asked to carry one out, you should also have been given training in how to do so…
Essentially, there are two types of risk assessment you need to consider: generic and individual.
1. Generic looks at the environment in general, including the equipment needed; how many people are needed to carry out a transfer safely; what the emergency procedures are; and any risks associated with the physical environment.
2. Individual risk assessments look at the specific moving and handling needs of a person, to ensure the safety of both care staff and client. This will include assessing the degree of help needed; any specific equipment requirements; the number of staff needed to complete the task safely.
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.
Some things to think about:
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?
The Client and Carers
• Type of disability – what is the person’s diagnosis and prognosis? Is their condition stable or likely to fluctuate or deteriorate?
• Are they able to cooperate with a transfer? Is this always the case, or does it vary according to how tired they are? If they can’t cooperate, do they understand the need to be moved, or are they likely to become agitated or upset?
• Size – check that the hoist and sling is suitable for the user’s size and weight.
• Confidence – is/are the carers confident in the use of the equipment?
• Physical strength – consider the size and strength of the carers. It requires quite a lot of effort to turn and move a manual hoist
The manufacturer or supplier of the equipment you are using should also be able to help you with advice on minimising risks.
I hope this helps.
Best wishes,
Frances
What profession able prescribe hoist
Hello Cris
It is generally an OT (Occupational therapist) who would assess a person and recommend a hoist if necessary.
Best wishes,
Frances
Hi, I’m struggling to compose a risk assessment for using a mobile hoist as I’ve never done one before, could you provide some guidance on the risks/ hazards & control measures please.
First, I must stress that this is just general information about risk assessments for moving and handling, and if you are being asked to carry one out, you should also have been given training in how to do so…
Essentially, there are two types of risk assessment you need to consider: generic and individual.
1. Generic looks at the environment in general, including the equipment needed; how many people are needed to carry out a transfer safely; what the emergency procedures are; and any risks associated with the physical environment.
2. Individual risk assessments look at the specific moving and handling needs of a person, to ensure the safety of both care staff and client. This will include assessing the degree of help needed; any specific equipment requirements; the number of staff needed to complete the task safely.
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.
Some things to think about:
The Home Environment
• Space – is there enough space to manoeuvre the equipment 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, an overhead hoist might be a better solution
The Client and Carers
• Type of disability – what is the person’s diagnosis and prognosis? Is their condition stable or likely to fluctuate or deteriorate?
• Are they able to cooperate with a transfer? Is this always the case, or does it vary according to how tired they are? If they can’t cooperate, do they understand the need to be moved, or are they likely to become agitated or upset?
• Size – check that the hoist and sling is suitable for the user’s size and weight.
• Confidence – is/are the carers confident in the use of the equipment?
• Physical strength – consider the size and strength of the carers. It requires quite a lot of effort to turn and move a manual hoist
If the person needs to be carried over a distance, it is advisable to use an overhead track hoist or a shower/commode chair rather than a manual hoist.
The manufacturer or supplier of the equipment you are using should also be able to help you with advice on minimising risks.
I hope this helps.
Best wishes
Frances
Is there any guidance anywhere to help carers determine when it is, or is not, appropriate to lift an injured resident after a care home fall?
Hello Yvonne
I have found some guidance in the form of a flowchart from the Scottish Care Inspectorate which looks to be useful:
https://www.careinspectorate.com/images/documents/2737/Tool_8_Pathway_for_managing_a_resident_who_has_fallen.pdf (pdf will open in a new browser window)
Best wishes,
Frances
Thank you for this. A relative was raised in a hoist after a fall despite having a suspected hip fracture, an injury from which death resulted some weeks later. I am advised no action can be taken against the care home. CQC claim the home had a first aid policy, which I have been unable to gain sight of, and said first aid training was up to date. There are a number of other short comings surrounding this accident and I find it surprising that CQC do not act when it is apparent that there were clear breaches of the law.
I am sorry to hear about this, Yvonne. Maybe another organisation would be more responsive. You can report incidents involving equipment such as hoists to the MHRA to follow up. There is more information here: https://www.independentliving.co.uk/cp-editorials/adverse-incidents/
The Health And Safety Executive, HSE, is another possibility, though they are more focused on injuries to workers.
Hi. I’m currently completing a Trusted Assessor course and need to answer a question regarding the risks associated with using a mobile hoist and those when not. If you have any examples of risk assessments, these would be useful
Hello Alastair
Unfortunately, I don’t have any examples to share. There is quite a lot of information on this page about the various elements you need to consider, and perhaps you can also get guidance from the Health & Safety Executive https://www.hse.gov.uk/ (external link will open in a new browser window)
I am struggling to compose a risk assessment for a person using a floor body hoist, standing hoist and ceiling hoist. Could you help me with the risks ,hazards and control measures to fill in
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I am struggling to compose a risk assessment for a person using a hoist and a stand aid . I have never done this before the client is in there own home. Could you help me with the risks, hazards and who may be at risk thanks Bev
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This information would also be useful for me , if that is possible please?
Replied by email!
I am also struggling with this topic! I have an individual who is used to common practice of using a standaid to get to commodes etc, then use a hoist to get into bed for convenience. Is this acceptable?
So long as all the procedures have been carefully risk-assessed and deemed to be suitable, I can’t think of any reason why it shouldn’t be acceptable.
Best wishes,
Frances