The spinal column is made up of individual bones (called vertebrae). Between these bones are joints that connect them together. Ligaments connect bones to support the joints. Failing to move an individual correctly can cause these ligaments to sprain. Clients should never be dragged when being moved as this may over stretch the joints and cause the ligaments to sprain. Muscles work by the containing fibres contracting and making the muscle shorten. When muscles shorten it pulls on the tendon and then on the bone it is attached to. Muscles are connected to bones via tendons.
When a client is moved and positioned it is vital this happens smoothly. Any sudden movements or pulling in any direction of a clients’ limbs or body can cause pulled muscles or tear tendons which can cause a lot of pain. (ones in limbs are covered with tissue. Putting pressure on an individual’s leg or arm when they are moving from one position to another can cause a bone to fracture. Fractures can also happen if there is an accident with equipment like a hoist and this falls onto the individual when moving-positioning them or using the wrong sling size and the individual falls out.
Legislation that is relevant includes the Management of health and safety at work regulations; this introduced the requirement for risk assessment, risks when moving and positioning individuals must be assessed, acted on and reviewed, also all staff must be trained in moving and positioning individuals. The lifting Operations and lifting equipment regulations introduced the requirement for employers to provide lifting equipment that is safe to use and maintained, staff must also be provided with training. The Manual handling Operations regulations for employers’ states that they must carry out risk assessments for all moves and reduce the risk of injuries from happening and avoid dangerous moving and handling. The employees’ responsibilities include using all equipment as trained to do so and follow all health and safety working practices and avoid putting themselves or other staff, clients or visitors at risk. I am to report any hazards or risks to my employer. Agreed ways of working mean that my employer must have workplace policies and procedures for moving and handling, these must be explained to staff, and staff provided with training and supervision. It is also important that all employees read these procedures. If they do not understand ask that they attend training, are supported with understanding all individuals’ needs, the moves needed, and all equipment being used.
I do this by ensuring that I am wearing appropriate clothing and foot wear when I move a client or am supporting them to change position to avoid any risk of being harmed. I also make sure that I do a manual risk assessment before performing any move or reposition. I will not use any equipment that I have not been trained to use and I check that there is enough space around me to carry out the move. All equipment needs to be checked that it is working correctly, if a hoist that it is charged, and all equipment must be clean and safe to use. I look for any obstacles, like loose rugs, clothes or boxes and move them to one side. It is important the space around me is clean and comfortable. All moving, and positioning must not be rushed. Infection control is also important, washing of hands before and after and wearing of PPE according to my workplace policy. I also check with the client their needs and preferences and check this against their plan. I then ask the client for their consent before the move and make sure I am using the correct equipment, that the sling and hoist are clean and safe to use and the correct ones for the client, these must then be stored away safely to avoid any accidents or them being used for someone else. In the plan it includes the individual’s weight and the sling and hoist to use for their weight and for some clients who are tall for example they need a much longer sling to support their head and body. Also, to consider is whether the client will keep their arms in the sling or whether they may decide not to or may become anxious when being moved. I will always reassure and explain the importance of keeping arms inside the sling for their own safety.
Minimise risk before moving and positioning different clients in terms of, accessing clients’ care plans and risk Assessments, carrying out visual checks of the area and equipment being used, seeking the clients’ consent and agreement from colleagues as well as applying precautions for infection prevention and control.
If risks from moving and handling are to be managed successfully, there must be support from those at the top of the organisation, whatever its size. This can be expressed in a clear statement of policy – supported by organisational arrangements – to ensure that the statement is implemented. Key elements include:
• recognition of the risks
• commitment to introducing precautions to reduce that risk
• a statement of clear roles and responsibilities
• an explanation of what is expected from individual employees
• arrangements for training and providing – maintaining equipment
• arrangements for monitoring compliance
• a commitment to supporting people who have been injured in connection with their work
Employers must reduce the risk of injury to staff and people using care services by:
• avoiding those manual handling tasks that could result in injury, where reasonably practicable
• assessing the risks from moving and handling that cannot be avoided
• putting measures in place to reduce the ris!4 where reasonably practicable
• follow appropriate systems of work and use the equipment
• provided co-operate with their employer and let them know of any problems
• take reasonable care to ensure that their actions do not put themselves or others at risk
Where an individual indicates a choice that you or others may consider to be a risk you should utilise your assessment skills to determine if there may be issues of capacity or safeguarding. If unsure, consult with your line manager. Record the decision & outcome and the discussion on the file. If there may be a safeguarding issue, refer to local safeguarding vulnerable adults’ procedures. If there are thought to be mental capacity issues you, or a competent person, should complete an assessment of capacity. If, having applied safeguarding procedures or capacity procedures, it is deemed that the person could not be supported in making their decision or choice, appropriate actions may need to be taken to protect the individual within safeguarding procedures or mental health legislation. However, a local authority has the power to refuse to fund a service which it believes, after a process of due discussion and exploration, would put the person at increased risk of harm. If, having applied safeguarding procedures or capacity procedures, it is deemed that the person could be supported in making the decision or choice then they should be supported to do so. Professionals and organisations supporting people who use social care and support services will ensure that everyone they work with is given the support to understand the issues of risk connected with their decision or choice, in a way that is appropriate and accessible to them. Professionals and organisations must be able to show that they have done this in a reasonable and proportional manner. Risk assessment conducted with individual or significant parties to the decision or choice may be one method of demonstrating levels of risk once the decision or choice is made. However, if the risk agreed on is unreasonable in all the circumstances, then the local authority or organisation may well be less protected. In principle, if a local authority or organisation actively supports an obviously hazardous course of action, then it could be legally liable should things go wrong, if what it agreed is too risky and therefore constituted negligence. Recording of risk does not necessarily indicate levels of understanding. Therefore, the work you have undertaken to ensure that the risk is understood must be recorded and shared with the service user. Any such records should be signed by the service user where possible.
There are many different aids and equipment that may be used for moving and positioning such as:
These are used along with a hoist to lift a person up and move from one place to another. A sling is designed to be comfortable and keep the client safe so having the correct sling for the client is important. You must also check before each use that there is no rips or tears in the sling and it appears safe too use.
These are used with a sling to lift a person and move them from on place to another. Each hoist has different weight capacity, so it is important you have the right hoist for the right client. Before using you must check there are no obvious signs of damage and that the hoist service check is in date.
These are used to slide a person up, down or across and can be used to turn a person onto their side. Two people should be supporting a client with this task for the safety of the client and staff. Always check there is no obvious signs of damage before use.
There are many types of stand aids, but the main aim is to assist a client that cannot stand unaided. These usually require two staff for the safety of the client and staff. Always check there is no obvious signs of damage to the equipment and it looks safe to use and check the service is in date.
You should seek advice and/or assistance if the client is injured or in pain. Many injuries are made worse by movement especially if spinal injuries are a possibility. Unless the client is in immediate danger or will require CPR then you should only ever move a client under the instruction of a paramedic or a doctor.
There are lots of different sources of information; in my workplace the moving and handling procedures and guidelines about the correct practices to follow, individuals’ risk assessment and care plans about their needs and practices agreed to follow – the individuals and their families can also help with what they find useful. I can also ask my colleagues and manager for information and advice. Sometimes we can also ask other health care professionals such as District nurses and moving and handling specialists’ specific questions or advice about issues – training courses and information leaflets are also useful.’
311 – Provide support to maintain and develop skills for everyday life
A skill is something someone can do. There are different ways to maintain the skills depending on the client and the lives they want to live. If they are having difficulty with bathing or washing they might need support to help them maintain their personal hygiene, and possibly could need aids such as hand rails, or shower chairs. Giving a client a walking aid to help them keep their independence with mobility like a walking frame. To keep skill development, it should be based on what type of skill, if they have capacity, or can perform certain skills. You should encourage as much as possible to do things themselves to promote their independence, rather than just doing things for them because it’s easier.
There are a range of different reasons why support may be needed to regain or develop skills such as if they are able to or they may not understand how to perform skills, they may not have the confidence, or be able to develop new skills, they could suffer from mental health, or learning disabilities. Supporting clients to develop or regain these skills will help lead a safe and happy life.
By helping people maintain, regain and develop everyday skills would benefit individuals in different ways. It would help them on their self-worth and self-esteem, it ensures that there are more opportunities and helps them to regain confidence and independence which can help them on working towards a better lifestyle. It will help them be more independent and make life easier for the client.
I always get the client involved in decision making and their family involved in their care. Sometimes problems can arise with their wishes or preferences, like if they wanted something on a certain day and they had a DOLS in place and us as staff know this, but the service user is adamant they want it. Me as a member of staff must be able to communicate with the client to a level which they understand to explain to them why they can’t have something on a certain day but c