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February 24, 2014

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Healthcare: why people handling training is not relevant


Sue Tudor, trainer and consultant for safety in social care

In one of my last roles, I spent many an hour investigating accidents and incidents around the equipment used to lift people in social and healthcare environments.

It became quite clear to me that the standard formats of manual handling training were not working, mainly due to the fact that there were no concessions to the reality of what the staff encountered day-to-day. Instead, it was a ‘one size fits all’ approach.

Management teams were also failing to understand the reality of what staff were facing, or where responsibility actually lay in the event of an incident.

The response I often got from managers in relation to an incident was: “They’ve had the training.” I have seen staff disciplined and even fired when the real cause was something underlying within the management structure and working culture — something rarely acknowledged by organisations trying to save money.                  

Manual handling is not difficult. Assessing people correctly for equipment is not difficult. But it is made increasingly hard by managers who are being blinded by information that is years old, and by not affording staff the credit of dealing with actual people in real life situations. Unless this changes, all the manual handling training in the world will make little difference to the reality of handling vulnerable people.

Learners most commonly complain about the difference between the training environment to the environments they actually work in.

There are also a number of common issues voiced regularly by staff members. Time restraints, coupled with the fact that staff are often low in numbers, force staff to take short cuts, further increasing the risk of injuries to themselves and to their service users.

Most manual handling training sessions are based on a standard format consisting of legislation, risk assessment and the safe principles of manual handling. Practical techniques will more often than not follow in the afternoon. From a staff point of view, this format is time consuming and tedious.

A report into manual handling injuries within domiciliary care staff showed that there had been a total of 22 incidents to care workers within a 12-month period. However, on reviewing the accident forms submitted to the safety team, it was acknowledged that all of the incidents had been caused by core principles of manual handling that had simply been forgotten.

This surely must beg the question whether these need to be included within the standard format of manual handling training? Many times staff have stated to me that the Manual Handling Operations Regulations 1992 (amended 2002) are irrelevant in their roles.     

When overseeing a training session, I would give staff a choice between words such as ‘practical’, ‘relevant’, ‘challenging’ and ‘unrealistic’ to describe manual handling training. Many will select the last two.

I kept getting the same comments from trainees: that the training, particularly basic practical techniques — such as ‘sit to stand’ — do not work with the majority of their service users.

There appears to be a general feeling among some managers and supervisors within residential and nursing settings that once staff have been trained, they should be “competent”, and commonly if an accident occurs it results in two staff being disciplined and invariably fired, when in most cases this is not necessary.

While it is important that staff are trained in the use of equipment and safe handling techniques, it is equally important that management keep up-to-date with what is happening in moving and handling practices.

I have delivered full training sessions for large staff teams, only for the whole session to be overturned by managers who then give out conflicting information to their staff.

Some managers need to appreciate the importance of keeping up-to-date with good practice and familiarising themselves with the various pieces of equipment available. This is far preferable to management applying blanket disciplinary hearings for what they perceive to be bad practice, when staff are only making a judgement call at a difficult time which cannot be managed by textbook techniques.

Within health and social care, there is a statutory duty of care imposed on the organisations that look after vulnerable people. Due to the nature of some training sessions — where staff are overwhelmed by instructions and information on their accountability and liability and threatened with ‘safeguarding’ issues surrounding bad practice — staff are not surprisingly reluctant to keep an open mind.

This general attitude is posing huge problems for staff teams, where because of compensatory patterns of movement or cognitive impairments, they cannot move their service users using textbook techniques. In turn, we should consider whether we are setting service users and our staff up for failure by expecting them to undertake textbook techniques that they cannot achieve.      

Training for staff will still be ‘irrelevant and unrealistic’ until we allow them a flexible and adaptable approach within their working roles, and train them adequately in undertaking risk assessments that are actually ‘person centred’. 

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Ian Pemberton
Ian Pemberton
10 years ago


A great article that raises a number of issues that as a profession we badly need to discuss.

I think that what you have identified with your training course is actually a widespread and common problem – the format of a lot of existing health and safety training is not fit for purpose.

As a profession we need to debate how we can improve health and safety training – thanks for raising the issue.


Jan Moore
Jan Moore
10 years ago

What a refreshing ‘take’ on the old ‘people handling’ courses that many care workers are required to attend but still get injured. As a safety professional, I too see the ‘back covering’ exercises used i.e. “she/he received training”.

Well done for raising this issue Sue.