The UK has a large care sector, with a diverse workforce providing support and services to a growing, vulnerable population.
Chris Jackson examines how best to apply health and safety to social care when balancing different needs.
Social care is a growing sector that requires many different role criteria. It currently employs 1.5 million people, and by 2025 it is estimated that another 1 million workers will be needed to meet England’s growing social care demands.
People who work in health and social care constitute a diverse workforce looking after a predominantly vulnerable population. Employees have the right to work in a healthy and safe work situation, and the people using services are entitled to care and support that is safe and takes their needs, freedom and dignity into account.
Managing these different needs can sometimes present unique and complex situations that can, if not effectively managed, result in serious harm to employees, people using care services and others. We all need to talk, and share, more than any other business sector.
The provision of care and support should be tailored to meet the needs of the individual and should encourage them to do what they can for themselves. This is particularly important in the provision of social care but also applies to people receiving longer-term care and support.
Often when assessing the care and support needs of an individual, everyday activities are identified that will benefit their lives, but also put them at some level of risk. This requires a balanced decision to be made between the needs, freedom and dignity of the individual and their own safety and that of others involved.
Care assessments should enable people to live fulfilled lives safely, rather than be a mechanism for restricting their reasonable freedoms. Many care providers find it hard not to slip towards a risk adverse approach for a multitude of reasons, for example, resources, bad experiences and a fear of the consequences from regulators if things go wrong.
But isn’t the whole idea of assessing risk that we take responsibility for making decisions based upon local information and intimate knowledge of a particular situation and then apply suitable control measures to mitigate the risk? If those decisions challenge the normal way of doing things, isn’t that exactly the point – that health and safety precautions should grow, develop and improve over time?
It has been said that any organisation that does health and safety well is likely to do other things well too. This provides you with an insight on the challenges of how health and safety is managed when dealing with all the interfaces arising from the people we support.
Culture: An array of problems/ challenges/issues need to be evaluated/ solved/implemented when dealing with our employees, carers and volunteers, as well as the interface with the client/service user/ people we support (not forgetting their family, friends and partners or advocates) and the many issues in the delivery of this support in the many types of settings. Conflicts do arise.
We may be working in a small residential care home providing extra care, a large nursing complex, a one person supported living situation or working alone with someone who lives in their own, or rented home in the community.
Protecting from harm: This can range from preventing falling from windows (with the use of window restrictors), scalds and burns (using thermostatic mixing valves and radiator covers), and dealing with appropriate legionella controls – i.e. hot water. The use of bed rails has raised debate about whether they are seen as a form of restraint (staffing levels, skills, equipment). Finally, it needs to be very clear that the risk assessment process links into a person’s care and support plan.
Regulation: The introduction of the Care Act from 1 April, and for safety practitioners, the move of some investigatory/regulatory powers from HSE to the Care Quality Commission (CQC) does leave concern. Is the CQC ready for this? How will it deal with a sudden death and its consequential investigation?
A new memorandum of understanding has been signed which came into effect again on 1 April – so what concerns may arise? We wait and see. We do have HSE and HSENI cross cutting all the UK, with independent care regulators working in England (CQC), Wales (Care and Social Services Inspectorate Wales), Scotland (Social Care and Social Work Improvement Scotland) and Northern Ireland (the Regulation and Quality Improvement Authority), along with all the local authorities and the Fire and Rescue Services.
Surely working in the care sector is safe? The latest figures from HSE showed that in the last full year, there were two fatalities. Furthermore, 1,048 employees working in residential and social work (which includes community) had suffered a major/ specified injury and 3,831 employees had been reported as having an ‘over seven day’ injury. So, 4,879 people had their day-today lives changed as a result of an injury working in the care sector.
How were these people injured you may ask? The headline reasons were: resulted from a handling injury, from a slip, trip or fall on the level, and from assault.
But we must also remember service user safety, which is not included in these figures – 36 fatalities to members of the public were recorded through RIDDOR, again, the headline reasons were falls, slips and trips and drowning or asphyxia.
Our risk assessments run into many pages, which must be good you may ask? Risk assessments must be seen as an effective working tool to ensure that everyone knows what to do and how to work and care safely. Quantity is not the overriding criteria but the content must capture the hazards, identify controls and make sure they are in place and followed.
Uploaded on the National Association for Safety and Health in Care Services (see box) website are some example risk assessments to help care providers who may be unsure as to what constitutes a suitable and sufficient risk assessment. Always being person centred, enabling a full and rewarding life.
So what can we all do to reduce this number? Think safely, work safely and care safely. Be open, report any concerns, but above all don’t compromise. It’s a case of we all need to look out for each other, nip bad practice in the bud, and praise good practice. So many lives could be affected if we don’t. It’s human factors four times over.
Chris Jackson, CMIOSH, is national chair of NASHiCS
Further information: http://www.hse.gov.uk/statistics/industry/healthservices/health.pdf
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