Moving and Handling when working for Private Clients

Moving and handling is a central part of caring for the elderly. You will have been training in it multiple times. As an independent carer, working for private clients, you are required to stay up to date with all the manual handling regulations. You must understand all the policies and procedures before lifting any load.

The Manual Handling Operations Regulations 1992 (MHOR) was amended in 2002 to cover a wide range of manual handling activities, including lifting, lowering, pushing, pulling and carrying. The ‘load’ can be either animate, such as a person or animal, or inanimate, such as a box or trolley.

Responsibility for safe handling lies with you. You must work within MHOR policies and procedures. You should also seek practical manual handling training from a recognised training provider, such as St Johns Ambulance (www.sja.org.uk).

Practising safe manual handling techniques significantly reduces the risk of injury to yourself and others. DO NOT wait for an injury to occur before taking action. Learn the correct lifting and carrying techniques before handling any load. Always assess the environment for potential hazards before undertaking manual handling activities, and make sure to take all necessary precautions.

Failing to lift or move a load correctly can result in injury. Potential injuries include slipped discs, dislocated joints, fractures, breaks, bruises or scrapes. Remember that poorly supported clients also risk suffering the same serious injuries.

High-level guidance on manual handling

As you know, and rather counterintuitively to your clients, you should never attempt to manually lift any person without the proper equipment. This refers to lifting the whole, or any significant part, of a person’s weight.

The only exception to this is in the case of a serious emergency, whereby leaving a client in their current position puts them at serious risk of injury or death.

Delivering manual handling

Before you do anything, you must assess the probable requirements and get the right equipment to enable you to deliver them. It is up to you and your client to make sure that you can do your job properly and safely.

• Talk to them about what help they need and if they have had any falls
• Talk to the family about the help they tend to give
• Ask them about the last time they went outside
• If unsure, ask them to perform tasks, like standing, for you.

If you are concerned that the required equipment is not available, we suggest that you speak with the family arranging the care. If the family don’t know very much about it, you could offer to contact their GP to get a needs assessment to help them to access the equipment needed to deliver care.

When undertaking manual handling operations, where the proper equipment is available, you should:

• Ensure that no person’s health or safety is placed at risk when carrying out manual handling activities;
• Learn and use the recommended techniques and equipment when undertaking manual handling tasks to minimise the chance of injury;
• Report any incident or issues arising from manual handling tasks to the client or their next of kin immediately.

Each time you go to use the equipment to lift someone, you should assess the risk:

• As an independent carer, you are required to carry out a risk assessment of all manual handling activities and report any issues to the family or next of kin, as they arise.
• Tasks in which risks are identified should be avoided, or the risk mediated and reduced to the lowest possible level.
• Test the equipment to ensure it is in good working order, and check the last time it was serviced.

You should then follow the TILE methodology (Task, Individual, Load, Environment)

Task:

• Bending and stooping to lift a load significantly increases the risk of back injury;
• As such, it is recommended that items are lifted from no lower than knee height and no higher than shoulder height;
• Outside of this range, lifting capacity is reduced and the risk of injury is increased;
• Where items are required to be lifted above shoulder height, a stand or suitable means of access should be used;
• Items requiring pushing or pulling should be placed as near to waist level as possible. Pushing is always preferable, especially where the back can rest against a fixed object to give leverage;
• Carrying distances should be minimised as far as possible, especially if the task is repeated regularly. Repetitive tasks should be avoided wherever possible;
• Avoid tasks which require twisting the body wherever possible, and consider:

Individual:

• Consideration must be given to the age, body weight, physical fitness and frailty of both the person undertaking the manual handling task and the person being assisted;
• Also, assess the personal limitations of all parties. Do not handle loads beyond individual capability. Assistance should be sought where necessary;

Load:

• To reduce strain, keep the load as close to the trunk of the body as possible. The load should not be of such a size as to obscure vision;
• Indication of the load’s weight and centre of gravity should be provided where appropriate;
• Where individuals can bear the weight independently, contact should only be provided to steady the individual and support their balance;
• If an individual falls to the ground while lifting a load, they should be encouraged to lift themselves back to a sitting position and then a standing position. If they are in danger by not being moved immediately, assistance should be sought.

Environment:

• Sufficient knowledge and understanding of the care environment can significantly reduce the risk of injury;
• The care environment must have adequate space to allow lifting or moving to be conducted safely. Any route through which people or objects are to be moved must be free from obstructions;
• Floors and other working surfaces must be in a safe condition. Measures should be taken to ensure adequate ventilation, particularly where there is limited natural airflow.

For more on the principles and practice of safe manual handling, see: www.ncfe.org.uk/

For a free workbook to help you revise MHOR regulations and techniques, go to: https://www.skillsforcare.org.uk/movingand handlingworkbook

To test your working knowledge here is a free question and answer test: https://www.test-questions.com/manual-handling-test-02.php

And if you need any further guidance, or simply want to learn more, you can visit:

• https://alison.com/course/back-care-and-manual-handling-theory-revised-2017
• https://www.safetyservicesdirect.com/moving-and-manual-handling-training-for-carers–care-workers-4756-p.asp
• https://www.nhs.uk/conditions/social-care-and-support/mobility-problems-carers/
• http://www.stroke4carers.org/?p=402
• http://www.hse.gov.uk/healthservices/moving-handling.htm
• https://www.clinicalskills.net/buy-the-book
• https://www.peoplefirstinfo.org.uk/looking-after-someone/looking-after-someone-safely/lifting-and-handling