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Health & Safety Policy for Lone Working

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Lone Working Policy Document Information Board Library Reference Document Type Document Subject Original Document Author Assured By Review Cycle HS_IGCS_04 Policy Health and Safety Head of Health & Safety/LSMS Quality and Healthcare Governance Committee 3 Years Version Tracking Version Date Revision Descr..

    Lone Working Policy

Document Information

    Board Library Document Document Original Assured By Review Reference Type Subject Document Cycle

    Author

    HS_IGCS_04 Policy Health and Head of Quality and 3 Years

    Safety Health & Healthcare

    Safety/LSMS Governance

    Committee

Version Tracking

    Version Date Revision Description Editor Approval

    Status 6.00 2007-09-25 Previous Board Approved Policy PAD Ratified 6.01 2009-05-15 Draft DB Draft 6.02 2009-06-25 Draft including amendments by Head of Health & Safety DB Draft 6.03 2009-06-29 Draft including amendments from Health Safety Security DB Draft

    and Fire Group and Safety Forum 29th June 2009

    6.1 2009-07-27 Revised and Approved by the Quality and Healthcare DB/PAD Ratified

    Governance Committee

    6.11 2010-07-12 Minor amendments agreed at Health, Safety, Security DB/PAD Draft

    and Fire Group

    6.12 2010-07-21 Revised and approved by the July Safety Management DB/PAD Draft

    Group

    6.13 2010-08-19 Minor amendments by deputy Director of Quality & DB/PAD Draft

    Healthcare Governance

    6.2 2010-09-07 Approved by the Quality and Healthcare Governance DB/PAD Ratified

    Committee

    6.21 2011-01-24 Administrative changes PAD Ratified

    Lone Working Policy

    Table of Contents

    1. Introduction ......................................................................................................... 3 2. Purpose or Aim ................................................................................................... 3 3. Scope ................................................................................................................... 3 4. Policy Statement ................................................................................................. 4 5. Roles and Responsibilities ................................................................................ 4 6. Standards .......................................................................................................... 12 7. Training .............................................................................................................. 13 8. Monitoring and Audit ........................................................................................ 13 9. Archiving of Master Documents ...................................................................... 14 10. Review ............................................................................................................... 15 11. References ........................................................................................................ 15 12. Appendix A ........................................................................................................ 17 13. Appendix B ........................................................................................................ 27

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    Lone Working Policy

    1. Introduction

    Avon & Wiltshire Mental Health Partnership NHS Trust to henceforth with this document referred to as the “Trust” is committed to providing a safe and secure

    environment for its staff.

    The provision of a safe and secure environment in this policy is recognised by the Trust as a statutory requirement to comply with the Secretary of State‟s Directions to NHS Bodies on Security Management Measures.

    This policy will be applied to the fair treatment of all people, regardless of their gender, race, colour, ethnicity, ethnic or national origin, citizenship, religion, disability, mental health needs, age, domestic circumstances, social class, sexuality, beliefs, political allegiance or trades union membership. The Trust is firmly opposed to any discrimination based on these human characteristics and values.

    2. Purpose or Aim

    The aim of this policy is to underline safety issues and contribute to the provision of a safer working environment for staff working alone. The Trust has a legal duty under the Health & Safety at Work Act 1974 to ensure so far as is reasonable and practicable the health and safety of its employees.

    Under the Health & Safety at Work Act 1974, all employees have a duty to ensure the safety of themselves and others who may be affected by their acts or omissions. In terms of lone working this can be seen to mean that any employee must not put themselves or others in a position of danger by either entering a dangerous situation, failing to provide adequate information to a colleague, failing to ensure that an adequate risk assessment is undertaken or not following an agreed safe system of work. Staff who feel that there is an unacceptable level of risk when engaging in a particular visit or environment therefore have the right to refuse such a visit provided there are reasonable grounds for making that judgement.

    3. Scope

    This policy shall apply to all Trust employees working in isolation when:

     Working in the community either through home visits or appointments at a

    third party premises.

     Escorting service users in the community.

     Staff who see service users for individual sessions in wards or clinics.

     Accompanying the service user to and or from a ward.

     On-call staff required to respond to clinical or non clinical emergencies, for

    example clinicians or estates staff.

     Reception staff working alone in a clinical reception area.

     Travelling alone as required by work.

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    Lone Working Policy

     Those staff that open and close Trust buildings early in the morning or late

    at night.

    This list is not exhaustive.

    4. Policy Statement

    The Trust believes that all staff, service users, carers and visitors should treat each other with dignity and respect and to behave in an acceptable and appropriate manner as set down in the Dignity at Work Policy. Staff have a right to work, as service users have a right to be treated, free from fear of assault and abuse. The Trust will ensure that systems are in place to provide staff with the tools to work and provide the best clinical care for its service users. Employees failing to observe this policy and applicable health and safety regulations may be subject to action in accordance with the AWP disciplinary policies and procedures. In order to minimise the risk of violence and aggression the Trust will work to implement its statutory duties highlighted by the Security Management Service (SMS). The Trust also recognises that it is important, as far as is reasonably practicable, to provide and maintain equipment and systems of work and procedures that are safe and without risks to health.

    Safe lone working is based on robust risk assessment and plans that manage these risks effectively. This policy requires that local procedures will be made by all teams carrying out lone working and these should encompass the following principles:

     Use of the Trust clinical risk screens and assessment tools.

     Thorough risk assessment of the service user and the location of the

    interview/visit is made prior to lone working.

     Individuals working alone will make their whereabouts known to an identified

    responsible member of staff.

     Arrangements will allow for them to contact and be contacted in the event of an

    emergency.

     Provide mobile phones to visiting staff.

     Ensure there are sufficient lines into the team base (if this is the way alarms

    are raised) to enable staff to get through to a colleague.

     All staff involved will be aware of the action to be taken in an emergency.

    5. Roles and Responsibilities

    In order to ensure that policy objectives are achieved it is necessary to communicate the role and responsibilities of all employees at all levels. It is therefore the responsibility of each member of the Trust to support and be familiar with this policy.

    5.1 Trust Board

    The Trust Board is ultimately responsible for fulfilling legal requirements

    relating to health, safety and welfare of those employees who work for the

    Trust including the protection of lone workers.

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    The Board is responsible for the assuring and improving the quality of clinical care by implementing clinical governance. The key principles of which are quality improvement, risk and performance management, systems for accountability and responsibility, formal audit and to minimise risks, undertake investigations and learn lessons from adverse events.

    5.2 The Chief Executive

    The Chief Executive takes specific responsibility for:

     Overall responsibility for the fulfilment of the relevant statutes. Advising the Trust Board on the review of existing policy arrangements

    and allocation of resources to implement health and safety procedures. Referring matters of a critical nature to the Trust Board for resolution and

    ensuring that adequate safety arrangements exist within the Trust.

    5.3 Executive Directors

    On behalf of the Chief Executive the Director of Nursing, Compliance, Assurance and Standards takes lead responsibility for the management of Health and Safety within the Trust.

    The Director of Nursing, Compliance, Assurance and Standards is also the nominated Security Management Director (SMD) liaising with the Counter Fraud Security Management Services (CFSMS).

    The SMD will be responsible for:

     Ensuring that appropriate security management provisions are made

    within the NHS organisation to protect lone working staff. Ensuring that measures to protect lone workers complies with all relevant

    health and safety legislation, Secretary of State Directions and takes into

    account NHS SMS guidance.

     The protection of lone workers by gaining assurance that policies,

    procedures and systems to protect lone workers are implemented. Raising the profile of security management work at board level and getting

    their support and backing for important security management strategies

    and initiatives.

     The nomination and appointment of a Local Security Management

    Specialist (LSMS) and through continued liaison to ensure that security

    management work including the protection of lone workers is being

    undertaken to the highest standard.

     Overseeing the effectiveness of risk reporting, assessment and

    management processes for the protection of lone workers. Where there

    are foreseeable risks, the SMD should gain assurance that all steps have

    been taken to avoid or control the risks.

     In conjunction with the other Executive Directors ensuring the provision of

    training, guidance and support to managers on the implementation of this

    policy.

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     Ensuring that systems exist to maintain records of accidents and

    dangerous occurrences and the reporting of incidents involving violence or

    aggression to HSE where appropriate. This includes notification to the

    HSE incidents reportable under The Reporting of Diseases and

    Dangerous Occurrence Regulations 1995 (RIDDOR) and incidents

    reportable to the CFSMS.

     Ensuring that employees who have been involved in a violent or

    aggressive situation are fully supported and assisted in any subsequent

    civil claim or application for Criminal Injuries Compensation provided that

    they were performing their authorised duties in the course of their

    employment.

     Lone working incidents within the Trust are considered at the Health,

    Safety, Security and Fire Group, and significant concerns are then

    reviewed at the Safety Management Group.

    5.4 Non-Executive Director for Security Management

    The Non-Executive Director for Security Management is responsible for promoting security management at Board level. The requirement for a Non Executive Director is set out in Secretary of State Directions to NHS Bodies on Security Management Measures 2004 (amended 2006). The role of the Non-Executive Director is to support, and where appropriate, challenge and support the Security Management Director on issues recommendations relating to security management at Executive Board level.

    5.5 Strategic Business Unit Directors, Clinical Directors, Corporate Directors

    All Directors are responsible for ensuring that for each service and department within their directorate:

     Complete risk assessment screening for all service users and where

    required a full multidisciplinary risk assessment is undertaken and that

    these assessments are reviewed.

     Ensure that risk assessments are carried out to identify the likelihood of

    a violent or aggressive situation occurring and that such situations are

    reduced or minimised by devising control strategies and risk

    management. Such risk assessments not only consider clinical issues

    but also environmental, procedural and practice issues.

     Develop control measures including robust risk management and safe

    systems of work are implemented in accordance with health and safety

    risk assessments.

     Complete and forward adverse incident forms to the Risk Dept in

    accordance with the Adverse Incident Policy.

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     Report incidents reportable under RIDDOR to the Head of Health and

    Safety without delay either by telephone or email followed by the

    electronic RIDDOR report on the Trust‟s intranet.

     Ensure systems are in place to disseminate information on risk

    management measures and responsibilities to all relevant staff. Monitor the implementation of this policy and provide support for line

    managers to ensure that their responsibilities are met.

     Local arrangements that implement this policy are devised and reviewed.

    5.6 Head of Service/Department/Line Manager

    Each Head of Service/Department/Line Manager has key responsibilities to: Ensure, within their area of responsibility, that this policy is complied with

    and that employees are sufficiently aware of and conversant with this

    policy to perform their duties.

     Ensure that risk assessments are carried out to identify the likelihood of

    a violent or aggressive situation occurring and that such situations are

    reduced or minimised by devising control strategies and risk

    management. Such risk assessments not only consider clinical issues

    but also environmental, procedural and practice issues including: assessing the level of training provided to staff;

     assessing communications with other teams, outside agencies and

    within the team to ensure that accurate, contemporaneous and relevant

    risk information is relation to clinical risks;

     ensure all staff are aware of the arrangements to fulfil this policy monitor and review arrangements in consultation with staff so that the

    local procedures can be reviewed effectively

     assessing the response to emergency situations, i.e. when a lone worker

    fails to return from a visit, response to building alarms, response to

    mount a PMVA response team etc;

     assessing the environment for factors which inhibit best practice i.e.

    vision, audibility, staff call alarms, patient to nurse call alarms, colour of

    decorations and furnishings, noise levels, signage and information,

    sources of potential weapons, dead end corridors, security, doors and

    interview spaces

     assessing lone worker situations including escorting of service users on

    or off a hospital site.

     Ensure that all new employees are made fully aware of local lone

    working procedures, as soon as is practicable, following their

    appointment.

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     Investigate violent or aggressive incidents taking action to avoid a

    recurrence, whilst supporting employees and directing to the appropriate

    support agencies and if required from the LSMS.

     Ensure that assessment and control measures are reviewed, clearly

    documented and amended in an appropriate format where necessary Ensure that the training needs of all Trust employees in their department

    are identified and that these needs are addressed.

     Ensure that employees are provided with supervision, information,

    instruction, education and training as is necessary on the likely risks and

    precautions that may be required and are provided with the opportunity

    to attend appropriate training identified through appraisal processes and

    required by this policy

     Ensure all visiting and escorting staff are provided with mobile phones,

    radios.

     Ensure all visiting and escorting staff are provided with a personal attack

    alarm.

     Ensure that all staff working within a patient environment are provided

    with appropriate fixed portable alarm call devices, and that these

    systems are maintained.

     Incidents reportable under RIDDOR should be reported to the Head of

    Health and Safety using the electronic RIDDOR reporting form on the

    Trust Intranet.

     Ensure that employees are supported if they have responded in any way

    during an incident which they determined as appropriate at the time.

    Inappropriate action may be seen as a sign of a training and

    development need.

     Ensure that employees are able to take time from their work to attend

    such counselling as the Trust Occupational Health or Employee Support

    Service deems necessary. It should be recognised that counselling may

    be necessary not just for those people who have experienced or

    observed a one-off violent or aggressive situation where injury may or

    may not be apparent but also for those who have suffered exposure to

    prolonged violence and aggression not characterised by a single event.

    5.7 Consultants

    Consultant psychiatrists are required to provide professional witness statements on any assaults by service users on Trust staff where a prosecution is contemplated

    5.8 Lone working staff

    The policy requires all employees to:

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     Exercising positive reporting regarding appointments, movement etc Comply with health and safety rules and regulations by co-operating with

    their line managers in undertaking risk assessments and incident

    investigations.

     Ensure that mobile phones are on when making visits or during

    escorting and that a personal attack alarm is carried and is functional. Follow this policy and any associated local or Trust procedures and

    guidelines. Certain employees may be required to follow specific local

    procedures if a report to base system is operated and an employee fails

    to report back .

     Communicate to line managers, supervisors, colleagues and employees

    of other organisations if there is a previous history of or likelihood of a

    service user displaying violent or aggressive behaviour making a clear

    record in the service users care plan and any referral documentation. Report all incidents or dangerous occurrences as soon as possible after

    the occurrence on a standard AWP incident form as per the Incident

    Policy.

    http://ourspace/Trust/Policies/Documents/GOV_IGCS_03.doc

     Act reasonably within the law and care for their own health and safety

    and that of others who may be affected by their acts or omissions.

    Employees must not knowingly put themselves or others into situations

    of significant risk and must only take part in those activities for which

    authorisation, suitable training and adequate protection has been given.

    This shall not be construed as precluding use of any reasonable force

    that may be required in an emergency involving a colleague or member

    of the public who is in danger. Employees who find themselves in a

    situation of significant risk must behave reasonably, refrain from using

    excessive force and perform only those duties authorised in the course

    of their employment.

     Bring any perceived risks, such as unsafe working conditions and

    training needs to the attention of their line manager.

     Undertake training as required by local procedure or Trust Policy. Bring to the attention of their manager any physical condition or mental

    health issue that prevents them from undertaking their duties or training

    safely.

    Under the Health and Safety at Work Act the Trust has a legal duty to protect the health, safety and welfare of its employees. Staff have a right under this act to withdraw from any situation where there is a threat or perceived threat to their personal safety or the safety of colleagues present. The Trust will support staff in this action. In the context of home visits this may mean withdrawing from the visit and possibly future visits until risk conditions improve. Each case should be considered on its own merits.

    An adverse incident form should be completed, even for a threat or near miss. A withdraw from a visit should also be fully documented within the users records with the actions and reasons fully recorded. This information must be

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    shared with the team, and other agencies as appropriate, to ensure that they are fully aware of risk factors to consider within their own risk management plans.

    5.9 Head of Health and Safety

     The Head of Health and Safety shall offer advice to managers on

    environmental risks in relation to lone working and health and safety risk

    assessment and management.

     The Head of Health and Safety liaising with the Trust Health Safety

    Security and Fire Group and the Learning and Development Department

    shall oversee the development of a range of training courses covering

    various aspects of managing and dealing with violence and aggression. The Head of Health and Safety (or delegated representative) will report

    any RIDDOR notifiable incidents to the Health and Safety Executive on

    behalf of the Trust.

    5.10 Local Security Management Specialist (LSMS)

    The Local Security Management Specialist (LSMS) will have delegated responsibility from the Accountable Director for the co-ordination of this Policy. The LSMS will undertake his/her duties in accordance with Secretary of

    State directions to health bodies on measures to tackle violence against

    staff, service users, carers and visitors, and any subsequent advice and

    guidance issued by the NHS Security Management Service.

     The LSMS will ensure that appropriate links are made with the Assistant

    Director of Risk & Compliance and the Head of Health and Safety. The LSMS will provide non clinical support and advice in relation to

    security, staff support, violence and aggression management and any

    appropriate training as recommended by the CFSMS.

     The LSMS will investigate incidents of violence against staff, when

    applicable, in order that appropriate sanctions can be made and allow

    consideration for preventative action.

    5.11 Occupational Health Provider

    The Trusts Occupational Health Providers incorporating Employee Support Services shall offer a confidential, independent and free counselling service to which employees may seek access on a self referral basis. The Trusts Occupational Health Provider shall complete health assessments for employees returning to work where referred by their manager in order to establish fitness for work and in accordance with Disability Discrimination legislation and suggest reasonable adjustments to reduce the risk.

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