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Lone worker policy - Portsmouth Hospitals NHS Trust

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Lone worker Policy. Issue 3. 20.09.2011 Page 1 of 15 Review date: 14.09.2012 Lone Worker Policy Reference Number 1.5 Version 3 Name of responsible (ratifying) committee Health & Safety Committee Date ratified 14.09.2011 Document Manager (job title) Health & Safety Advisor Date..

    Lone Worker Policy

Reference Number 1.5

    Version 3

    Name of responsible (ratifying) committee Health & Safety Committee

    Date ratified 14.09.2011

    Document Manager (job title) Health & Safety Advisor

    Date issued 20.09.2011

    Review date 14.09.2012

    Electronic location Health and Safety Policies

    Related Procedural Documents

    Lone Worker Personal safety; Violence to staff; Staff

    Key Words (to aid with searching) welfare; Security; Hazards; Risk assessment; Working

    environment; Forms; Health service staff.

    Lone worker Policy. Issue 3. 20.09.2011 Page 1 of 15 Review date: 14.09.2012

CONTENTS

     QUICK REFERENCE GUIDE ................................................................................................... …....3

    1. INTRODUCTION .............................................................................................................. ……4 2. PURPOSE ............................................................................................................................... 4 3. SCOPE .................................................................................................................................... 4 4. DEFINITIONS .......................................................................................................................... 5 5. DUTIES AND RESPONSIBILITIES .......................................................................................... 5 6. PROCESS ............................................................................................................................... 6 7. TRAINING REQUIREMENTS .................................................................................................. 6 8. REFERENCES AND ASSOCIATED DOCUMENTATION ........................................................ 6 9. MONITORING COMPLIANCE WITH, AND THE EFFECTIVENESS OF, PROCEDURAL

     DOCUMENTS ......................................................................................................................... 7

    APPENDIX 1: GUIDANCE ON RISK MANAGEMENT AND ASSESSMENT FOR LONE

    WORKERS………………………………………………………………………………………………7

    APPENDIX 2: STAFF SAFETY CHECKLIST FOR COMMUNITY VISITS………………………12

    APPENDIX 3: STAFF SAFETY CHECKLIST FOR WORKPLACE……………………………….13

Lone worker Policy. Issue 3. 20.09.2011 Page 2 of 15 Review date: 14.09.2012

QUICK REFERENCE GUIDE

    This policy must be followed in full when developing or reviewing and amending Trust procedural documents.

    For quick reference the guide below is a summary of actions required. This does not negate the need for the document author and others involved in the process to be aware of and follow the detail of this policy.

    1. Lone working has been identified as a possible risk to NHS workers; this policy sets out good

    practice guidance for those who work alone.

    2. Employees that work alone are more vulnerable to violence from members of the public.

    Furthermore lone working may mean that there are additional difficulties in obtaining

    assistance in the event of an incident such as accidents or vehicle breakdowns. Whilst

    recognising that this document is aimed at lone workers, the majority of practice can apply to

    other situations where staff are working remotely.

    3. This policy will include all lone workers whether they are working for the Trust or acting

    directly or indirectly for or on behalf of the Trust.

    4. Lone Workers are those persons who work by themselves without close or direct supervision.

    5. Managers are responsible for carrying out the risk assessment using the guidance as

    required by this policy and the Trusts health and safety policy.

    6. A risk assessment should be undertaken after identifying lone working using the appendices

    and any remedial actions taken that reduce the risk.

    7. Training should be relevant to the nature of the lone working risk.

    8. Primary references are the Health & Safety at Work Act and Trust Health and Safety Policy

    9. Monitoring will be through the Health & Safety Operational Group and Health & Safety

    Steering Group.

Lone worker Policy. Issue 3. 20.09.2011 Page 3 of 15 Review date: 14.09.2012

    1. INTRODUCTION

    Lone working has been identified as a possible risk to NHS workers; this policy sets out good practice guidance for those who work alone. The Trust will ensure, so far as is reasonably practicable, that staff who are required to work alone or unsupervised for significant periods of time are protected from risks to their health and safety. Measures will also be adopted to protect anyone else affected by lone working.

    Lone working exposes staff to particular hazards. The Trusts intention is where practicable, to entirely remove the risk from these hazards or, where complete elimination is not practicable, to reduce the risk to an acceptable level.

    2. PURPOSE

    It is intended that this policy will be a generic policy that reflects the diversity of the constituent bodies of the Trust, and in so doing aid the development of departmental specific policies.

    A number of Trust staff routinely work alone, others may do so infrequently because particular circumstances dictate. Authoritative bodies have increasingly recognised that the risk of injury to NHS staff, from members of the public has substantially increased in recent years. Employees that work alone are more vulnerable to violence from members of the public. Furthermore lone working may mean that there are additional difficulties in obtaining assistance in the event of an incident such as accidents or vehicle breakdowns. Whilst recognising that this document is aimed at lone workers, the majority of practice can apply to other situations where staff are working remotely.

    Health and safety legislation currently in force does not prohibit lone working, except in a few specific circumstances e.g. working in confined spaces. The employer has a general duty under Section 2(1) of the Health and Safety at Work etc. Act, 1974, to ensure so far as is reasonably practicable the health, safety and welfare at work of employees. Further, the Management of Health and Safety at Work Regulations, 1999, requires that work activities are risk assessed. The risk assessment needs to consider options to eliminate or control a hazard in order to decrease the degree of risk to as low as is reasonably practicable. The assessment should consider the suitability of the member of staff to undertake lone worker duties.

    3. SCOPE

    This policy will include all lone workers, whether they are working or acting directly or indirectly for or on behalf of the Trust. For convenience this policy will refer to all these groups as staff. Lone workers are those who work by themselves without close or direct supervision and include:

Trust Premises

    ; Reception staff manning desks out of hours for late clinics or over the weekend

    ; Staff working outside standard working hours on stand-by duty or on call such as

    Radiology, Pathology, Theatres, Junior Doctors, Pharmacy, Chaplains

    ; Departments where staff work an extended day or week therefore few staff are

    present in the premises e.g. Library, Pharmacy

    ; Staff working autonomously in clinical areas

    ; Small departments located off main corridors and buildings e.g. Medical Photography,

    maintenance staff in the Boiler House

    ; Staff who are as part of their duties are expected to work alone e.g. security staff

    patrolling the Trust premises

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    ; Where the nature of the work requires the individual to work in

    isolated/remote/confined areas e.g. maintenance staff in plant areas.

Non Trust Premises

    ; Community based staff working autonomously at other premises e.g. community

     dieticians/assistants

    ; Staff who visit patient homes e.g. Midwifery, Dieticians, Chaplains, Emergency Care

     practitioners etc

    ; Individuals who visit staff at home e.g. Chaplains

    ‘In the event of an infection outbreak, flu pandemic or major incident, the Trust recognises that it may not be possible to adhere to all aspects of this document. In such circumstances, staff should take advice from their manager and all possible action must be taken to maintain ongoing patient and staff safety’

    4. DEFINITIONS

“Lone Workers” are those who work by themselves without close or direct supervision.

    5. DUTIES AND RESPONSIBILITIES

Legal and statutory responsibilities

    Under Section 7 of the Health and Safety at Work etc. Act 1974, it is the responsibility of employees to take reasonable care of their own health and safety at work and that of other persons who may be affected by their acts or omissions. All staff must comply with all safety procedures/safe systems of work and approved codes of practice pertaining to their particular work activities and report all incidents that have led or may lead to injury or damage.

Senior Managers

    Senior Managers are responsible for ensuring risk assessments are undertaken (see appendices 1-4), local policies and procedures are introduced; safe systems of work are adopted; training is available; health and safety training records are maintained; ensuring statutory compliance; accident/incident reporting; communication; support; liaison; and audit within their service.

Line Managers

    Line Managers will establish and supervise safe systems of work; provide, and ensure all staff have received appropriate training; and ensure that other policies and procedures are observed.

Occupational Health Department

    The Occupational Health Department will provide health assessments and advice with respect to health issues as they affect the ability to carry out lone work, where required. Where lone working is identified as a requirement of a post at the pre-employment stage, health assessment will be carried out.

Health and Safety department

    The Health and Safety Department will provide advice on completion of risk assessments and compliance with this policy

Employees

    All employees are required to comply with the Trusts policies and attend training as appropriate. They should use all safety/ communication equipment at the appropriate time, and in the appropriate manner; follow the Trust’s procedures for the use of this equipment; report unsafe

    activities or faulty equipment to their Line Manager; report all adverse incidents or near misses using the Trust’s incident reporting system.

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    6. PROCESS

    In order for this policy to be implemented lone workers need to be identified and training to be provided in line with this policy. A risk assessment is required (see section on duties and responsibilities below, Appendix 1, and the Trust’s Risk Assessment Policy). A staff safety checklist (appendix 2 for home visits, appendix 3 for workplaces) may be completed as part of this process. Any safeguards and actions implemented can be recorded on the form at the appropriate appendix.

Defining Working Limits

    From the results of the risk assessment the manager/supervisor must establish clear procedures to set limits of what can and cannot be done while working alone. Where any doubt exists supervisory authorisation should be sought

Permits to Work

    In certain circumstances when risks are particularly high, or specific legal requirements exist some or all of the above maybe contained within a written “Permit to Work” without which the activity cannot be undertaken at all. e.g. work in confined spaces, poor atmospheres or High Voltage (HV) Electricity

    7. TRAINING REQUIREMENTS

This training must be relevant to the nature of the work undertaken.

    The aims and objectives of Violence and Aggression Training will encompass all appropriate aspects of appropriate action to be taken in the event of a risk. Line managers are required to make adequate arrangements to ensure that staff attend the appropriate courses and that training is regularly updated as required.

    8. REFERENCES AND ASSOCIATED DOCUMENTATION

    Health and Safety Executive: Working Alone in Safety; controlling the risks of solitary work Health and Safety at Work etc Act 1974 section 7

    Regulation 3 of the Management of Health and Safety at Work Regulations 1999 Appendix 1 Guidance on risk management and assessment for lone workers

    PHT Trust Health and Safety Policy

    CFSMS Not Alone A Guide for the Better Protection of Lone Workers in the NHS

    Trust Policy and Protocol for Dealing with Harassment, Aggression & Violence from Service Users

    Zero Tolerance Literature at www.nhs.uk/zerotolerance

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    9. MONITORING COMPLIANCE WITH, AND THE EFFECTIVENESS OF, PROCEDURAL DOCUMENTS This policy will be monitored for effectiveness on an annual basis through;

     Element to be monitored Lead Tool Frequency Reporting arrangements Acting on recommendations and Lead(s)

    Duties Chair of relevant Review of Annually Report on attendance forms part Chair of relevant committee committee attendance sheets of review of Terms of Reference: addressed by chair with relevant member Compliance reported HR Appraisals: % Annually Heads of Nursing: CSCs ; Through CSC structure uptake monitored ; As part of CSC performance by HR reviews ; As part of HR reports to Trust Board Requirement to undertake Health and Monthly Reported to Risk Assurance Health and Safety Advisor ; Review of Trust appropriate risk assessments Safety Advisor Committee and Clinical Service Centre Risk Registers ; Review of incident

    database

     Progress against Health and Health and Review of Health Annually Reported to Health and Safety Health and Safety Advisor

    Safety Advisor Committee Safety risks and and Safety annual recommendations plan

     Arrangements for ensuring Health and Review of RIDDOR Annually Reported to Health and Safety Health and Safety Advisor /

    safety of lone workers Committee LSMS Safety Advisor / Review of incident LSMS database

    85% uptake of mandatory Learning & Essential training Monthly Reports are provided to CSCs on Executive Management training compliance Development tracker Team, as part of monthly Performance Reviews Department Business Manager

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APPENDIX 1: GUIDANCE ON RISK MANAGEMENT AND ASSESSMENT FOR LONE WORKERS

    The key to maximising safety wherever lone working is being considered is the performance of a satisfactory risk assessment, which should address two main features:

    ; Whether the work can be done safely by lone workers

    ; What arrangements are required to ensure, so far as is reasonably practicable, the lone

    worker is at no more risk than employees working together

    Identify all those who may be at risk. It is important that these individuals are made aware of the outcome of the risk assessment and informed of all necessary control measures.

There are Five Steps to effective Risk Assessment: -

    Step 1 Identifying and Analysing the Risk

    A positive, proactive and planned approach is required so that looking for hazards becomes a working habit a natural, normal part of managing, supervising and undertaking one’s job.

Risk identification - Look for the Hazards

Some of the hazards you may wish to consider may include:

Workplace:

    Identify hazards specific to the workplace/environment, which may create particular risks for lone workers, e.g. remote areas, laboratories, workshops, confined spaces. Consider access requirements, transport and parking arrangements, etc.

    Process:

    Identify hazards specific to the work process, which may create particular risks for lone workers, e.g. work on electrical systems, confined spaces, hazardous substances, work in the community, interaction with people with a known history of violent or aggressive behaviour. Equipment:

    Identify hazards specific to the work equipment, which may create particular risks for lone workers, e.g. manual handling, operation of essential/emergency controls.

    Individual:

    Identify hazards specific to the individual, which may create particular risks for lone workers e.g. medical conditions, disabilities, female employees, expectant mothers, age, inexperience, is there access to adequate rest, hygiene, refreshment, welfare and first aid facilities, etc. Work Pattern:

    Consider the lone worker's work pattern and how it relates to those of other workers, in terms of both time and geography.

    Step 2 Assessing the Risk (please refer to Portsmouth Hospitals NHS Trust Risk

    Assessment Policy)

    The identification and assessment of the risks to people is particularly important.

Who might be affected?

    The persons affected will range from those involved in the task - the operator, patients, students etc. or those who may not be in the work place at the time e.g. domestic staff, employees walking through the area, contractors, visitors, maintenance staff or members of the public etc. The effect of a hazard can depend on a number of factors; the following should be taken into account:

    ; Individual characteristics e.g. age, gender, health, etc;

Account should also be taken, in particular to:

Young workers/trainees;

    Agency or bank staff

    Level of training;

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Knowledge;

    Attitude;

    People sharing the workplace;

    Visitors

    Contractors;

    Patients

To determine the level of risk, the following should be considered. Are there appropriate policies,

    procedures, good practice standards and guidelines in place and are they?

    ; Suitable?

    ; Used?

    ; Up-to-date?

Are there standards for record keeping?

    Are there informed consent arrangements?

    Are standards of care delivered?

    What measures are currently in place to prevent or control risk? Is there a system of monitoring recurring problems?

    Have staff been trained, is information available and up to date, so that staff have the knowledge to

    complete a task safely?

    Are legal requirements being met?

Other points to be considered:

Are your staff

    Fully trained in strategies for the management and prevention of violence and aggression?

    Briefed about the areas where they work?

    Aware of attitudes, traits or mannerisms which can annoy clients etc? Given all available information about the client from all relevant agencies?

Have they…

    Understood the importance of previewing cases?

    Left an itinerary?

    Made plans to keep in contact with colleagues?

    The means to contact you - even when the switchboard may not be in use? Got your home telephone number, mobile number, bleep number, pagers etc (and you theirs)?

    A sound grasp of your Trust’s preventive strategy?

    Authority to arrange an accompanied visit, security escort, or use of a taxi?

Do they…

    Have access to forms for reporting adverse incidents or near misses? Appreciate the need for this procedure?

    Use them?

    Feel confident to terminate an interview prematurely?

    Know how to control and defuse potentially violent situations? Appreciate their responsibility for their own safety?

    Understand the provisions for their support by your Trust?

    Step 3 Preventing, Eliminating, Reducing or Controlling the Risk Once risks have been identified and analysed, it is necessary to consider how they can be:

Eliminated

    Controlled

    Avoided

    Reduced

    Made less costly

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A range of precautionary measures needs to be considered:

    ; Supervision. The extent of supervision required will depend upon the level of risks involved

    and the ability and experience of the lone worker. A few examples of supervisory measures

    which may be useful in some circumstances, include:

    ; Periodic telephone contact with lone workers,

    ; Periodic site visits to lone workers,

    ; Regular contact, e.g. telephone, radio, etc.,

    ; Automatic warning devices, e.g., motion sensors, etc.,

    ; Manual warning devices, e.g., panic alarms, etc.,

    ; End of task/shift contact e.g., returning keys.

What to do in an emergency

    Training. Identify the level and extent of training required, taking into account the nature of the lone working activity. Consider the knowledge and experience of individuals, particularly young and new workers. Lone workers should be given information to deal with normal everyday situations but should also understand when and where to seek guidance or assistance from others, i.e. unusual or threatening situations, etc.

    ; Identify any equipment requirements; duress alarms, mobile phones etc.

    ; In the case of lone workers working at the Trusts premises; carry out site surveys to look at

    the physical security of the lone working area. Recommend and implement any

    improvements.

    Managers could identify unsafe areas by using a questionnaire for lone workers. Establish close working links with the Police, Social Services and Local Authorities. By sharing information potential risks to staff can be identified, reduced and incidents can be avoided. Under the Crime & Disorder Act lead authorities have a duty of care to provide information that may prevent the commission of an offence, in particular offences of violence.

    Negotiate agreement between the police, social services, mental health services and ambulance Trusts on effective and consistent procedures for the detention of patients under the Mental Health Act that ensure the safety of all staff. This is vital to prevent staff from different agencies clashing during emergencies because of different procedures or priorities.

    Providing a Trust/Local Health Board driver, or a taxi if appropriate, in areas where cars might be vandalised, or staff have to go through unsafe areas to make visits.

    Arranging for patients or clients to be seen at clinics rather than at home, if at all possible. Indicate on patient notes if a potential problem exists. This enables other health care staff to prepare and assists with risk assessments. Arranging for another member of staff or a reliable relative of the patient or client to be present during the visit, e.g. if a member of staff is vulnerable to sexual harassment while visiting a member of the public.

    Traceability of staff particularly when undertaking domiciliary visits. It is vital that there are procedures in place so members of a team can be traced. Other procedures that complement this include phone-in arrangements and buddy systems.

    Organising support across different Trust/Local Health Board’s or agencies. Such arrangements exist, for example, between midwives and ambulance services or police, and between Community Psychiatric Nurses (CPNs) and social services.

    Maintaining, and adhering to, a list of types of incident that community staff working on their own are not allowed to attend, without adequate support e.g. presence of police, for example, pub fights, domestic violence, overdoses and certain problem locations.

    Increased security (e.g. CCTV, secure access, personal alarms)

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