Health & Safety

Introduction

The topic of health and safety may appear overwhelming to some people because of the large number of sub-topics it contains – we will be discussing legislation, roles and responsibilities, risk assessment, infection control, manual handling, accidents, sudden illnesses, medication, healthcare tasks, hazardous substances, fire safety, security and stress management.

But don’t let that put you off! Health and safety is an essential aspect of working in health and social care, but really it boils down to just a few underpinning principles:

• Always work in a safe way
• Report any health and safety concerns you have
• Work in line with organisation policies and procedures

Health & Safety legislation

The Health and Safety at Work Act 1974 is the primary piece of legislation that covers health and safety in the UK. There are also several regulations that are in place to ensure compliance with the act in certain situations. For example, COSHH regulations provide guidance for the safe storage, use and disposal of hazardous substances, and RIDDOR regulations govern the reporting of dangerous occurrences, injuries or death in the workplace.

A useful list of legislation relating to health and safety can be found here.

Health & Safety policies & procedures

To ensure compliance with legislation, regulation, and safe practice, your employer will have several policies and procedures in place relating to workplace tasks and activities. For example, your employer may have a policy relating to where medication or cleaning products are stored, or the procedure to follow if a fire breaks out within the building.

You should be familiar with your organisation’s policies and procedures and follow them at all times.

Roles & responsibilities

To comply with health and safety law, employers, employees and others (e.g. visitors, contractors etc.) have several roles and responsibilities.

Roles and responsibilities of the employer

• To write and review policies and procedures and ensure they are accessible to employees
• To perform risk assessments so that risks can be minimised or eliminated
• To provide and maintain any equipment that is required by employees (including PPE)
• To provide employees with sufficient health and safety training
• To provide first aid and welfare facilities

Roles and responsibilities of the employees

• To follow the employer’s policies and procedures
• To work in a way that promotes safety and prevents harm to self or others
• To report any health and safety concerns to their employer
• To not perform any tasks that are beyond the scope of their role or require specialist training that they do not have (see below)
• To use equipment safely and correctly

Roles and responsibilities of others

• To not do anything that may put themselves or others at risk of harm
• To adhere to organisational policies and procedures
• To report any health and safety concerns they have

Tasks that require specialist training

Some tasks related to health and safety require specialist training and should not be performed by anyone without such training because it could result in harm to themselves or others. These tasks include:

Task/activity	Reason
Administering medication	There could be an increased risk of harm to individuals from medication administration errors.
Performing first aid	There could be an increased risk of harming individuals if actions are not carried out correctly.
Performing healthcare tasks	There could be increased risks to an individual’s health or well-being if tasks are not carried out correctly.
Moving and assisting	There could be increased risks of harm of injury to self or others if tasks are not carried out correctly.
Food preparation	There could be an increased risk of food poisoning or allergic reactions

Risk assessment

As noted earlier, an employer has a duty to ensure that risk assessments are carried out to identify risks of harm and reduce or eliminate them.

The risk assessment process involves taking an objective look at the potential harmful effects of an area of work and finding ways that they could be performed in a safer way or actions that could be taken to avoid or reduce risk. This information should be recorded and reviewed on a regular basis.

For example, when carrying out a fire risk assessment, the assessor may identify that a cluttered corridor could impede an evacuation should a fire break out. They may also notice that one of the fire extinguishers has passed its expiry date. To resolve these issues, the assessor may advise that the clutter from the corridor is placed in storage and that the fire extinguisher is replaced. They would then document their findings and monitor the situation to ensure that their recommendations are followed. After a specified timescale, the risk assessment cycle would begin again.

Regular risk assessment is essential for ensuring that the workplace is safe for employees, service users and visitors. Risk assessment can also be used in collaboration with individuals to weigh up the benefits and risks of performing a particular task or making a certain decision.

Reporting concerns

Any potential risks to health and safety should be reported in line with organisational policies and procedures as soon as possible. This helps to ensure that the potential risk does not result in harm. Where possible, employees should try to resolve or minimise a risk upon its discovery, providing it is within the scope of their role.

For example, if an employee discovers a spillage or leakage on the floor or a corridor that could result in a trip, slip or fall, they may mop it up to remove the hazard. Or, if their job role does not provide them with access to cleaning equipment, they may place a ‘wet floor’ sign next to it whilst they report it to the cleaning team or their manager.

Infection prevention & control

All care workers must take sufficient measures to prevent the spread of infection within the workplace and understand the actions that should be taken if there is an infection outbreak. This information should be documented in organisational policies and procedures.

This is important because it prevents avoidable harm that could be caused due to not taking adequate safety precautions. This is particularly relevant in settings where individuals may be elderly or have health conditions that reduce the efficacy of their immune system.

How infections are spread

Infection results from a harmful pathogen entering an individual’s body and causing illness. Examples of pathogens include bacteria, viruses and parasites.

The chain of infection describes the process that can result in a pathogen entering an individual’s body. Breaking the chain at any point can prevent the possibility of infection.

Link	Example
Existence of pathogen	Bacteria
Reservoir (where pathogen multiplies)	Throat
Portal of exit	Mouth
Transmission	Coughing
Portal of entry	Nasal passage
Vulnerable host	Elderly individual

How to reduce the spread of infection

The table below lists several ways that infection can be prevented in a health care setting.

Method	How it helps
Wear disposable PPE, such as aprons, facemasks and gloves	Creates a barrier to prevent pathogens from living on skin and clothes
Change PPE between service users	Prevents pathogens from one individual from coming into contact with others
Wash hands	Kills any bacteria on the hands
Use plasters/bandages/dressings	Prevents pathogens entering the body through breaks in the skin
Hot wash soiled clothes and linen	Kills bacteria

Your employer must provide you with any Personal Protective Equipment (PPE) you need to perform your job role safely. They must also provide you with any training that you require in relation to the use of PPE and infection prevention and control. Part of this training will involve knowing how to wash your hands correctly.

Other ways that you can prevent the spread of infection include:

• Ensuring nails are trimmed
• Not wearing jewellery (other than a wedding band)
• Washing/bathing regularly to keep skin and hair clean
• Staying away from the workplace when you are ill
• Wearing clean, freshly laundered clothing
• Avoiding habits that involve touching your face

Moving & assisting

Moving and assisting relate to tasks and activities that involve the transition of individuals or objects from one location to another. This could, for example, be carrying a heavy box into another room or assisting an individual in getting into bed.

Legislation that relates to moving and assisting includes:

• The Manual Handling Operations Regulations 1992 (as amended 2002)
• The Provision and Use of Work Equipment Regulations (PUWER) 1998
• The Lifting Operations and Lifting Equipment Regulations (LOLER) 1998

Moving and assisting tasks can either be manual or involve equipment.

Manual handling

To safely move and carry objects manually, you should:

• Adhere to organisational policies and procedures
• Ensure the route and final location are clear before beginning the manoeuvre
• Keep your back straight
• Bend at the knees
• Never carry anything too heavy for you
• Ask for assistance from others when required

Use of equipment

Moving and assisting equipment can include hoists, slings, wheelchairs and trolleys. To use equipment safely, you should:

• Adhere to organisational policies and procedures
• Only use it for its intended purpose
• Ensure that you have had sufficient training
• Carry out safety checks
• Report any defects immediately

Accidents & sudden illnesses

Accidents are adverse events that occur in the workplace that result in harm. Examples can include:

• Slips and trips
• Cuts
• Trapping fingers

Sudden illness refers to times when an individual suddenly and unexpectedly falls ill. Examples can include:

• Food poisoning
• Heart attack
• Allergic reactions

Your organisation will have policies and procedures relating to accidents and sudden illness, and you should ensure that you adhere to them if such an event happens.

This will usually involve ensuring the affected individual’s comfort, providing first aid/medication where required (and if sufficiently trained) and contacting emergency services when necessary.

All accidents and sudden illnesses must be recorded according to organisational systems and processes and reported to a manager.

Under RIDDOR regulations, some situations must be reported to the Health and Safety Executive (HSE). This includes incidents that result in death or serious injury, serious near-misses and certain diseases.

Medication & healthcare tasks

As mentioned earlier, medication administration and other healthcare activities should only be carried out if you have received sufficient training and been assessed as competent in performing the task.

In addition, you should ensure that you follow organisational policies and procedures and the directions on any medications that you administer.

This ensures that potential harm can be avoided, for example, from:

• An overdose of medication
• An underdose of medication
• Creams and ointments being applied incorrectly
• Incorrect use of equipment

Hazardous substances

COSHH regulations provide guidance for the safe use, storage and disposal of any hazardous substances used as part of working practices. Harmful substances can include:

• Medication
• Cleaning and disinfecting products
• Soiled clothes and bedding
• Fuels
• Paint and decorating products

Principles relating to the safe storage of hazardous substances include:

• Complying with policies and procedures
• Restricting access, where necessary
• Following storage recommendations on the label
• Ensuring they cannot be accidentally knocked over
• Providing a suitable environment (e.g. refrigerated medication, flammable liquids stored in a cool area)
• Ensuring labels are not removed, or the substance is transferred to another container

Principles relating to the safe use of hazardous substances include:

• Complying with policies and procedures
• Following the directions on the label
• Using PPE (e.g. gloves), where required
• Cleaning up spillages immediately and in line with recommendations on the label
• Returning the hazardous substance to the designated storage area immediately after use

Principles relating to the safe disposal of hazardous substances include:

• Complying with policies and procedures
• Following the directions on the label
• Keeping relevant records

Fire safety

Your organisation will have policies and procedures relating to fire safety, including any risk assessments that have been performed and evacuation procedures. In addition, all staff should have basic training in fire safety, which should form part of their induction into a service. You should be aware of what you should do in the event of a fire and know the closest fire exit from all areas of the building.

All staff must be diligent in preventing fires and understand how to stop a fire from spreading if it does break out.

Ways to prevent fires from starting include:

• Ensuring heat sources are well ventilated and not covered
• Ensuring flammable materials are stored safely
• Not using naked flames unless absolutely necessary
• Extinguishing naked flames as soon as they are finished with
• Extinguishing cigarettes properly
• Maintaining a clean and tidy work environment
• Regularly testing electrical equipment
• Not using defective electrical equipment (e.g. frayed wires etc.)
• Not leaving heat sources unattended (e.g. heaters, oven, hob etc.)

Ways to prevent fires from spreading include:

• Ensuring the workplace is clean, tidy and uncluttered
• Use of equipment, such as fire extinguishers or fire blankets
• Keeping doors and windows closed
• Calling the emergency services as soon as possible

Security

Security is important for the safety of employees, service users and visitors to a place of work. It ensures that only people that have been authorised can gain access to the building, premises or confidential information.

Your employer will have policies and procedures that set out how an individual’s identity should be checked before being granted access to the building or information.

Security protocols may involve:

• Checking ID badges
• Providing visitor’s badges
• Contacting the visitor’s employer
• Calling an individual back on their employer’s phone number
• Checking that visitors have an appointment
• Asking visitors who they are here to see
• Challenging unknown persons in the workplace
• Ensuring information is only shared on a need-to-know basis
• Questioning what visitors say
• Reporting concerns to a manager or security personnel
• Start-of-day and end-of-day procedures

Some employers may have a lone-working policy to protect employees who work in settings where they are the only staff member. There may be similar protocols in place if employees leave the office on their own to visit other locations. In these situations, it is good practice to ensure that at least one other staff member knows your whereabouts. This ensures that in an evacuation of the workplace (due to a fire, for example), your employer does not think you are still inside the building. It also means that you can be located more quickly and easily in an emergency.

Stress management

Care work can be stressful at times, so employers that value their workforce will have systems and processes to support employees who may be suffering from stress-induced illness.

Stress in itself is not a bad thing – it can motivate us to achieve our goals and objectives – but too much stress over too long a period can damage our health.

It is important to recognise that the signs, symptoms and triggers of stress vary from person to person, so it is helpful to have some self-awareness of how stress affects us and how we deal with it personally. By understanding ourselves on this level, we can identify that we may be experiencing too much pressure and put in place early interventions to reduce it before it causes us too much harm.

Some typical signs and indicators of stress include:

• Not wanting to go to work
• Overwhelming emotions of sadness or anger
• Tiredness or fatigue
• Irrational behaviour or being quick to anger
• Substance abuse
• Physical health conditions (e.g. IBS, skin rash etc.)
• Changes to eating or sleeping patterns

And some of the triggers that can induce stress include:

• Having too much work to do and not enough time to do it
• Changes in life and/or work (e.g. new workplace policies, bereavement etc.)
• Harassment, bullying or discrimination
• Lack of support or supervision

As well as understanding the outward effects of our own responses to stress, it is helpful to recognise how stress can affect others. This can help us understand and be empathetic towards changes in behaviour in others and provide them with help, guidance and support to reduce the stress in their lives.

Several strategies can be used to overcome stress, and the most effective method will vary between individuals. These strategies include:

• Meditation
• A healthy balanced diet
• Physical exercise
• Getting enough sleep
• Supervision
• Talking therapies (e.g. counselling, CBT etc.)
• Socialising

Sources of additional support and information

If you need to find further information relating to any of the topics discussed here, you may find the following sources useful:

• Policies and procedures
• Your manager or more experienced colleagues
• The Health & Safety Executive (HSE)
• Training
• Supervision
• Own research