Moving and Handling
CONTRIBUTING TO THE MOVEMENT AND HANDLING OF INDIVIDUALS TO MAXIMISE THEIR COMFORT
PREPARING INDIVIDUALS AND ENVIRONMENTS FOR MOVING AND HANDLING
For good practice, and in law, the Home has to have a Risk Assessment for Moving and Handling. In a Care or Nursing Home Moving and Handling is applied to the clients of that Home, it also covers loads and tasks outside of the client area, i.e. carrying of goods from one area to another. The Risk Assessment takes into account the client and those assisting the client. When the assessment is completed, a Moving and Handling plan can be devised.
Risk factors can change by the second; therefore Risk Assessments must be updated regularly to meet the changing circumstances. Where a carer believes that the Moving and Handling criteria has changed, and the plan is no longer appropriate and it is believed to be a health and safety danger to the client or others, then the carer should contact the Person in Charge and / or Trainer. The Person in Charge and / or Trainer will then review the move before attempting that move. Where a manoeuvre is being considered, back up staff should be available to help if an unknown or unseen problem arises.
Included in the Risk Assessment should be the ability of the client to maximise their involvement as to what they can do physically without help and what help if any they need to be moved. Some clients will be fully mobile, some partially and some totally immobile. Any action and / or support given must be in line with the plan of care and the carer’s assessment.
The Risk Assessment Policy should include a statement that the client should be informed of any move and explain any manoeuvre or situation that may be relevant to the move
The carer should also seek the clients co-operation prior to any move taking place as well as ensuring that the client understands as far as possible what is happening and to be done. This should be done in language that the client can comprehend. The carer should not attempt any move that they are not physically capable of.
The Risk Assessment policy should also refer to the area being a safe place to move and manoeuvre to ensure no hazards are present. All should agree on the timing of the move.
The client can then be manoeuvred to a safe comfortable place or position.
The carer should ensure that any clothing or footwear should appropriate for the task to be applied.
Any equipment to be used must be assessed as being ‘fit for purpose’ prior to use, and in full working order. Any doubts and the equipment must not be used and information about it’s condition passed on to the Person in Charge.
Where a move is planned but the carer is unsure or clear that they cannot manage the move alone, assistance must be requested without delay in order to safely move a client. Under no circumstances must an unsafe move be attempted.
ASSIST INDIVIDUALS TO MOVE FROM ONE POSITION TO ANOTHER
In all circumstances, clients should be given the opportunity to involve themselves in the process of any moving activity, subject to physical and / or psychological deficits. It should be remembered that although most clients are conscious, at times there will be unconscious or dying clients who may be able to hear what is happening. Therefore it is better that all clients are involved through verbal and non verbal communication, even if it is felt that they are not aware. Any concerns about a move should be made to the Person in Charge or Trainer. Failure to do so may result in disciplinary action of the carer for putting the client, themselves and others at risk. The carer may also be in breach of Health and Safety legislation.
No move or change of position will be carried out without taking into account which move will be most suitable for the individual, in the most appropriate way, either by equipment or manually.
It is important to stress that any Moving or Handling should be appropriate to:
- The Client
- The Clients condition (short and or long term)
- The employee/s condition (short and or long term)
- Employee ability and limitations
- When more than one employee, all their abilities and limitations
- The available equipment
Where the clients advice is not appropriate for the change or move planned, discussion should take place with an appropriate Person in Charge and / or Trainer as soon as possible to find common ground on the best, safe, appropriate way to change or move. No lift must take place that is unsafe, either for a client or an employee or others in the immediate area or vicinity.
Moving and handling are not done unless the move is appropriate for both the carer and individual to manage or self manage. Due care should be taken to ensure that both carer and individual are physically well enough before the move takes place. Any equipment must be fit for purpose and the carer must be competent in it’s use.
REASONS FOR MOVEMENT
- Transfer from sitting/ lying to wheelchair/chair
- Sit or turn in bed
- Moving to make bed when occupied
- Transfer from bed to trolley
METHODS OF CHANGE OF POSITION
- Transfer Board
Every effort should be made to minimise:
Every effort should be made to maximise:
- Client independence
- Self Respect
- Privacy and dignity
Often, because clients know their limitations and disabilities, they are the best forms of advice about a particular change or move, therefore their advice should be taken into consideration when an appropriate move (either manually or by using equipment) is planned. Moving a client alone or with another carer, the move should be co-ordinated so all are moving at the same time to minimise the danger of injury.
Explain what is going to happen in clear, concise language at a pace and level that they would understand. This will aid the co-ordination of the change or move. It is also important to ask questions to minimise pain and discomfort, as sometimes clients may be reticent to complain.
The Carer, in all cases should refer to the Care Plan and Moving and Handling plan before engaging themselves in an effort to change or move a client. The plan should meet the needs of the client for moving and have an up to date Risk Assessment.
Any change in the clients condition, seen as a result of a change or move should be reported to the Person in Charge immediately, accurately stated and written up in the clients care notes.
Where furniture and fitments have been moved, they are put back to the original positions unless there are health and Safety reasons for a change in placement. Any equipment associated with, and including the Hoist, should be used, correctly, cleaned, maintained and stored as described in the manufacturers instructions.
ASSISTING INDIVIDUALS TO PREVENT AND MINIMISE THE ADVERSE EFFECTS OF PRESSURE
In all cases, the client should be encouraged to be as self-managing as possible, with a pro-active system of advice and care from the care team to prevent the breakdown of a client’s skin and diminish the need for pressure sore care.
FACTORS INFLUENCING PRESSURE SORES
- Rough and / or unsuitable material
- Skin condition
- Poor nutrition
- Poor circulation
Any change, improvement or deterioration in skin condition may be related to the above situations should be reported without delay to the Person in Charge. All advice should be at a manner, level and pace that the client can absorb and understand.
CLIENT INVOLVEMENT, PRIVACY, DIGNITY AND COMFORT
Clothing should be gently applied, without rigorous activity likely to cause injury. The client should at all times be positioned and supported in such a way that they have maximum comfort and minimum risk of any pressure points. They should also be either able to move themselves periodically or be moved with assistance, by full lift action or by hoist to prevent pressure area risk. At all times, privacy and dignity should be paramount. The end product of this action should leave the client in a comfortable, safe and relevant position for their circumstances.
The client should either by self-management of help change position at regular intervals. They may need to be advised to do so, or changed by the carer/s. No actions should be taken without reference to the care plan of the client and the up to date Moving and Handling plan that each client must have. All employees should be aware of the existence of these plans and where to find the information.
Where any changes take place, in accordance with the Person in Charge or Handling Trainer, the Care and Moving and Handling plans should be updated and amended.
Any change, improvement or deterioration in skin condition may be related to situations should be reported without delay to the Person in Charge.
Pressure areas must be relieved by repositioning at regular intervals, good wholesome and nutritious diet, good hygiene, proper fluid, intake and output, urine and faeces management and care and creams to the effected regions.
All pressure relieving equipment must be used as instructed, and should be cleaned, maintained and stored in accordance with manufacturers instructions.
The frequency of any moves should be indicated in the plan. Some thought should also be given to comfort and support aids that may be required, such as specialist mattresses, cushions, beds, padding and any other material likely to benefit the clients comfort and support.