What's the safest way to handle clients with mobility problems?

The social and healthcare sector is one of the highest risk areas for back injuries at work. Around half of all accidents reported in the sector happen to workers helping patients with mobility problems. This includes supporting, carrying, pushing and pulling, as well as lifting, patients. But manual handling injuries are preventable.

Even though they are people, patients with mobility problems are heavy loads, and workers handling patients with mobility problems are covered by the Manual Handling Regulations 1992. The Regulations say that your employer must:

• Avoid manual handling wherever possible, eg by using hoists or other equipment.
• Assess the risks and reduce them as far as is reasonably practicable.

Any equipment provided by your employer is covered under the Provision and Use of Work Equipment Regulations 1998. These Regulations do not cover equipment provided by the client, but your employer is still responsible for making sure you are safe.

Clients also need to be treated with dignity, and the Health and Safety Executive (HSE) admits this a difficult area. For example, some home care service providers have adopted 'no lifting' policies. Such policies are open to misinterpretation, and the HSE stresses that 'the Manual Handling Regulations should not be applied arbitrarily to care plans in this way'.

HSE guidance on Handling home care says employers should:

• Take a cooperative approach – do risk assessments as part of needs assessments so that health and safety is built into the care package.
• Discuss things with clients and their family/carers so that what is achieved is maximum protection for both careworker and client.
• Have a risk management policy, including how risk management fits into the overall care plan.
• Train careworkers properly in safer handling techniques and provide regular refresher training. (see back posture for more information)
• Supply assistive devices, such as hoists, wheelchairs and walking/standing aids, and maintain them properly.

The HSE says that good risk assessments will include:

• Details of the client's height, weight, abilities and any problems they have understanding and cooperating with careworkers.
• Recommended ways of moving clients, eg from bed to chair, to the lavatory, into the bath, and the equipment needed.
• The minimum number of staff needed for each task.
• Arrangements for both day and night-time care.