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Posted By David Mains
I don't know if anyone else out there heard this story on the news a couple of days ago. I assume that it will go to appeal but at the moment the ruling raises some interesting questions regarding human rights against a duty to protect employees.
Cut and pasted from the BBC news web site.
The High Court has backed a family's attempt to overturn a council ban on lifting disabled, elderly and sick people, in what could be a landmark ruling. The family, who cannot be named for legal reasons, challenged a ban by East Sussex County Council on care workers manually lifting their two adult disabled daughters.
In the High Court, Mr Justice Mumby ruled there must be a balance between care workers' safety and the rights of disabled people.
He said: "For much of the time East Sussex County Council and its officers seem to me to have gone out of their way to try and help this family."
The council said it would study the 90-page court report to see exactly what implications it may have.
'Piece of furniture'
In a statement the council said: "We are currently analysing it to see how our procedures and guidance to staff and care providers needs to be revised.
"This will take some time because of the size and complexity of the document."
The county council introduced the guidelines in 1993 and says it has refined them since after consultation with experts including the Health and Safety Executive, the Royal College of Nursing and back pain charity BackCare.
The mother of the two women, who have very profound learning and physical difficulties, said: "The health and safety legislation did not differentiate between picking up a human being and picking up a piece of furniture.
"Up until now the balance has been much more in favour of the care worker than it has been in favour of the disabled person."
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Posted By Michael Webb
David,
Check out the Disability Rights Commission web-site - www.drg-gb.org, and go to the 'information and legislation' section.
Their statement states that the High Court suggests that the RCN's guidance is 'not an entirely safe guide', and that providers should follow HSG225, in particular the risk assessment for individual persons.
In my Social Housing environment, this could be potentially difficult with approx. 1500 tenants in sheltered housing schemes/attached properties and Community Alarm users that at some stage may require 'lifting'. An example of this would be when someone falls over in the night, activates their alarm & a member of our staff responds.
Carrying out 1500 individual risk assessments could be difficult; so could ensuring the 20 staff receive the necessary information.
Food for thought!!
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Posted By John Dodson
There is a a more detailed account on the DRC website. I've pasted a couple of extracts on the judges thinking below:
Justice Munby declared that the RCN guidance 'is not necessarily an entirely safe guide' and that guidance by the Health and Safety Executive [2] is the most 'relevant' to home care situations and the 'appropriate' guide, which takes account of disabled people's human rights to dignity, freedom and independence.
The judge made clear that there may be some instances where lifting a disabled person may not be 'reasonably practicable', but that consideration should not be made without a thorough risk assessment taking into account the impact on the disabled person, their wishes and feelings and their human rights.
I don't disagree with this in principle and I do disagree with 'no lift' policies but I am concerned it could be misinterpreted and there is the possibility of some 'inappropriate' risk assessments in some quarters. There will always (in my view) be a point where the service cannot be delivered safely and where the only option will be to find an alternative care package.
See DRC Website:
http://www.drc-gb.org/dr.../NewsRelease_030218b.asp
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Posted By David Mains
Michael, John,
thanks for the links. They certainly give more detail than was reported by the national news media. Dumbing down?
Manual handling in the home is certainly not a black and white area due to factors surrounding patients, space, equipment, facilities, resources to name but a few.
Michael, my organisation has an individual patient manual handling R/A form that is 1 A4 page. Let me know if you want a copy.
Hopefully we haven't heard the last of this case.
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Posted By Elizabeth Hallows
Interesting!
The law only requires us to reduce the risk as far as reasonably practicable, but the RCN has said that handling patients [their terminology] may continue provided that it does not involve taking most or all of a patient's weight. A useful phrase from the HSE [Handling Home Care] says something along the lines of - carers must not be put at risk unreasonably and clients wishes on mobility assistance must be respected wherever possible. of course, it becomes tricky when these are diametrically opposed...
On a personal level [carrying out manual handling risk assessments of disabled people almost daily], I can't imagine recommending that an adult sized person with no weight bearing ability at all should be lifted manually. Surely the weight guidelines in the manual handling regs would back up this view?
Perhaps the most complicated risk assessment is required when the service user is able to partially weight bear.
I have a manual handling risk assessment form[s] which I use to assess people, and would be happy to pass them onto anyone interested.
In response to Michael, at the top of the thread..surely it wouldn't be safe for a warden to lift a fallen person from the floor? All kinds of checks need to be done first, to ensure no broken hips, etc, and this is best left to the professionals. In terms of the person on the floor, they'll not have much longer to wait if an ambulance is called, than being lifted by the warden, and have the benefit of being assessed by a properly trained person.
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Posted By Robert M Edwards
We are still awaiting for the transcript of the judgment on this one and when it arrives we will revisit the topic. There are far reaching ramifications on HRA in the manual handling of care service users for a number of local authorities.
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Posted By Ken Taylor
For our care staff, manual handling consists of assisting persons, standing, sitting, with transfers and the like and using approved equipment (eg hoists) for lifting. Once comfronted by a fallen person unable to rise the ambulance service is called as they are in a potential injury situation requiring emergency aid.
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Posted By wendy macdonald
As most of you have now realsied this is not as straight forward as 'shall we shant we lift' as we are dealing with people and not objects. The Manual handling Regs do not differentiate between a load being a person or an object so this also muddies the water! You also have the DDA and the Human Rights Act to consider now also. The RCN are one of the leading bodies for professional health care and their guidance/codes of practice was quoted last year to me by an HSE Inspector as a minimal standard when he was investigating an accidnet within our Warden Call Team who up until then had been allowing staff to lift clients who had fallen treating it as an emergency situation.
They dont anymore and now have a clear no lifitng policy unless the perosns life is in danger, and lifitng equipment to take out to each home as soon as a call comes in where it is thought someone has fallen - they are also all trained in Frist aid to assess the client before attempting to use the equipment and if in doubt ring for an ambulance. May also be worth noting that our Ambualnce servcie will NOT lift a patient unless there is a specifc health need and they need to go to hospital for treament so its no good saying ring for an ambulance if someone is on the floor - what has happened to 'foreseeable' incidents where control measures need to be in place??
Can i just throw a few more points in to be considered?
October 2002 - Nurse awarded £420,000 for a cumulative back injury where Mr Justice Simon ruled that arrangements for Newham Health Care trust were 'inadequate properly to protect their staff and patients.' The nurse involved claimed she had injured her back not through one specifc incident but over a number of years of poor staffing levels, only one hoist between 2 wards resulting in staff having to lift patients of up to 12stones.
In adtion to this injury payout the trust also faced a bill for £400.000 for costs.
February 2000 - £800,000 for nurse who tried to lift a 12st patient in ITU as no mecahincal lifting equipment was available.
Forgive me if i am wrong, but do we as professionals also not have a duty to protect our own staff and follow good practice? If leading bodies like the RCN and BackCare state that it is dangerous to undertake the lifitng of 'most or all of a patients bodyweight' shouldnt we listen and take that on board? what happens if someone - patient/client or employee gets injured during a 'lift'? Can we afford the claim and publicity? Can we also afford to loose dedicated members of staff who are torn between using equipment and lifitng at the best of times when a patient/client does not really 'like' it?
I really feel that there needs to be some clear guidance from the HSE and/or ammendment to the Manual Handling Regs to take into account the lifitng of people otherwise professionals like ourselves will be tearing our hair out trying to and perhaps not working to the same standards.
This debate will go on and on until clear guidance is issued and we shouldnt need to rely on court cases to set a precidence for standards. Anyone else feel the same???
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