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DC112-Safe Moving and Handling of People with Bariatric Care Needs Policy

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Registration Number: {{org_field_registration_no}}

Safe Moving and Handling of People with Bariatric Care Needs Policy

1. Purpose

The purpose of this policy is to ensure that people with bariatric care needs receive safe, person-centred and dignified moving and handling support in their own homes and in any other community setting in which {{org_field_name}} provides care. The policy establishes the arrangements for assessing and managing risks to the person, care workers and others who may be affected by moving and handling activities.

{{org_field_name}} will avoid hazardous manual handling so far as is reasonably practicable. Where moving and handling cannot be avoided, the organisation will ensure that the activity is subject to a suitable and sufficient risk assessment, that identified risks are reduced to the lowest level reasonably practicable, and that appropriate staffing, equipment, training, supervision and contingency arrangements are in place.

Care will be delivered in accordance with the person’s assessed needs, wishes, preferences, communication requirements, consent and rights. No person will be denied appropriate care, unnecessarily restricted or treated less favourably because of their weight, body shape, disability, health condition or equipment requirements.

This policy supports compliance with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, particularly the requirements relating to person-centred care, dignity and respect, consent, safe care and treatment, safeguarding, premises and equipment, good governance and staffing.

2. Definitions

For the purpose of this policy:

3. Scope

This policy applies to:

The policy applies whenever staff support a person with bariatric care needs, including:

This policy must be read alongside the organisation’s general moving and handling policy, risk assessment policy, health and safety policy, safeguarding policy, consent and mental capacity policy, incident reporting policy, equipment policy, infection prevention and control policy, lone working policy and emergency planning arrangements.

4. Legal and Regulatory Framework

{{org_field_name}} will comply with all legislation and statutory requirements relevant to moving and handling. These include, but are not limited to:

The organisation will also have regard to relevant current guidance issued by the Care Quality Commission, the Health and Safety Executive, the Medicines and Healthcare products Regulatory Agency, equipment manufacturers and recognised professional bodies.

5. Roles and Responsibilities

5.1 Registered provider

The registered provider is responsible for ensuring that adequate resources, governance systems, competent advice, staffing arrangements, training, equipment, maintenance arrangements and emergency plans are available to implement this policy.

5.2 Registered manager

The registered manager is responsible for:

5.3 Moving and handling assessor

The person completing or approving a moving and handling assessment must be competent for the complexity of the assessment. Where needs are complex or outside the assessor’s competence, advice must be sought from an occupational therapist, physiotherapist, specialist moving and handling adviser, community equipment service, manufacturer or other relevant professional.

5.4 Care coordinators and supervisors

Care coordinators and supervisors must ensure that:

5.5 Care workers

Care workers must:

6. Assessment and Individual Moving and Handling Plan

A suitable and sufficient moving and handling risk assessment must be completed before {{org_field_name}} begins any moving and handling activity for a person with identified or suspected bariatric care needs. The assessment must be completed by a person who is competent to assess the complexity of the person’s needs, the task, the equipment and the environment.

Where urgent care begins before a full specialist assessment can be completed, an interim assessment and safe temporary plan must be documented. Staff must not undertake any task that has not been assessed as safe.

The assessment must consider, as applicable:

The assessment must result in an individual moving and handling plan that gives clear, step-by-step instructions for every assessed task. The plan must identify:

Generic instructions such as “use hoist”, “assist with transfer” or “two carers” are not sufficient.

The assessment and plan must be developed with the person and, with appropriate consent, their representative, family, advocate and relevant health or social care professionals. A copy or accessible summary must be available to the person where appropriate.

Risk assessment must not be used to impose blanket restrictions. Safety must be balanced with the person’s autonomy, privacy, dignity, independence and right to take informed risks. Where the person chooses an option that carries risk, staff must provide relevant information, explore safer alternatives and record the decision-making process. The organisation must not use coercion, neglect or withdrawal of essential care as a means of managing risk.

7. Consent, Capacity and Best-interests Decisions

Staff must obtain the person’s valid consent before undertaking moving and handling support. Consent must be informed, voluntary and specific to the proposed care and may be expressed verbally, non-verbally or through other recognised communication methods.

Staff must presume that an adult has capacity unless there is evidence to the contrary. A diagnosis, disability, communication difficulty, appearance, body weight or an apparently unwise decision must not by itself be treated as evidence that the person lacks capacity.

Where there is reason to doubt capacity, a decision-specific and time-specific assessment must be completed in accordance with the Mental Capacity Act 2005. All practicable steps must first be taken to support the person to understand, retain, use or weigh relevant information and communicate their decision.

Where the person lacks capacity for the specific decision, any action must be in their best interests and must be the least restrictive available option. Relevant representatives, attorneys, deputies, advocates and professionals must be consulted as required. Decisions and the reasons for them must be recorded.

Staff must not proceed by force, deception or restraint merely because a moving and handling task is included in the care plan. Any physical intervention that may amount to restraint must be lawful, necessary, proportionate, in the person’s best interests and covered by appropriate assessment and authorisation.

8. Safe Moving and Handling Practice

Before each moving and handling activity, care workers must:

Staff must avoid physically lifting or supporting a substantial part of a person’s weight wherever reasonably practicable. Techniques involving dragging, shoulder lifting, underarm lifting, pulling on limbs, lifting by clothing, improvised lifting or any other unsafe manoeuvre are prohibited.

Staff must not rely solely on “proper body mechanics” or handling technique as a substitute for avoiding hazardous manual handling or providing suitable equipment and staffing.

Staff must not:

Where a task requires two or more workers, one worker must coordinate the activity. All workers must understand the plan, use agreed commands and stop immediately if any participant identifies a safety concern.

Staff must preserve privacy and dignity throughout. Clothing and coverings must be arranged appropriately, exposure minimised and conversations about weight or body size conducted sensitively and only where relevant to care.

9. Selection, Provision and Safe Use of Equipment

Equipment must be selected following an individual assessment. It must be suitable for the person, the required task, the home environment and the workers who will use it.

Relevant equipment may include:

Equipment must only be introduced following assessment and must be used in accordance with the individual moving and handling plan and the manufacturer’s instructions. HSE guidance states that moving and handling equipment should be introduced only after assessment and used in accordance with the care plan and manufacturer’s instructions.

Before use, the organisation must verify:

Staff must complete and record pre-use checks in accordance with the manufacturer’s instructions and organisational procedures. Any equipment that is damaged, contaminated, malfunctioning, incomplete, incompatible, outside its safe working load or overdue for required examination must be removed from use immediately, clearly labelled and reported.

Makeshift repairs, unauthorised modifications and the substitution of unassessed equipment are prohibited.

Lifting equipment used at work must be managed in accordance with the Lifting Operations and Lifting Equipment Regulations 1998 where those Regulations apply. Lifting operations must be properly planned by a competent person, appropriately supervised and carried out safely.

Equipment used to lift people must normally undergo thorough examination by a competent person at least every six months, or in accordance with a written examination scheme. Thorough examination is separate from routine maintenance and servicing.

Other work equipment must be inspected and maintained at suitable intervals in accordance with the Provision and Use of Work Equipment Regulations 1998 where applicable, the manufacturer’s instructions, the level of risk and any requirements of the equipment owner or supplying service.

Records of examination, inspection, servicing, maintenance, repairs and defects must be retained and available to relevant staff.

10. Equipment Ownership and Shared Responsibilities

Where equipment is owned, hired, supplied, installed, maintained or examined by another person or organisation, {{org_field_name}} must establish and record:

Staff must not assume that equipment is safe merely because it belongs to the person, their family, the NHS, the local authority, a landlord or another provider. The registered manager must take reasonable steps to obtain relevant instructions, examination records and assurances before staff use the equipment.

If safe equipment cannot be provided or responsibility for its safety cannot be established, the affected moving and handling activity must not be undertaken until an authorised safe alternative has been agreed.

11. Slings and Equipment Compatibility

The individual moving and handling plan must specify the exact sling or other accessory required, including its type, size, material, attachment system and any special positioning instructions.

Staff must verify before use that:

Staff must not select a sling solely by the person’s weight. Body shape, dimensions, posture, skin condition, comfort, control of the head and trunk, amputation, pain and the intended task must also be considered.

A trial lift must be undertaken where required by the assessed plan, during which the person is raised only sufficiently to confirm comfort, security, positioning and attachment before the transfer continues.

12. Training, Competency and Supervision

Staff must not undertake moving and handling activities unless they have received training appropriate to their role and have been assessed as competent for the tasks and equipment they are expected to use.

Training must include, where relevant:

Practical training must reflect the equipment and activities used by the service. Generic classroom or online training alone is not sufficient evidence that a worker is competent to use a particular hoist, sling, standing aid or other item of equipment.

Competency must be assessed through observation of practice by a suitably competent assessor. The assessment must be documented and must identify the tasks and equipment for which the worker has been approved.

Refresher training and reassessment must be provided:

Annual refresher training may form part of the organisation’s arrangements, but the passage of one year must not be the only trigger for review. Staff competency must be monitored continuously through supervision, observation, audit, incident review and feedback.

Staff who have not demonstrated competency must not undertake the relevant activity without direct supervision by a competent person.

13. Communication, Equality, Privacy and Dignity

People with bariatric care needs must be treated with dignity, compassion and respect. Staff must not use humiliating, judgemental, dismissive or stigmatising language or make assumptions about the causes of a person’s weight or health condition.

Staff must:

The person’s weight and body measurements are confidential health information. They must be recorded and shared only where necessary for safe care, equipment provision or another lawful purpose.

Concerns that a person is being neglected, humiliated, denied care, inappropriately restrained or placed at avoidable risk because of their weight or body size must be reported under the organisation’s safeguarding procedures.

14. Staffing and Visit Planning

The number of workers required for each activity must be determined by risk assessment and recorded in the individual moving and handling plan. Staffing must not be reduced below the assessed level because of absence, delay, cost, visit duration or operational pressure.

Care rotas must provide:

Family members, friends or informal carers must not be counted as trained staff unless this has been explicitly assessed, agreed with them, documented and supported by appropriate instruction. They must not be pressured to participate.

Where assessed staffing is unavailable, staff must not improvise or undertake the task with fewer workers. They must keep the person safe and comfortable, inform the office or on-call manager immediately and activate the contingency plan.

15. Emergency Procedures and Contingency Planning

An individual contingency plan must be established where a failure of equipment, staffing, utilities or access could prevent essential care or place the person at risk.

The plan must address, where relevant:

Staff must know how to access the contingency plan at all times, including outside normal office hours.

15.1 Responding to a fall

Following a fall, staff must:

Staff must not use a hoist or lifting cushion following a fall until injury and clinical considerations have been addressed in accordance with the post-fall protocol.

15.2 Emergency evacuation

Where the person may require assistance to evacuate, the risk assessment must identify a realistic and person-specific emergency plan. The plan must consider the home layout, exit routes, stairs, door widths, the person’s mobility, the number of staff normally present, equipment availability and the potential response of the fire and rescue service.

Staff must not be instructed to carry out an evacuation technique that exposes them or the person to an uncontrolled risk of serious injury. Where safe evacuation cannot be achieved with the usual staffing and equipment, the registered manager must escalate the matter to the relevant commissioner, housing provider, fire and rescue service, occupational therapist or other responsible organisation.

16. Changes in Need and Stop-work Procedure

Staff must stop a moving and handling activity where:

Stopping an unsafe activity must not result in abandonment or neglect. Staff must:

17. Safeguarding

Unsafe moving and handling may constitute abuse or neglect where it results from deliberate action, reckless practice, repeated failure to follow assessed arrangements, withholding necessary equipment, discriminatory treatment, inappropriate restraint or failure to provide essential care.

Staff must immediately report concerns including:

The registered manager must consider whether a safeguarding referral is required under the Care Act 2014 and whether the police, local authority, commissioner, CQC or another body must be informed.

18. Incident, Near-miss and Defect Reporting

All moving and handling incidents, injuries, near misses, equipment failures and unsafe conditions must be reported promptly through the organisation’s incident-reporting system.

Reports must include:

The registered manager must review each report and consider:

The outcome of investigations and any lessons learned must be documented, implemented and shared with relevant staff.

19. Governance, Monitoring and Continuous Improvement

{{org_field_name}} will maintain systems that enable the registered provider and registered manager to assess, monitor and improve the quality and safety of moving and handling practice.

Monitoring arrangements will include:

Audits must identify:

Significant concerns must be escalated to the registered provider without delay. Repeated shortfalls must be investigated to identify underlying organisational causes rather than being attributed only to individual workers.

Records must be accurate, complete, contemporaneous, securely maintained and accessible to authorised persons. This includes assessments, plans, consent and capacity records, competency assessments, equipment records, incident reports, investigations, notifications and audit actions.

20. Review of Individual Assessments

Each person’s moving and handling assessment and plan must be reviewed:

Review frequency must reflect the level of risk and rate of change. A standard annual review is not sufficient where needs are unstable or risks are significant.

21. Policy Review

This policy will be formally reviewed at least annually and sooner where:

The registered manager is responsible for ensuring that approved amendments are communicated to relevant staff and incorporated into training, supervision, risk assessment forms, care-planning documents and audit tools.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.

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