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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Safe Moving and Handling of Bariatric Service Users Policy

1. Purpose

The purpose of this policy is to ensure the safe, dignified, and effective moving and handling of bariatric service users at {{org_field_name}}. Bariatric service users are individuals with severe obesity (typically defined as having a BMI of 40 or above or weighing over 25 stone/158kg).

This policy ensures that all staff, equipment, and procedures comply with the highest safety standards, promoting dignity, independence, and well-being while reducing the risk of injury to both staff and service users.

This policy aligns with:

• The Regulation and Inspection of Social Care (Wales) Act 2016, ensuring that service users receive safe and effective care​.
• Care Inspectorate Wales (CIW) regulations, which require proper risk assessments, staff training, and suitable equipment​.
• The Manual Handling Operations Regulations 1992, which mandate safe lifting practices and risk reduction strategies.
• The Health and Safety at Work Act 1974, which requires a safe working environment for staff and service users.
• The Equality Act 2010, ensuring dignity and non-discrimination for bariatric individuals.
• The Social Services and Well-being (Wales) Act 2014, promoting person-centred care and safety.

This policy aims to:

• Ensure staff competence in safely moving and handling bariatric service users.
• Provide appropriate equipment to support safe movement.
• Protect the dignity and rights of bariatric individuals.
• Prevent injury to both service users and staff.
• Ensure risk assessments and care plans are specific to each individual’s needs.

2. Scope

This policy applies to:

• All employees at {{org_field_name}}, including nurses, carers, therapists, and housekeeping staff.
• All service users classified as bariatric, requiring specialist support for mobility and personal care.
• Visitors, contractors, and emergency responders, who may need guidance when assisting bariatric individuals.

This policy covers:

• Risk assessments and care planning for bariatric service users.
• Specialist equipment and facilities for safe moving and handling.
• Staff training and competency requirements.
• Procedures for manual handling, transfers, and repositioning.
• Emergency evacuation procedures for bariatric individuals.

3. Risk Assessment and Individual Personal Planning

3.1 Assessment Before and on Commencement of the Service

Before agreeing to provide care and support to an individual who has bariatric or other specialist moving and handling needs, {{org_field_name}} must determine that the service is suitable to meet the individual’s assessed care and support needs and to support the individual to achieve their personal outcomes.

The determination must take account of all relevant information available, including:

• the individual’s existing care and support plan;
• relevant health, occupational therapy, physiotherapy or other professional assessments;
• the individual’s views, wishes, feelings, preferences and desired personal outcomes;
• risks to the individual’s health, safety and well-being;
• risks to staff and other individuals;
• the individual’s mobility, balance, ability to weight-bear and ability to participate in transfers;
• the individual’s weight, body dimensions and body shape where these are relevant to the selection and safe use of equipment;
• any physical or health condition that may affect moving and handling, including pain, respiratory difficulties, skin integrity, tissue viability, oedema, fatigue, falls risk or other relevant clinical factors;
• the space and environmental requirements necessary to carry out transfers, repositioning, personal care and emergency evacuation safely;
• the type, size, safe working load and availability of any specialist equipment required;
• the number of suitably trained and competent staff required to undertake each moving and handling activity safely; and
• any reasonable adjustments required to enable the individual’s needs to be met safely and without discrimination.

Where the individual does not have an existing care and support plan, {{org_field_name}} must carry out an assessment of the individual’s care and support needs and identify their personal outcomes before agreeing to provide the service. The assessment must be undertaken by a person who has the skills, knowledge and competence to carry it out and who has received appropriate training.

An initial personal plan must be prepared before care and support commences. Where an individual is admitted because of an urgent need for care and support and it has not been possible to prepare the personal plan beforehand, the personal plan must be prepared within 24 hours of commencement of the service.

Within seven days of commencement of the provision of care and support, {{org_field_name}} must complete the provider assessment required by the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended. The provider assessment must include the individual’s moving and handling needs and risks where these are relevant.

Where the individual has complex or specialist moving and handling needs, the person completing the assessment must have appropriate competence in those needs or obtain timely advice from an appropriately qualified professional.

3.2 Individual Moving and Handling Arrangements Within the Personal Plan

The individual’s assessed moving and handling requirements must be incorporated into their personal plan and must provide staff with clear instructions for each relevant moving and handling activity.

Where applicable, the personal plan must identify:

• what the individual can do independently and the assistance they require;
• the individual’s ability to weight-bear and participate actively in transfers;
• the agreed method for transfers, repositioning, mobility assistance, personal care and recovery following a fall;
• the specific equipment required for each activity;
• the specific hoist to be used where hoisting is required;
• the make, model, type and size of sling or other lifting accessory to be used where necessary;
• the required sling attachment or loop configuration where this is relevant to safe use;
• the safe working load of equipment and confirmation that it is suitable for the individual;
• any compatibility requirements between hoists, slings and other accessories;
• the number of staff required for each activity;
• the positioning of staff and identification of the person responsible for leading the manoeuvre where more than one member of staff is required;
• measures required to protect skin integrity and prevent avoidable pressure damage;
• environmental or space requirements for the manoeuvre;
• communication needs and the individual’s preferred method and language of communication;
• measures required to protect privacy and dignity;
• foreseeable circumstances in which the planned technique must not be used; and
• the action staff must take if the individual’s ability, condition, equipment or environment differs from that described in the personal plan.

The individual must be involved in preparing and reviewing their personal plan. The placing authority, where applicable, and any representative must also be involved in accordance with the requirements of the Regulations.

The moving and handling risk assessment and personal plan must be available to staff who provide the individual’s care and staff must follow the documented safe system of work.

3.3 Review and Revision

The individual’s personal plan must be reviewed whenever required and at least once every three months.

The moving and handling assessment and relevant parts of the personal plan must also be reviewed without unnecessary delay where there is:

• a significant change in the individual’s weight, body dimensions, mobility, ability to weight-bear or health condition;
• a fall, moving and handling incident, injury or near miss;
• evidence that the current method is causing pain, distress, skin damage or other harm;
• a change in the individual’s ability to participate in a transfer;
• a change to the equipment being used;
• a change to the environment in which moving and handling takes place;
• evidence that the existing assessment may no longer be valid; or
• advice from a relevant healthcare or other professional requiring a change in practice.

Following each review, the assessment and personal plan must be revised where necessary and relevant staff must be informed of the change before the revised method is used.

4. Specialist Equipment and Facilities

4.1 Provision and Selection of Equipment

{{org_field_name}} must ensure that premises, facilities and equipment used in the moving and handling of individuals are suitable for the service provided and for the assessed needs of the individual.

Specialist equipment may include, according to individual assessed need:

• bariatric mobile or fixed-track hoists;
• appropriately sized and compatible lifting slings;
• bariatric profiling beds;
• pressure-relieving mattresses and repositioning systems;
• reinforced wheelchairs and specialist seating;
• shower chairs and bathing equipment;
• air-assisted transfer or lifting equipment;
• transfer aids;
• specialist commodes and toileting equipment; and
• suitable emergency evacuation equipment.

Equipment must be selected following assessment of the individual and the proposed moving and handling activity. Staff must confirm that equipment is appropriate for the individual, the task and the environment and that its safe working load will not be exceeded.

Where a hoist and sling are used together, they must be compatible in accordance with the manufacturers’ instructions and the individual’s moving and handling assessment.

Equipment must not be introduced or substituted solely because it is available. Where different equipment is proposed, the individual’s assessment and personal plan must first be reviewed where the change could affect the safety of the moving and handling activity.

4.2 Safe Use, Inspection and Maintenance

Moving and handling equipment must:

• be suitable for its intended purpose;
• be used only for activities for which it is designed;
• be used in accordance with the manufacturer’s instructions and the individual’s assessment and personal plan;
• have its safe working load clearly identified where applicable;
• be maintained in an efficient state, in efficient working order and in good repair;
• be subject to appropriate inspection where deterioration may result in a risk to health or safety; and
• be taken out of use immediately where a defect or condition makes, or may make, continued use unsafe.

Staff must undertake the required pre-use safety checks before using moving and handling equipment. A pre-use check does not replace statutory inspection, servicing, maintenance or thorough examination.

Only staff who have received appropriate training and have been assessed as competent may use specialist moving and handling equipment.

Any equipment defect, damage, malfunction, missing identification or uncertainty about the equipment’s safe working load or suitability must be reported immediately. Equipment that cannot be confirmed as safe must be clearly identified and removed from use until it has been assessed and made safe.

4.3 Lifting Operations and LOLER Thorough Examination

Where lifting equipment is used by staff at work, {{org_field_name}} must comply with the Lifting Operations and Lifting Equipment Regulations 1998.

Every lifting operation involving lifting equipment must be:

• properly planned by a competent person;
• appropriately supervised; and
• carried out in a safe manner.

Lifting equipment and lifting accessories used to lift people, including relevant hoists and slings, must be subject to a thorough examination by a competent person at the statutory intervals.

Unless a compliant written examination scheme prepared by a competent person specifies an alternative interval, lifting equipment and accessories used for lifting people must be thoroughly examined at least every six months.

Thorough examination is separate from routine maintenance and servicing and neither servicing nor a staff pre-use check may be treated as a substitute for a statutory thorough examination.

Thorough examination must also take place where required by LOLER, including following circumstances that may jeopardise the safety of the equipment.

Reports of thorough examination must be retained in accordance with the statutory requirements. Any defect identified by the competent person must be acted upon within the timescale specified. Equipment presenting an immediate danger must not remain in use.

Hoists, slings and other lifting accessories must be identifiable so that staff can establish that the correct equipment is being used and that the required examination status can be verified.

All statutory examination, inspection, servicing, maintenance, repair and defect records must be retained and available for monitoring and inspection.

5. Staff Training and Competency

5.1 Mandatory Training for Staff

All staff working with bariatricservice users must complete specialist manual handling training, including:

• Safe use of bariatric hoists and slings.
• Techniques to reduce strain and prevent musculoskeletal injuries.
• Dignity and communication techniques for bariatric care.
• Emergency procedures for handling falls and evacuations.

5.2 Supervision and Assessment

• New staff must shadow experienced colleagues before handling bariatric service users independently.
• Competency assessments are carried out annually to ensure continued proficiency.

6. Safe Moving and Handling Procedures

6.1 Transfers, Repositioning and Hoisting

{{org_field_name}} must apply the hierarchy required by the Manual Handling Operations Regulations 1992, as amended.

Staff must:

• avoid hazardous manual handling operations so far as is reasonably practicable;
• where hazardous manual handling cannot reasonably be avoided, ensure that a suitable and sufficient assessment has been undertaken; and
• reduce the risk of injury from any remaining hazardous manual handling so far as is reasonably practicable.

No member of staff must undertake an unassessed moving and handling activity or use a technique that conflicts with the individual’s current moving and handling assessment and personal plan.

Appropriate mechanical or other assistance must be used where identified by the assessment. Manual assistance may only be provided where the activity has been assessed, staff are trained and competent to undertake it, and the method is consistent with the individual’s personal plan and safe system of work.

Before a planned transfer or repositioning activity, staff must:

• confirm the identity and wishes of the individual;
• check the current moving and handling assessment and personal plan;
• explain the proposed activity to the individual in a way they can understand;
• obtain the individual’s co-operation and involve them as much as their abilities allow;
• confirm that the required number of competent staff are available;
• ensure that the environment provides sufficient safe working space;
• confirm that the correct equipment and accessories are available;
• complete the required equipment pre-use checks; and
• stop and seek further assessment or advice if the circumstances differ from the documented plan.

Where more than one member of staff is involved, one person must lead the manoeuvre and staff must agree the procedure and communication to be used before starting.

Where a hoist is used, the individual’s moving and handling assessment and personal plan must specify, as applicable:

• the hoist required;
• the sling type and size;
• the relevant attachment or loop configuration;
• any additional safety device required;
• the number of staff required; and
• any individual-specific precautions.

Staff must not exceed the safe working load of any item of equipment and must not use incompatible equipment or accessories.

An individual must not be left unattended in a hoist or in another position where this creates a foreseeable risk of falling or injury.

6.2 Falls and Recovery From the Floor

Following a fall, staff must first assess the immediate situation and obtain appropriate clinical or emergency assistance where injury is suspected or the individual’s condition requires it.

Staff must not attempt an unassessed hazardous manual lift of an individual from the floor.

The individual must be moved from the floor using the method and equipment identified through an appropriate assessment, taking account of:

• suspected injury;
• the individual’s medical condition;
• their ability to participate;
• their weight and body dimensions;
• available space;
• the equipment available; and
• the number and competence of staff required.

Where an air-assisted lifting device, hoist or other specialist recovery equipment is used, it must be suitable for the individual and the task, within its safe working load and used by appropriately trained and competent staff.

Where safe recovery cannot be achieved using the assessed equipment and available competent staff, or where serious injury is suspected, staff must obtain appropriate assistance from emergency services or other relevant healthcare professionals.

Where emergency services are contacted, staff must provide accurate and relevant information about the individual, including known weight or equipment requirements where these are relevant to safe assistance.

Every fall and moving and handling incident must be recorded and must prompt consideration of whether the individual’s risk assessment and personal plan require review.

6.3 Emergency Evacuation

The moving and handling needs of an individual who requires bariatric or specialist assistance must be considered within the service’s fire risk assessment and the individual’s emergency evacuation arrangements.

Emergency evacuation arrangements must take account of:

• the individual’s mobility and ability to participate;
• their weight and body dimensions where relevant;
• the number of staff required to provide assistance;
• the physical layout and escape routes;
• the safe working load and suitability of evacuation equipment;
• the individual’s location within the premises; and
• foreseeable staffing levels, including at night.

Any evacuation chair, mattress, sled or other evacuation device selected for the individual must be suitable for the person, the environment and the intended evacuation method and must not be used beyond its safe working load.

Staff expected to use specialist evacuation equipment must receive appropriate training and be competent in its use.

Emergency evacuation arrangements must be reviewed when the individual’s mobility, weight, health condition, accommodation, equipment requirements or other relevant circumstances change.

7. Dignity and Person-Centred Care

7.1 Respecting Privacy and Dignity

• Ensure bariatric service users feel respected and supported in all aspects of their care.
• Use appropriate terminology (avoid words like “heavy” or “difficult”).
• Ensure privacy when assisting with personal care.

7.2 Communication and Emotional Wellbeing

• Encourage open discussions about preferences for moving and handling.
• Provide emotional and psychological support to help maintain confidence and self-esteem.

8. Monitoring, Incident Reporting and Statutory Notifications

8.1 Internal Reporting and Review

All moving and handling accidents, injuries, equipment failures and near misses involving individuals or staff must be reported promptly through {{org_field_name}}’s incident-reporting arrangements.

Records must include sufficient information to establish:

• what occurred;
• who was involved;
• the moving and handling activity being undertaken;
• the equipment and method being used;
• any injury or harm sustained;
• immediate action taken;
• whether medical or other professional assistance was required;
• whether equipment was removed from use;
• whether the individual’s risk assessment or personal plan was reviewed;
• any remedial or preventive action required; and
• whether an external statutory notification or report was required.

Moving and handling incidents and near misses must be reviewed to identify whether changes are required to risk assessments, personal plans, equipment, staffing arrangements, staff competence, training or the environment.

8.2 Notification to Care Inspectorate Wales

The service provider must comply with Regulation 60 and Schedule 3 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended.

Where a moving and handling incident amounts to a notifiable event under those Regulations, the service provider must notify Care Inspectorate Wales without delay and in writing, in the manner and form required by Care Inspectorate Wales.

This includes notification of a serious accident or injury to an individual where the notification criteria are met.

For the purposes of the statutory guidance relating to serious accidents or injuries, notification is required where an accident or injury to an individual, in the reasonable opinion of a healthcare professional, requires treatment by that or another healthcare professional and has or may have resulted in:

• damage or impairment, whether permanent or likely to last for more than 28 days, of the individual’s sensory, motor or intellectual functions;
• changes to the structure of the individual’s body;
• prolonged pain or prolonged psychological harm; or
• death or shortening of the individual’s life expectancy.

The service provider must also notify Care Inspectorate Wales without delay and in writing of any moving and handling equipment failure, staffing failure or other event where the circumstances prevent, or could prevent, the provider from continuing to provide the service safely and the notification requirements in Schedule 3 are met.

The completion of an internal accident or incident report does not replace the requirement to make a statutory notification to Care Inspectorate Wales.

8.3 RIDDOR

The responsible person must assess moving and handling accidents, injuries, occupational diseases and dangerous occurrences against the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013.

Where an incident meets the statutory RIDDOR reporting criteria, it must be reported to the appropriate enforcing authority within the timescale required by the Regulations.

This includes consideration of applicable reporting requirements for:

• deaths arising from work-related accidents;
• specified injuries to workers;
• over-seven-day incapacity of workers;
• reportable occupational diseases;
• specified dangerous occurrences; and
• work-related accidents involving a person who is not at work where the statutory criteria for reporting are met.

RIDDOR reporting is separate from notification to Care Inspectorate Wales. Where both reporting regimes apply, both reports must be made.

8.4 Safeguarding and Equipment Concerns

Where a moving and handling incident raises a concern about abuse, neglect, improper treatment or unsafe practice, staff must follow {{org_field_name}}’s safeguarding procedures without delay and appropriate referrals must be made in accordance with the Wales Safeguarding Procedures and statutory requirements.

Where an incident involves a defect or failure of lifting or other specialist equipment, the equipment must be removed from use where continued use may be unsafe and the matter must be managed in accordance with applicable equipment-safety, LOLER, PUWER and manufacturer reporting requirements.

8.5 Monitoring and Audit

{{org_field_name}} will monitor moving and handling practice, equipment safety, staff competence and compliance with individual moving and handling arrangements.

The existing six-monthly audit programme will include, as applicable:

• compliance with individual moving and handling assessments and personal plans;
• completion and currency of statutory LOLER thorough examinations;
• servicing, maintenance and inspection records;
• equipment defects and equipment taken out of service;
• staff training and competency records;
• moving and handling accidents and near misses;
• CIW notifications and RIDDOR reports where applicable;
• actions arising from incidents or audits; and
• evidence that required improvements have been implemented.

Individuals receiving the service will continue to be encouraged and supported to provide feedback about the safety, dignity and effectiveness of the moving and handling support they receive.

9. Related Policies

This policy should be read alongside:

• Health and Safety at Work Policy​.
• Risk Management and Assessment Policy​.
• Infection Prevention and Control Policy​.
• Safeguarding Adults from Abuse and Improper Treatment Policy​.
• Fire Safety and Evacuation Procedures​.

10. Policy Review

This policy will be reviewed annually or sooner if legislation, CIW regulations, or best practices change. Staff feedback and service user experiences will be considered in updates.

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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}}
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