1.1 Identify current legislation, national guidelines, policies, procedures and protocols in relation to moving and positioning individuals
In health and social care, moving and positioning refer to the crucial handling and moving of care recipients in a practical, dignified, safe, and professional manner. People’s rights to receive care may be violated if their movement and positioning are not done correctly and professionally. This can also cause discomfort. Therefore, it is crucial to be knowledgeable about the various laws and regulations that are in place in order to guarantee a good handling and positioning process. The condition of the person may limit or impede unassisted mobility. Many activities in social health care require moving and positioning, such as eating, reading, using the restroom, etc. This may be hampered by the individual’s condition. Injuries to the spine, pelvis, or limbs as a result of an accident are examples of such conditions. Osteoarthritis may also be to blame. Patients with this condition will require assistance with positioning and movement.
Highlights of various laws relating to people’s movement and placement are provided below.
Health and Safety at Work Act 1974
- It outlines the obligations of employers and employees in terms of providing health and social care.
- It guarantees everyone’s safety, health, and well-being within the institution.
- It is also referred to as the enabling act because it serves as the foundation for subsequent health and safety laws.
It requires employers and healthcare organisations to have health and safety policies and procedures in place. It also requires employees to follow the employer’s code of conduct.
Management of Health and Safety at Work Regulations 1999
- The employer develops working policies and procedures that the employee is required to follow to comply with safety regulations.
- It requires employers to assess the risks to the health and safety of their workers and other members. Of the institution. The risk analysis of moving and placing people should be part of this.
- It requires the employer to establish a code of conduct that all employees must strictly abide by in order to maintain workplace safety.
Manual Handling Operations Regulations 1992
Employers are required to provide the necessary tools along with adequate training for their staff.
- Employees are responsible for ensuring both their own and others’ safety.
- Employees are required to complete the necessary training and only use and handle the equipment for which they have received the necessary training.
- Employees must refrain from using any risky or harmful manual handling techniques.
- It describes the prevention, evaluation, and reduction of injury risk that results from handling activities like pushing, lifting, lowering, or carrying people or equipment.
Provision and Use of Work Equipment Regulations (PUWER 1998)
Underr this regulation:
- Only qualified individuals are permitted to handle and operate any equipment.
- It must be ensured that all safety and health warnings are visible and that adequate supervision is provided when using the equipment.
- Employers must make arrangements for the replacement or repair of damaged equipment and must make sure that workers don’t use faulty equipment.
Lifting Operation and Lifting Equipment Regulations (LOLER) 1998.
- Lifting equipment should only be used for lifting.
- Trained employers must use lifting equipment and procedures
- Lifting activities must be carefully planned and limited to trained personnel.
- Lifting equipment needs to be installed and maintained properly, and safety checks need to be documented.
Personal Protective Equipment at Work Regulations 1992.
- These rules mandate that employers provide and maintain personal protective equipment.
- Employees using PPE must receive adequate training and supervision from their employers.
- Employers are required to give PPE to employees at no cost to them.
- When positioning and moving, PPE must be worn.
Reporting of Injuries, Disease and Dangerous Occurrences Regulation (RIDDOR 2013)
According to these regulations, employers must provide employees with sufficient training on how to move and position people while promptly reporting any injuries or accidents that occur on the job
National guidelines
Several guidelines on the proper methods to employ, the duties of employees, and employee-safe procedures for moving and positioning people have been developed in the UK by various organisations. Below are some examples of these national regulations.
Health and Safety Executive (HSE): The professional organisation in charge of workplace health, safety, and welfare. This body has established manual handling at work as a policy to encourage the safe handling and moving of individuals.
Royal College of Nursing: is the organisation responsible for regulating nurses, midwives, and healthcare assistants. Shoulder lifts must not be used when moving people, according to its documented guidelines on moving and handling. Other safety, handling, moving, and position procedures were also highlighted.
National Back Exchange (NBE). This non-governmental organisation develops and promotes the use of best and safe practices for the movement and positioning of people.
Policies, procedures and protocols.
Employees must make sure to read and understand the guidelines on the moving and positioning of individuals that are being cared for in order to ensure the safety and well-being of the individual. The employer or management should have already established a code of practise that should include all safety precautions, policies, procedures, and good work practices in relation to the movement and positioning of individuals. Employees are required to move and handle objects at work according to established procedures.
When preparing to move someone, it is important to perform a number of safety checks to make sure there is enough room for movement and positioning while taking into account the person’s weight and the best way to move them.
Only moving and handling tasks for which they have received training may be performed by employees.
To avoid recurrence, make sure to report all activities, including health and safety inspections, incorrect equipment usage, and unsafe behaviour on the part of coworkers. In order to move and position people safely and prevent personal injury, it is important to maintain good posture.
Make sure that everyone involved in the moving and handling process can communicate clearly. Having a clear understanding of everyone’s part in the process and encouraging the person to actively taking part.
When in doubt, it is best to get clarification from an experienced senior colleague (a supervisor or manager). It is not advisable to assume because this could result in a departure from the accepted best practice, endangering everyone’s safety, well-being, and health.
1.2 Summarize own responsibilities and accountability in relation to moving and positioning individuals
Individual moving and positioning is a process that calls for thorough task knowledge as well as total adherence to institutional moving and positioning policies and procedures. Below is a description of some of the duties.
- Ensuring the protection of each person’s right to dignity and privacy while they are being moved and positioned, such as by covering the patient before they’re being moved and closing the door while doing so.
- Ensuring your own safety and the safety of everyone else involved in the positioning and moving process. This can be achieved by making sure there is enough room to carry out the task.
- Ensuring that all work is done in accordance with established working procedures.
- Following all guidelines, training, and information provided by the employers.
- Actively taking part in seminars and training on handling and moving things, then ensuring that your work practises reflect that.
- Limiting one’s movement and positioning to those for which they have received training, refusing to engage in such activities, and making sure their employer is fully aware of this.
It is the responsibility of everyone involved in moving and positioning an individual to make sure they are safe while doing so. As a result, it’s critical to be aware of one’s obligations and to make sure that the procedure is carried out in accordance with the organisation’s code of conduct.
Due to the risk of harm or accident, this should be done with the utmost respect for the person’s safety, dignity, and rights. Employees are responsible for any accidents, and if the proper procedures are not followed or safety is neglected, these can result in reprimands or even outright dismissal.
1.3 Describe health and safety factors in relation to moving and positioning individuals
The maintenance of the person’s health and safety as well as that of everyone else involved in the moving and positioning process, is a crucial component of duty care. Therefore, certain factors should be taken into account in order to ensure the safety of everyone involved in the process.
Competence is crucial: The employer must provide adequate training on proper moving and positioning techniques. The career must be familiar with the procedure, and if the person is the employer, they may offer training with or without the help of the local authority. In addition to having the appropriate training, competence calls for the person performing the task, as well as any coworkers, to be physically fit and in good health. All those involved in the process must also wear appropriate clothing to keep them safe and not impede their actions. Additionally, it necessitates careful preparation, discussion of the activity with the individual and everyone else involved, and using the necessary tools. Competence can only be increased by having self-confidence in one’s abilities and training.
The moving and positioning process: It is crucial to plan ahead for active movement and positioning, such as switching from a wheelchair to a bed and vice versa.
Another aspect to take into account is the objective of the activity of moving and positioning. Moving to the bathroom or helping the person to perform tasks like sitting or eating are two examples.
To properly plan and make provisions to ensure the safety of oneself and all participants, the requirement of equipment in the procedure must also be taken into consideration.
The environment of activity: It is crucial to think about whether the environment in which the activity will take place is appropriate. Before beginning, the environment must undergo a thorough risk assessment, and any materials that may be obstructive or hazardous must be considered and removed.
Along with each person’s preference or need, environmental factors like temperature and ventilation should be carefully taken into account. In order to reduce the risk of infection for individuals and participants, a clean environment must be maintained before, during, and after the activity.
The individual to be moved or positioned: The type of support required, the person’s height, and weight are all things to take into account when moving or positioning an individual. Additionally, it’s crucial to see to it that the person’s needs are met and that they are kept safe from harm and infection. Preserving the person’s dignity and privacy while moving and positioning them, and encouraging their independence when moving and adjusting their position must all come into play.
2.1 Outline the anatomy and physiology of the human body in relation to moving and positioning individuals
The physical structure that facilitates movement is referred to as anatomy. Examples of anatomy include joints, muscles, and bones, whereas physiology refers to how body parts work.
The skeletal system
This phrase alludes to the bony framework that promotes movement, stability, and balance. The body system cannot effectively carry out these functions without the body’s skeleton. Therefore, damage to this structure would prevent the body from performing this function as intended. The spinal column, which consists of bones stacked on top of each other with cartilage in between, is one of the main parts of the body’s skeleton. Vertebrae are the stacked bones. It’s critical for the caregiver to have a thorough understanding of the anatomy and physiology of the human body before beginning the moving and positioning activity in order to do so safely. This would simplify the task and allow the professional to move and position the people without risking an injury while bending over or crouching.
Bones: Bones make up the skeletal system.
These bones come in four different varieties:
- Short bones are small and weaker than other bones, such as long bones.
- Long bones are strong, dense, and can withstand pressure, such as that applied to the thighs and forearms.
- Unusual bones: These bones have a structure that is neither short, flat, nor long. The skull’s bones are an example of this.
- As their name suggests, flat bones are typically large and flat in shape, protecting the body’s internal organs. The rib and shoulder bones are two examples.
When someone has broken or fractured a bone, it is important to move and position them carefully because it can be painful and, if done incorrectly, only result in discomfort. A fracture can also result from failing to move and position safely and in accordance with the employer’s procedure. The following types of fractures are possible:
- Simple fracture: This kind of fracture affects the bone beneath the skin.
- Compound fractures are those in which the bone has pierced the skin.
- Multiple bones can break at once in a severe fracture.
- In a green stick fracture, only one side of the bone is broken, or only a portion of the bone is broken.
Joints serve as the connection between bones. There are three types of joints: synovial, fixed, and cartilaginous.
- Fixed Joints are fixed and do not move at all, for example. Head bones
- Bones are joined together at cartilaginous joints to allow for very small or limited movements. Consider the spinal column.
- Synovial joints are what give the body the ability to move in different directions.
Muscle.
Muscles help joints and bones move by contracting, and they are connected to the bones by tendons. Smooth, skeletal, and cardiac muscles are the three different types of muscles. When muscles are forced to contract too quickly or strongly while moving or changing positions, they can become damaged (torn).
2.2 Describe the impact of specific conditions on the movement and positioning of an individual
To perform moving and positioning activities safely, it’s crucial to consider the individual’s unique condition. Each person will be moved or positioned differently depending on these particular circumstances.
As a result, it’s crucial to carry out background checks on care plans for specific people and put the right safety precautions in place to reduce the risk of harm. Following are some specific conditions and their effects on people’s movement and positioning.
Dementia– Memory lapses or memory loss are symptoms of the disease dementia. It can affect one’s ability to carry out daily tasks and can either be full or partial dementia. As a result of memory loss, this may cause the affected person to forget why, where they are, or where they are going. As a result, it is expected to take repeated actions toward them or offer assistance in moving them to the desired location.
Mobility is hampered by dementia, which increases the risk of falling or stumbling. When moving and positioning occur, this should be kept in mind.
Dementia also makes it difficult for a person to understand instructions; in this situation, talking at length should be replaced with more gestures and brief, clear words.
Amputation– Amputation is the complete or partial loss of a limb due to an infection or accident. When moving and positioning, an amputee may have stronger muscles on the side opposite the amputated limb; this should be taken into account, and adequate support should be provided.
It is significant to remember that an amputee may have a different range of motion in their joints, and for such a person, adequate support is needed to perform moving and positioning activities safely.
Some amputees may use their prosthetics as supports, so this should be taken into account when moving and positioning such a person.
Arthritis– Arthritis is a painful joint inflammation that limits movement and causes discomfort. Rheumatoid and osteoarthritis are the two types of arthritis.
Since arthritis typically affects the joints and causes stiffness, an individual’s joints should not move outside of what is comfortable to reduce pain and discomfort. Avoid holding the injured joints while moving or positioning them, as well as sudden or jerky movements.
The effects of moving and positioning activities on the afflicted joints can be lessened with the use of handling equipment. Additionally, using protective coverings on the painful joints will keep them from hurting while moving.
Hearing loss– Complete or partial hearing loss is referred to as hearing loss. To communicate effectively, it is important to make sure that the person wearing the hearing aids is wearing them while moving and positioning. Environmental factors, such as noise, may make it difficult for you to move and position such a person, so it’s best to do these things in a place that’s calm and less crowded. Additionally, it might be a good idea to stand in front of that person to express support and other activities while speaking slowly and making gestures.
Loss of sight: Loss of sight is the complete or partial loss of vision. Such a person needs assurance and audible words of encouragement when being moved or positioned because they often feel uneasy and confused when changing positions. This can be helped by making them aware of their surroundings and where things like furniture and electronics are located.
When moving and positioning such a person, verbal communication should always be used.
Parkinson’s disease: Parkinson’s disease is a central nervous system disorder that impairs movement. It frequently includes tremors, which can make moving and positioning activities challenging because the person is at risk of falling or losing their balance, so assistance is needed throughout the process. Since this condition can make mobility slow, it’s crucial to motivate the person with patience and encouragement. Support must be provided at all times because the person may become fatigued and dizzy, which could cause them to lose their balance while moving or positioning.
3.1 Describe the action to take if the individual’s wishes conflict with their care plan
Following an individual care plan and conducting a thorough risk assessment before moving or positioning someone is crucial because it ensures their safety and should be done in accordance with the employer’s established operating procedures. However, there are times when people will not cooperate and will not follow the operational procedure as set forth. Instead, they may choose a different course of action, which may not be entirely safe or clear, in defiance of the employers’ preferred method of working.
First of all, departing from a person’s care plan would mean failing to follow the employer’s established operating procedure. This would be a serious violation of the employer’s policy and could lead to the worker’s immediate dismissal. Following the individual’s care plan would also greatly increase the risk of injury or death for the individual, the caregiver, and others involved in the moving and positioning process.
The person may feel disrespected and think he or she is not being treated fairly if the deviation in the plan they requested is not followed. The person might feel undercut and believe that his right to make decisions has been violated, which could strain the previously established working relationship. In order to successfully manage the conflict of interest, it is crucial to use some sort of balancing technique.
Explain the employer-approved procedure of action to the individual patiently, stressing its significance and safety implications. This will reassure and persuade the person that their safety and the safety of everyone involved is a top priority.
Make sure to discuss the possible outcomes with the person in order to help them understand the importance of adhering to the employer’s work schedule and to give them the opportunity to decide.
Additional safety assurance can be provided to such a person by talking with them about the conflicting issues and learning why they chose a different care plan, as this may raise concerns about their lack of confidence or sense of safety in the employer’s work plan.
Make a thorough written record of all discussions, including the actions taken and the justifications for each individual decision and the subsequent course of action, in order to make all pertinent information available to colleagues who require it.
Make sure to inform a superior of the disagreement (e.g. supervision). You can ask the superior staff for additional advice and recommendations if the conflict cannot be resolved or safety cannot be guaranteed by clearly stating the disputing issues and including all relevant information.
All disputes must be handled empathetically and rationally. Sincere care and concern must be used to comprehend each person’s request, which often leads to an amicable resolution.
4.5 Describe the aids and equipment that may be used for moving and positioning
During moving and positioning activities, each person’s requirements and preferences are different. As a result, there are various tools and equipment that can be chosen in order to move and position the person in a safe and practical manner.
Sitting aid: For people who require assistance getting out of bed and into a sitting position, there are sitting aids.
Mobility aid: Wheelchairs and mobility scooters are two examples of those.
The size of the mobility scooter should be chosen based on the person’s weight and height. In addition, they have handlebars and seats that can be adjusted for comfort. Depending on the user’s weight and height, wheelchairs come in various sizes and are either electric or manual. While an electric wheelchair can be operated by either a career or an individual, a manual wheelchair requires assistance from the career.
Walking aid: These are used by people who need assistance to walk. These items include walking sticks, rollators, and frames for walking. They typically have an aluminium frame that is sturdy, and some models have wheels.
Standing aids: Standing aids are available in both manual and electric types. These are for people who need assistance standing up from a chair, wheelchair, or toilet seat because their mobility is impaired. These standing aids improve mobility by facilitating transitions between positions.
Bath hoists: These are used to lift people into and out of baths; they can be fixed to the floor, suspended from the ceiling, or mobile.
Ceiling track hoist– This is a portable, detachable hoist that can be moved from one position to another independently by an individual using a remote handset in a small space.
5.1 Describe when advice and/or assistance should be sought in relation to moving or positioning an individual
It may be necessary to seek advice and assistance when performing moving and positioning activities on individuals; it’s important to recognise these situations and know how to respond appropriately.
Several of these examples include:
Changes in carer or colleagues’ well-being. When this happens, it is best to stop the activity, as continuing would be unwise and could endanger the carer and the person. In such situations, a carer or colleague could become suddenly ill, which could be caused by work stress or a pre-existing condition. To lessen the possibility of injuring someone, such an unfit person can be replaced. According to the employer’s code of conduct, such an incident should be reported.
Changes in individual’s condition: The person’s condition may change while they are moving and positioning; they may grow tired from the activity or become apprehensive at an unexpected time. In these cases, it is advisable to stop the process and offer the person support and reassurance, even though this does not mean that the person’s condition has worsened. In accordance with the employer’s protocol and code of conduct, a proper report must be made.
Emergency occurrence: In the event of an unplanned emergency, such as a cardiac arrest or convulsion, the carer must have received sufficient training in handling emergencies, and the employers’ agreed-upon protocol and code of practice must be followed, along with prompt notification to the relevant department.
Individual refusing to participate actively: When a person refuses to actively participate, it may be because they are afraid, distrustful, or not confident in their carer. In these cases, the person should be reassured of the competence of the carer and patiently explained to the significance and consequences of their refusal. Once the person has been professionally informed of the need to consult the employer for guidance regarding the established code of practice, politely accept if the person is still adamant.
Career and colleagues’ competence: In some situations, using specific equipment or following specific procedures when moving and positioning people may call into question one’s own or a co-worker’s competence. When this occurs, the activity must stop, and reports must be filed in accordance with the employer’s policy and operating procedures. To keep everyone involved safe, additional training or knowledge may be required.
Faulty or unavailable moving and positioning aids or equipment: in these situations, the activity must be stopped and a report filed in accordance with the employer’s protocol and code of conduct.
5.2 Describe sources of information available in relation to moving and positioning individuals
For a variety of reasons, information is frequently required when moving and positioning people. This information can be obtained from both internally and externally of the institution. Let’s start with the external sources of information. These include:
Training sessions: These are a good source of information because they typically share current information that can be used to update knowledge on crucial topics like the newest medication or a new practice technique for moving and positioning. External training can be obtained online or at a physical location.
Publication: Reading educational and informative materials, such as books, journals, and research papers, is a good way to gain the most up-to-date knowledge possible about moving and positioning techniques.
Professionals: With their years of training and experience, professionals have a wealth of knowledge that one is fortunate enough to have access to through mentoring, discussion, or observing them in action. Safety officers, physiotherapists, and moving and handling trainers are examples of such professionals.
Websites: The Health and Safety Executive is an example of a website that is full of the most recent moving and positioning techniques, as well as the laws and legislation that cover them.
Internal sources of information
Individual: Information about preferences for moving and positioning, as well as reactions to and opinions about cutting-edge techniques, can be obtained directly from individuals in a personal and accurate manner.
A common working method is to use the employer’s manual or position-moving procedure guidelines as a good source of information. A common working method is to use the employer’s manual or position-moving procedure guidelines as a good source of information.
Documents: To provide pertinent information on treatment history, allergies, and equipment use, documents such as care plans, treatment charts, and risk assessment guidelines pertaining to a person’s history of moving and positioning activities can be accessed.
Colleagues: Colleagues are a good source of information about the working environment and a person’s past activities. Other people, such as family members who support the individual, can also provide useful information.
REFERENCES
- Ferreiro Peteiro, M. (2014) Level 2 Health and Social Care Diploma Evidence Guide, Hodder Education
- Michie, V. Morris, C. Baker, L. Collier, F. and Marshall, T. (2011) Level 2 Health and Social Care Diploma, Hodder Education
- www.actiononhearingloss.org.uk Action on Hearing Loss – resources and information about the impact of hearing loss
- www.arthritisresearchuk.org Arthritis Research UK – resources and information about arthritis
- www.cerebralpalsy.org.uk Cerebral Palsy UK – resources and information about cerebral palsy
- www.dementiauk.org Dementia UK – resources and information about dementia
- www.gov.uk The UK Government’s website – information about current legislation including health and safety
- www.hse.gov.uk Health & Safety Executive – resources and information about moving and handling in the adult social care sector Level 2 Diploma in Care 48
- www.hda.org.uk Huntington’s Disease Association – resources and information about Huntington’s Disease
- www.mind.org.uk Mind – resources and information about the Mental Capacity Act 2005, including useful terms
- www.mssociety.org.uk Multiple Sclerosis Society UK – resources and information about MS
- www.musculardystrophyuk.org Muscular Dystrophy UK – resources and information about MD
- www.nhs.uk NHS – general information about conditions, symptoms and treatments
- www.parkinsons.org.uk Parkinson’s UK – resources and information about Parkinson’s
- www.rnib.org.uk Royal National Institute of Blind People (RNIB) – resources and information about sight loss in the UK
- www.skillsforcare.org.uk Skills for Care – resources and information on the Care Act 2014, the code of conduct for adult care workers
- www.skillsforhealth.org.uk Skills for Health – resources and information on the Care Act 2014, the code of conduct for adult care workers
- www.stroke.org.uk Stroke Association – resources and information about strokes, why they happen and the difficulties people may experience
