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Domiciliary Care – support for lone workers

An effective lone working policy will give domiciliary care workers guidance and support, and identify their responsibilities when on duty. The policy should be designed to minimize risks and provide a risk management framework. The policy should be a clear, easily read document that is available to all domiciliary care staff.

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The HSE (Health and Safety Executive) suggest that establishing a healthy and safe working environment for lone workers can be different from organising the health and safety of other employees, but lone workers should not be put at more risk than other people who work for an Agency.

It will often be safe to work alone. However, the law requires employers to think about and deal with any health and safety risks before people are allowed to do so.

Things the employer should consider that help ensure domiciliary care workers are not put at risk include: •    assessing areas of risk including violence, manual handling, the medical suitability of the individual to work alone and whether the workplace itself presents a risk to them •    requirements for training, levels of experience and how best to monitor and supervise them •    making sure that the line manager knows what is happening, including having systems in place to keep in touch with them •    Employers have a duty to assess risks to lone workers and take steps to avoid or control risks where necessary.

This must include: •    involving workers when considering potential risks and measures to control them; •    taking steps to ensure risks are removed where possible, or putting in place control measures, eg carefully selecting work equipment to ensure the worker is able to perform the required tasks in safety; •    instruction, training and supervision; •    reviewing risk assessments periodically or when there has been a significant change in working practice. This may include: •    being aware that some tasks may be too difficult or dangerous to be carried out by an unaccompanied worker; •    when a risk assessment shows it is not possible for the work to be conducted safely by a lone worker, addressing that risk by making arrangements to provide help or back-up. Risk assessment should help employers decide on the right level of supervision. There are some high-risk activities where at least one other person may need to be present. Examples include: •    working in a confined space, where a supervisor may need to be present, along with someone dedicated to the rescue role. Training Domiciliary care workers unlike residential care workers are unable to ask more experienced colleagues for help on the job, they have to rely on the guidance provided by their line manager off the job. They therefore need to be sufficiently experienced and fully understand the risks and precautions involved in their work and the location that they work in.

Training is particularly important in enabling people to cope in unexpected circumstances and where there may be exposure to violence and aggression.

Supervision The extent of supervision required depends on the risks involved and the ability of the lone worker to identify and handle health and safety issues. The level of supervision needed is a management decision, which should be based on the findings of a risk assessment, i.e. the higher the risk, the greater the level of supervision required.  Consideration should be given to new domiciliary care workers who are undergoing training being accompanied by a more senior member of staff as part of their induction.

Monitoring Monitoring Procedures must be put in place to monitor lone workers as effective means of communication are essential.

These may include: •    supervisors periodically visiting and observing people working alone; •    pre-agreed intervals of regular contact between the lone worker and supervisor, using phones, radios or email, bearing in mind the worker’s understanding of English; •    manually operated or automatic warning devices which trigger if specific signals are not received periodically from the lone worker, e.g. staff security systems; •    implementing robust system to ensure a lone worker has returned to their base or home once their task is completed.

Emergency procedures Risk assessments should identify foreseeable events. Emergency procedures should be established and employees trained in them. Information regarding emergency procedures should be given to domiciliary care workers.

Summary It is essential that the domiciliary care worker has a clear policy that provides sufficient information to enable the worker to feel confident when carrying out their job. Key to the policy is the assessment of risk along with effective training to reach competency, supported by supervision and monitoring and what to in an emergency. The policy should be seen as a worthwhile investment by providers and in the long run may help to retain domiciliary care workers within the Agency.

Albert Cook Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy

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