1. Manual Handling Training Presentation
A Basic Introduction to
Safer Manual Handling
This presentation is intended as only an introductory session to manual handling, eg in supporting basic induction. For staff who have roles which involve moving and handling skills, such as those who have to move service users, additional training will be required, and should be provided by an appropriately qualified manual handling trainer.

2. What is Manual Handling?
Manual handling refers to the moving of objects or people by hand without mechanical help and includes such things as lifting, pushing, pulling, dragging, carrying and lowering
Manual handling most commonly refers to care staff handling or moving service users
However, it also applies to many other work activities such as lifting pots and pans in a kitchen, stacking shelves, moving bags of linen, etc
Ask the group what they understand by manual handling. When some suggestions have been made, click to display the definition.

3. What Does the Law Say about Manual Handling?
The Manual Handling Operations Regulations 1992 place a duty of care on employers to protect service users and staff through the employment of safe working practices, including safe moving and manual handling
As part of its registration arrangements the Care Quality Commission requires services to ensure the safety of service users, to ensure that equipment is safe to use and to ensure that staff are adequately trained
Remind the group that the need for safe manual handling is not only covered by health and safety law but is also an important factor in registration with the CQC.

4. What Are the Risks Involved with Manual Handling?
Poor handling techniques and methods can cause injuries to staff
Common injuries involve back pain or what are commonly referred to as musculoskeletal disorders
Manual handling accidents can also cause serious or even fatal injuries to service users
Ask the group what they think the risks of manual handling might be. Click to reveal the slide.
The most common risk with manual handling is that of injury — usually a back injury, a pulled muscle or a sprain. These are commonly referred to as musculoskeletal disorders, or MSDs. Such injuries, particularly back injuries, can be very painful and serious and can lead to considerable amounts of time off work.
In the case of manual handling activities that involve the handling of service users, risks will also include possible injury to the service user being handled. In the care sector there is a history of incidents where service users have been dropped, injured and even killed as a result of poor or inappropriate manual handling techniques or the use of defective or inappropriate equipment. Such incidents not only have the potential to cause human tragedy and injury but also can result in costly litigation and damages.

5. Manual Handling Risk Assessments
All manual handling tasks that have the potential for injury should be fully assessed
If the activity involves the occasional lifting of small, regular- shaped, lightweight items, the risk can be deemed to be negligible
If the task involves the movement of a heavier item, or one which is an irregular shape, for example, then the risk is increased and an assessment is necessary
This slide presents an opportunity to expand on the risk assessment policy and tools.
The Health and Safety Executive has developed a tool called the Manual Handling Assessment Chart (MAC) which can be used to help assess the most common risk factors in lifting, carrying and team handling. Care managers may find the MAC useful to help identify high-risk manual handling operations and to help complete detailed risk assessments.

6. Reducing the Risk of Injury
The main duty on a manager is to avoid causing their staff to perform lifting operations that might involve an appreciable risk of injury
Wherever possible, hazardous manual handling tasks should be eliminated or avoided completely
Where it is not practical to do this, such as wherever an activity simply has to be done, the manager should assess the activity and take steps to reduce the risk to the lowest reasonably practical level
As the risk of injury increases managers should look at the activity increasingly closely to ensure it has been properly assessed and the risk of injury has been reduced as far as possible.
There is no such thing as a perfectly safe manual handling task as all handling carries risk, no matter how small. Assessing the risk of injury is therefore often a matter of judgment.

7. Factors to Consider in a Risk Assessment
Task I
Individual capability L
Load E
Environment
Ask the group what they think are the factors they would need to consider when conducting a manual handling risk assessment.
A commonly used mnemonic device for remembering manual handling risk assessment categories is TILE – Task, Individual capability, Load and Environment.

8. The Task
Does the task need to be done, eg can the service user move themselves?
Can the need for performing the task be reduced?
Is the task urgent?
Can the task be partially or totally mechanised?
How far is the load from the handler's body?
Does the task require excessive lifting or lowering, carrying, pushing or pulling?
Is there a risk of sudden movement of the load?
Ask the group what aspects of the task might affect a manual handling activity. Click to display the slide suggestions. These are not exclusive but provide an idea of the sort of questions that should be asked in an assessment. Others include the following.
Does the task require frequent or prolonged physical effort?
Is twisting and stooping or reaching upwards involved?
Is there the opportunity for sufficient rest or recovery periods?
Is handling while seated an option?
Would the task be safer if handled by a team?

9. Individual Capability
Does the task require unusual capability, eg above-average strength or agility?
Would the task endanger those with a health problem or learning/physical disability?
Would the task endanger pregnant women?
Does the task call for special information or training?
Ask the group what aspects of the task might affect a manual handling activity. Click to display the slide suggestions. These are not exclusive but provide an idea of the sort of questions that should be asked in an assessment.

10. The Load Is the load heavy, bulky or unwieldy?
Is the load difficult to grasp, eg does it have handles or is it slippery or wet?
Could the load be unstable or likely to move unpredictably, such as a person?
Could the load be harmful, eg sharp or hot?
Is the load awkwardly stacked?
Is the load too large for the handler to see over?
Is there any other resistance that the handler is likely to encounter?
Ask the group what aspects of the task might affect a manual handling activity. Click to display the slide suggestions. These are not exclusive but provide an idea of the sort of questions that should be asked in an assessment.

11. The Environment
Temperature and humidity: extremes of temperature can have a substantial effect on the risk of injury
Lighting: is there adequate lighting, natural or artificial?
Space: do space constraints prevent good posture or technique?
Flooring: are floors uneven, slippery or unstable?
Noise: a noisy environment can prevent employees hearing commands during team lifting procedures
Housekeeping: is the environment free from clutter?
Ask the group what aspects of the task might affect a manual handling activity. Click to display the slide suggestions. These are not exclusive but provide an idea of the sort of questions that should be asked in an assessment.

12. Safer Manual Handling Assess all manual handling operations for risk
Avoid the need for manual handling or minimise risk wherever possible by redesigning tasks and processes
Use equipment or aids such as hoists and trolleys wherever possible
Distribute handling tasks evenly throughout the working day or share heavy work between teams
Care managers should reduce the risks of any manual handling activity to the lowest reasonably practical level. That means reducing the risk until the cost of any further precautions — in terms of time, effort or money — would be far too great in proportion to the benefits.
Risks can best be reduced by redesigning the work process to make it safer, by changing the working environment, by altering the load, by providing mechanical aids or by additional training.

13. Safer Lifting
Always assess the lift first and avoid lifting anything that is too heavy or awkward
Lift from above knee and/or below elbow height
Keep the load close to your body with trunk upright and upper arms aligned vertically
Use both hands
Keep a firm grip and keep the load in front of the body
Avoid lifting loads from the floor or loads above head height
Avoid lifts where the trunk twists in relation to the hips and thighs or where you have to lean to one side as the load is lifted
There is no single correct way to lift. However, the Health and Safety Executive (HSE) publishes basic advice in a free leaflet called Getting to Grips with Manual Handling: A Short Guide for Employers, available on its website.
The guidance is summarised on this slide.
Neither the law nor the HSE sets maximum weight limits as what is considered important is the risk involved in a lift, not necessarily the weight of the item.
Stress that there is no threshold below which manual handling operations are regarded as “safe”. Manual handling injuries can happen to anyone regardless of capability, age, strength or fitness.
The safest course of action is to avoid lifting wherever possible.

14. Manual Handling and Service Users
Service users have a range of different mobility and handling needs and will typically require different levels of assistance and handling care
Where individual service users need assistance with their mobility it is essential that their records or care plans contain a full assessment of their needs
The assessment should identify the moving and handling aids and techniques that are required to move the service user safely in any situation
There always needs to be a balance in approach to ensure that:
care workers are not required to perform tasks that put them or their service users at unreasonable risk
service users' personal wishes on mobility assistance are respected wherever possible
service users' independence and autonomy is supported as fully as possible.

15. Service Users’ Needs
Staff might need manual handling skills to help service users:
get in or out of bed, or turn over or sit up in bed
bathe or shower
use the toilet
sit up in a chair
stand or walk
get up from the floor after a fall
transfer to or from a wheelchair or get in and out of a vehicle
Ask the group what sort of manual handling needs service users might have. Get some suggestions and then reveal the slide.

16. Minimal Handling Policy
The physical handling or lifting of service users should be minimised or avoided wherever possible
Provide aids to independence to enable service users to help themselves as much as possible
Where handling of service users is required, staff should be appropriately trained and equipped
This policy not only minimises the risk to both staff and service users, but also maintains the service user's dignity and independence and encourages their mobility
If the audience requires an example, talk about helping a service user transfer from a wheelchair. This can be done in a variety of ways according to the level of the service user’s disability and the difficulty of the task, both of which will need to be assessed prior to the transfer.
However, the safest method from a manual handling point of view is to help the service user to transfer themselves if they can. This will not only be safer for staff but would also maintain the service user's independence and dignity.
Every service user should have their needs assessed and any help they require should be documented in their plan of care.

17. Safer People Handling
Only safe and up-to-date people-handling techniques are to be used and every people-handling activity should be assessed before being carried out
Dangerous or unsafe people-handling techniques not only cause injuries to staff but also can seriously injure service users
Using poor and unsafe techniques to move people may constitute actual physical abuse and may result in prosecution
Only staff appropriately trained in the moving and handling of service users and in the safe use of hoists should be involved
Examples of injuries caused by unsafe techniques include:
pressure sores, especially on the sacrum or heels
shearing injuries to the skin caused by friction
bruises
fractures
cuts
dislocated joints
nerve damage
restricted circulation.
Serious accidents, or complications from injuries caused by dangerous techniques, can even have fatal results.

18. Manual Handling Aids and Equipment
Manual handling aids and equipment are designed to make manual handling tasks easier or safer
They should be used wherever indicated in a manual handling risk assessment
Examples include:
hoists for helping with the moving and handling of service users
linen and food trolleys for moving loads
transfer boards to help service users move from a wheelchair to a bed or a toilet, etc
slide and glide sheets for moving people in bed
turning aids to help people to stand and turn

19. Lifting Operations Using Hoists
A hoist should be used only for the moving and handling of a service user by staff who are trained and competent in its use
A service user being lifted in a hoist is vulnerable and relies on the operator of the hoist for their safety
Unsafe use of the hoist, poor maintenance, or the use of inappropriate or defective hoists or slings can be the cause of potentially fatal accidents
Here the main elements of the policy on the use of hoists can be introduced.
Stress that this does not constitute training in the use of a hoist but is designed to raise staff awareness of hoist use. Further training will be required for all care staff who will be expected to use a hoist.

20. Manual Handling and Pregnant Staff
The Management of Health and Safety at Work Regulations require that special attention be given to identifying and controlling risks that may affect women who are pregnant, have given birth in the previous six months or are breastfeeding
Pregnant staff are especially at risk when performing manual handling tasks
Manual handling tasks should be avoided by pregnant staff where possible and all tasks should be assessed

21. Manual Handling Training
All staff will be given adequate training and information on the manual handling risks relevant to their work area and how to avoid them
Manual handling training is mandatory and must be completed by all staff as part of their induction and as updates
This slide gives an opportunity to present the training policy. It should be adapted as required.

22. Summary Comply with the manual handling policy at all times
Remember that poor manual handling techniques and methods can cause injuries to staff and service users
Assess all manual handling operations for risk
Eliminate or avoid manual handling tasks wherever possible
Where this is not practical the risks should be reduced
Use equipment or aids wherever possible
Only use a hoist if appropriately trained and following a risk assessment
Attend all required manual handling training
Click to present each point as a reminder of the content of the session.