PREVENTING SLIPS, TRIPS AND FALLS (INCLUDING FALLS FROM HEIGHT)

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1 SECTION; 16 - HEALTH AND SAFETY POLICY & PROCEDURE: NATURE AND SCOPE: SUBJECT: POLICY TRUSTWIDE PREVENTING SLIPS, TRIPS AND FALLS (INCLUDING FALLS FROM HEIGHT) This policy has been produced in line with the Management of Health and Safety at Work Regulations 1999 and all other nationally accepted standards, guidelines and Codes of Practice to implement all reasonably practicable measures to reduce risks associated with slips, trips and falls (including falls from height). DATE OF LATEST RATIFICATION: MARCH 2015 RATIFIED BY: TRUST HEALTH AND SAFFETY COMMITTEE IMPLEMENTATION DATE: MARCH 2015 REVIEW DATE: MARCH 2018 ASSOCIATED TRUST POLICIES AND PROCEDURES: Health, Safety & Welfare Manual Handling and Back Care Using Bedrails Safely and Effectively 3.06 Falls: The Assessment, Prevention and Management of Patient Falls (Adult Services) 1.34 ISSUE 4 MARCH 2015

2 NOTTINGHAMSHIRE HEALTHCARE NHS FOUNDATION TRUST PREVENTING SLIPS, TRIPS AND FALLS (INCLUDING FALLS FROM HEIGHT) CONTENTS 1.0 Introduction 2.0 Policy Principles 3.0 Definitions 4.0 Duties 5.0 Risk Assessment 5.1 Risk Assessment of Patients 5.6 Environmental Risk Assessments 5.7 Falls from Height 6.0 Implementation Preventing Slips, Trips and Falls 6.3 Preventing Slips 6.4 Preventing Trips 7.0 Training 8.0 Target Audience 9.0 Review Date 10.0 Consultation 11.0 Relevant Trust Policies and Procedures 12.0 Monitoring Compliance 13.0 Equality Impact Assessment 14.0 Legislation Compliance 15.0 Champion And Expert Writer Appendix 1 Causative Factors and Slip Risk Controls Appendix 2 - Slips, Trips and Falls on the Same Level Audit Form Appendix 3 Record of Changes Appendix 4 Employees Record of Having Read the Policy / Procedure ISSUE 4 MARCH

3 NOTTINGHAMSHIRE HEALTHCARE NHS FOUNDATION TRUST PREVENTING SLIPS, TRIPS AND FALLS (INCLUDING FALLS FROM HEIGHT) POLICY 1.0 INTRODUCTION 1.1 Slips, trips and falls (including falls from height) can be serious and costly. Slips and trips are the most common workplace hazards and are reported to make up over a third of all injuries, with 95% of major slips resulting in broken bones. The purpose of this Policy is to set out the framework for carrying out suitable and sufficient risk assessments for the prevention and management of slips, trips and falls, (including falls from height) to Nottinghamshire Healthcare NHS Trust (The Trust) staff, its patients and any other person(s) who may be affected its activities. 1.2 The Health and Safety at Work etc Act 1974 requires employers to ensure their employees and anyone else who could be affected by their work are kept safe from harm and that their health is not affected. This means that risks must be controlled to ensure people do not slip, trip and fall. 1.3 The Management of Health and Safety at Work Regulations 1999 places duties on employers to assess risks (including slip and trip risks) and where necessary take action to safeguard health and safety. 1.4 The Workplace (Health, Safety and Welfare) Regulations 1992 places a requirement on the employer to ensure floors are suitable for the workplace and work activity, that they are kept in good condition and free from obstructions. Further, people must be able to move around safely. 1.5 The Work at Height Regulations 2005 place duties on employers and any person that controls the work of others (for example facilities managers or building owners who may contract others to work at height). They apply to all work at height where there is a risk of a fall liable to cause personal injury. 1.5 The National Patient Safety Agency (NPSA) and the Health and Safety Executive (HSE) have both produced guidance and recommendations on the prevention and management of slips, trips and falls, specific to health care providers. 1.6 Patient safety is a key focus, especially when providing care and services to older and vulnerable persons. Falls are a particular clinical concern because of the frequency that they can occur and also because of the physical and psychological consequences. It is therefore essential that all patients who could be at risk from falls are assessed appropriately. See Policy 1.34 Falls: The Assessment, Prevention and Management of Patient Falls (Adult Services). 1.7 Accidents can be cut dramatically through planning and positive management during refurbishment and new build, together with good housekeeping and ensuring any clinical contributory factors are also considered. This policy document also provides guidance on preventing patient falls and on the management of floor surfaces to minimise risks associated with exposure to slip and trip hazards as far as reasonably practicable. 1.8 The important area of managing the need for staff employed by the Trust who work at height should be addressed and must be avoided where it can. All work at height must be risk assessed. ISSUE 4 MARCH

4 2.0 POLICY PRINCIPLES 2.1 The Trust recognises its duties to ensure so far as is reasonably practicable the health, safety and welfare at work of all its staff, patients and any other person(s) who may be affected by its activities are not exposed to risk. 2.2 The Trust will ensure compliance with legal and other requirements placed up on it to implement all reasonably practicable measures to reduce workplace risks. Progressive health and safety improvements will be actively sought by all Managers to ensure full compliance with legislation. This will play a key role in the continued improvement of the effectiveness of the organisation and the quality of service provided. 2.3 The Trust also accepts that in order to achieve a high standard of health and safety performance, there will be funding implications, which it will endeavour to adequately resource. 2.4 The Trust recognises that successful risk management is brought about through good management and effective communication with staff. The Trust considers that successful management of health and safety has the benefit of improving the overall operation of The Trust facilities by reducing injuries and ill health, improving patient safety, protecting the environment and reducing unnecessary losses and liability. 3.0 DEFINITIONS 3.1 It is important to identify a practical definition of a slip, trip and fall that is relevant in either clinical or non-clinical settings. Slip: Trip: Fall: Fall from Height: A slip is to slide accidentally causing the person to lose their balance, which is either corrected or causes a person to fall. A trip is to stumble accidently, often over an obstacle causing the person to lose their balance, which is either corrected or causes the person to fall. A fall is a sudden, unintentional change in position causing an individual to land at a lower level, on an object or the floor, whether or not an injury is sustained. Applies to any place, including at or below ground level, and obtaining access to or egress from it while at work, except by a staircase in a permanent workplace. 4.0 DUTIES 4.1 The Chief Executive has overall responsibility for health and safety within The Trust. However, it is the duty of all employees to act responsibly with regard to health, safety and welfare matters, to do everything practicable to prevent injury to themselves or others and to co-operate fully in implementing health, safety and welfare initiatives. Any health, safety and welfare concerns should be brought immediately to the attention of their immediate manager for action. 4.2 Each Director / Head of Service / General Manager has responsibility for ensuring compliance with the requirements of this Policy and that this policy is implemented within their area. ISSUE 4 MARCH

5 4.3 Each Director / Head of Service / General Manager is responsible for ensuring that all hazards are identified and where those risks from the hazards are significant that suitable and sufficient risk assessments with action plans are in place. 4.4 Each Director / Head of Service / General Manager is responsible for monitoring the results of risk their risk assessments and action plans and will allocate appropriate resources to manage the risks, which can not be managed locally. 4.5 Managers are responsible for ensuring the undertaking and thereafter the review or in light of changing activities or priorities, a risk assessment of all slips, trips and falls (including falls from height) hazards within their area of responsibility, where hazards have been identified. Ensuring that staff know of and have access to the risk assessments for the hazards to which they and / or others may be exposed to Ensuring that patient falls risk assessments are undertaken, reviewed as appropriate and made available in patient records see Trust Policy 1.34 Falls: The Assessment, Prevention and Management of Patient Falls (Adult Services). Ensuring that significant findings of risk assessments are acted upon in a timely manner in accordance with the level of risk and up on any concern from their respective staff and / or others Implementing and monitoring appropriate control measures, within their area of responsibility, to reduce risk to the lowest level reasonably practicable. Identify training needs of their staff relating to this Policy and ensuring all training is undertaken. Ensuring that risk assessments are overseen by a person(s) with competence in the relevant risk assessment methodologies and techniques. Ensuring that this process is followed where staff work on shared sites. All findings must be communicated to all relevant persons / parties who should each co-operate with the other(s). 4.6 The Estates Department is responsible for ensuring Trust premises are maintained in good order, including flooring, lighting and external surfaces. 4.7 Facilities must also ensure guidance and advice referred to in HTM 61 is followed with regard to flooring design, specification, procurement constructions, commissioning, cleaning and maintenance of flooring. Where / when possible they must also ensure that appropriate lighting is provided in all areas in order to reduce the risk of slips, trips or falls resulting from poor / inadequate visibility. 4.8 All employees are responsible for ensuring that they co-operate with Managers in implementing this policy and to: Ensure a safe environment, within their scope of influence, in Trust and non Trust premises. Wear appropriate footwear for the work area and the task to be performed. Reporting accidents / incidents / near misses immediately. ISSUE 4 MARCH

6 5.0 RISK ASSESSMENT 5.1 Risk Assessment of Patients This will include health care settings and patient s home environments. Where a risk of falls has been identified a Falls Risk Assessment must be carried out see Policy 1.34 Falls: The Assessment, Prevention and Management of Patient Falls (Adult Services). 5.2 Environmental Risk Assessments As part of this policy all areas will complete Appendix 4, which forms part of the Trust Health and Safety Self Audit Tool. Any areas of identified risk must be suitably risk assessed Should any area of risk be identified, Appendix 1 (causative factors and slip risk controls) gives information and examples from the HSE on how they can be controlled The HSE s Slips and trips e-learning package (STEPe) can also be used to assist with the risk assessment. Copies can be obtained from the HSE s web site or the Trust Health and Safety Team. 5.3 Falls from Height The risk assessment must ensure all work at height is properly planned and organised and this must be completed by those involved in work at height and who are deemed to be competent The risks from work at height must be assessed and only appropriate work equipment selected, used properly and inspected and maintained. When selecting work equipment you need to consider risks that may be associated with installation, use, dismantling and rescue In all instances the hierarchy for managing and selecting equipment for work at height apply, namely: avoid work at height where you can use work equipment or other measures to prevent falls where you cannot avoid working at height where you cannot eliminate the risk of a fall, use work equipment or other measures to minimise the distance and consequences of a fall should one occur Ladders must be used in appropriate circumstances and it should be noted that they may not be the most suitable access equipment for the work. Fragile surfaces must be properly controlled. Note: work at height is not sitting on a chair or using permanent stairs if there is no maintenance or structural work being carried out. 6.0 IMPLEMENTATION PREVENTING SLIPS, TRIPS AND FALLS 6.1 The main causes of slip / trip incidents in healthcare are: Slippery / wet surfaces due to water or other fluids ISSUE 4 MARCH

7 Slippery surfaces due to dry / dusty floor contamination e.g. talcum powder Obstructions trailing cables; chair legs; equipment Uneven surfaces or changes in level e.g. unmarked ramps Clinical Factors weakness, visibility, medication, illness etc 6.2 Other factors which contribute to slips and trips include; poor levels of lighting; disabling glare; unsuitable footwear; carrying of loads or improper cleaning regimes. In the health service we also need to consider human factors such as people running and the abilities of patients. 6.3 Preventing Slips Prevent contamination getting onto floor Control contamination Eliminate adverse environmental conditions Improve floor conditions Review work activities Design out problems Review work activities Employee attitude Suitable & timely cleaning regimes Control contamination Check lighting is suitable Is there condensation? Is ice a potential problem? Ingress of rainwater What tasks are undertaken? Can floor roughness be improved? Replace Floor Introduce footwear controls What tasks are undertaken? Consider Staff and Patient footwear 6.4 Preventing Trips Walkways Design & Maintenance Trip Triangle Housekeeping All three areas need to be right in order to prevent trips. Walkways Are they suitable? Are they in the correct place? What tasks are carried out on the walkway? Does this prevent the employee from seeing where they are going? Do they meet the clinical needs of the patient group? Design and Maintenance Is the walkway kept clear (no trailing wires / obstructions)? Do cleaners / employees have a see it, sort it attitude? Is the cleaning regime effective? Housekeeping Is the floor suitable for the environment? Is it fitted correctly and properly maintained? Are walkways wide enough & level? ISSUE 4 MARCH

8 Are stairs consistent and well marked? Is the lighting adequate? Is there adequate storage? 7.0 TRAINING Preventing Slips, Trips and Falls (including Falls from Height) The Trust acknowledges that importing knowledge and developing skills is key to the effective management of slips, trips and falls and working at height. It is therefore essential that the importance and significance of such issues is communicated at all levels throughout all occupational groups. 7.2 All new employees will attend a Local Induction, which will highlight the potential risks associated with slips, trips and falls and basic preventative action that can be taken. 7.3 Specific training on risk assessments and associated risks with regards to slips, trips and falls (including falls from height) is available from the Trust Health and Safety Team. 7.5 All training must be identified and wherever possible undertaken prior to any work taking place. 7.5 Records must be kept where non mandatory training is carried out. These must be kept and up to date. 7.6 The Trust recognises that training alone will not be a substitute for other measures such as building design, environmental considerations and actions as a result of the findings of risk assessments. 8.0 TARGET AUDIENCE 8.1 This policy applies to all Trust staff working on Trust premises or on shared sites. 9.0 REVIEW DATE 9.1 This policy will be reviewed every 3 years or in light of organisational or legislative changes CONSULTATION Trust Health, Safety and Security Committee Executive Leadership Council 11.0 RELEVANT TRUST POLICIES & PROCEDURES Health, Safety and Welfare Manual Handling and Back Care Using Bedrails Safely and Effectively 1.26 Falls: The Assessment, Prevention and Management of Patient Falls (Adult Services) MONITORING COMPLIANCE 12.1 Each Executive Director will monitor the implementation of this Policy and Procedure in all areas of their control and ensure that risk assessments are completed and reviewed This Policy and its associated documentation will be monitored for compliance and effectiveness at regular intervals by the Trust Health, Safety and Security Committee. ISSUE 4 MARCH

9 Process for Monitoring Compliance Preventing Slips, Trips and Falls (including Falls from Height) The monitoring arrangements for compliance and effectiveness will be to undertake scheduled audits across The Trust, reporting findings to relevant managers and the Trust Health, Safety and Security Committee on a regular basis There will be joint responsibilities in undertaking audits All Local Areas will complete and keep risk assessments and action plans Trust specialist Advisers will routinely audit completion of all relevant risk assessment and action plan documentation Methodology will be to review all relevant documentation i.e. risk assessments, action plans and incidents reported Audits will take place in line with the Trusts Health and Safety Management System Audit Programme Risk assessments will be an integral part of the Trust Health and Safety Management System and performance reporting procedures 13.0 EQUALITY IMPACT ASSESSMENT 13.1 This Policy has been assessed using the Equality Impact Assessment. The outcome of the Initial Screening Assessment was that the policy could not adversely affect different groups on the grounds of disability, BME, gender, age or sexual orientation LEGISLATION COMPLIANCE 14.1 Health & Safety at Work etc. Act All other Health & Safety Regulations 15.0 CHAMPION AND EXPERT WRITER 15.1 The Champion for the document is Executive Director, Forensic Services and the Expert Writer is Ian Freegard, Trust Health and Safety Manager. ISSUE 4 MARCH

10 APPENDIX 1 CAUSATIVE FACTORS AND SLIP RISK CONTROLS (taken from HSE information sheet No2 Slips and trips in the health services) ENVIRONMENTAL FACTORS Causative Factors Contamination of the floor from: Spillages of solid, liquid materials Wet cleaning methods Shoes / clothing Ingress of mud / water from external areas Dry contamination e.g. dusts, powders, polythene bags, cardboard placed over spills Wind driven rain, sleet and snow through doorways Condensation from poor ventilation, food trolleys Practical Measures for slips risk control Eliminate contamination Maintain equipment to prevent leakage Install suitable entrance matting systems Place entrances to suit the prevailing weather (only an option for new build) Put up effective entrance canopies If not reasonably practicable: Prevent contamination becoming deposited on walking surfaces Use dry cleaning methods for floors Clean and dry incoming footwear If not reasonably practicable: Limit the effects of contamination By immediate clearing up of spillages By prompt repair of leaks By limiting the area of contamination By restricting access to contaminated areas Inherent slip resistance of the floor not maintained adequately e.g. from incorrect or inadequate cleaning, maintenance or wear If there is still a risk follow the next steps Maximise the surface roughness and therefore slip resistance of the existing floor surface Methods of cleaning and cleanliness of flooring is an important factor to consider, in conjunction with slip resistance. The frequency of cleaning will be determined by how many and the type of pedestrians, who will use the floor. Floor manufacturers are required to provide information on the cleaning regime needed to make their floor safe in the intended environment and this information should be passed to the relevant employees. Just a small amount of contamination, wet or dry, is sufficient to make a smooth floor dangerously slippery. Take the following measures to minimise the risks due to wet cleaning. Thoroughly dry the wet floor after cleaning Exclude people from the wet cleaned area until dry Clean by dry methods wherever possible Clean in sections so that there is always a dry path through the area Clean during quiet hours ISSUE 4 MARCH

11 Causative Factors Practical Measures for slips risk control Thoroughly rinse wet cleaning areas Use warning signs to identify contaminated floors or floors after cleaning Spot cleaning and cleaning of spillage will be needed between scheduled whole floor cleaning (and it is equally important to thoroughly dry those areas). Frequent spot cleaning can supplement whole floor cleaning Maintain floors and drainage to maximise slip resistance. A residual film of water is just as slippery as a puddle and is more difficult to identify. The slip resistance of the floor is too low This is influenced by: The friction between the floor and shoe The presence of suitable surface microroughness The hardness of the floor Applications for sealing floors during installation Later modification of the floor surface such as inappropriate varnishing / sealing / polishing If this is not enough, take the following steps: Increase the surface roughness of the existing floor Flooring can be treated to increase surface roughness though this may have an impact on infection control. Before considering these options Estates design team and infection control must be consulted. The use of stick-on anti slip strips may offer limited improvement, but strips should be placed very close to one another and carefully maintained. If it is possible to influence staff footwear, then anti-slip footwear may be an option. If this is not enough: Lay a more slip-resistant floor with higher surface roughness and higher coefficient of friction In a few cases a new floor may be required. Draw up a performance specification; this should include specialist slip resistance data. Experience of how that floor performs in a similar situation may help; and a small sample of the preferred materials will confirm manufacturer s claims and their suitability. See the installation is correctly done Check the specification has been met Steps and Slopes: Do they cause sudden changes in step or not offer adequate foothold and/or handhold? Check that steps give adequate foot and handhold and that slopes have no sudden changes Is the lighting adequate? Are handrails in place? ISSUE 4 MARCH

12 Causative Factors Adverse environmental and other conditions hiding the condition of the floor and distracting attention. Low light levels Shadows Glare Excess noise Extremes of temperature The use of repeating patterns on floor coverings that might be disguising a change in level Bulky / awkward personal protective equipment Practical Measures for slips risk control Are stairs clearly demarked visually? Remove all sudden changes in level Ensure stairs have clearly visible nosings, good handrails and suitable balustrades Ensure that the rise and tread of each step in a stair is consistent in size throughout the flight Ensure that any applied slip-resistant nosing does not create a tripping or heel-catch hazard Good visual cues for changes in floor level and surface are essential See that the prevailing conditions allow good visibility of and concentration on floor conditions For example provide adequate lighting and see environmental demands do not distract attention from the floor condition. ORGANISATIONAL FACTORS The nature of the task being carried out such as: The need to carry, lift, push, lower or pull loads The need to turn, to move quickly or to take long strides Distractions Having no hands free to hold on to handrails to stop a fall Encumbrance or restricted vision Individual capability Poor knowledge of risks and measures Poor health & safety Poor eyesight Fatigue Physical frailty/disability ENVIRONMENTAL FACTORS Analyse the tasks in any slip risk area to see that only careful walking is required Tasks should not compromise ability to walk safely. Tasks should be: Mechanised to avoid the need for pushing, lifting carrying, pulling etc while walking on a slippery surface Moved to a safer area Allocate tasks in high slip risks areas only to those competent to follow slip precautions Supervise and monitor physical controls to see safer practices are followed Safety culture, which is not supportive. For example where the risks are accepted as part of the job. Establish a positive attitude that slips can be controlled. This is achieved through clear line management responsibilities and consultation with employees ISSUE 4 MARCH

13 Causative Factors Practical Measures for slips risk control PERSONAL PROTECTIVE EQUIPMENT: FOOTWEAR FACTORS Shoes offer insufficient slip resistance in combination with the floor surface, because of: Contamination of shoes Sole material Sole pattern Type of shoe Wear Fit Maintenance /renewal Unsafe action by staff, due to: Lack of awareness of risk Knowledge of how slips occur Information and training, or Distraction, carelessness Select suitable shoes for the floor, environment and the individual Base this on experience and information / advice from suppliers. Ensure employees maintain their shoe soles in good repair and keep them free from contamination. Replace them before they have worn smooth. Where overshoes are required, use good quality reusable ones where possible, laundering them between uses. Disposable overshoes can be slippery are and easily split. INDIVIDUAL FACTORS Train, inform and supervise employees on the risk, the control arrangements and employees role(s) especially to: Clean as they go Report contamination Maintain footwear Walk appropriately to circumstances Set procedures for visitors ENVIRONMENTAL FACTORS Uneven Surfaces Eliminate holes, slopes or uneven surfaces which could cause trips risks For example gulleys, holes, steps To do this: inspect and maintain floors so they have a consistent surface finish with no holes to cause a tripping hazard. Highlight any changes in level, particularly at single steps making them clearly visible, avoid open gulleys and channels Obstructions For example accumulation of articles such as trolleys, wheelchairs, medical equipment, waste, trailing cables, floor sockets etc. Good housekeeping Eliminating materials likely to obstruct walkways and therefore lead to trips For example analyse work flows and design process so waste and equipment does not accumulate on walkways Or if this is not reasonably practicable: Adverse environment For example inadequate illumination to see floor properly, or glare Prevent material obstructing walkways For example provide sufficient suitable receptacles for items, mark out walkways, working areas and receptacle locations and make sure they are kept free of obstruction Provide suitable lighting to permit obstructions to be seen ISSUE 4 MARCH

14 Causative Factors Practical Measures for slips risk control ORGANISATIONAL FACTORS The nature of the tasks creates obstructions Analyse the tasks and process flows to see if work can be handled to eliminate or Safety culture, which is not supportive. minimise obstructions For example where risks are accepted as part of the job Establish a positive attitude that trips can be prevented INDIVIDUAL FACTORS Safe practices not followed Train, inform and supervise employees ISSUE 4 MARCH

15 Slips and Trips Hazard Spotting Checklist Preventing Slips, Trips and Falls (including Falls from Height) APPENDIX 2 (Health and Safety Executive checklist documentation) Potential issue Outdoor areas Can anything be found on the paths, steps and fire escapes that could cause slips, eg build-up of leaves, wet grass, moss, mud etc? Are paths prone to ice build-up during winter months? Tick if yes Suggested action Set up a regular work schedule for clearing paths, tackle busy routes first. Consider cutting back plants and trees that overlap paths. Consider alternative, safer routes. Monitor weather conditions and put a winter procedure in place, eg gritting. Are there any changes in level on the path that are not easy to see, eg small slopes? Are there holes, potholes, or uneven paving on footpaths/sides of paths? Are fire escapes slippery when wet? Highlight hazard improve lighting, apply contrasting eyecatching colour to slope (eg non-slip paint, flush-fitting bolt-on material). Barrier off area as a temporary solution, ensure barriers cannot be easily moved. Highlight hazard, eg improve lighting, use eye- catching colour on defective area as a temporary solution. Maintenance required fill in holes, re-lay paving, replace broken paving stones. Improve grip consider applying slip-resistant coating/strips or bolt-on slip-resistant material (caution do not create a trip hazard). Doorway Is the floor between the building threshold (entrance) and the entrance matting slippery when wet? Entrances Is there water on the floor from rain etc? Is it making the floor slippery? Are there any trip hazards in the area, eg trailing cables, deliveries, mats with curled up edges, or other objects? Improve grip consider extending mat or exterior paving, applying slip-resistant coating/strips or changing to more slip-resistant material. Stop water entering building construct canopies over entrances, improve external drainage, keep doors closed when you can. Prevent water spreading fit large and absorbent entrance mats to dry shoes. Remove water quickly review cleaning system, introduce dry mopping, consider introducing heaters/underfloor heating to speed up drying time. Improve grip consider fitting slip-resistant flooring. Housekeeping needed tidy away cables, provide safe delivery storage area, clear away boxes and equipment, fix down mat edges or replace if necessary. Corridors and offices ISSUE 4 MARCH

16 Potential issue Are there any subtle changes in floor level, eg slopes, small steps, abrupt changes from one flooring material to another? Are the floors smooth in areas where contamination can be found on the floor (eg liquids, food and food wrappers, dusts, polythene, condensation etc?) Are the tiles or flooring becoming unstuck or curling at the edges? Are there holes? Is the anti-slip floor coating or grip tape worn smooth or damaged? Are there any trip hazards around workstations or in corridors and walkways, eg trailing cables, boxes, deliveries, equipment or other objects? Are light levels too low to see the floor surface clearly? Is light reflecting on the smooth flooring creating glare? Tick if yes Suggested action Highlight hazard improve lighting, use eye-catching colour on slope/step, clearly highlight change from one flooring material to another. Stop contamination from getting onto floor provide bins for litter, fix leaks, fit lids on containers, close doors leading from working areas. Prevent spreading drip trays beneath plants/ machines/water coolers. Remove contamination quickly review cleaning system, spot clean spills, dry mop large wet areas, vacuum/brush up dry materials. Is flooring regularly monitored. Maintenance required fix down tiles and carpet edges, replace if necessary, fill in holes, replace cracked tiles. Maintenance required replace damaged and worn coatings. Consider changing flooring. Housekeeping needed keep walkways clear, tidy away or use cable covers, provide additional storage, clear away boxes and equipment. Improve lighting new bulbs, additional lights. Improve lighting re-angle lights, install blinds or anti-glare grills or glazing films. Consider removing floor surface shine. Stairs and ramps Are step nosings (edge of step) hard to see, rounded, damaged or slippery? Are handrails available? Are they easy to reach and useable? Is the height (rise) of the steps or depth of tread (going) inconsistent throughout the flight? Check lighting is sufficient to see step edges clearly. Highlight the very edge of the step with a nosing that has a high visibility, square edge and non-slip finish. For difficult to replace round-edged nosing, ensure nonslip edging wraps right around the edge of the nosing. Provide a handrail on at least one side of the stairs; if flight of stairs is wider than 1 m, provide handrails on both sides and a third, middle handrail if 2 m or wider. Handrail heights should be between 900 mm and 1000 mm and be parallel to the pitch line (slope) of the flight of stairs. On landings where the handrail provides guarding the height should be 1100 mm. Recommendations for handrail shape, diameter and distance from wall can be found in the Building Regulations and British Standards. Highlight the problem, eg with warning notice. Correct the rise/going of the stairs so they are all of equal height. ISSUE 4 MARCH

17 Potential issue Tick if yes Suggested action Are the stair treads slippery? Thoroughly clean on a regular basis to remove contaminants. Replace stair covering with one with better slip resistance. Are any ramps or slopes in or around the workplace difficult to see? Highlight ramp with contrasting colour and check lighting levels. Improve grip consider fitting slip-resistant flooring. As with flights of stairs, consider providing handrails. Work areas and work platforms (eg kitchens, warehouses, storerooms) As part of the work process, is contamination (fluids, solids, dust, debris etc) getting onto the floor? Is the floor slippery? People spillages, overfilling containers, clearing waste off work surfaces onto the floor, discarding debris onto the floor. Machines leaks, overspray, spills, by-product. Process overspills, leaks, byproduct. Is condensation forming on the floor? Is condensation forming on overhead pipework and dripping onto the floor. Is the floor slippery? Is poor drainage causing a pooling of fluids on the floor? Cold store is there ice build-up on the floor? Is the floor slippery? Stop contamination from getting onto floor change system of work, improve work area layout, provide bins, dust extraction, lids on containers, reduce quantity of product in containers, fix leaking machinery. Prevent contamination spreading use drip trays, screens to stop splashes, good floor drainage, high- lipped sinks, bunding around machines. Remove contamination quickly spot clean spills, dry mop large wet areas, vacuum/brush up dry materials. Improve grip consider slip-resistant flooring; provide slipresistant footwear. Improve ventilation use extraction. Insulate overhead pipework. Improve grip consider slip-resistant flooring; provide slipresistant footwear. Improve floor drainage. Remove ice. Door maintenance check door closes and seals properly replace seals, fix door and frame. Prevent humidity, eg fit automatic doors, curtains, humidity controls. Consider supplying slip-resistant footwear. Are designated walkways unusable or partially blocked? Create a clear and even walkway through the workplace. Housekeeping needed tidy away cables, provide additional storage, clear away clutter, boxes and equipment, safely store pallets. Are walkways uneven, do they have holes or missing tiles? Barrier off area as a temporary solution, ensure barriers cannot be easily moved. Highlight hazard, eg improve lighting, use eye-catching colour on defective area as a temporary solution. Maintenance required fill in holes, relay/replace defective flooring. ISSUE 4 MARCH

18 Potential issue Are there any raised carpet edges or holes? Tick if yes Suggested action Firmly stick down raised or loose edges. Maintenance required replace all or damaged section of carpet. Are the tiles or flooring becoming unstuck or curling at the edges? Firmly stick down loose tiles and raised edges. Maintenance required replace all or damaged section of flooring. Are there any trip hazards around workstations, eg trailing cables, boxes, deliveries or other objects? Encourage a see it, sort it mentality among staff. Housekeeping needed keep walkways clear, tidy away or use cable covers, provide additional storage, clear away boxes and equipment. Are light levels too low to see clearly? Is light bouncing off the flooring creating glare? Is water getting onto the floor? Is the floor slippery when wet? Improve lighting new bulbs, re-angle, additional lights, install antiglare grills. Stop glare consider removing floor surface shine. Toilets, bath and shower rooms Stop water getting onto the floor improve shower curtains/screens, position sufficient hand dryers close to sinks. Remove water quickly regular monitoring, spot clean, dry mop wet areas. Improve floor drainage where possible. Improve grip consider fitting slip-resistant flooring. Are taps or pipes leaking? Prevent contamination spreading provide drip trays as a temporary solution. Maintenance required fix leaks and taps. Cleaning Are spillages left on the floor for some time before they are cleaned up? Encourage a see it, sort it mentality among staff. Ensure spills cleaning equipment is readily available for use. Review/improve cleaning regime and timings of cleaning schedule. Consider introducing a roving cleaner. Are small spills wet mopped? Spot clean small spills using absorbent cloth/paper towel. Provide training and then supervise. Ensure spills cleaning equipment is readily available for use. Can people walk through areas during wet mopping or when floors are still wet? Is the floor smooth or slippery when wet? Are warning signs left out long after the spill has gone and floor has dried? Keep people off smooth wet floors Barrier off/close off areas, wet mop out of hours when no-one is around. Reduce drying time dry mop the floors with a clean, proprietary dry mop. Remove cones and signs as soon as cleaning is completed and floor is dry. Provide training and then supervise. ISSUE 4 MARCH

19 Potential issue Does the floor look dirty even though it has just been cleaned? Are people slipping on the floor even though it has been cleaned and is dry? Tick if yes Suggested action Check manufacturers /suppliers cleaning instructions are being followed. Review floor cleaning method, alter to suit floor type. Provide training on new method and then supervise. Thoroughly clean to remove build-up of polish, grease etc. Review and alter floor cleaning method. Provide training on new method and then supervise. Can cleaning equipment leads be seen crossing or blocking walkways, creating a trip hazard? Coil up unused equipment cable. Change power source provide additional power sockets; use socket nearest area being cleaned. Consider change to battery-powered equipment. Provide training on new method and then supervise. Do bin bags/cleaning equipment in walkways create trip hazards? Provide training on awareness of trip hazards and how to avoid them and then supervise. Tasks Do tasks stop people seeing slip or trip hazards, eg carrying items that restrict view, upset people s balance, rushing? Review and improve manual handling and moving procedures. Review work activity. Risk Assessment Are slips and trips identified as hazards within specific activity risk assessments? Consider slips and trips as hazards within activities you risk assess. Implement appropriate controls to eliminate or reduce to lowest level possible. If any area on the Check list has been ticked the issue may require risk assessing to ensure relevant controls are put in place if the issue cannot be immediately rectified. ISSUE 4 MARCH

20 APPENDIX 3 The Policy for: Preventing Slips, Trips and Falls (Including Falls From Height) Issue: 4 Status: Author Name and Title: APPROVED Ian Freegard, Trust Health & Safety Manager Issue Date: MARCH 2015 Review Date: MARCH 2018 Approved by: Distribution/Access: TRUST HEALTH AND SAFETY COMMITTEE Normal RECORD OF CHANGES DATE AUTHOR POLICY/ DETAILS OF CHANGE PROCEDURE Strengthen policy principles, duties, monitoring 08/2011 I Freegard compliance and to include Falls from Height. Amendments to include County Health Partnerships (CHP) and new Patients Post Falls Protocol 04/2012 I Freegard New Paragraph at 8.4. One other minor amendment at 01/2015 I Freegard (Issue 4) 8.5. Minor changes to Appendices 4 and 5. Removal of Patient Safety Risk Assessment Tool and amendments to Appendix 2 ISSUE 4 MARCH

21 EMPLOYEE RECORD OF HAVING READ THE POLICY APPENDIX 4 Title of Policy: Preventing Slips, Trips and Falls (Including Falls From Height) I have read and understand the principles contained in the named policy. PRINT FULL NAME SIGNATURE DATE ISSUE 4 MARCH

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