SLIPS, TRIPS AND FALLS POLICY

SLIPS, TRIPS AND FALLS POLICY First Issued Issue Version Purpose of issue/description of change Planned Review Date 2 Root cause analysis (RCA), RIDDOR August 2012 and inspection of communal areas referenced Named Responsible Officer Approved By Date Health & Safety Advisors Health Safety & Welfare Committee September 2010 Policy File:- Health & Safety Impact Assessment Screening Complete- Date Full Impact Assessment Required- HS25

NHS WIRRAL SLIPS, TRIPS AND FALLS POLICY Contents: 1. Introduction 2. Policy Statement 3. Strategy for Compliance 4. Responsibilities 4.1 Chief Executive and Heads of Service 4.2 Managers 4.3 Head of Capital Projects & Premises Management 4.4 Employees 4.5 H&S Advisor 5. Management of Slips, Trips and Falls 6. Clinical and Workplace Risk Assessments 7. Recording 8. Monitoring Related Documentation Appendix 1 Slips, Trips and Falls - Likely Causes Appendix 2 Managing Risk of Slips, Trips or Falls Appendix 3 Good Housekeeping Guidelines 2/12

1.0 INTRODUCTION The Management of Health and Safety at Work Regulations, in accordance with the Health and Safety at Work Act, include duties for people in control of workplaces to assess the risks (including slips, trips and falls) associated with workplace environments. A risk assessment is also a requirement under the Work at Height Regulations 2005, where there is a potential risk of falls from height. They require appropriate arrangements for effective planning, organisation, control, monitoring and review of any measures to safeguard health and safety. The Workplace (Health, Safety and Welfare) Regulations also require that floors and surfaces are, so far as is reasonably practicable, suitable for purpose and do not expose persons to risk. 2.0 POLICY STATEMENT NHS Wirral recognises its responsibilities under Health and Safety legislation and the duty to provide, so far as is reasonably practicable, working environments that are safe and healthy for all employees, contractors, voluntary workers, visitors and members of the public. NHS Wirral will endeavour to protect staff and other persons, to whom it has third party liability, from the effects of slips, trips and fall hazards and risks, by good management and risk assessment. 3.0 STRATEGY FOR COMPLIANCE NHS Wirral will manage the risks from slips, trips and falls in the same manner as for other risks i.e. Step 1 Step 2 Step 3 Identify the Hazards By looking around the workplace / domestic environment (including outdoor areas) for anything that may be a slip or trip hazard, such as poor floor surfaces, etc. See Appendix 1 Decide who might be Harmed and How By considering who will come into the workplace and whether they are at risk. Those at greater risk than others e.g. those with a disability, the elderly, young or infirm may require special consideration. Evaluate the Risk By considering the precautions already in place and assessing whether they adequately deal with the risks. See Appendix 2 Managing the Risk of Slips, Trips or Falls 3/12

Step 4 Step 5 Record the Findings Using NHS Wirral Risk Assessment process and form HS9(1) Review Assessment from Time to Time If there is any significant change, the risk assessment must be reviewed to evaluate whether precautions are still adequate. Assessments must always be reviewed after an accident or incident involving slips, trips or falls or a near miss with the potential to have caused an accident. 4.0 RESPONSIBILITIES 4.1 Chief Executive and Heads of Service Responsibilities Ensure the effective implementation of this policy Allocate sufficient resource to enable the policy to be delivered Monitor the overall effectiveness of the policy 4.2 Managers Responsibilities Ensure assessments include the risk of slips, trips or falls occurring Monitor the effectiveness of existing controls and implement any further controls agreed as a result of assessment Include inspection of the workplace within local safety inspection regimes Thoroughly investigate accidents and incidents involving slips, trips and falls and use any reports of near misses to determine and address potential risk. 4.3 Head of Capital Projects and Premises Management / Office Services / Business Support Manager Community Clinics Organise and oversee any necessary remedial action required to address significant slip or trip hazards on NHS Wirrral premises involving SLA agreements with CWP Estates or other contractors e.g. for repairs/ gritting etc. Ensure that arrangements are in place for the cleaning and maintenance of internal floor surfaces Ensure that periodic inspections of external areas and internal communal areas are undertaken, recorded and actioned to reduce the risk of slips, trips and falls 4.4 Employees Responsibilities Co-operate with their manager in undertaking workplace or clinical assessment, as appropriate, to determine the risk of slips, trips or falls Comply with the control measures identified in risk assessments Report to their line manager any concerns regarding slip, trip or fall hazards 4/12

Take care of their own health and safety and not place others at risk of slips, trips or falls by what they do or fail to do e.g. by cleaning up spillages immediately and ensuring that hazard signs are in place if appropriate Wear footwear which is appropriate to their workplace and role Participate in the slip, trip and fall monitoring process 4.5 Health & Safety Advisor Responsibilities Monitor accident / incident trends with regard to slips, trips and falls Provide training and advice in the prevention of slips, trips and falls Provide assistance as required with workplace or community risk assessments and inspections 5.0 MANAGEMENT OF SLIPS, TRIPS AND FALLS 5.1 Planning NHS Wirral will introduce systems which will:- Identify priorities and set targets for improvement Remove risks or minimise them by using control methods. See Appendix 3. 5.2 Organisation Secure progressive improvement in reducing slips, trips and falls by:- Involving and gaining the commitment of staff Giving individuals responsibilities to ensure their areas are kept clean and tidy Recording arrangements and making details clear to everyone 5.3 Control Ensure health and safety by :- Identifying individuals most at risk Checking work processes are being carried out correctly Keeping records of cleaning and maintenance work Carrying out hazard spotting inspections 5.4 Monitoring and Review To achieve progressive improvement :- Review the approach in the light of experience; look at accident investigation and inspection reports. Do they show improvement? Discuss slip and trip risks with safety representatives. Re-train staff if required and read available policies and strategies 5/12

Always review clinical and workplace risk assessments after reports of slips, trips or falls. 6.0 CLINICAL AND WORKPLACE RISK ASSESSMENTS If the fall involves an older person and it is suspected that the fall was not due to an environmental hazard alone, consideration should be given to carrying out a falls risk assessment. A clinical falls risk assessment should be completed for individuals who have fallen, or who may have the potential to fall and recorded on the necessary Falls Risk Assessment form (see Falls Risk Assessment) Workplace / environment risk assessments should consider the potential hazards associated with slips, trips and falls e.g. floor covering, lighting, trailing wires etc. and identify the control measures required to eliminate, reduce or control such risk. 7.0 RECORDING Slips, trips and falls must be reported and investigated according to the Accident / Incident Reporting Policy. NHS Wirral s Accident / Incident Form must be used and a score allocated according to the risk profile matrix. Near misses associated with slip, trip and fall hazards must always be reported and investigated in the same manner so that NHS Wirral can address the cause(s) and reduce the likelihood of an accident happening. Lessons learnt from slip, trip or fall incidents arising out of a workplace or activity, the control measures put in place and updated risk assessment must be communicated to employees and other appropriate persons having access to the workplace. Lessons learnt from slip, trip or fall incidents involving patients (clinical risk), including updated risk assessments, must be shared with employees involved in their care. As appropriate and to aid learning, information should also be shared across other service areas. 8.0 MONITORING All accidents and incidents are monitored by the Provider Services Governance Group; any slip, trip or fall incidents which are not deemed to have been managed appropriately are subject to further investigation by this group. Slip, trip and fall accident /incident trends are monitored by the Health, Safety and Welfare Committee. 6/12

Any slip, trip or fall accident resulting in a reportable injury top the HSE under the Reporting of Injuries Diseases or Dangerous Occurrences Regulations (RIDDOR) will be subject to a Root Cause Analysis (RCA) Related Documentation: Falls Risk Assessment Falls Screening Tool Falls Procedure (GP21) 7/12

Appendix 1 Slips, Trips and Falls Likely Causes Slip, trip and fall accidents may have different causes, but often have the same result. By looking at the contributing factors separately, it is possible to work out more accurately the cause of the slip or trip accident. A. Slip Hazards Spills and splashes of liquids and solids Wet floors (following cleaning) Unsuitable footwear Rain, sleet and snow, ice Change from a wet to dry surface (footwear still wet) Unsuitable floor surface/covering Dusty floors Sloping surfaces B. Trip Hazards Loose floorboards/tiles Uneven outdoor surfaces Holes/cracks Changes in surface level- ramps, steps and stairs Cable across walking areas Obstructions Bumps, ridges and protruding nails etc Low wall and floor fixtures- door catches, door steps Electrical and telephone socket outlets C. Fall Hazards Staff not trained in moving and handling patients Over reaching Climbing on furniture Rushing down steps/stairs, faulty or unsuitable equipment Ladders Faulty equipment D. Factors which Increase Risk Patients assessed to be at increased risk of falling, moving around unsupervised in own home or service area Untrained staff Risk assessments not carried out regularly Poor or unsuitable lighting Wrong cleaning regime/materials Moving goods/carrying/pushing or pulling a load Rushing around Distractions/fatigue Effects of alcohol Drugs and Medications 8/12

Appendix 2 Managing the Risk of Slips, Trips and Falls There are many simple measures that can be taken to reduce or eliminate slip, trip or fall risks. The following table gives some suggestions. HAZARD SUGGESTED ACTION Spillage of wet and dry substances Bodily fluids Untrained staff or lack of continuous training of staff Clean up spills immediately. If a liquid is greasy, ensure a suitable cleaning agent is used After cleaning, the floor may be wet for some time. Use appropriate signs to tell people the floor is still wet and arrange alternative bypass routes. Trained staff must be used to carry out the required duty, i.e. moving and handling of patients, in-service training should be made available to staff. No risk assessments Risk assessments should be done at regular intervals, also incidents must be reported and control measures put in place. Miscellaneous rubbish, for example plastic bags Patients left unsupervised Slippery surfaces Keep area clear, remove rubbish and do not allow to build up. Patient movement must be monitored at all times and activities supervised Access the cause and treat accordingly, with appropriate cleaning method, regime/material. Poor lighting Improve lighting levels and placement of light fittings to ensure more even lighting of all floor areas Changes of level Improve lighting, add apparent tread nosings. Slopes Improve visibility, provide handrails, and use floor markings Unsuitable footwear Ensure patients and employees choose suitable footwear, particularly with the correct type of sole. 9/12

Appendix 3 Good Housekeeping Guidelines Work Place Conditions 1. Get workplace conditions right in the first place. It will make tackling slip and trip risks easier. Choose the right floor surfaces and suitable lighting, properly plan pedestrian and traffic routes and avoid overcrowding. All these are important. Good Housekeeping 2. Good housekeeping is important in preventing hazards and applies as much to wards, offices and other premises/facilities provided by the PCT and workshops, etc. Keep work areas tidy. It will create a better working environment and mean fewer accidents. Training 3. Properly train workers, particularly in the correct use of any safety and cleaning equipment provided, and clearly state who is responsible for what; this will help to minimise risks. Cleaning Equipment, Materials and Methods 4. Ensure that cleaning methods and equipment are suitable for the type of surface being treated. These depend on several factors, such as the type of use and location and will have been identified in the risk assessment. Take care not to create additional slip and trip risks, for example from residues not properly removed from a surface. Encourage the use of scrubber dryers. Maintenance Programmes 5. A proper programme of maintenance will ensure that the steps you have taken remain effective. Repairs 6. Necessary maintenance and repairs must be carried out. Cleaning Activities 7. While cleaning and maintenance work is being carried out, take care to avoid creating hazards. Fence off wet surfaces until dry, take care with trailing leads from cleaning equipment, and if possible carry out cleaning and maintenance during quieter hours. 10/12

A good system of maintenance ensures that: 8. a) maintenance (including inspection, testing, adjustment and cleaning) is carried out at suitable intervals (e.g ladder/steps/step stool checks) b) dangerous defects are corrected and access to faulty equipment or hazardous areas is prevented in the meantime. c) suitable records are kept so that the system can be monitored. 9. Lighting should enable people to see obstructions on the floor, potentially slippery areas etc. So they can work safely. Replace, repair or clean lights before the lighting levels become insufficient for working. 10. Arrange lighting and light fittings so they do not create dazzling light or glare that can make it difficult to see. Ensure light levels are not reduced, for example by goods stacked in such a way as to block light or cast shadows. 11. Local lighting should always be provided at staircases and changes of level; it is usually also needed at ramps where there is no change in colour, texture or flooring material from level walkway to ramp. Flooring 12. Poor floor conditions are a major cause of slips and trips. Regular checks should be made for loose floor finishes, holes and cracks in surfaces, loose and worn out rugs and mats, etc. 13. Even a good surface will become dangerous in certain conditions, for example if liquids are spilt onto it. However, where they do occur they should be cleaned up immediately or the area fenced off to make people aware until they can be cleaned up. Where the floors are unavoidably wet or dusty through work activity, take special care in the choice of floor coverings or floor surface. Obstructions 14. Failure to tidy up properly and objects left in walk ways can easily go unnoticed and cause a fall. Where it is not possible to remove obstacles, take precautions to reduce the risk of accident by preventing access. Or warning people of the dangers, for example by using warning signs or hazard cones. Footwear 15. While much can be done to reduce hazards, there will often be some remaining risk. An important second line of defence will be to ensure people have the right footwear. 11/12

Version Control Sheet Version Number Date of Removal Author Name Status Live/outdated Shredded Yes/No Replacement Number Comments Signature 1 Beryl Walker/ Amanda Adams 12/12