SLIPS, TRIPS AND FALLS POLICY (STAFF) HEALTH & SAFETY POLICY HS25. Version 1 Date Issued January 2012 Review Date January 2013

SLIPS, TRIPS AND FALLS POLICY (STAFF) HEALTH & SAFETY POLICY HS25 Version 1 Date Issued January 2012 Review Date January 2013 Policy Author Risk Advisor: Approved by Quality & Governance Committee Date Approved April 2012

CONTENTS Section Page 1 Introduction 3 2 Purpose 3 3 Definitions 3 4 Responsibilities 4 5 Workplace Risk Assessments 8 6 Recording 9 7 Employees Training 9 8 Monitoring 10 9 References 10 10 Related Policies 11 Appendices Appendix 1 Generic Workplace Risk Assessment Form 12 Appendix 2 Managing the Risks of Slips, Trips and Falls 19 Appendix 3 Process for Monitoring Compliance with the Procedure for Slips, Trips and Falls 21 Appendix 4 Community Workers Home Environment Risk Assessment 23 Appendix 5 Home Environment Risk Assessment Flowchart 27 Appendix 6 Risk Assessment in the Home Environment Checklist 28 2/28 HS25 Slips Trips and Falls Policy (Staff) - Version 1

WIRRAL COMMUNITY NHS TRUST SLIPS, TRIPS AND FALLS POLICY 1. INTRODUCTION Wirral Community NHS Trust recognises its responsibilities under Health and Safety legislation and the duty to provide, so far as is reasonably practicable, working environments that are safe for all employees, patients contractors, voluntary workers, visitors and members of the public. 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. PURPOSE The purpose of this policy is to provide information and guidance on the management of slip, trip and fall risks within the Trust. This policy supports the Health and Safety Policy by detailing particular arrangements for the management of factors leading to slips, trips and falls. The risk identification and management process (GP45) details the risk assessment process to be followed in relation to the management of risks associated with slips trips and falls 3. DEFINITIONS A fall is an event which results in an individual or a body part of the individual coming to rest inadvertently on the ground or other surface lower than the individual, whether or not an injury is sustained (Cohen & Guin; 1991). A slip is a slide accidentally causing the individual to lose their balance, this is either corrected or causes an individual to fall (Adapted from COED 2000). A trip is to stumble accidentally often over an obstacle causing an individual to lose their balance, this is either corrected or causes an individual to fall (COED 2000). A place is at height if a person could be injured falling from it, even if it is at or below ground level (except by a staircase in a permanent workplace) 3/28 HS25 Slips Trips and Falls Policy (Staff) - Version 1

Work includes moving around at a place of work but not travel to or from a place of work. 4. RESPONSIBILITIES Committees 4.1 The Board of Directors The Board of Directors will: Review risks and associated action plans that have been escalated by the Quality and Governance Committee. Review risks and associated action plans relating to slips trips and falls for mitigation or reduction in the level of risk which score 15 or above using the Trust risk scoring matrix (Appendix 2) 4.2 Quality and Governance Committee The Quality and Governance Committee will: Receive assurance that Wirral Community NHS Trust meets all relevant statutory and regulatory obligations in relation to Health Safety, quality, clinical governance and compliance through its reporting and monitoring structures Advise Wirral Community NHS Trust Board of all significant risks, areas for development and exceptional good practice, ensuring lessons are learned and shared 4.3 Quality, Patient Experience and Risk Group In particular, the Quality, Patient Experience and Risk Group will: Review and monitor any service level risks scoring 12 and above and escalate risks which score 15 or above when appropriate to the Quality and Governance Committee Distribute risk flyers if required to raise awareness around risks and or incidents categories 4.4 Health Safety and Wellbeing Group The Health Safety and Wellbeing Group will: Monitor Wirral Community NHS Trust s Health, Safety and Wellbeing Strategies, action plans and performance. Review new legislation and guidance Provide advice on health, safety and wellbeing policies and approve these for endorsement by the Quality and Governance Committee 4/28 HS25 Slips Trips and Falls Policy (Staff) - Version 1

Review accidents and incidents which have an impact on employees and non-employees and the environment Raise awareness of any significant risks within the organisation and ensure these are included on business or corporate risk registers as appropriate Develop initiatives for Health, Safety and Wellbeing promotion throughout the organisation including slips, trips and falls prevention. Review HR KPIs including sickness absence and Occupational Health reports Receive and review reports from Occupational Health provider Monitor effectiveness of Health, Safety and Wellbeing policies Receive regular performance assurance reports from all services including evidence of: o compliance against policies and standards o inspection regimes o any other areas where the Group requires assurance or to report performance or compliance Provide advice on proposals to improve the workplace and link to other groups as appropriate e.g. Infection Control. Consider specific issues relating to health, safety or the wellbeing of employees which cannot be addressed through management structures Review reports from other internal or external committees / groups if appropriate Work with external organisations to share and learn from best practice Receive assurance of the Trust s response to reports from external agencies, including the Health and Safety Executive and Environment Agency Raise employees awareness of benefits available to them to promote their wellbeing 4.5 Service/Divisional Governance Committee The Service/Divisional Governance Committee which will: Discuss, agree and monitor action plans for risks belonging to their service. Ensure significant risks are recorded using the service risk register Escalate risk issues which score 12 or above using the Trust risk matrix to the Quality, Patient Experience and Risk Group. Review incidents, complaints and claims which occur in the service Discuss audit findings and implementation of action plans 4.6 Chief Executive The Chief Executive has the overall accountability for the implementation and review of this policy. The Chief Executive has the ultimate responsibility of ensuring that the Trust has adequate arrangements in place to reduce the risk from slips, trips or falls accidents in the Trust. 5/28 HS25 Slips Trips and Falls Policy (Staff) - Version 1

4.7 Divisional Manager/Service Lead Responsibilities These members of staff are responsible for: Ensuring that the Trust s Slips, Trips and Falls Policy is implemented within their area of control Planning the capital investment required to address matters arising from risk assessments undertaken Ensuring risk assessments encompass the risk of slips, trips and falls and working at heights for environments where employees may be working and that employees for whom they are responsible are aware of these risks Ensuring employees awareness of this policy and their responsibilities and also ensuring that employees receive training appropriate to the risks involved Ensure all employees within their service receives suitable training, information and instruction on falls prevention Enforce the Dress and Uniform policy within their areas of responsibility and take appropriate action to ensure compliance Monitor compliance with relevant risk assessments and safe systems of work designed to reduce the risk of slips, trips and falls Include inspection of the workplace within local safety inspection regimes 4.8 Managers Responsibilities Managers are responsible for: Ensure assessments include the risk of slips, trips or falls occurring are completed 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. Ensure leaks and other defects, which may result in a person, slipping, tripping or falling are promptly reported and the area is made safe Ensure all relevant rules, procedures relating to slips, trips and falls are brought to the attention of and made available to the employees under their control and that appropriate warning notices and all instructions are prominently displayed 4.9 Head of Estates / Office Services / Business Support Manager Community Clinics In addition to the responsibilities of the managers as outlined in earlier sections, the Head of Estates, Office Services and Business Support Manager Community Clinics are responsible for: Ensuring floor surfaces replaced or newly fitted as part of a modification, extension or new build comply with standards of slip resistance/surface roughness 6/28 HS25 Slips Trips and Falls Policy (Staff) - Version 1

Ensuring adequate control of contractors to ensure potential hazards associated with their work that may cause persons to slip, trip or fall are eliminated where possible or are adequately controlled Ensuring sufficient arrangements are in place to deal promptly with leaks and other defects which may cause a person to slip, trip or fall Ensuring slip, trip fall accident and incidents in common areas are promptly reported and, where appropriate, properly investigated; also ensuring appropriate action is taken and recorded Ensuring sufficient arrangements are in place to regularly inspect both internal and external common areas of the Trust, identifying hazards, which may cause a person to slip, trip or fall. Records of inspections and any action taken to be recorded Ensuring cleaning regimes are adequately risk assessed and sufficient safety equipment is provided for employees so they may comply with the preventative and protective measures designed to reduce slips trips and falls (See Appendix 2) Assisting the Trust Health & Safety Advisor with flooring risk assessments in common areas (See Appendix 2) and the development and review of a slip, trip and falls action plan Monitoring compliance with relevant risk assessments Ensuring that arrangements are in place for gritting of external areas in the event of adverse weather conditions 4.10 Employees Responsibilities All employees have a general duty to take reasonable care of their own safety and that of others who may be affected by their actions, which includes the prevention of the risk of slips, trips and falls to patients, other employees and visitors alike. All employees must further ensure that they: Co-operate with the Trust to enable it to meet its obligations in respect of the management of slips, trips and falls Be vigilant and ensure any slips and trips hazards that they are aware of are reported to their Line Manager as a minimum requirement Appropriately clear up any spillages and use appropriate signage to warn people of hazards and/or arrange for the spillage to be cleared to take remedial action to protect themselves and others from injury Complete the Trust incident reporting form where an incident or near miss occurs, as detailed in the Incident Reporting Policy Undertake all necessary risk assessments and keep them up to date Attend health and safety training, including refresher and update courses as identified in the training needs analysis Wear suitable footwear for the workplace and working environment 4.11 Health & Safety Advisor Responsibilities The Health and Safety Advisor is responsible for: 7/28 HS25 Slips Trips and Falls Policy (Staff) - Version 1

Liaising with Head of Estates to ensure flooring is either replaced or newly fitted as part of a modification or extension and that any modification or new build complies with the surface roughness Assisting Head of Estates to ensure adequate control of contractors to ensure potential hazards associated with their work that may cause persons to slip, trip or fall are eliminated where possible or adequately controlled Assisting Services with the risk assessment process and development of safe systems of work to ensure the risk of slips, trips and falls is eliminated or reduced Ensuring all major injuries resulting from slip, trip, fall type accidents are promptly investigated within 25 working days, appropriate action is taken and any action taken is recorded and the Health & Safety Executive are notified as per the requirements of the Reporting of Injuries, Diseases or Dangerous Occurrences Regulations (RIDDOR) Monitoring accident and incident statistics relating to slips, trips and falls and advise management of ways of reducing slips, trips and falls Ensuring sufficient arrangements are in place to regularly inspect common areas of the Trust, identifying hazards which may cause a person to slip, trip or fall and records of inspection and actions taken are recorded Assisting Head of Estates with flooring risk assessments in common areas and the development and review of a slip, trip and falls action plan Raising awareness of slips, trips and falls through Health and Safety Committees, awareness days, safety campaigns and other forums 5. WORKPLACE RISK ASSESSMENTS The Management of Health & Safety at Work Regulations 1992 emphasise the need for the employer to carry out risk assessments and to have effective control measures in place to reduce the likelihood of accidents, including slips trips and falls, to employees and others. They also include the need for effective planning, control measures and a continuous monitoring and review process that evaluates the measures that have been adopted to reduce the risks. Full details of the risk assessment process can be found in GP45 Procedure for Risk Identification and Management. 5.1 Risk Assessment and Prevention Measures In order to ensure that, wherever possible, slips, trips and falls are prevented; managers should undertake, as a minimum, the following requirements for the Service or area that they are responsible for: Identify potential slip, trip and fall hazards relating to activities carried out within their areas of responsibility and the precautions to be taken, through the risk assessment process using the trust Generic workplace risk assessment form for premises utilised by Community employees (see Appendix 1) using the guidance in Appendix 2.. For those employees that deliver care in the patients own home the generic home risk assessment form (Appendix 4) should be completed according to the process outlined (Appendix 5).using the home environment checklist as a guide (Appendix 6) 8/28 HS25 Slips Trips and Falls Policy (Staff) - Version 1

It is responsibility of the Head of Estates management to ensure the appropriate risk assessments are in place in relation to contractors who are engaged to complete work on our behalf. The Control of Contractors Policy (HS16) details the management arrangements in place for the control of contractors including the review of method statements, risk assessments to ensure potential hazards associated with their work that may cause persons to slip, trip or fall from height are eliminated where possible or are adequately controlled 6. RECORDING Slips, trips and falls incidents and near misses must be reported and investigated according to the Accident / Incident Reporting Policy GP 8 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 including updated risk assessments, must be shared with employees as appropriate and to aid learning, information should also be shared across other service areas. 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 further analysis. 7. EMPLOYEES TRAINING Slips, trips and falls training is incorporated into the Trust s training needs analysis which includes the Essential Learning programme for both clinical and non-clinical employees (Bands 1-6). The frequency of attendance for Refresher Mandatory Training for all employees groups is detailed in the Trust s core mandatory training matrix approved by the Education and Workforce Committee. Slips, trips and falls training for employees includes the following: Reference to the Dress and Uniform Policy and importance of wearing the correct footwear Importance of ensuring local spillage procedures are in place Importance of reporting of defects in floor surfaces Importance of reporting of accidents and near misses Accident investigation process All core mandatory training is recorded centrally by the Quality and Governance Service. Quarterly monitoring reports are prepared for the Learning and Development Group to monitor attendance rates. 9/28 HS25 Slips Trips and Falls Policy (Staff) - Version 1

Process for raising awareness To ensure, employees and others are made aware of the control measures in place to prevent or reduce slips trips and falls, awareness information is provided as required : Employees Through the Essential Learning programme Through local Induction Through Risk Flyers and initiatives highlighting key learnings Through Service Governance meetings Making employees aware of the findings of risk assessments and the controls that have been put in place By ensuring the findings of investigations are shared with the relevant employees Others Through the local induction process conducted by the member of staff responsible 8. MONITORING The effectiveness of this policy will be assessed by trend analysis of local incident reporting and follow-up action of slips, trips and falls incidents. Accident and incident reports will be analysed by the Health and Safety Advisor and quarterly reports presented to the Health, Safety and Wellbeing Group. The Health, Safety and Wellbeing Group will monitor and review this policy on a annual basis (or sooner in light of changes in legislation or practice). This will provide a measurement of performance and ensure adequate processes and structures are in place, as well as continuing compliance with statutory responsibilities. Services will be required to produce an annual service assurance report to The Health, Safety and Wellbeing Group detailing compliance against Health and Safety Risks. Full details of the monitoring process are outlined in Appendix 3 9. REFERENCES The Health & Safety at Work Etc Act 1974 The Management of Health & Safety at Work Regulations 1999 etc The Workplace (Health, Safety and Welfare) Regulations Health & Safety Executive Guidance: Preventing Slips and Trips at Work ING 225 The Work at Height Regulations 2005 (as amended) 10/28 HS25 Slips Trips and Falls Policy (Staff) - Version 1

10. RELATED POLICIES GP45 Procedure for Risk identification and Management HS16 Control of Contractors Policy GP8 Incident Reporting Policy 11/28 HS25 Slips Trips and Falls Policy (Staff) - Version 1

Appendix 1 Generic Workplace Risk Assessment Form Location/Activity: Assessment date: Assessor: Signature: Review date: Ref Hazards Risks People at risk Current Control Measures L x C = R Is further action required (Y/N) Damaged floor surfaces Falls resulting in minor injuries requiring first aid treatment in isolated cases broken bones Clinic Employees Services users including those with mobility problems Children. Monthly workplace inspection carried out by clinic employees http://nww.wirral.nhs.uk/document_upload s/health_and_safety/monthlysafetycheck s.pdf Defects reported to estates for action Cleaning regime in place warning notices positioned when required http://www.wirral.nhs.uk/document_upload s/policies_hs/hs25slipstripsfallspolicya pr08.pdf First Aid First aiders / emergency first aiders appointed and First aid boxes located in clinic http://www.wirral.nhs.uk/document_upload s/policies_hs/hs12_firstaidpolmay09.pdf 12/28

Ref Hazards Risks People at risk Current Control Measures L x C = R Is further action required (Y/N) Manual Handling of office equipment and consumables Musculoskeletal injuries resulting in back pain from handling heavy objects Clinic Employees Employees attend half day manual handling course and every three years/ Storage of materials to ensure light objects at high level Use equipment if provided for lifting and carrying eg trolleys http://www.wirral.nhs.uk/document_upload s/policies_hs/hs3manualhandlingpolicy October2008.pdf Display Screen Equipment Posture problems and pain, discomfort or injuries to hands and arms from improper use, incorrectly set up workstations. Headaches and sore eyes from work environments eg poor lighting, glare etc Clinic employees DSE users identified and assessments completed by DSE assessor. Advice provided to DSE users either during assessment or DSE user course Assessments reviewed when there are changes to the workstation or user issues Eye tests provided to those who need them Employees advised to take regular breaks/change of activity every 50-60 mins Employees who identify health issues associated with DSE use are referred to OH http://www.wirral.nhs.uk/document_upload s/policies_hs/hs17_dse_policy_april200 9v3.pdf 13/28

Ref Hazards Risks People at risk Current Control Measures L x C = R Is further action required (Y/N) Electrical Shock, burns from faulty electrical equipment. Fire Clinic employees Estates conduct annual PAT on electrical equipment. No personal electrical equipment to be used without prior PAT test by estates Visual checks conducted by users to identify any faults Clinic employees to report damaged, faulty equipment to estates. Electric panel cupboard to be kept locked at all times Regular inspection conducted of electrical installation by estates Gas Fire, leaks, CO poisoning Boiler and gas installation checks carried out. Emergency shut-off valve identified and local procedure for suspected gas leak in place Isolation identified in emergency plan for site Asbestos Clinic employees very low risk from exposure Maintenance workers at higher risk from lung related diseases if fibres released into air Clinic employees Estates Contractors Asbestos containing material identified with asbestos register (located with estates) Estates employees to check register prior to invasive work. Clinic Co-ordinators informed of location of asbestos. Work by contractors managed by estates details of asbestos identified within permit to work issued by estates. 14/28

Ref Hazards Risks People at risk Current Control Measures L x C = R Is further action required (Y/N) Fire Serious injury, fatality from smoke inhalation burns Cllinic Employees Service users including those with mobility problems Children Fire Safety Policy in place for the trust http://www.wirral.nhs.uk/document_upload s/policies_hs/hs10_fire_safety_policy_ April2009_v3.pdf Fire Risk assessment completed for the premises. Monthly fire warden checks conducted to ensure exits and fire escape routes clear Employees undergo annual fire safety training Fire wardens appointed and undergo regular training Program of regular maintenance in place for Fire extinguishers, emergency lighting, fire alarm. Program of weekly fire alarm call point testing in place Fire evacuation drills conducted annually All the above information kept within fire log book. Water systems Legionnaires disease Scalding Clinic Employees Service users http://www.wirral.nhs.uk/document_upload s/policies_hs/hs22%20control%20of%20 Legionella%20Policy%20April%202009%2 0v2.doc Legionella risk assessments in place for premises owned and managed by NHS Wirral. CWP estates inspect, maintain and test water systems including schedule of water temperature testing Flushing of infrequently used outlets e.g. showers. Wash hand basins etc by occupants. Thermostatic mixing valves (TMV) to reduce supply temperature in patient areas. Maintenance checks in place by Estates 15/28

Ref Hazards Risks People at risk Current Control Measures L x C = R Is further action required (Y/N) Lone Working Injury or ill health Clinic Employees Lone working policy and local lone working procedures http://www.wirral.nhs.uk/document_upload s/policies_hs/hs6_lone_working_policy April2009v3.pdf Lone worker checklists completed by employees working in the community Employees attend conflict resolution training. Reception desks with security screening in place. CCTV located in.. Panic alarm situated. Incidents reported to LSMS for review and further investigation Working at Height Falls from any height can cause bruising and fractures Clinic Employees Stepladders/ kick stools used to access high shelves are regularly inspected (6monthly) and tagged. Defective items are removed from service. http://nww.wirral.nhs.uk/document_upload s/health_and_safety/stepsandstepladder InspectionandTaggingProcedureAug07.pdf Clinical Waste & Sharps Infection, needlestick injuries Clinic Employees Service Users Contractors Infection Control http://www.wirral.nhs.uk/plans_policies_pu blications/policies/infection_control.html Sharps are disposed of according to waste policy Sharps Policy Clinical waste bins and sharps boxes are located in Waste segregation and identification Clinical waste is stored in a secure area located.. Clinical waste is collected on a weekly basis 16/28

Ref Hazards Risks People at risk Current Control Measures L x C = R Is further action required (Y/N) Substances Hazardous to Health (cleaning products, body fluids, substances used for clinical procedures, latex) Toxic, irritant, harmful, corrosive Clinic Employees Service Users Contractors COSHH policy http://www.wirral.nhs.uk/document_upload s/policies_hs/hs7_coshh_policy_april_ 2009v3_2_070409.pdf COSHH register, material safety data sheets and assessments are available for chemicals used within clinics Appropriate storage and disposal arrangements are in place for chemicals Personal protective equipment is provided as outlined in the assessment. Spillage kit located centrally within clinic areas and employees trained in use Compressed Gases Asphyxiation, O2 enrichment, Fire, Musculoskeletal injuries Clinical Employees Service Users Contractors Training for employees using compressed gases Number of gas bottles within building is limited Gas bottles store upright and secured in position Rooms containing bottled gases identified on site plan and on doors External, secure storage area provided for bulk gases Gas bottle trollies used for movement of gas bottles Medical Devices Clinical incidents, infection Clinical Employees Service Users Medical Device policy http://www.wirral.nhs.uk/document_upload s/policies_hs/hs14medicaldevicespolicy October07.pdf Users are trained in the use of devices Medical Device alert process in place and cascaded to employees Equipment is Inspected and calibrated in line with trust policy Defects are reported to medical device coordinators and or Health and Safety advisors 17/28

Ref Hazards Risks People at risk Current Control Measures L x C = R Is further action required (Y/N) 18/28

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 employees or lack of continuous training of employees 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 employees must be used to carry out the required duty, i.e. moving and handling of patients, in-service training should be made available to employees. 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. 19/28

Appendix 3 Process for Monitoring Compliance with the Procedure for Slips, Trips & Falls (Employees and Others) Minimum requirement to be monitored Process for monitoring (e.g. audit) Responsible individual / group/ committee Frequency of monitoring Evidence Responsible individual for development of action plan Responsible committee for monitoring of action plan and Implementation Description of the duties Review of the policy Health Safety & Wellbeing Group Annually Group minutes Health & Safety Advisor Quality and Governance Committee How the organisation assesses the risk of slips, trips and falls involving staff and others (including falls from height) Service assurance report Health Safety & Wellbeing Group Annually Group minutes Health & Safety Advisor Quality and Governance Committee How the organisation trains staff in line with the training needs analysis Analysis of training statistics Health Safety & Wellbeing Group Annually Report from Learning and Development Head of Quality and Governance Education and Workforce Committee 20/28

Minimum requirement to be monitored Process for monitoring (e.g. audit) Responsible individual / group/ committee Frequency of monitoring Evidence Responsible individual for development of action plan Responsible committee for monitoring of action plan and Implementation How the organisation raises awareness about preventing and reducing the number of slips, trips and falls involving employees and others. Minutes of Health Safety & Wellbeing Group and Risk and Governance Group Health Safety Wellbeing Group Annually Risk Flyers Lesson plan from essential Learning Health & Safety Advisor Health Safety & Wellbeing Group 21/28

Appendix 4 Community Workers Home Environment Risk Assessment Title Date: Assessor: Signature: Review date: Ref Hazards Detail any specific hazards 1 Access to the property and the external environment. Tick all risks that apply Risks Moderate injury RIDDOR reportable incident Slips, Trips and falls Violence, aggression People at risk Employees Current Control Measures Delete those that do not apply; Add any specific control measures to be put in place Footwear in accordance with dress code policy Additional sources of light e.g. torch carried Reported concerns to householder Two members of employees to in attendance. Informed other team members and line management of issues. L x C = R (see note 1) Further action require d Yes / No 2 Internal stairs / staircases Moderate injury RIDDOR reportable incident Slips, trips and falls Employees Footwear in accordance with dress code policy Make full use of any available handrail(s) Avoid over burdening when carrying equipment / supplies via stairs Lighting switched on if required Reported concerns to householder Make use of wider part of treads on turns in stairs 22/28

Ref Hazards Detail any specific hazards 3 Infection Control Hygiene Also refer to Service risk assessments for Healthcare Acquired Infections (HCAIs) Tick all risks that apply Risks Moderate Injury RIDDOR/ Agency Reportable Bites from pests Blood born infection from contact with sharps Inadequate hand hygiene facilities People at risk Employees/Se rvice user and Carer Current Control Measures Delete those that do not apply; Add any specific control measures to be put in place Concerns raised with householder Informed other team members/ line management of concerns. Referred to.. Sharps boxes provided Community hand hygiene packs (NHS) Employees immunisation L x C = R (see note 1) Further action require d Yes / No 4 Violence and Aggression Lone Working issues Moderate Injury RIDDOR/agency reportable incident Verbal abuse Employees Lone working policy and local procedure Conflict resolution training attended Information obtained from GP referrals Mobile phone carried Two members of employees in attendance. where there is a history of security/personal issues Informed other team members/ line management LSMS/ of concerns. 5 Dogs and other pets Moderate Injury RIDDOR/ Agency Reportable incident Bites Slips, trips or falls Fleas Infection Employees Owners requested to secure dogs / animal in another room / area prior to and during visit. Concerns raised with line management if animal owner non compliant. 23/28

Ref Hazards Detail any specific hazards Tick all risks that apply Risks 6 Lighting Moderate Injury RIDDOR/ Agency Reportable incident People at risk Employees/se rvice user Current Control Measures Delete those that do not apply; Add any specific control measures to be put in place Concerns discussed with householder Issue raised with line management and team. Relevant agencies informed L x C = R (see note 1) Further action require d Yes / No 7 Restrictions on space (also refer to specific service user manual handling risk assessment) Major Injury RIDDOR/ Agency Reportable Slips, trips and falls Employees Concerns discussed with householder and recommendations made Patient moving and handling assessment completed. Issue raised with line management and team. 8 Property condition Specify concerns.. Moderate Injury RIDDOR/ Agency Reportable Slips, trips and falls Employees/Se rvice user Concerns discussed with householder and recommendations made. Issue raised with line management and team Referred to.. 9 Smokers Minor injury/illness Employees Letter to patient to refrain from smoking prior to and during treatment 24/28

Ref Hazards Detail any specific hazards 10 Potential for Fire (also refer to oxygen therapy risk assessment) Tick all risks that apply Risks Major/catastrophic People at risk Employees/Se rvice user Current Control Measures Delete those that do not apply; Add any specific control measures to be put in place Concerns discussed with householder and recommendations made. Issue raised with line management and team. Obtain permission for Fire Brigade to conduct fire risk assessment L x C = R (see note 1) Further action require d Yes / No 11 Chemicals Moderate Injury RIDDOR/ Agency Reportable Slips, trips and falls Employees Concerns discussed with householder and recommendations made to secure chemicals away from treatment area Issue raised with line management and team. In completing the risk assessment employees are required to comply with all relevant NHS policie Patients Full Name DOB NHS No 25/28

Appendix 5 Home Environment Risk Assessment (RA) Initial Assessment Visit Review the Home Environment using the Community Workers Checklist (see page 2 below) No Hazards Hazards Record that no significant risks identified on assessment documentation Complete Community Workers Home Environment Risk Assessment. Tick any generic risks and controls and add any specific hazards you identify along with any further controls to be put in place If there are improvements to the environment that the householder/service user can make. raise directly with them and record these on the RA documentation. RA to be kept in patient notes Calculate risk ratings for the hazards that exist If significant issues are identified which compromise the health and safety of employees /service user, raise your concerns with the team leader and generate an incident report Share findings with colleagues so that on future visits they can monitor that improvements have been made Team leader to identify any further control measures that are required to mitigate the risk. Employees are informed of these controls. Where there are issues of noncompliance or significant H+S issues, refer to Service Lead /Locality manager for action plan to be generated. 26/28

Appendix 6 Risk Assessment in the Home Environment Community Workers Checklist Listed below are a number of concerns which if considered to present significant risk should prompt employees to complete a specific risk assessment form as part of the care plan Concern Access to the property and the external environment Internal stairs / staircases Infection Control Hygiene (Refer to body fluids generic risk assessment) Violence and Aggression Issues regarding Lone working Pets Lighting Restrictions on space Property Condition Examples Difficulty in gaining access e.g. Narrow stair cases in the case of flats Loose paving Uneven or damaged steps Obstructed or poorly opening doors Lack of natural light or night time lighting Wet / muddy conditions in the winter months that can cause paving /walkways to be slippery Previous history of security issues in and around the neighbourhood affecting personal safety or vehicle No handrail / loose handrail No banister rails, very low or loose banisters Turns in staircases with either of the above Loose or worn carpets Obstructions on stairs (plants, baskets, ornaments etc.) Poor lighting conditions in enclosed stairways Evidence of lack of housekeeping / removal of waste. Contamination of furnishings Infestation by rats, mice and other pests eg cockroaches MRSA Other infectious diseases Inadequate hand washing facilities Knowledge of associated issues from service user or relatives Drug / alcohol abuse Mental illness Violence and aggression etc. Hostile Animals in particular dogs Pet excrement Evidence of infestation of pets eg fleas Low levels of lighting giving poor visibility when delivering care Low levels of lighting particularly in conjunction with difficult internal or external access Congested internal environment in terms of layout. Consider in terms of delivery of treatment and implications for patient moving and handling. Evidence of loose wiring, electrical wiring in poor condition. Worn or torn carpets, damaged or uneven floor surfaces presenting a trip hazard DIY projects in progress / unsafe condition Leakage or frequent spillages presenting slip hazards 27/28

Smokers Potential For Fire Chemicals Boiler / gas fires in poor condition Service user and / or other occupiers of premises known to be smokers. Consider also fire associated risks if oxygen therapy equipment present Unguarded fires Fixtures and / or furnishing in close proximity to sources of heat Consider also fire associated risks if oxygen therapy equipment present Evidence of stored chemicals e.g. petrol 28/28