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Health and safety issues and care workers

The residential care industry provides employment for care workers in hospitals, nursing homes and other work places where round the clock social assistance is provided to the elderly, sick, children and other individuals whose special needs require such help. In these circumstances, a variety of health and safety issues arise for care workers. Employers should assess risks to health, implement safe systems of work, ensure that care workers receive appropriate training in the tasks that they are being asked to perform and provide and maintain in good condition all necessary work equipment.

Many care workers will work through Agencies who will generally also have responsibilities for the health and safety of the care worker as well as the employer with whom the worker might be placed.

What types of health and safety issues might care workers be faced with?

Lifting and handling injuries

Almost forty per cent of injuries reported within the residential care sector arise from manual handling. This involves more than simply lifting or carrying something. Manual handling incorporates a range of work activities involving the moving of loads by :-

• lifting
• lowering
• pushing
• pulling
• carrying
• moving
• bending
• twisting
• holding
• reaching
• repetitive movements involving any of the above tasks

Employers should ensure that they have effective management and training policies in place, provide and make full and proper use of any ergonomic equipment to avoid the need for employees to undertake manual handling operations at work involving a risk of injury and adequately assess the risk of any manual handling operation that cannot be avoided. The following types of issue may be relevant in assessing manual handling risks in the work place :-

• has there been adequate staff training?
• does the lay out of the work place make it difficult for staff to maintain correct posture?
• are there tasks involving frequent manual handling and can they be reduced?
• are the loads to be handled below mid thigh or above shoulder level - heavy or awkward loads or those moved frequently should not be stored at these levels?
• is the load difficult to handle because of its shape, content or its ability to move itself?
• are there sufficient staff and are rest breaks allowed?
• is the flooring in the work place uneven or slippery?
• is the work place excessively hot, cold or humid?
• is the lighting adequate?
• is the physical ability of the individual capable of moving the load?

The employer has a legal duty to provide a safe and healthy work place for all employees. All tasks in the work place involving manual handling must be identified and the risk or likelihood of injury assessed. Where there is a risk of injury it should be avoided "so far as is reasonably practicable". The risk of injury must be weighed against the cost or effort required to re-design the procedure. Employers have a legal responsibility to :-

• avoid the need for hazardous manual handling so far as is reasonably practicable;
• assess the risk of injury from any hazardous manual handling that cannot be avoided; and
• reduce the risk of injury from hazardous manual handling so far as is reasonably practicable;
See also work related back injury

Slipping and Tripping Injuries

According to the Health and Safety Executive slips and trips at work are responsible for one third of all major incidents involving employees and care workers are at risk of suffering such an accident. Most occur as a result of wet or contaminated conditions and often arise as a result of a failure by employers to adequately identify and assess potential risks to employees at work. Floor surfaces should be regularly checked for wear and tear, should be kept clean and free from obstructions with warning signs or barriers used where necessary. Lighting levels should be adequate. Employers who breach this duty to safeguard the health and safety of their employees at work are likely to be responsible for any foreseeable injuries suffered by a care worker and to be held liable in damages.

Occupational dermatitis

Occupational dermatitis is skin disease that is caused by or aggravated by substances or conditions at work. Often, it begins with redness and itchiness but may develop to include swelling, scaling, cracking, blistering and bleeding. Care workers may be at risk of developing occupational dermatitis from exposure to latex gloves, disinfectants such as formaldehyde and gluteraldhyde and from regular wet work.
See occupational dermatitis

Occupational Asthma

Care workers may be at risk of developing Occupational asthma from exposure to disinfectants such as formaldehyde and gluteraldhyde and latex products such as gloves. Physical symptoms of occupational asthma might include coughing, wheezing, breathing problems and chest tightness.
See occupational asthma

Other health issues caused by biological agents

Care workers may be at risk from the handling of clinical waste and soiled laundry which may be contaminated. Employers should operate procedures for the safe handling, storage, spillage control and disposal of hazardous agents and vigorous training should be provided. Care workers also run the risk of contact with blood, body fluids and contaminated needles presenting a significant risk to health.

Employers have an obligation to identify and assess risks caused by biological agents under The Control of Substances Hazardous to Health Regulations 2002 which oblige employers to make a "suitable and sufficient" assessment of the risks from chemicals and hazardous substances. All necessary measures to prevent risks to health should be introduced and checked periodically to ensure effectiveness. A system of health surveillance for employees should be introduced where necessary and information and training to all staff should be provided on the risks involved and how they can be prevented. Personal protective equipment should be provided and maintained where appropriate.

Work related stress

Because of the nature of the work in which they are involved in sometimes dealing with seriously ill and terminal patients and others with sometimes significant social problems care workers may become susceptible to work related stress. Those working long hours and night workers may be particularly vulnerable to stress related illnesses.

See stress related injury claims against an employer

Violence at work

Care workers may be at risk of violence from aggressive patients and relatives. Under the Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulations 1999, Employers have a legal duty to protect the health, safety and welfare of their employees. A formal risk assessment should be carried out to measure the risk of work place violence. Employers should review procedures after every incident. It may be possible identify improvements that could help avoid a similar incident happening again. Clear procedures should be introduced providing advice as to what to do if an incident occurs, how it is to be reported and how the procedure itself is to be monitored.

Pregnant workers

Employers are obliged by law to assess the health and safety risks posed to pregnant workers, workers who have recently given birth and workers who are breastfeeding.

In particular, the risks posed to these groups of workers by certain physical, biological and chemical agents, industrial processes and working conditions should be considered and adjustments should temporarily be made to working conditions or hours to avoid exposing them to such risks. For example, such workers should not be exposed to extremes of heat or cold, the handling of loads entailing risks and mental and physical fatigue.

Please contact us for further information.