LONE WORKER POLICY
Version 6
Name of responsible (ratifying) committee Health & Safety
Date ratified 02 November 2016
Document Manager (job title) Health & Safety Adviser
Date issued 05 December 2016
Review date 30 November 2018
Electronic location Health and Safety Policies
Related Procedural Documents - Lone Worker Personal safety; Violence to staff; Staff Key Words (to aid with searching) welfare; Security; Hazards; Risk assessment; Working environment; Forms; Health service staff
Version Tracking Version Date Ratified Brief Summary of Changes Author 6 02.11.2016 No changes J Cattle 5 05.11.2014 Policy re-write J Cattle
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 1 of 35 CONTENTS
QUICK REFERENCE GUIDE...... 3
1. INTRODUCTION...... 4 2. PURPOSE...... 4 3. SCOPE...... 4 4. DEFINITIONS...... 4 5. DUTIES AND RESPONSIBILITIES...... 5 6. PROCESS...... 8 7. TRAINING REQUIREMENTS...... 21 8. REFERENCES AND ASSOCIATED DOCUMENTATION...... 22 9. EQUALITY IMPACT STATEMENT...... 23 10. MONITORING COMPLIANCE WITH PROCEDURAL DOCUMENTS...... 24
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 2 of 35 QUICK REFERENCE GUIDE
This policy must be followed in full when developing or reviewing and amending Trust procedural documents.
For quick reference the guide below is a summary of actions required. This does not negate the need for the document author and others involved in the process to be aware of and follow the detail of this policy.
1. Identification of Lone Workers
2. Identification of Risks
3. Implement and manage control measures
4. Share relevant information
5. Post incident Action
6. Post Incident review
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 3 of 35 1. INTRODUCTION
Portsmouth Hospitals NHS Trust are committed to ensuring the safety of its employees who are exposed to risks arising from lone working activities both within and away from a recognised workplace or base.
The Trust has a statutory duty under the Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulations 1999 to identify work hazards, assess the risks involved and implement suitable and sufficient measures to avoid or control the risks, which includes the risks associated with lone working.
2. PURPOSE
Therefore, the aim of the policy and the guidelines is to eliminate the potential risks associated with lone working and where this is not possible, the risks will be minimised to the lowest possible level so far as is reasonably practicable
3. SCOPE
This document applies to all directly and indirectly employed staff within Portsmouth Hospitals NHS Trust and other persons working within the organisation in line with the Trust’s Equal Opportunities Document. This document is also recommended to Independent Contractors as good practice The policy is specifically aimed at those employees whose work is intended to be carried out unaccompanied or without immediate access to another person for assistance; this mainly includes Trust employees who tend to work alone, which includes employees working from home and who visit patients
‘In the event of an infection outbreak, flu pandemic or major incident, the Trust recognises that it may not be possible to adhere to all aspects of this document. In such circumstances, staff should take advice from their manager and all possible action must be taken to maintain ongoing patient and staff safety’
4. DEFINITIONS
Lone Working The NHS Protect defines lone working as:
any situation or location in which someone works without a colleague nearby; or when someone is working out of sight or earshot of another colleague.
The Health and Safety Executive (HSE) defines lone workers as:
those who work by themselves without close or direct supervision.
Dynamic Risk Assessment:
“the continuous assessment of risk in the rapidly changing circumstances of an operational incident, in order to implement the control measures necessary to ensure an acceptable level of safety”
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 4 of 35 (HM Fire Service Inspectorate 1998)
Examples of Lone Workers - below is a list of some typical examples of NHS lone workers in community care, mental health and learning disability and social care sectors, the list is not exhaustive:
ambulance personnel, such as patient transport services
a receptionist working alone in a clinic reception area
community midwives
community clinical staff
staff who see patients/service users for individual sessions in wards or clinics
nursing and clinical staff on escort duty
carers in the community and in community homes
a technician working alone in a laboratory to provide an out-of-hours service
those who provide primary care services, such as single-handed GP practices, community pharmacists and dentists or opticians (they may provide out-of-hours services, dispense controlled drugs/emergency medicines or make domiciliary visits)
NHS security staff on patrols, particularly at night
a hospital porter conveying medicines/samples etc to wards and departments, using corridors and public walkways where they might not come into contact with any other colleagues
staff who have to travel between NHS sites and premises to provide a service
on-call staff required to respond to clinical or non-clinical emergencies out of hours and off-site – for example, clinicians and estates engineers
those who open (or reopen) and close NHS buildings either early in the morning or late at night
smoke-stop coordinators or counsellors
NHS staff who use areas off-site to smoke
NHS staff travelling to and from vehicles/bicycles parked on NHS premises or in the community.
5. DUTIES AND RESPONSIBILITIES
The Chief Executive
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 5 of 35 The Chief Officer has a legal duty to ensure the health, safety and welfare of those employees who work for the organisation including the protection of lone workers. The Security Management Director (SMD) has overall responsibility for operational aspects.
The Board
In accordance with the Corporate Manslaughter and Corporate Homicide Act 2007, having overall responsibility for ensuring that the health and safety management systems relating to Lone Working are effectively implemented, monitored and reviewed.
Security Management Director:
is responsible for ensuring that appropriate security management provisions are made within the NHS organisation to protect lone working staff
should ensure that measures to protect lone workers complies with all relevant health and safety legislation, and takes into account NHS Protect guidance
has overall responsibility for the protection of lone workers by gaining assurance that policies, procedures and systems to protect lone workers are implemented
has responsibility for raising the profile of security management work at board level and getting their support and backing for important security management strategies and initiatives
has responsibility for the nomination and appointment of Local Security Management Specialists (LSMS) and through continued liaison to ensure that security management work (including the protection of lone workers) is being undertaken to the highest standard
should work with the Risk Management Team to oversee the effectiveness of risk reporting, assessment and management processes for the protection of lone workers. Where there are foreseeable risks, the SMD should gain assurance that all steps have been taken to avoid or control the risks.
The SMD for Portsmouth Hospitals NHS Trust is the Director of Nursing and Quality
Local Security Management Specialist (LSMS):
will assist the Trust Health & safety Adviser to update policies and procedures for the safety of lone workers
advises the organisation on systems, processes and procedures to improve personal safety of lone workers and make sure that proper preventative measures are in place
advises the organisation on appropriate and proportionate physical security, technology and support systems that improves personal safety of lone workers. Ensure that this is appropriate, proportionate and meets the needs of the organisation and lone worker
plays an active part in assisting managers identifying hazards, assessment and management of risks. Advises on the proper security provisions needed to mitigate the risks and protect lone workers.
in the event of an incident, the LSMS is to liaise with the police to allow for any follow up action.
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 6 of 35 Should be involved in any post incident root cause analysis, working with managers to identify any shortcomings and learn from them, ensuring that appropriate measures are taken to negate or mitigate future failings.
Service/Team Managers:
are to identify all staff who are lone workers, based on recognised definitions, (see section 2)
will ensure that this policy and all other relevant policies and procedures are disseminated to staff
will ensure that a proper risk assessment is conducted (in consultation with the relevant personnel) to ensure that all risks from lone working are identified and that proper control measures have been introduced to minimise, or mitigate the risks before staff enter a lone working situation
will forward copies of all local lone working procedures to the LSMS for quality assurance and audit purposes
will ensure that lone workers are provided with sufficient information, training, instruction and supervision before entering a lone worker situation
will ensure physical measures are put in place and appropriate technology is made available to ensure the safety of lone workers
that staff have received conflict resolution training and device training provided by the service supplier in the event of being issued with lone worker devices
will ensure that all the relevant staff undertake regular reviews of hazards and associated risks to make sure that all measures are effective and continue to meet the requirements of the lone worker
are to ensure that they forward copies of all agreed local lone working and escalation procedures to the LSMS.
where a security incident has occurred, must make sure that the employee completes an incident reporting form as soon as possible and this gets reported to the LSMS
where someone has been assaulted, must ensure that the individual is properly de- briefed, undergoes a physical assessment, any injuries are documented and they receive access to appropriate post incident support
will ensure that following an incident, a risk assessment is carried out as soon as possible and immediate control measures are put in place. This is prior to a formalised review of lessons learnt following an incident.
Lone working staff members:
have a responsibility to do all they can to ensure their own safety and that of their colleagues and follow the local service procedure. This is in line with current health and safety legislation
will undertake all relevant training including conflict resolution training and device specific training before entering a lone worker situation
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 7 of 35 are to seek advice from their line manager, action guidance, procedures and instruction to avoid putting themselves or their colleagues at risk
will conduct proper planning prior to a visit and utilise continual dynamic risk assessment during a visit. Explain that staff should never put themselves or their colleagues at risk and if they feel at risk they should withdraw immediately and seek further advice or assistance
are to properly utilise all appropriate technology which has been provided for their own personal safety, ensure that they attend training in the use of such technology and associated support services, where provided
must report all incidents even where they consider it to be a minor incident, including ‘near misses’ to enable appropriate follow up action to be taken
The Health & safety Committee:
In accordance with the Corporate Manslaughter and Corporate Homicide Act 2007, ensuring that the health and safety management systems relating to Lone Workers are effectively implemented, monitored and reviewed.
6. PROCESS
6.1 Legislation/Regulation
Clause 24 of the NHS Standard Provider Contract
Clause 24 requires the Board • Nominate an Executive Director to lead work to tackle violence against staff and the management of security. • Record physical assaults, verbal abuse and all criminal acts and security breaches on a national incident reporting system • Appoint an accredited Local Security Manager Specialist (LSMS) to investigate cases of assault, whether it is physical or otherwise, damage to or theft of Trust property where the police are not investigating and to liaise with the police service and Crown Prosecution Service.
Health and Safety at Work Act 1974
NHS organisations have responsibilities under the Health and Safety at Work Act 1974, particularly in relation to employers ensuring, as far as is reasonably practicable, the health, safety and welfare of employees at work.
The Management of Health and Safety at Work Regulations 1999
These Regulations require employers to assess risks to employees and non employees and make arrangements for effective planning, organisation, control, monitoring and review of health and safety risks.
Where appropriate, employers must assess the risks of violence to employees and, if necessary, put in place control measures to protect them.
Safety Representatives and Safety Committees Regulations 1977 (a) and The Health and Safety (Consultation with Employees) Regulations 1996 (b)
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 8 of 35 Employers must inform and consult with employees in good time on matters relating to their health and safety. Employee representatives, either appointed by recognised trade unions under (a) or elected under (b) may make representations to their employer on matters affecting the health and safety of those they represent.
The Corporate Manslaughter and Corporate Homicide Act 2007
This legislation creates a new offence under which an organisation (rather than any individual) can be prosecuted and face an unlimited fine, particularly if an organisation is in gross breach of health and safety standards and the duty of care owed to the deceased.
6.2 Procedure
The Risk Management Process
Safe lone working is reliant on the judgement of the staff member making the risk assessment and, if applicable, conducting the visit, whether this is a first visit or as part of an ongoing care plan
Risk Management is to be conducted in accordance with the Risk Management Policy. A full guide to the process is contained within that document.
Any questions regarding the Risk Management Process are to be directed to the Head of Risk Management.
Identification of risks
The identification of risks relies on using all available information in relation to lone working to ensure that the risk of future incidents can be minimised. This includes learning from operational experience of previous incidents and involving feedback from all staff and stakeholders. It is therefore essential that staff are encouraged to report identified risks to managers, as well as ‘near misses’, so that a risk assessment can be carried out, appropriate action taken and control measures put in place.
Identification of risk for lone workers
The risk identification process should be carried out to identify the risks to lone workers and any others who may be affected by their work. This information is needed to make decisions on how to manage those risks and ensure that the action taken is proportionate. Arrangements also need to be made to monitor and review the findings.1
This risk identification should consider:
lone working staff groups exposed to risk
working conditions: normal, abnormal and hazardous conditions, such as dangerous steps, unhygienic or isolated conditions, poor lighting
particular work activities that might present a risk to lone workers, such as prescribers carrying prescription forms and medicines on their person, particularly controlled drugs
staff delivering unwelcome information or bad news: whether they have received suitable and sufficient training to deliver sensitive or bad news and defuse potentially violent situations
1 See Management of Health and Safety at Work Regulations 1999 Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 9 of 35 the possibility of an increased risk of violence from patients/service users due to alcohol abuse, or drug misuse in relation to their clinical condition or response to treatment, and the risk of violence from their carers or relatives
the lone worker wearing uniforms when visiting certain patients/service users
working in or travelling between certain environments or settings
lone workers carrying equipment that makes them a target for theft or makes them less able to protect themselves
evaluation of capability to undertake lone working – for example, being inexperienced or pregnant, or having a disability.
Risk Assessment
The key to risk assessment is to identify hazards, understand how and why incidents occur in lone working situations and learn from that understanding to make improvements to controls and systems to reduce the risk to the employee. To achieve this, the following factors should be considered and documented2:
type of incident risk (e.g. physical assault/theft of property or equipment)
frequency/likelihood of incident occurring and having an impact on individuals, resources and delivery of patient care
severity of the incident: cost to the healthcare organisation in human and financial terms
confidence that the necessary control measures are in place or improvements are being made
the level of concern and rated risk
what action needs to be taken to ensure that improvements are made and risks reduced.
Managing Risk
Managers are required to implement measures to manage, control and mitigate risks to lone workers. The levels of follow-up action should be proportionate to the level of concern highlighted in the risk assessment.
These measures should be specific, commensurate with the risk identified, and realistic. Any associated costs need to be included not only in terms of resources and purchasing equipment but also staffing, training and expertise.
Measures might include removing weaknesses or failures that have allowed these incidents to take place (procedural, systematic or technological), and identifying further training needs of staff in relation to the prevention and management of violence, or other training such as correctly identifying and operating the relevant technology.
Before a lone worker home visit
2 For further information, see the Health and Safety Executive’s Five Steps to Risk Assessment: http://www.hse.gov.uk/risk/fivesteps.htm Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 10 of 35 Where it is practicable3, a log of known risks should be kept by the department. This should record the location and details of patients/service users/other people that may be visited by staff, where a risk may be present. This log should be kept securely and the information should be accurate and reviewed regularly. It should be available to lone workers to inspect ahead of any visit they make. Consideration should be given to requiring, as part of a lone worker’s job description that they inform their manager or buddy (see 6.18) if they have to make a visit to an address or person on that log.
Violent Patient Scheme
This is managed by NHS England (Wessex), NHS Organisations should utilise the violent patient scheme (VPS) to manage the risks to lone working staff. It may not be appropriate for lone workers to visit patients on the VPS in their homes, but if there is a clinical need, managers and staff should ensure that an appropriate risk assessment is conducted and the necessary measures are in place beforehand.
Lone working staff may need to come into contact with family members of a patient who is on the VPS when providing clinical care/treatment. Proper provisions should be made to deal with this scenario.
Violent Patient Indicator
NHS organisations may operate a violent patient indicator (VPI) process, whereby the records of patients who present a known risk of violence (or who have been identified as being potentially violent following an incident) are marked. The VPI or marker should outline the nature of the risk and practical advice for lone working staff. Such systems are usually based electronically, so their accessibility to lone workers who are not based centrally or who do not have access to electronic systems is a consideration. Trusts should have their own protocols in place for the operation of any VPI scheme to make sure that it is fairly and consistently applied.
Information Sharing
As part of the risk management processes outlined above, information concerning risks of individuals and addresses should, where legally permissible, be communicated internally to all relevant staff who may work with the same patients/service users.
Members of any one family may be users of a number of the community services provided by the Trust and sharing information between services is essential if the safety of all staff involved is to be maintained.
Service/Team managers are to notify other services of high-risk patients/clients, using the most appropriate means (i.e. e-mail) when information needs to be cascaded as quickly as possible.
Wherever possible and legally permissible, the healthcare organisation should also share information on known risks of addresses and associated individuals externally, within the health, social care and other public sectors. This should include social care services, the ambulance service, patient transport services and primary care where applicable. A means of achieving this should be built into a local information sharing protocol. Communication could also be facilitated through existing participation in crime and disorder partnerships, community groups and other health-care organisation forums, and liaison with the police.
3 If staff work from a variety of locations, a written log may be difficult to implement and maintain. Where this is in place, consideration should be given to placing it in a secure location that is only accessible to managers and lone workers – for example, on the trust intranet or by setting up a group calendar in MS Outlook® Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 11 of 35 Low-Risk Activities
There may be certain scenarios and activities that can be classified through a risk assessment as low-risk – for example, staff undertaking office work during normal daytime hours. Staff in this situation may be authorised to work alone without the agreement of their line manager. However, risk assessments need to consider not only safety while at work during normal office hours, but also issues of location and timing relating to personal safety (e.g. someone leaving an empty building, alone, at night).
High-Risk Activities
If there is a history of violence and/or the patient/service user, other friends/relatives who may be present or the location is considered high-risk, the lone worker must be accompanied by at least one colleague or security officer or, in some cases, by the police. Consideration should be given to whether the patient/service user should be treated away from their home, at a neutral location such as a clinic, or within a secure environment.
Scheduling Visits
Before visiting a location or patient/service user that is a known risk, colleagues who may have worked alone in the same situation previously should be contacted. This aids communication and informs the action taken to minimise the risks.
If there are known risks associated with a particular location or patient/service user, lone workers should consider, in consultation with their manager, rescheduling the visit so they can be accompanied by another member of staff or security or police presence. As part of the risk assessment process, consideration should also be given to whether they should, and can, be treated by attending a clinic or hospital.
If practical, the time of day and day of the week for visits should be varied when visits are frequent.
If a lone worker has been given personal equipment, such as a mobile phone or a lone worker device, this is safety protective personal equipment supplied in support of providing a safe working environment as required by health and safety legislation. All due care should be taken by the lone worker to maintain the equipment in good working order and ensure it is fully charged and ready to use (see section 3.7).
Emergency Equipment
As part of the planning process, the emergency equipment that may be required should be assessed. This might include a torch, map of the local area, telephone numbers for emergencies (including local police and ambulance service), a first aid kit, etc.
Lone Worker Movements
Lone workers should always ensure that someone else (a manager or appropriate colleague) is aware of their movements. This means providing them with the address of where they will be working, details of the people they will be working with or visiting, telephone numbers if known and expected arrival and departure times.
Lone workers should leave a written visiting log, containing a diary of visits, with a manager and colleague(s). This information must be kept confidential. Details can be left on a whiteboard or similar, if it is in a secure office to which neither patients/service users nor members of the public have access and is not overlooked through windows.
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 12 of 35 Arrangements should be in place to ensure that if a colleague with whom details have been left leaves work, they will pass the details to another colleague who will check that the lone worker arrives back at their office/base or has safely completed their duties. For office-based staff, if details have been left on a whiteboard, they must not be erased until it has been confirmed that the lone worker has returned safely or completed their duties for that day.
Details of vehicles used by lone workers should also be left with a manager or colleague, for example, registration number, make, model and colour.
Procedures should also be in place to ensure that the lone worker is in regular contact with their manager or relevant colleague, particularly if they are delayed or have to cancel an appointment.
Where there is genuine concern, as a result of a lone worker failing to attend a visit or an arranged meeting within an agreed time, or to make contact as agreed, the manager should use the information provided in the log to locate them and ascertain whether they turned up for previous appointments that day. Depending on the circumstances and whether contact through normal means (mobile phone, pager, etc) can be made, the manager or colleague should involve the police, if necessary (see escalation process in 3.2.5.10).
If it is thought that the lone worker may be at risk, it is important that matters are dealt with quickly, after considering all the available facts. If police involvement is needed, they should be given full access to information held and personnel who may hold it, if that information might help trace the lone worker and provide a fuller assessment of any risks they may be facing.
It is crucial that contact arrangements, once in place, are adhered to. Many such procedures fail simply because staff members forget to make the necessary call when they finish their shift. The result is unnecessary escalation and expense, which undermines the integrity of the process.
“The Buddy System”
It is essential that lone workers keep in contact with colleagues and ensure that they make another colleague aware of their movements. This can be done by implementing management procedures such as the ‘buddy system’.
To operate the buddy system, an organisation must ensure that a lone worker nominates a buddy. This is a person who is their nominated contact for the period in which they will be working alone.
The nominated buddy will:
be fully aware of the movements of the lone worker
have all necessary contact details for the lone worker, including next of kin
have details of the lone worker’s known breaks or rest periods
attempt to contact the lone worker if they do not contact the buddy as agreed
follow the agreed local escalation procedures for alerting their senior manager and/or the police if the lone worker cannot be contacted or if they fail to contact their buddy within agreed and reasonable timescales.
The following are essential to the effective operation of the buddy system:
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 13 of 35 the buddy must be made aware that they have been nominated and what the procedures and requirement for this role are
contingency arrangements should be in place for someone else to take over the role of the buddy in case the nominated person is unavailable, for example if the lone working situation extends past the end of the nominated person’s normal working day or shift, if the shift varies, or if the nominated person is away on annual leave or off sick.
Escalation Process
All services must operate an escalation procedure, outlining who should be notified if a lone worker cannot be contacted or if they fail to contact the relevant individual within agreed or reasonable timescales. The escalation process should include risk assessment and identification of contact points at appropriate stages, including a line manager, senior manager and, ultimately, the police. Any individual nominated as an escalation point should be fully aware of their role and its responsibilities.
Manage Behaviour - Cultural Sensitivity
Staff members must be aware of cultural and gender issues before entering a lone worker situation, to avoid the possibility of escalating a situation.
Whilst In a Lone Working Situation
The situation with the greatest potential for adverse risk, is when in a lone working situation, be that in the community or at a health site. There are several strategies that should be employed to reduce exposure to such risks.
Dynamic Risk Assessment
The importance of dynamic assessment is that it enables lone workers to anticipate and recognise the early warning signs of suspected risks and enables safe early interventions to minimise or negate the risk to themselves and others. It recognises that situations change rapidly as do associated risks and that dynamic risk assessment should be an ongoing process.
Dynamic risk assessments should be conducted as necessary in the circumstances in place at the time. The process involves:
• The assessment of risk in dynamic situations is undertaken before, during and after a home visit, potentially hazardous appointment or working period.
• The benefits of proceeding with a task must be weighed carefully against the adverse risk posed to the lone worker
• What sets DRA apart from systematic risk assessment is that it is applied in situations that are:
- unpredictable/unforeseen risks
- the risk environment rapidly changes
- allows individual to make a risk judgement
- provides personnel with a consistent approach to assessing risk
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 14 of 35 Recognising warning signs
This section should explain the importance of lone workers being able to recognise the warning signs, including if anyone present is under the influence alcohol, drugs, confused, animals present etc. Being aware of warning signs enables action to be taken, including a decision to continue to work or withdraw as appropriate.
Under no circumstances should a lone worker put themselves, their colleagues, other patients or service users in any danger.
Management of a violent or abusive incident
All incidents of violent and/or abusive behaviour should be handled in accordance with the procedures set out in the Management of Violence, Aggression and Abuse against Staff policies.
Dealing with animals
Staff must consider the potential risks posed by household pets when conducting home visits. Considerations will of course involve safety, allergies and infection control.
Where animals are present and the staff member is concerned for any of the above reasons, a polite request should be made for the animal to be placed in a different room. If the resident/owner is not content with this request and has had the clinical and personal safety issues explained in a calm manner and if appropriate the visit should be abandoned and reported in accordance with the risk reporting policy.
Escorting patients/service users
Those services that have occasion to escort service users are to ensure that they risk assess each service user and individual occurrence. They should consider:
The physical and mental state of the patient and whether they are capable of being transported.
The level of staff experience, their qualifications and the number of staff needed to manage the patient.
The type of transport to be used (e.g. ambulance, patient transport service, contracted taxi service or lone worker’s vehicle).
Physical safety measures during the escorting process should be outlined. Lone workers should not escort a patient if there are any doubts about their own safety.
What is the process if conflict arises? This should follow local procedures, which may involve calling the police, their manager, a colleague or buddy.
Appropriate planning and provision should be made for the safe return of a lone worker to a familiar place, once the patient has been dropped off.
Lone working and lease/private vehicles
Lone working staff should ensure that they know where they are going, plan their route and always carry a map.
When working in evenings/nights staff members should ensure that they park in a well lit area, as close to the patient’s door as possible, facing in the direction in which they will leave. Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 15 of 35 If an area is known to be unsafe a decision will need to be made by the line manager and staff member on the safety of the visit and an appropriate plan implemented.
Staff members in uniform should keep their uniform out of sight as much as possible and keep any equipment locked safely in your boot as this may make them a target. All personal belongings are to be kept out of sight.
Staff members should carry their car keys in their hand when leaving the premises, in order to avoid looking for them outside, which could compromise personal safety.
The inside of the car and area around the car should be checked for possible intruders before entering.
Once inside the car, all doors should be locked, especially when travelling at slow speed, at traffic lights or known danger areas.
Lone Workers should not unlock or wind car windows down to talk to people you do not know, even if they may be in distress or requiring help; they should stop in a safe place as soon as practicable and call the emergency services as appropriate.
Staff should not display signs such as ‘nurse on call’ as this may encourage thieves to break into the vehicle.
The Health and Safety Executive’s safe driver programmes advise that lone workers should reverse into car parking spaces so that, if attacked, the door acts as a barrier.
If followed, or if in doubt as to whether they are being followed, lone workers should drive to the nearest police station or manned lit building such as a petrol station, to request assistance.
If a lone worker uses their own vehicle, then it should be properly maintained. Importantly it should include what safeguards to make when driving alone and how to handle a situation where the vehicle breaks down or is involved in an accident.
Lone working and taxis
The Trust does not advocate the use of taxis or private hire vehicles for use by lone workers. Where there is an operational requirement for such transport to be used, lone workers are only use reputable licensed companies and they should book in advance. Private hire cabs should not be used, other than licensed or registered hackney carriages.
Staff members should avoid displaying uniform or equipment which would identify them as health workers. They should ensure that they remain in possession of all equipment and records and they do not leave any in the vehicle on exiting it.
Lone working and travelling by foot
Where staff need to take part of their journey by foot they should always endeavour to use well lit paths and pavements. They should avoid unoccupied/populated areas and should ensure that their colleagues are aware of the route being taken prior to the journey.
Staff members need to be aware of the areas that they are working in and plan their journey accordingly. Uniforms should be covered up and equipment and other items should be kept to a minimum. In the event of a situation where a staff members has concern for their safety they should head for the nearest public area (Shop, Petrol Station, Police station etc) If possible look out for street CCTV cameras and try and remain in view of these.
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 16 of 35 Lone working and public transport
Where it is necessary to utilise public transport, staff members should prepare for their journey by ensuring they know the routes and times of buses/trains etc. They should stick to using larger stations and bus stops in busy areas.
Following an incident
Reporting
All staff members and their line managers are required to report all incidents of physical, non- physical assault, theft, and damage to NHS property to the Risk Department & LSMS, using the Trust Adverse event Reporting System at the earliest opportunity. This will enable the LSMS to conduct an investigation and to ensure that all appropriate cases of physical assault are reported to the police as soon as possible for appropriate action to be taken, where appropriate.
Staff should be supported and encouraged to report an incident to the LSMS using the approved system, in the knowledge that it will be investigated and appropriate action taken. Staff should also report near misses that could have resulted in a serious incident.
This will also ensure that any lessons learned can be fed back into risk management processes to make sure similar incidents do not recur. It also means that further preventive measures can be developed, sanctions taken (where appropriate) and increased publicity generated, creating a strong deterrent effect.
If an incident causes more than three consecutive days’ absence from work, there is also a legal requirement for it to be reported to the Health and Safety Executive under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 1995. This must be done in addition to reporting all physical assaults to the LSMS and line managers should contact the Trust’s Health and Safety Advisor immediately they become aware of the change in RIDDOR status.
Post-incident support Incidents that occur in lone working situations, whether they involve assaults on staff, theft or criminal damage to NHS property, have a direct impact on both the human and financial resources allocated to the NHS to deliver high-quality patient care.
Line Managers are to ensure that any lone worker, who becomes the victim of a crime, is fully supported and referred to the Trust’s Occupational Health Service and the counselling service where required. The LSMS will confirm that this action has been taken during their enquiries.
If assaulted, the individual will also need to undergo a physical assessment and receive treatment for any injuries, so they are well enough to return to work.
Post-incident action
Following an incident or threat in a lone working situation, the LSMS should make sure that there are effective arrangements to ensure that incidents and risks are reported and dealt with in accordance with the national frameworks for tackling violence and security management work.
If the incident involves a physical assault on a staff member, it must be reported to and investigated by the LSMS. Where appropriate, it should also be reported to the police as soon as possible, the LSMS is available to provide advice on the appropriateness of this where uncertainty exists.
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 17 of 35 If the incident involves a non-physical assault, such as verbal abuse, it must be reported, investigated staff should be fully supported by both their line manager and the LSMS. In some cases it may be possible to take action against a verbally abusive individual.
For all incidents, irrespective of whether the police may be pursuing a case against offenders, LSMS’ should be involved in any Root Cause Analysis of the incident.
For incidents where violence is not a factor, such as theft or criminal damage, line managers are to ensure that staff report these to the police, where appropriate, and through the adverse event reporting system. Reporting has a significant effect, as it will determine the actions and investigation undertaken by the LSMS. The investigation will establish, where possible, who the offenders are and whether there are any trends or patterns that can be identified to prevent a recurrence and determine the actions required to control and reduce the risk. Such information can also be used to inform action that needs be taken to enhance security/staff safety and allow for solutions to be developed for specific problems.
Post-incident review
Post-incident review will enable all available information to be used to ensure that lessons can be learned and the risk of future incidents minimised. The key to post-incident review, risk assessment and follow-up action is an understanding of how and why incidents occur in lone working situations and being able learn from that understanding. In order to achieve this, the following factors should be considered:
type of incident (for example, physical assault/theft of property or equipment)
severity of incident
likelihood of incident recurring
cost to healthcare organisation (human and financial)
individuals and staff groups involved
weaknesses or failures that have allowed these incidents to take place (for example, procedural, systematic or technological)
training needs analysis of staff, in relation to the prevention and management of violence, the correct use and operation of lone worker protection technology or other relevant training
review of measures in place to manage and reduce identified risks
review of the effectiveness of support measures for the staff involved
technology in place to protect lone workers.
Sanctions
There are a range of sanctions that can be taken against individuals (or groups) who abuse NHS staff and professionals, or who steal or inflict damage on its property. These range from criminal prosecutions and Anti-Social Behaviour Orders to civil injunctions. There are also a series of administrative sanctions that can be considered where appropriate. Managers should consult with the LSMS to ascertain the most appropriate sanctions. The victims’ wishes should always be of paramount importance.
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 18 of 35 Sanctions will be considered in each and every case where appropriate and having taken account of any legal advice received from the NHS Legal Protection Unit.
Publicity
Where considered appropriate the Trust may choose to publicise any particular case in local and national media, internal Trust communications and NHS publications. The reason for this action is to increase awareness nationally and locally that criminal acts against the Trust is not acceptable and to publicise the Trust’s willingness to take action against perpetrators.
In any case where such action is considered, full consultation between the Service Manager, LSMS, Head of Communications and full consideration of the Caldicott Principles is to take place prior to any media release. Under no circumstances are staff permitted to approach the press directly in relation to an incident. All press and media liaison must be via the Communications Team.
Technological Responses to Lone Worker Risk
Introduction
Technology should not be seen as a complete solution in itself. Consideration must be given to the legal and ethical implications of its use, as well as to its limitations.
Technology, however, can play an important part in helping to protect lone workers, as part of a robust risk assessment process. This section provides advice to help manage expectations in relation to this. It is clear that technology can only be effective if it works alongside:
a rigorous risk assessment process for managers and staff
clear and robust management policies and procedures that put in place measures to address identified and potential risks and to deal with incidents when they occur
managers and staff accepting responsibility for and supporting the need to operate systems, procedures and technology provided for their protection
the sharing of information from within and outside the NHS on identified and potential risks
support and proportionate response from the police and technology support services when a lone worker device is activated
the provision of good-quality conflict resolution training to help staff prevent and manage violent situations
device-specific lone worker safety training including scenarios that reflect the fact that lone workers have been issued with a device and that support services are in place.
The requirement for technology should result from risk assessments, pre-or post-incident reviews and analysis of relevant reports and operational information. It is essential that Service Managers contact the LSMS, prior to procurement to ensure that the technology and training is appropriate and fit for purpose. Where such devices are issued, the LSMS and Service Managers should ensure that it is used appropriately, effectively and that it is proportionate to the problem it is intended to address.
Lone working devices
It is essential to recognise that lone worker devices will not prevent incidents from occurring. They will not make people invincible, nor should they be used in a way that could be seen to Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 19 of 35 intimidate, harass or coerce someone. However, if used correctly in conjunction with robust procedures, they will enhance the protection of lone workers. Lone workers should still exercise caution even if equipped with such devices and continue to use the dynamic risk assessment process. Finally, lone workers should remember that a device will only be useful if checked regularly, properly maintained and kept fully charged.
The use of such devices can send a strong deterrent message to potential offenders. They may also improve the feeling of confidence amongst NHS staff, helping to reduce the fear of crime. However, physical security measures in the absence of appropriate policies, procedures, and training to prevent and manage violence may create a false sense of security. It is therefore important to ensure that robust policies and procedures are available to work in conjunction with such devices.
If a lone worker protection device is misused frequently or maliciously, the matter should be referred to the LSMS for investigation, the results of which may result in disciplinary action being taken.
Where lone worker devices are issued, staff members are to be fully trained in their use prior to deployment.
Practical suggestions on the use of a mobile phone
Lone workers will inevitably carry mobile phones and they should always check the signal strength before entering a lone working situation. A mobile phone should never be relied on as the only means of communication. Lone workers should tell their manager or a colleague about any visit in advance, including its location and nature, and when they expect to arrive and leave. Afterwards, they should let their manager or colleague know that they are safe.
If provided, a mobile phone should always be kept as fully charged as possible.
The lone worker should ensure they can use the mobile phone properly, by familiarising themselves with the handset and instruction manual.
Emergency contacts should be kept on speed dial.
The phone should be kept nearby and never left unattended.
Lone workers should be sensitive to the fact that using a mobile phone could escalate an aggressive situation.
In some circumstances, agreed ‘code’ words or phrases should be used to help lone workers convey the nature of the threat to their managers or colleagues so that they can provide the appropriate response, such as involving the police. The decision to use code words or phrases should give due consideration to the ability of a member of staff to recall and use them in a highly stressful situation.
A mobile phone could also be a target for thieves. Care should be taken to use it as discreetly as possible, while remaining aware of risks and keeping it within reach at all times.
Staff members are reminded that it is against the law to use a mobile phone whilst driving.
7. TRAINING REQUIREMENTS
7.1 Portsmouth Hospitals NHS Trust recognises the need for effective training of staff to deal with violence, aggression & abuse related issues and will, through the Training and
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 20 of 35 Development Department and the LSMS, ensure security advice and training, is provided with regard to Conflict Resolution Training to reduce the likelihood of assault.
7.2 Lone Worker Safety Awareness
7.3 The LSMS is to be actively involved in the Induction Training programme for all staff and will provide a 45 30 minute presentation.
7.4 The LSMS is will attend localities to give presentations on crime reduction and personal safety measures to any group of staff that request it. These sessions can be booked through Learning and Development
7.5 Prevention and Management of Violence (Conflict Resolution Training)
7.6 Prevention and Management of Conflict Resolution TrainingViolence Training will be provided tois mandatory training for all staff that have contact with patients and/or the public, however initial efforts will be focused on those who are at greater risk, such as:
• Those who work in areas with the highest instances of physical or non physical assault
• Those who have higher than average contact with patients or the public
• Those members of staff selected on the basis of the trust’s risk assessment process
7.7 Specific staff groups identified by the NHS Protect as requiring CRT are:
• GPs
• Outreach or community staff
• Ward Staff (Clinical & Non-clinical)
• Reception Staff
• GP Staff
• Public Health Medicine, Community Health Services Medical and Dental Staff
• Ancillary staff not mentioned above
• Security Staff (where employed)
7.8 The above list is not exhaustive and does not preclude individuals from being trained on the basis of an identified need.
7.9 Refresher training is to be undertaken by all frontline staff as a minimum by the end of the third year following their initial attendance on a Conflict Resolution National Syllabus training course, and thereafter on a three-yearly cycle.
7.10 Mental Health and Learning Difficulties staff will be provided with training that is specifically designed for these specialist fields. This training must conform to the national standard (Promoting Safer Therapeutic Services).
7.11 Breakaway Training and Assault Avoidance will be provided to all staff where there is a need identified by a formal risk assessment and consultation.
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 21 of 35 7.12 Physical Intervention or Control and Restraint Training will be provided to those clinical staff members working in the residential mental health services and security staff in accordance with individual service requirements. Learning & Development is to identify suitable training packages that conform to national clinical guidance and consult with the LSMS prior to entering into any contractual agreements.
7.13 Managing Clinically Related Challenging Behaviour Training wil be available with the aim of ensuring that staff working in healthcare services can safely prevent and manage challenging behaviours while delivering high-quality care in a safe environment.
This will include:
■ Identification of and response to unmet patient needs ■ More personalised patient care ■ Better medical assessment, diagnosis and treatment in a challenging behaviour situation ■ Staying safe in emergency situations ■ Effective communication techniques
7.14 All Training Bookings are to be controlled by Learning & Development.
7.15 Security Training will be provided to all staff in accordance with the organisational Training Needs Analysis.
8. REFERENCES AND ASSOCIATED DOCUMENTATION
Legislation & Regulation
The Corporate Manslaughter and Corporate Homicide Act 2007 Safety Representatives and Safety Committees Regulations 1977 (a) The Health and Safety (Consultation with Employees) Regulations 1996 (b) The Management of Health and Safety at Work Regulations 1999 Health and Safety at Work Act 1974 Human Rights Act 1998 Secretary of State Directions ((2003) (2004) both amended in 2006) Improving safety for lone workers- A guide for managers, NHS Staff Council Working alone - Health and safety guidance on the risks of lone working, HSE NHS Security Manual – Chapters 22b & 23
Trust Policies
Improvised Explosive Devices Policy Risk Management Policy Emergency Planning Policy Adverse Event Reporting Policy Health & Safety Policy Lockdown Policy Lone Working Policy Management of Violence, Aggression and Abuse against Staff Policy Local Fraud & Corruption Policy Whistleblowing Policy
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 22 of 35 9. EQUALITY IMPACT STATEMENT
Portsmouth Hospitals NHS Trust is committed to ensuring that, as far as is reasonably practicable, the way we provide services to the public and the way we treat our staff reflects their individual needs and does not discriminate against individuals or groups on any grounds.
This policy has been assessed accordingly
Our values are the core of what Portsmouth Hospitals NHS Trust is and what we cherish. They are beliefs that manifest in the behaviours our employees display in the workplace. Our Values were developed after listening to our staff. They bring the Trust closer to its vision to be the best hospital, providing the best care by the best people and ensure that our patients are at the centre of all we do. We are committed to promoting a culture founded on these values which form the ‘heart’ of our Trust:
Respect and dignity Quality of care Working together Efficiency
This policy should be read and implemented with the Trust Values in mind at all times.
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 23 of 35 10. MONITORING COMPLIANCE WITH PROCEDURAL DOCUMENTS
Minimum requirement to be Lead Tool Frequency of Reporting Lead(s) for acting on monitored Report of arrangements Recommendations Compliance Requirement to undertake Health and Safety • Review of Trust and Clinical Service Centre Monthly Policy audit report Health and Safety Advisor appropriate risk assessments Advisor Risk Registers: 100% of actions in plan are to: completed by the designated target date Health and Safety Committee Progress against Health and Health and Safety • Review of Health & Safety annual plan: Annually Policy audit report Health and Safety Advisor Safety risks and Advisor 100% of actions to mitigate risks are to: recommendations completed by the designated target date Health and Safety Committee Arrangements for ensuring Health and Safety • Review of RIDDOR Annually Policy audit report Health and Safety safety of lone workers Advisor/LSMS • Review of incident database to: Advisor/LSMS To ensure 100% of required actions have Health and been implemented Safety Committee
This document will be monitored to ensure it is effective and to assurance compliance.
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 24 of 35
Equality Impact Screening Tool
To be completed and attached to any procedural document when submitted to the appropriate committee for consideration and approval for service and policy changes/amendments.
Stage 1 - Screening
Title of Procedural Document: Lone Worker Policy
Date of Assessment 02.11.16 Responsible H&S/LSMS Department Name of person Jenny Cattle Job Title H&S Advisor completing assessment Does the policy/function affect one group less or more favourably than another on the basis of : Yes/No Comments Age N Disability N Learning disability; physical disability; sensory impairment and/or mental health problems e.g. dementia Ethnic Origin (including gypsies and travellers) N Gender reassignment N Pregnancy or Maternity N Race N Sex N Religion and Belief N Sexual Orientation N If the answer to all of the above questions is NO, the EIA is complete. If YES, a full impact assessment is required: go on to stage 2, page 2
More Information can be found be following the link below www.legislation.gov.uk/ukpga/2010/15/contents
Stage 2 – Full Impact Assessment Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 25 of 35 What is the impact Level of Mitigating Actions Responsible Impact (what needs to be done to minimise / Officer remove the impact)
Monitoring of Actions The monitoring of actions to mitigate any impact will be undertaken at the appropriate level
Specialty Procedural Document: Specialty Governance Committee Clinical Service Centre Procedural Document: Clinical Service Centre Governance Committee Corporate Procedural Document: Relevant Corporate Committee
All actions will be further monitored as part of reporting schedule to the Equality and Diversity Committee
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 26 of 35 Appendix 1
CHECKLIST FOR MANAGERS
Are your staff –
issued with all relevant policies and procedures relating to lone working staff?
trained in appropriate strategies for the prevention and management of violence (in particular, have they received conflict resolution training)?
given all information about the potential risks for aggression and violence in relation to patients/service users and the appropriate measures needed to control these risks?
issued with appropriate safety equipment and the procedures for maintaining such equipment?
trained to be able to confidently use a device and familiar with the support service systems in place before being issued with it?
aware of how to report an incident and of the need to report all incidents when they occur?
issued with the necessary contacts for post-incident support?
Are they –
aware of the importance of doing proper planning before a visit, being aware of the risks and doing all they can to ensure their own safety in advance of a visit?
aware of the importance of leaving an itinerary of movements with their line manager and/or appropriate colleagues?
aware of the need to keep in regular contact with appropriate colleagues and, where relevant, their nominated ‘buddy’?
aware of the need to carry out continual dynamic risk assessments during a visit and take an appropriate course of action?
aware of how to obtain support and advice from management in and outside of normal working hours?
aware that they should never put themselves or colleagues in any danger and if they feel threatened should withdraw immediately?
Do they –
appreciate the organisation’s commitment to and support for the protection of lone workers and the measures that have been put in place to protect them?
appreciate that they have their own responsibilities for their own safety?
appreciate the circumstances under which visits should be terminated?
appreciate the requirements for reporting incidents of aggression and violence?
understand the support made available to lone workers by the trust, especially post-incident support and the mechanism to access such support?
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 27 of 35 Appendix 2 Community Based Lone Worker Form Name of lone Mobile No worker: Home address
Car Home Tel No: Registration:
Date of Visits:
Patient visits in order:
Patient name: Tel No: Patient address:
Patient name: Tel No: Patient address:
Patient name: Tel No: Patient address:
Patient name: Tel No: Patient address:
Patient name: Tel No: Patient address:
Patient name: Tel No: Patient address:
Expected time of completing visits
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 28 of 35 Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 29 of 35 Appendix 3
LONE WORKER INFORMATION SHEET
Team:______Name Make of Vehicle Registration Colour Work Mobile No. Home Address Emergency Personal Mobile No. and Phone No. Contact Name, Home and Mobile No.
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 30 of 35 2 Minute Lone Worker Violence, Abuse and Harassment Risk Assessment Form
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 31 of 35 Consequence 1. Insignificant 2. Minor 3. Moderate 4. Major 5. Catastrophic Minor bruises/ Some minor injuries/ Many minor injuries/ Some major injuries/ ill-health Death minor ill-health. ill-health temporarily permanently incapacitating Harm discomfort/ incapacitating
affects wellbeing. One day Service One week Service One month Up to 6 months Service 6 months to 1 year Service disruption/ disruption/ disruption/ disruption/ <5 staff absent. Service 11-20 staff absent. 21-50 staff absent. Disruption disruption/ 1 or 2 staff absent. 5-10 staff absent. Replacement of Replacement of Minor out-of-court Civil action – no defence. Criminal prosecution. Litigation property. property & finances settlement. Damage Minor property Slight property Moderate property Severe property Loss of whole damage/no damage/impacts on damage/impacts on site damage/impacts on local department/impacts on regional environmental impacts. internal environment. environment. environment. environment. Reputation/ Damage to individual’s Damage to team Damage to Service Damage to Trust Damage to Health Authority Confidentiality/ reputation. reputation. reputation/local media reputation/local media reputation/ national media Data Loss Minor breach of Temporary loss of coverage on day. Loss coverage <3 days. coverage <3 days. Prosecution confidentiality. information. of information/ records. Irrecoverable loss of vital under Data Protection legislation. Minor complaints to Minor complaints to Some complaints to records/ information. Complaints at Stage II or III of team. local Management. Senior Management. Complaints to Chief NHS Complaints Procedure. Executive. Enforcing Audit non-conformance/ Breach of procedure/ Improvement Notice. Prohibition Notice. Government Investigation. Action advice from enforcers. Directive from enforcers.
Consequence Table: Likelihood Table: Level Descriptor Description 5 Almost Certain Expected to occur in most circumstances.. 4 Likely Will probably occur in most circumstances. 3 Possible Might occur at some time.
2 Unlikely Not expected but conceivable. Could occur sometime.
1 Don’t expect to happen. Can only imagine happening in exceptional circumstances. Rare
Risk Matrix: Likelihood Action Priority
5. Almost Certain 5 10 15 20 25 25 Prohibited; Stop immediately 4. Likely 4 8 12 16 20 16-20 Very High 3. Possible 3 6 9 12 15 12-15 High 2. Unlikely 2 4 6 8 10 6-10 Medium 1. Rare 1 2 3 4 5 1-5 Low t Consequence c i
n Tolerable: a risk can be considered ‘Tolerable’ AFTER it has e h a t
p r c r a been reduced to its lowest residual risk that is reasonably i r o o f o . . . . . i r j e n t
1 2 3 4 5 practicable. i n a d s g M o a M i t s M a
n Best Practice: examples of ‘Best Practice’ include; working to I C legislative requirements; adopting latest technology; complying with compliance standards (e.g. Controls Assurance, CNST 8 etc.); positive audit outcomes; positive benchmarking with 9 Risk Control Options: Risk Control Options 1st Risk Avoidance (informed decision not to become involved in the risk situation) 2nd Risk Transfer (shifting the responsibility for burden or loss to another party) 3rd Risk Reduction (selective application of appropriate techniques, engineering and/or management principles) 4th Risk Acceptance (an informed decision to accept the consequences and likelihood of the risk) 10 Further Action Criteria:
Using Best Risk Level Tolerable? Action if answered ‘No’ to BOTH Tolerable and Best Practice questions (see definition) Practice?
11 Not 12 Not Work should not be started or continued until the risk has been reduced. If it is not Prohibited Applicable Applicable possible to reduce the risk, even with unlimited resources, the work must remain prohibited. 14 Yes/N15 Yes/N Work should not be started until the risk has been reduced. Considerable resources may Very High o o have to be allocated to reduce the risk. Consult with Senior Manager. Documented & Detailed Risk Assessments Required. 17 Yes/N18 Yes/N Work should be strictly limited until the risk has been reduced. Significant resources may High o o have to be allocated to reduce the risk. Consult with Senior Manager. Documented & Detailed Risk Assessments Required. Efforts should be made to reduce the risk, but the cost of reduction should be carefully 20 Yes/N21 Yes/N measured and limited. If ‘Consequence’ is ‘‘Major’, Catastrophic’ or ‘Extremely Harmful’, Medium o o emergency measures MUST be in place should the risk be realised, and control measures carefully monitored. Consider Risk Assessments if ‘Consequence’ is ‘Major’, ‘Catastrophic’ or ‘Extremely Low 24 Accept, unless easily improved at no extra cost. No Further Documentation Necessary.
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 32 of 35 2 Minute Risk Assessment of Violence Occurring During Home Visits (July 2011)
Summary of Assessment Overall priority for action: Low/Medium/High/Very High/Restricted Location …………………………………………………………….. Signature ......
Staff involved in assessment Date of assessment ...... …….
Violence & Aggression Checklist Answer ALL questions by circling EITHER Y, N or Hazard eliminated/Not Applicable Hazard Date 1. Consider local RISK MANAGEMENT ARRANGEMENTS Y N eliminated/Not eliminated TO REDUCE VIOLENCE Applicable? Do your work instructions highlight the risks of violence to you, and the safety precautions you are to follow? 1 5 0 Has a lone worker risk assessment been carried out? 1 3 0 Is another member of staff, who will be able to assist you if necessary aware of the visit? 1 10 0 Hazard Date Consider the TASKS Y N eliminated/Not eliminated Applicable?
Have you considered whether the task could cause anger/distress in the 1. 1 12 0 client (e.g. giving bad news)?
Have you designed your work to ensure that minimum amounts of 2. 1 15 0 drugs/needles are used in public view? Have you designed your work to ensure minimum amounts of expensive looking equipment are used in public view? 1 15 0 Have you got a personal attack alarm with you? 1 10 0 Have you got a torch and spare batteries for visits to areas with poor lighting (e.g. rural areas)? 1 6 0 Do you have rescue arrangements should your vehicle break down and sufficient fuel for the full journey plus detours? 1 6 0 Hazard Date Consider INFORMATION, INSTRUCTION AND TRAINING Y N eliminated/Not eliminated Applicable? Have you received training in Conflict Resolution within the last 3 years? 1 15 Have you considered how you will call the Police if necessary? 1 15 0 Have you got good quality information about your clients and their needs? 1 12 0 Have you got read the clients records and check for any risk items? 1 12 0 Are your clients aware of the tasks you are going to perform? 1 9 0 Hazard Date Consider the COMMUNICATIONS Y N eliminated/Not eliminated Applicable? Where panic alarm systems are in use, do you know how and to whom you should communicate to ensure a rapid competent response? 1 20 0 Are communications with base/supervision available to you at all times? 1 20 0 For known violent clients, have coded distress/duress messages been established whereby you can call a colleague should you anticipate an 1 25 0 incident happening, without the client knowing you have done so? Can a colleague then respond to a duress message in a similarly discreet manner to ascertain the level of risk and what assistance is needed? 1 25 0
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 33 of 35 Hazard Date Consider the VISITS Y N eliminated/Not eliminated Applicable? Do you know the clients being visited as non-threatening or have you had uneventful visits to them previously? 1 20 0 If the places being visited have pets, do you know if they’re friendly or if they will be secured from causing you harm? 1 9 0 Do you feel comfortable about the visit? 1 9 0
Check Use the result and all available information to the What’s the highest score circled? = determine your action from the grid below: scores :
Result Action Tick 1– 5 Ensure all information about the client is accurate. Keep unnecessary drugs/equipment locked in boot Low Priority of car. Ensure a colleague knows about the visit. Continue with visit but be vigilant. All above plus: Identify an escape route for your return to the car. On entering house note your exit 6 – 10 route and keep this available. Make sure assistance can be called and know how long that assistance Medium Priority will take to arrive. All above plus: Inform base of visit before commencing. Take all personal precautions available (e.g. 12 – 15 personal alarm) into visit. Consider having a means available of communicating externally whilst in High Priority the visit. Consider need to be escorted during visit. All above plus: consider whether the visit is essential or not. Consider whether an alternative venue (e.g. Clinic) could be used for this task. Discuss in advance the plan for the visit, including expected 16 – 20 time of arrival/time of departure, with team colleagues who can assist if necessary. Ensure an escort Very High is present throughout the visit. Ensure external communications are available throughout the visit. Priority Park car in a secure area wherever practicable and ensure it cannot be blocked in before returning to it. DO NOT UNDERTAKE THE VISIT UNLESS YOU ARE COMPLETELY SURE THAT YOU ARE 25 ADEQUATELY EQUIPPED TO DO SO! RESTRICTED REPORT RISK ASSESSMENT RESULTS TO MANAGEMENT IMMEDIATELY AND SEEK ADVICE!
Rationale: where necessary, record the rationale behind your assessment and any comments you wish to note.
Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 34 of 35 Lone Worker Policy Version: 6 Issue Date: 05 December 2016 Review Date: 30 November 2018 (unless requirements change) Page 35 of 35