Back problems account for a vast amount of absence from work in the UK. Care home staff are particularly vulnerable to musculoskeletal problems. Ensuring that your staff receive training in moving and handling clients can minimise absences and give them the confidence to transfer people safely.Training for care staff should include the principles of manual handling, the anatomy of the spine and risk assessment as well as specific training on how to move people and the use of various handling aids. Training on the causes of back pain is also important as it can explain how using approved techniques and equipment can prevent back problems from occurring.
The legislation that covers the provision of moving and handling training to care staff is contained in the following:
- The Health and Safety at Work Act (1974)
- Manual Handling Operations Regulations (1992)
- Management of Health and Safety at Work Regulations (1999)
- Lifting Operations and Lifting Equipment Regulation (1998)
- Provision and Use of Work Equipment Regulations (1998)
- Reporting of Injuries, Diseases and Dangerous Occurrences Regulations RIDDOR (1995)
The regulations in their entirety offer a systematic approach to manual handling. They recommend that one should avoid manual handling so far as is reasonably practicable by redesigning the task or by automating the process. Employers should make a suitable assessment of any task to be carried out and the risk of injury from any operations that cannot be avoided should be reduced so far as is reasonably practicable. These regulations underpin moving and handling training for people working in care homes.
Structure and Mechanics of the Spine
Basic training should inform participants that the spine has three main curves: the cervical (forwards), the thoracic (backwards) and the lumbar (forwards). These curves allow limited movement from front to back and from side to side. In relation to manual handling the spine is most stable when loads are applied vertically as it is distributed throughout the spine, discs, ligaments and muscles. The spine contains 24 individual vertebra and nine fused to form the sacrum and coccyx. These are supported in position by ligaments and a pair of small apophyseal joints that slide together and protect the spine from excessive flexion and rotation. Strength is further given by muscles of the back, trunk and abdomen. The vertebrae are interspersed with intervertebral discs which act as shock absorbers and allow flexibility. They contain a capsule of thick fluid called the nucleus pulposus surrounded by a tough fibrous layer called the annulus fibrosus.
Staff should be given practical training in moving people in different situations, for example transfers from chair to bed, from sitting to standing, moving in bed and all the situations that are encountered in a care home. They should also be given practical training in the use of aids such as hoists, slide sheets, turntables and walking aids.
It is important that staff receive training in the use of the specific equipment available in their workplace and that they understand the importance of individual risk assessments for each client.
Smith writes on health and safety issues for a range of health and social care websites and offline publications. As a physiotherapist she has been responsible for the design of moving and handling courses used in various care homes.