| 1 | Moving and handling peopleHSE: Moving and handling in health and social care | Care staff, and the 18 residents who need help to move. Back injury and strains to carers from lifting, transferring and repositioning people; injury to the person being moved from a poor technique or the wrong equipment. | 4 | 4 | 16 | • Each person who needs help to move has a written moving and handling plan that says what equipment and how many staff are needed• Hoists, slide sheets, stand aids and slings are available, matched to the person, and inspected every six months• All care staff have moving and handling training with practical sessions, refreshed yearly• Staff do not lift a person manually except in an emergency, and know how to respond to a fall• Plans are reviewed when a person's condition changes and after any incident• Staff report near misses, pain and equipment faults, and reports are acted onand 3 more | 3 | 2 | 6 | None |
| 2 | Infection and biological hazardsHSE: Health and social care | All staff, all residents, and visitors during an outbreak. Infections caught from people, body fluids, soiled laundry, clinical waste, animals or contaminated water, including norovirus, flu, hepatitis and Legionella. | 4 | 4 | 16 | • Hand washing facilities and hand sanitiser are provided and staff wash their hands at the right times• Gloves, aprons and, where needed, masks and eye protection are provided and worn for contact with body fluids• Clinical waste and sharps go in the correct containers and are collected by a licensed contractor• Cleaning schedules cover the areas and equipment that spread infection, with a procedure for body fluid spills• Staff are offered the vaccinations relevant to their work, such as flu and hepatitis B• There is an outbreak plan that says when to exclude staff and residents and who to tell• Water systems are assessed for Legionella and the control scheme is followedand 4 more | 3 | 2 | 6 | None |
| 3 | Slips, trips and falls on the same levelHSE: Slips and trips | Residents most of all, then staff and visitors: bathrooms, corridors after cleaning, the garden path. Sprains, fractures and head injuries from slipping on wet or contaminated floors, or tripping over cables, uneven surfaces, boxes and trailing leads. Slips and trips are the most common cause of injury at work. | 4 | 4 | 16 | • Spills are cleaned up straight away and the wet area is signed or cordoned until it is dry• Floors are cleaned when the area is quiet, and the method leaves them dry, not wet• Walkways are kept clear of boxes, stock and equipment, and cables are routed away from walkways or covered• Lighting is good enough to see the floor, including on stairs and outside at night• Damaged flooring, loose mats and worn steps are reported and repaired• Stairs have a handrail, the edge of each step is visible, and nothing is stored on them• Entrance matting stops rain being walked in, and outside paths are gritted in icy weather• Each resident has a falls risk assessment in their care plan• Corridors are cleaned one side at a time so a dry route is always availableand 6 more | 4 | 2 | 8 | • Provide slip resistant footwear for staff who work on floors that are often wet. |
| 4 | Violence, aggression and abuseHSE: Violence at work | Care staff, from residents who become distressed, and occasionally from relatives. Physical injury, threats and verbal abuse from customers, clients, service users or the public, and the stress and anxiety that follow. Higher where staff handle cash, refuse service, work alone or care for people who may become distressed. | 3 | 4 | 12 | • Staff report every incident of violence or abuse, including verbal, and the reports are reviewed• Staff have been trained to recognise warning signs, calm a situation and get away from it• Staff can call for help quickly, with a colleague nearby, a panic alarm or a phone to hand• There is a clear policy that abuse is not tolerated, staff can refuse service, and the police are called for assaults• Staff involved in an incident are debriefed and offered support, and time off if needed• Care plans record known triggers and what calms each resident, and staff read them before working with someone newand 3 more | 2 | 3 | 6 | • Change the layout so staff can leave, and keep cash low with a time delay safe or frequent banking. |
| 5 | Lone workingHSE: Lone working | The two night staff, on separate floors from 10 pm to 7 am. Injury or illness with no one to help, and higher risk of violence, when staff work alone: out of hours cleaning, home visits, driving, opening and closing, working in a store room. | 4 | 3 | 12 | • Tasks with a higher risk, such as work at height or handling aggressive people, are not done alone• Lone workers check in at agreed times, and someone knows where they are and what to do if they do not check in• Lone workers carry a charged phone and know who to call, and a personal alarm or lone worker device is provided where the risk is higher• Lone workers have been trained for the work and told what to do in an emergency, including first aid and fire• Lone workers can lock the premises, control who comes in, and are not expected to challenge intruders• The on call manager phones at midnight and 4 am; night staff carry the cordless phones and the call system pendantsand 3 more | 3 | 2 | 6 | • Ask lone workers about any condition that could make working alone unsafe and adjust the work. |
| 6 | Burns and scalds from hot surfaces, liquids and steamHSE: Catering and hospitality | Residents at baths, showers and radiators; kitchen and care staff with hot drinks and food. Burns and scalds from ovens, hobs, fryers, grills, hot water, steam, hot oil and hot equipment such as straighteners and irons. | 4 | 3 | 12 | • Hot water outlets that people can be scalded by are fitted with thermostatic mixing valves or marked as very hot• Staff have been shown how to use each piece of hot equipment safely and how to treat a burn• Cold running water is available for treating burns and a burns kit is in the first aid box• Thermostatic mixing valves on every bath and shower are checked and recorded monthly• Radiators in resident rooms have low surface temperature coversand 2 more | 4 | 1 | 4 | • Provide dry oven gloves and cloths suited to the equipment and brief staff not to use wet cloths.• Set the rule that oil is only moved when cool and fryers are drained with the right equipment.• Rearrange hot equipment so nobody has to reach across it. |
| 7 | Hazardous substancesHSE: COSHH basics. COSHH assessments needed | Domestic staff, care staff using sanitiser, and residents who could reach unlocked products. Burns, dermatitis, asthma, poisoning and long term illness from cleaning products, solvents, dusts, fumes and biological agents. Each substance needs its own COSHH assessment; this entry records that the risk exists and is controlled. | 4 | 3 | 12 | • Every hazardous substance in use has a COSHH assessment, kept in a register with the supplier data sheet• Substances are stored in their original labelled containers, in a locked or controlled store, away from incompatible products and food• The gloves, eye protection and other PPE the assessment calls for are provided and worn• Staff have been told the hazards and the controls for each product they use, and have signed the assessment• Spill kits, eyewash and first aid measures matching the products in use are in place and staff know where they areand 2 more | 4 | 1 | 4 | • Check whether a less hazardous product or a ready diluted version would do the job. |
| 8 | FireHSE: Introduction to fire safety | Everyone in the building; most residents need help to evacuate. Burns, smoke inhalation and death if a fire starts and people cannot get out. Sources of ignition include electrical faults, cooking, heaters, smoking and hot work; fuel includes waste, packaging, furnishings and flammable liquids. | 5 | 2 | 10 | • A fire risk assessment has been done for the premises and its actions are complete or in hand• Escape routes and fire exits are kept clear and unlocked while people are inside, and exit signs are visible• There is a way to raise the alarm that everyone can hear, and it is tested regularly• Extinguishers are provided for the type of fire likely, serviced yearly, and staff know when not to use them• Staff know the evacuation procedure and the assembly point, and a drill is held at least once a year• Waste, packaging and stock are kept away from ignition sources and cleared regularly, and flammable liquids are kept in a suitable store• Heaters, cooking equipment and electrical equipment are turned off when not in use and are not left unattended• Anyone who needs help to leave has a personal evacuation plan agreed with themand 5 more | 5 | 1 | 5 | None |