Understand own responsabilities and the responsabilities of of others

April 22, 2019 Nursing

Understand own responsabilities and the responsabilities of of others, relating to health and safety in the work setting

Legislation relating to general health and safety in a health or social care work setting

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The settings in which you work are generally covered by the Health and Safety at Work Act 1974. The act has been updated and supplemented by many sets of regulations and guidelines, which extend it , support it or explain it.

Health and Safety Work Act is an umbrella for:
1. Manual Handling Operations Regulations 1992 (amended in 2002)
2. Control of Substances HAZARDOUS TO Health Regulations 2002 (COSHH)
3. Reporting of Injuries, Diseases and Dangerous Occurences Regulations 1995 (RIDDOR)
4. Health and Safety First Aid Regulations 1981
5. Management of Health and Safety at Work Regulations 1999

Health and safety policies and procedures agreed with the employer and Health and Safety responsabilities of yourself and others in the work setting

You share the responsibility ith your employer for your own safety and that of all the people you support.
There are many regulations, laws and guidelines dealing with health and safety.

Employers have to :
? Make the workplace safe
? Prevent risks to health
? Ensure that machinery is safe to use, and that safe working practices are set up and followed
? Make sure that all materials are handled, stored and used safely
? Provide adequate first aid facilities
? Tell you about any potential hazards from the work you do, chemicals and other substances used by the organisation, and give you information, instructions, training and supervision as needed
? Set up emergency plans
? Make sure that ventilation, temperature, lighting and toilet, washing and rest facilities all meet health, safety and welfare requirements
? Check that the right work equipment is provided and is properly used and regularly maintained
? Prevent or control exposure to substances that may damage your health
? Take precautions against the risks caused by flammable or explosive hazards, electrical equipment, noise and radiation.
? Avoid potentially dangerous work involving manual handling and, if it cannot be avoided, take precautions to reduce the risk of injury
? Provide health supervision as needed
? Provide protective clothing or equipment free of charge if risks cannot be removed or adequately controlled by any other means
? Ensure that the right warning signs are provided and looked after
? Report certain accidents, injuries, diseases and dangerous occurrences to either the Health and Safety Executive or the local authority

As an employee, your rights are :

? As far as possible, to have any risks to your health and safety properly controlled
? To be provided, free of charge, with any personal protective and safety equipment
? If you have reasonable concerns about your safety, to stop and leave your work area without being disciplined
? To tell your employer about any health and safety concerns you have
? To get in touch with Health and Safety Executive or any local authority if your employer will not listen to your concerns, without being disciplined by them
? To have rest breaks during the working day, to have time off working during the working week and to have annual paid holiday

As an employee, your responsibilities are:

? To take responsible care of your own health and safety
? If possible, to avoid wearing jewellery or loose clothing if operating machinery or using equipment
? If you have long hair or wear a headscarf, to make sure it is tucked out of the way
? To take responsible care not to put other people – fellow employees and members of the public – at risk by what you do or not no in the course of work
? To cooperate with your employer, making sure that you get proper training and that you understand and follow the company’s health and safety policies
? Not to interfere with or misuse anything that has been provided for your health, safety or welfare
? To report any injuries, strains or illnesses you suffer as a result of doing your job
? To tell your employer if something happens that might affect your ability to work, because your employer has a legal responsibility for your health and safety, they may need to suspend you while they find a solution to the problem , but you will normally be paid if this happens
? If you drive or operate equipment or machinery, to tell your employer if you take medication that makes you drowsy, they should temporary move you to another job if they have one for you to do to

Both the employee and the employer are jointly responsible for safeguarding the health and safety of anyone using the premises.
The policy presented at the work setting must include:

? A statement of intention to provide a safe workplace
? The name of the person responsible for implementing the policy
? The names of any other people responsible for preventing particular health and safety hazards
? A list of identified health and safety hazards and the procedures to be followed in relation to them
? Procedures for recording accidents at work
? Details for evacuation of the premises

Tasks that should not be carried out without special training

All manual and handling needs to be carried out by people who have had training to do it. Employers are obliged to provide training in manual handling. Training is not a one-off,it is important to be up to date with the latest techniques and equipment, as well as any changes in the regulations. This area of work is very tightly controlled by legislation and regulations for very good reasons, moving people without proper training is dangerous both for them and for you.

How to access additional support and information relating to health and safety

Health and safety is an important issue, and it is always better to ask for more help than to make a guess and get something wrong.

You may find that you need some additional help because :
? Are unsure about what legislation and guidelines apply
? Do not know what action to take to ensure safety
? Are concerned about a particular situation or person
? Are unhappy about the risks from a pieces of equipment or another hazard
? Are unclear about who has responsibility

The Line Manager is always the first choice for additional information but information can also be found at www.hse.gov.uk .

Understand the use of risk assessments in relation to health and safety

Why it is important to assess health and safety hazards

Risk assessment in health and social care is important for everyone whether they are employers, self-employed or employees, who are required by law to identify and assess risks in the workplace. There are many regulations that require risks to be assessed and some are covered by the European Community Directives:

? Management of Health and Safety at Work Regulations 1999
? Manual Handling Operations Regulations 1992
? Personal Protective Equipment at Work Regulations 1992
? Health and Safety (Display Screen Equipment) Regulations 1992
? Noise at Work Regulations 1989
? Control of Substances Hazardous to Health Regulations 2002 (COSHH)
? Control of Asbestos at Work Regulations 2002
? Control of Lead at Work Regulations 2002
There are other regulations that deal with very specialised risks such as major hazards and ionising radiation.

The Management of Health and Safety at Work Regulations 1999 state that employers have to assess any risks which are associated with the workplace and work activities. This means all activities, from walking on wet floors to dealing with violence. Having carried out a risk assessment, the employer must then apply risk control measures. This means that actions must be identified to reduce the risks.
The risk assessment can also be carried out at someone else place.

How and when to report potential health and safety risks

It is important to develop and awareness of health and safety risks and that you are always aware of any risks in any situation you are in. In your workplace, you have a responsibility to report any unsafe situation to your employer.

Reporting of Injuries, Diseases and Dangerous Occurences (RIDDOR) Regulations 1995

Reporting accidents and ill-health at work is a legal requirement. All accidents, diseases and dangerous occurrences should be reported to the Incident Contact Centre. The information is important because that risks and causes of accidents, incidents can be identified and any necessary risk assessments carried out. All notifications are passed on to either the Local Authority , Environmental Health Department or the Health and Safety Executive.

The employer needs to report:
? Deaths
? Major injuries
? Accidents resulting in more than three days off work
? Diseases
? Dangerous occurrences

How risk assessments can help address dilemmas between rights and health and safety concerns

If you work in someone home or long term residential setting, you have to balance the need for safety with the rights of people to have their living space the way they want it.
Both you and the people you support are entitled to expect a safe place in which to live and work, but remember their rights to choose how they want to live.
Concerns for security can also create difficult situations. Of course, people have a right to see whomever they wish, but there can be situations where there may be concerns about vulnerable people being exploited or placed at risk of harm. You cannot insist on the levels of security that people adopt in their own homes, but you can advise people of the risks of opening doors to strangers or inviting them in.

People also need to assess the risks involved in doing the things they wish to do safely and without placing themselves at undue risk of harm.

Understand procedures for responding to accidents and sudden illness.

Different types of accidents and sudden illness that may occur

If accidents or injuries occur at work, either to you or to someone you are supporting, then the details must be recorded.
Your employer should have procedures in place for making a record of accidents – either an accident book or an accident report form. This is not only required by the RIDDOR regulations but also by the inspection bodies in all UK countries.

Make sure you know where the accident report forms or the accident book is kept and who is responsible for recording accidents.
Any medical treatment or assessment which is necessary should be arranged without delay. If someone has been involved in an accident you should check if there is anyone they would like to be contacted, perhaps a relative or friend. If the accident is serious, and you cannot consult the person, the next of kin should be informed as soon as possible.

Complete a report and ensure that all witnesses to the accident also complete reports. The following information should be included in the report:
? Date, time and place of accident
? Person/people involved – bearing in mind the Data Protection Act
? Circumstances and details of exactly what you saw
? Anything that was said by the people involved
? The condition of the person after the accident
? Steps taken to summon help, time of summoning help and time when they arrived
? Names of any other people who witnessed the accident
? Any equipment involved in the accident

Types of accidents and sudden illness that may occur in a health or social care setting

You may be involved with any of these emergencies when you are at work, whether you work in a residential, hospital or community setting.
There are major differences between the different work situations
? If you are working in a hospital where skilled assistance is always immediately available, the likelihood of your having to act in an emergency, other then summon help, is remote
? In a residential setting, help is likely to be readily available, although it may not necessarily be the professional medical expertise of a hospital
? In the community, you may have to summon help and take action to support a casualty until the help arrives. It is in this setting that you are most likely to need some knowledge of how to respond to a health emergency

The general guidance in taking initial action until further assistance arrives ins as follow :

? Severe bleeding
? Cardiac arrest
? Shock
? Loss of consciousness
? Epileptic seizure
? Choking and difficulty with breathing
? Fractures and suspected fractures
? Burns and scalds
? Poisoning
? Electrical injuries

Procedures to follow if an accident or sudden illness should occur

Severe bleeding

Severe bleeding can be the result of a fall or injury. The most common causes of severe cuts are glass, as the result of a fall into a window or glass door.


There will be apparently large quantities of blood from the wound. In some very serious cases, the blood may be pumping out. Even small amounts of blood can be very frightening, both for you and the casualty.Remember that a small amount of blood goes a long way and things may look worse than they are. However, severe bleeding requires urgent medical attention in hospital. Although people rarely bleed to death, extensive bleeding can cause shock and loss of consciousness

? To bring the bleeding under control
? To limit possibility of infection
? To arrange urgent medical attention

Action for severe bleeding

You will need to apply pressure to a wound that is bleeding. If possible, use a sterile dressing. If one is not readily available use any absorbent material, or even your hand. Do not forget the precautions. You will need to apply direct pressure over the wound for 10 minutes to allow the blood to clot.

If there is any object in the wound, such as the piece of glass, DO NOT TRY TO REMOVE IT. Simply apply pressure to the sides of the wound. Lay the casualty down and raise the affected part if possible. Make the person comfortable and secure.

In a residential care setting, call for the senior registered nurse to assess the severity of the injury. They will make the decision regarding whether the wound is severe enough to call a paramedic.

Protect yourself

You should take steps to protect yourself when you are dealing with casualties who are bleeding. Your skin provides an excellent barrier to infections, but you must take care if you have any broken skin, such as a cut, graze or sore. Seek medical advice if blood comes into contact with your mouth or nose, or gets into your eyes. Blood borne viruses can be passed only if the blood of someone who is already infected comes into contact with broken skin.
Ideally wear disposable gloves. If this is not possible, cover any areas of broken skin with a waterproof dressing.

Cardiac arrest

Cardiac arrest occurs when a person’s heart stops. Cardiac arrest can happen for various reasons, the most common of which is a heart attack , but a person’s heart can also stop as a result of shock, electric shock, a convulsion or other illness or injury.

? No pulse
? No breathing

? To obtain medical help as a matter of urgency

It is important to give oxygen, using mouth to mouth resuscitation and to stimulate the heart, using chest compressions. This procedure is called cardio-pulmonary resuscitation (CPR). You will need to attend a first aid course to learn how to resuscitate.

Action for cardiac arrest

Check whether the person has a pulse and whether they are breathing. If not, call for urgent help from a senior registered nurse who will assess the need for summoning emergency services.
Start methods of resuscitation if you have been taught how to do it. The pattern is two breaths then 30 chest compressions. Repeat this until help arrives if you have been trained to do it.


Shock occurs because blood is not being pumped around the body efficiently. This can be the result of loss of body fluids through bleeding, burns, severe vomiting or diarrhoea , or a sudden drop in blood pressure or a heart attack.

? Will look very pale, almost grey
? Will be very sweaty, and the skin will be cold and clammy
? Will have a very fast pulse
? May feel sick and may vomit
? May be breathing very quickly

? To obtain medical help as a matter of urgency
? To improve blood supply to heart, lungs and brain

Action for shock

Summon expert medical or nursing assistance. Lay the person down on the floor. Try to raise the feet off the ground to help the blood supply to the important organs. Loosen any tight clothing.

Watch the person carefully.Check the pulse and breathing regularly. Keep the person warm and comfortable, but do not warm the casualty with direct heat, such as a hot-water bottle.
Raise the feet off the ground and keep the casualty warm.
DO NOT ALLOW THE CASUALTY TO EAT OR DRINK, or leave the casualty alone, unless it is essential to do so briefly in order to summon help.

Loss of consciousness

Loss of consciousness can happen for many reasons, from a straightforward faint to unconsciousness following a serious injury or illness.

A reduced level of response and awareness. This can range from being vague and woozy to total unconsciousness.

? To summon expert medical help as a matter of urgency
? To keep the airway open
? To note any information which may help to find the cause of the unconsciousness.


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