POLICY TITLE

Moving and handling children and young people with disabilities

POLICY REFERENCE NUMBER CG006

LEAD POLICY AUTHOR/S

Heather Anderson – Health and Therapies Manager Deputy Head of Service

ACCOUNTABLE DIRECTOR

Simon James – Associate Director of SEN & Disability

APPROVED BY: Clinical Governance Group (approved November 2015)

RATIFIED BY: Rob Henderson

EQUALITY IMPACT STATEMENT

A screen assessment has been undertaken to ensure that equality is promoted and there is no discrimination in view of race, disability, age, gender, sexual orientation or religious belief.

EQUALITY IMPACT STATEMENT

Yes

RELATED POLICIES Incident Policy

Safeguarding Policy

Health & Safety Policy

Consent Policy

Critical Incident Policy

IMPLEMENTATION DATE Feb 2016

NEXT REVIEW DATE Feb 2019

Contents

1. Introduction ....................................................................................................................... 1

2. Background ........................................................................................................................ 1

3. Scope ................................................................................................................................. 2

4. Responsibilities .................................................................................................................. 3

5. Responsibilities for children ............................................................................................... 5

6. Record keeping .................................................................................................................. 5

7. Adverse incidents and emergencies .................................................................................... 5

8. Moving and handling in fire evacuation .............................................................................. 6

9. Risk assessment of handling tasks ...................................................................................... 6

10. Differences of opinion ........................................................................................................ 8

11. Training ............................................................................................................................. 8

12. Behavioural handling issues ............................................................................................... 9

13. Equipment ......................................................................................................................... 9

14. References ....................................................................................................................... 11

Appendix 1: Moving and handling risk assessment form .............................................................. 12

Appendix 2: Moving and handling assessment template .............................................................. 14

Appendix 3: Collection and delivery of equipment checklist for risk assessment .......................... 15

Appendix 4: Existing controls for moving and handling practice ................................................... 16

Appendix 5: Generic Personal Emergency Evacuation Plan ........................................................... 17

Appendix 6: Risk assessment for physiotherapists (as part of initial assessment template) .......... 18

Membership of Policy Development Group ................................................................................. 19

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1. Introduction

This policy aims, as far as is reasonably practicable, to ensure the health and safety of children, employees and others in relation to moving and handling children and young people with special education needs (SEN) or a disability, whilst removing or reducing the risk of manual handling injuries. This guidance applies to any activity that involves the use of bodily force in lifting, lowering, pushing, pulling, carrying, supporting or otherwise moving a person, taking account the Disability Discrimination Act 1995, the SEN and Disability Act 2001, The European Convention for the Protection of Human Rights and Fundamental Freedoms and the EU Charter of Fundamental Rights (Nice 2000). The policy is designed to provide a balanced approach to the protection of the health, safety and welfare of both children and the staff who support them. It complies with the requirements of the Manual Handling Operations Regulations, 1992 (revised 1998 edition), (amended 2002), the Health and Safety at Work Act 1974 and the Reporting of Incidents, Diseases and Dangerous Occurrences Regulations, 1995. The policy aims to provide a balanced approach to keeping staff and carers safe and reducing injury whilst supporting the developmental needs of children and young people with disabilities and special educational needs. Total risk avoidance is not appropriate and likely to result in children and young people’s needs and development not being supported and nurtured appropriately for their overall health, wellbeing and success in education.

2. Background

Achieving for Children’s (AfC’s) services support children’s health and wellbeing. Children and young people with physical disabilities may require specialist support and moving and handling to enable them to access everyday activities and educational opportunities. Good moving and handling may be required to prevent injury or avoid further complications to their condition. Equipment may be required in the home, in educational, respite, short breaks and early years’ settings to support moving and handling. “Working with disabled children and young people may involve moving and handling risks. We need to manage these risks effectively, in ways that ensure we do not limit disabled children and young people’s opportunities to play, and to have a wide social experience at home, in education and in their community. The human rights and safety of the child and the worker must be carefully balanced in a way that ensures that both sets of rights are maintained.” (The Common Sense Approach to Moving and Handling of Disabled Children and Young People) Children with special educational needs sometimes require specialist support to meet these needs and enable them to access the curriculum. The Equality Act states that, “The special educational needs (SEN) framework is designed to identify, assess and make provision for children’s special educational needs. Special educational provision should include any educational aids and services where these are necessary to meet a child’s identified needs.”

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3. Scope

This policy applies to all permanent, locum, agency, bank and voluntary staff who work within Achieving for Children in the course of their employment. It applies to all staff who have involvement in moving and handling children and young people for the purposes of:

Accessing everyday activities

Accessing education

Enabling inclusion

Providing specialist support and therapy.

Advising others about appropriate moving and handling

Providing education about appropriate moving and handling.

In the event of a major incident or emergency, 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 safety. Schools and other educational or early years’ settings are required to make reasonable adjustments to enable children and young people to access the environment. This policy does not apply to schools and settings but acknowledges that Achieving for Children staff are often working within these environments and that staff need to understand roles and responsibilities in these contexts, as well as supporting schools and settings to support children and young people. Schools have a responsibility:

To avoid treating a child with disabilities less favourably than a non-disabled child

Proactively take reasonable steps to ensure disabled children and disabled prospective children are not placed at a disadvantage to those not disabled

To have a plan, in writing, (accessibility plan) which sets out how they will increase disabled children’s participation in the curriculum and improve the physical environment to allow this, where necessary.

AfC does not support a no lifting policy, on the basis that this totally ignores the needs of the child and young person, and their rights under the Equality Act, the Manual Handling Operations Regulations and the Health and Safety Act. Regulations, do not prohibit all moving and handling, rather they require employers to adopt a risk management approach.

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4. Responsibilities

4.1 Employers

Are responsible for the actions of their employees and must ensure good practice is followed. But also that they provide appropriate training and support to their staff to ensure they can fulfil their roles safely in line with legislation

4.2 Clinical Governance Group

The Clinical Governance Group will receive audits and reports against monitoring of this policy, and report to the Senior Leadership Team, and who are ultimately accountable to the AfC Board.

4.3 Managers

Managers are responsible for ensuring the workplace has safe systems of work and monitoring procedures in relation to moving and handling. This includes:

Ensuring their staff are adequately trained to safely undertake risk assessments and manual handling

Providing appropriate supervision to support staff in moving and handling activities

Ensuring risk assessments are undertaken and suitable control measures for moving and handling activities

Following up any incidents, accidents, injuries arising from moving and handling related causes.

The overall management responsibility for the Integrated Service for Children with Disabilities with moving and handling needs lies with the Head of Service

4.4 Social Care Occupational Therapy Team

The Social Care Occupational Therapy Team provides a service for the provision of equipment and accompanying advice in the home. From autumn 2015, the Social Care Occupational Therapy Service also offers commissioned specialist expertise and advice service to schools and settings, offering expert moving and handling advice as well as advice about environmental adaptations required to meet the needs of children with a high level of need. This includes:

Identifying suitable moving and handling equipment for use at home

Monitoring the contractor responsible for the provision of moving and handling equipment in the community

Providing an advice service to other professionals within AfC.

4.5 Occupational Health and Safety Team

Provides information and guidance to AfC in relation to moving and handling

Investigates accidents relating to moving and handling in conjunction with managers and staff

Ensures that there is adequate and suitable training provided for staff

4.6 Business Support Manager

The Business Support Manager is responsible for managing the contracts for the maintenance of the hoists on site at Moor Lane and at Windham Croft Centre.

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Property management There is a contract in place to service the hoists within the Integrated Service for Children with Disability which is managed via property services in Kingston. At the Croft Centre, a contract has recently been set up to do this servicing for service hoists and beds. Both contracts sit with NH Maintenance.

4.7 Staff

All AfC staff are required to follow the Health and Safety Policy, the moving and handling guidance set out in this document and attend regular training to maintain their knowledge and skills Staff who hold responsibility for, or who are very involved in moving and handling children as part of their core work or in conjunction with therapeutic handling, must ensure that appropriate moving and handling risk assessments have been carried out (and documented accordingly), and that appropriate protocols and plans are in place to support work undertaken with the child. In addition to the above, staff who move and lift children as part of their role are required to:

Attend training around moving and handling on an annual basis

Ensure that they have risk assessed any moving and handling situations before intervening or being involved, except in emergencies and situations that could not be foreseen but require a response

Work to generic risk assessment principles where moving and handling needs are standard and do not require a bespoke moving and handling risk assessment

Report to their manager, any change in health status or any injuries that might impact on their ability to move and handle children

Seek supervision and peer or expert support when more difficult moving and handling situations are encountered

Report accidents at work that arise from moving and handling activities to the Health and Safety Team so appropriate action can be taken to prevent a recurrence

Wear clothing and footwear that is appropriate for the work they are involved with.

In some cases AfC staff are instrumental in developing and contributing professional advice to inform moving and handling practice for individual children.

4.8 Fitness of staff

If there are any concerns about the fitness of staff to perform moving and handling activities, advice from Occupational Health should be sought. Any employee who has sustained an injury that may affect their ability to move and lift safely should inform their manager as soon as possible. It may be necessary to seek advice from the Occupational Health Team to determine fitness for work. The service manageror team leader, in conjunction with the moving and handling advisors, may seek an occupational health assessment if concerns are raised following a discussion with their manager. Each situation is assessed individually.

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5. Responsibilities for children

The right of all children and young people to safe and appropriate assistance in terms of their moving and handling needs is recognised by AfC. It is expected that their dignity and privacy will be protected at all times. By implementing safe systems of work (handling plans) following risk assessment, children and young people will receive the most appropriate support and the risk of injury to staff, children and young people will be minimised. As far as they are able, children and young people will be expected to move independently and take responsibility for their safety and that of others. When assessed as appropriate and in the child and carer’s best interest, use should be made of suitable mechanical equipment and aids that assist in the safer handling of children and young people. This should not be the default position and should only be used where a risk assessment has deemed the use of such aids to be necessary. Under certain special circumstances, however, when dealing with movement needs of individuals who have physical and/or learning difficulties, it may be necessary to move or position them by manual lifting. A documented risk assessment should be completed in this instance, with any risks reduced as far as is reasonably practicable. It is important to make decisions about moving and handling with the child’s or young person’s participation. An assessment may be required to assess the child’s or young person’s understanding of the situation, and their mental capacity, in order to assess how much participation they should make within any decisions. Where a child or young person requires moving and handling with the support of equipment in the home, the social care occupational therapists will provide on the safe use of any equipment which is prescribed.

6. Record keeping

Moving and handling risk assessments should recorded in the child’s or young person’s notes so that good practice can be audited, shared with others and reviewed as appropriate. There should be a risk assessment available in the notes for any child where moving and handling risks are identified. Where risks over and above the usual level for that professional activity are identified, there should be clear written moving and handling guidance in the child’s notes – this may be recorded within the risk assessment.

7. Adverse incidents and emergencies

An adverse incident is any event or circumstances arising during care that could have, or did, lead to unintended or unexpected harm, loss or damage. Emergencies are generally foreseeable. Therefore, the risk of having to lift a child or young person who does not have a risk assessment in place, should be minimal. Real emergencies include

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situations where a person is in water and in imminent danger of drowning, and in these cases a dynamic risk assessment will take place.

8. Moving and handling in fire evacuation

All employees and children with disabilities must be able to leave the building promptly in the event of an emergency. Any evacuation plan should not rely on the Fire and Rescue Service to make it work. Fire evacuation assessments should be completed for each AfC building where children or young people with mobility problems would need physical assistance. Arrangements will be confirmed in a Personal Emergency Evacuation Plan (PEEP) which is undertaken by:

The manager of the building, or

The AfC officer responsible when visiting an external site. 8.1 Training staff in moving and handling in emergency evacuation

Staff who are required to provide physical assistance to children or young people during emergency evacuation must have completed the moving and handling training and PEEPs training. 8.2 Evacuation chair provision

If children or young people are unable to manage stairs and are dependent on lifts to move between floors, it is likely that some form of evacuation chair will be required for emergency evacuation. Where there is an evacuation chair in place, there should be nominated trained staff within the building who can support anyone needing to use the chair in the event of an evacuation The person who carries out the fire risk assessment for the building will determine the number of chairs that will be required to enable evacuation from all parts of the building, in the event of a fire. The assessment will be in addition to the existing fire risk assessment. Consideration must be given to the number of staff that will be needed to assist a child or young person to use the evacuation chair. Maintenance of evacuation chairs is the responsibility of those managing the building, to ensure that all evacuation chairs on-site are maintained in good working condition. Any concerns or defects should be reported to the manufacturer as soon as they are discovered.

9. Risk assessment of handling tasks

In line with The Manual Handling Operations Regulations (1992), which require manual handling risk assessments to be carried out in all cases where hazardous unavoidable manual handling tasks have been identified, the Health and Safety Executive publish guidelines to help employers determine which tasks require risk assessment. However, these guidelines pertain only to inanimate loads. There are agreed controls in place for all moving and handling tasks (appendix 4), which should be displayed in areas where staff are undertaking moving and handling on a regular basis.

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Moving and handling risk assessment templates are in use in the Integrated Service for Children with Disabilities and are included in appendices 1, 2 and 3. There is also a specific physiotherapy assessment form available (appendix 6). Risk assessments are undertaken by physiotherapists, occupational therapists, nurses, home and community support staff and others relevant staff involved in delivering care. Risk assessments will vary depending on the establishment and the circumstances of the child’s needs. They are reviewed and updated according to the needs of the child, and as these needs can change frequently, it is essential that the risk assessment takes any changes into account. As a minimum they are reviewed annually. A copy of the risk assessments are held in the child’s case file which is accessible to all AfC staff. Moving and handling risk assessments should, where relevant, be shared across the organisation and its teams to ensure relevant staff are aware they have been undertaken. Meanwhile, all staff need to be aware of local arrangements. Review of assessments is undertaken by the AfC member of staff responsible for care, which includes moving and handling. Due to the complexity of the handling tasks associated with children and young people with physical disabilities and their vulnerability, AfC requires that risk assessment are carried out for all those requiring physical assistance from their support worker. Where staff are working with a number of children with similar needs, this may be covered by a more generic risk assessment which is not necessarily individualised. However, these should be used after there has been a review of needs and this should be noted in written case notes. The risk assessment (appendix 1) must take into account:

The task: referred to as transfers, from wheelchair to class chair, from class chair to change bed

The individual’s (employee’s) capabilities

The load (child or young person)

The environment

The equipment that is needed or in place.

Access to the curriculum, therapies and other school activities are very important to children with disabilities and must be considered during the risk assessment process. Risk assessments may include a handling plan and specific instructions for manual techniques and/or equipment. Where appropriate, photos should be taken to ensure techniques and equipment are used correctly with that child. Where equipment is installed or specific handling techniques are recommended, onsite training for all staff who will use that equipment must be organised. Equipment must not be used until specific equipment training has been provided.

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If a child or young person is hoisted, slings or standing harnesses must be assessed to ensure they are suitable for that child. If at any time a member of staff is experiencing difficulties with a particular task, regardless of whether anyone else has the same concerns, they must inform their line manager so that a risk assessment review can be carried out.

10. Differences of opinion

When a child or young person (or parent or carer speaking on their behalf) refuses to be moved according to the handling plan, there should be a discussion between staff, the staff in any school or setting, and the child or young person to explore the reasons, and discuss the benefits of the handling plan. Other methods or equipment should be considered, so that there is a clear understanding of the potential options for moving and handling. If the child, parent or carer still refuses, staff must consider the risk of injury to staff from manual handling balanced against the risk to the child if the procedure is not carried out. The result of this assessment would usually be to change an element of care. This should be agreed by everyone concerned: child, parent, carer, employee, therapist etc. Ultimately, if the child, parent or carer insists on a practice that is unsafe, AfC staff can refuse to carry out this procedure and seek legal advice.

11. Training

There is general moving and handling training on offer within Kingston and Richmond. This is essential training for those who are moving and handling on a regular basis, or as an inherent part of their work, and should be attended before moving and handling children. It is important that staff understand the potential risks associated with moving and handling and know how to keep themselves safe, and to protect themselves from injury.

Therapist and nursing staff, and any other relevant AfC employees within the Integrated Service for Children with a Disability, where moving and handling is inherent to their work, must attend specific moving and handling children training on an annual basis to support safe moving and handling and to reflect and review their practice. The training also serves to update staff about any new equipment, new evidence or new thinking in the area of moving and handling.

All staff required to move and handle as part of their work (people and objects) are required to undertake training on an annual basis. The following courses are available through the Workforce Development Team.

11.1 Moving and lifting people

The course will include:

Undertaking risk assessments

Recording and communicating health and safety information

Practical moving and lifting techniques – people and objects

Practical use of lifting equipment including use of slings, mechanical aids and ensuring equipment is safe to use.

11.2 Personal Emergency Evacuation Plans (PEEP)

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How to undertake and record a PEEP

Erecting and folding the chair

Moving the chair on the level

Moving the chair downstairs with a person in it

Stowing the chair away securely after use.

A PEEP format is included in this policy in appendix 5. 11.3 Evacuation chair training

Most evacuation chair suppliers will provide a single basic training session in the use of their product when the equipment is supplied.

All staff that may be involved in emergency evacuation of children and young person should attend training and complete all parts of the training session. Any health problems that prevent staff from participating fully in the training session should be identified to the line manager. Staff that are trained in the use of the evacuation chairs will need to practise use of the chairs with colleagues regularly (twice yearly at least) to ensure that their skills remain up-to-date.

11.4 Annual or bi-annual refresher training

This will include an update on the following.

Undertaking risk assessments

Recording and communicating health and safety information

Practical moving and lifting techniques – people and objects

Practical use of lifting equipment including use of slings, mechanical aids and ensuring equipment is safe to use.

E-learning courses, for office-based staff who occasionally move equipment, are available via Evolve. All staff are required to complete the on line course.

12. Behavioural handling issues

There may be occasions when a child or young person who is usually mobile and physically independent, is unable to cooperate due to behavioural issues. This does not present a manual handling risk unless the child is in imminent danger and must be physically moved to safety. If a manual handling situation due to behavioural issues becomes a regular occurrence with a child, there may need to be a multi-professional meeting to discuss and agree a way forward, including professionals with expertise around behaviour management, as well as those with expertise around moving and handling.

13. Equipment

All equipment that comes under the Lifting Operations and Lifting Equipment Regulations (1998) is subject to thorough annual inspection and testing. All hoists must have an up-to-date service and

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maintenance agreement indicating that the most recent inspection has taken place within six months. Each hoist must display a sticker showing the last date of service. Hoists that have not been serviced within the last year should be taken out of service immediately. All staff using the equipment must have received training with that equipment. Clear instructions should be provided (which may include photos) to ensure that the equipment is used as intended. Equipment must not be used until specific onsite training has been provided. All staff must carry out a visual inspection before using any equipment to check for signs of wear and tear or damage. Any hoists or equipment that is powered must be kept charged according to manufacture guidelines and all staff using it must know how to use the emergency stop and emergency lower option. Equipment must be stored appropriately so that it is easily accessible when needed and does not represent a hazard. In the equipment store at Moor Lane, a clear fire exit route must be maintained at all times. Equipment choices must take into account the handling tasks that would be associated with that equipment. Wherever possible, equipment that meets the child’s or young person’s needs and reduces handling tasks for staff should be considered in preference to equipment that solely meets the child’s or young person’s needs.

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14. References

Moving and Handling Children and Young People with Disabilities Surrey County Council, 2009/2010 The Common Sense Approach to Moving and Handling of Disabled Children and Young People The Scottish Government, 2012 Health and Safety at Work Health and Safety Executive, 1974 Equality Act 2010 Government Equalities Office, 2013 Manual Handling Operations Regulations Health and Safety Executive, 1992 Reporting of Injuries, Diseases and Dangerous Occurrences Regulations Health and Safety Executive, 2013 Lifting Operations and Lifting Equipment Regulations Health and Safety Executive, 1998 Provision and Use of Work Equipment Regulations Health and Safety Executive, 1992

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Appendix 1: Moving and handling risk assessment form

Name:

Date of birth:

1) Area (Environment) 2) Activity (Task) Children’s therapy and nursing

Moving and handling children and young people

3) Hazards associated with the activity (Load) Injury to staff Injury to child or young person Injury to those carrying out therapy programmes 4) Persons Affected (Individual)

5) Standards to be reached (legal/policy)

Staff member Child or young person Other staff carrying out therapy programmes

AfC Moving and Handling Policy

Health and Safety at Work etc, Act, 1974

Equality Act 2010, Government Equalities Office, 2013

Manual Handling Operations Regulations, Health and Safety Executive, 1992

Lifting Operations and Lifting Equipment Regulations. Health and Safety Executive, 1998.

Provision and Use of Work Equipment Regulations. Health and Safety Executive, 1992.

6) Current controls (including equipment) Controls Maintained by

All qualified staff HCPC or NMC registered

Unqualified staff work to a care plan under delegated responsibility

Moving and handling policy in place for AfC

Moving and handling risk assessment forms included in case notes

Specific individualised risk assessment where assessed as required

Availability of equipment to support moving and handling

Assessment of the environment to ensure it is suitable for moving and handling

Manual handling equipment used to move children, where risk is identified as medium or high

Annual training of staff

Therapeutic handling is planned and delivered within the context of a care plan and includes roles and contexts for other staff and carers working with the child or young person

Health and Therapy Manager Team Leads PT/OT/nursing Teams

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7) Risk rating (with current controls in place) – please tick

High: requires additional individualised risk assessment and multi-disciplinary or specialist advice

Medium: requires additional individualised risk assessment

Low: covered by standard practice of the service

8) Reasons for medium and high risk

9) Further controls necessary for medium and high risk Control Actioned by

10) Risk rating (when new controls in place) High

Medium

Low

11) Completed by

Date: 12) Date of risk assessment review

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Appendix 2: Moving and handling assessment template

Area Activity Therapy Services Moving and Handling Children

No: Potential risks Current controls Maintained by Injury to staff

Injury to child Assessment of environment Assessment of child’s physical condition and understanding of their limitations and support and management needs

Unsuitable environment Assessment of environment

Need for equipment to support moving and handling Physiotherapy, occupational therapy, nursing assessment of child and young person’s needs Identification of equipment needed to handle child

Need for two people Health assessment

Loss of function, not maintaining function of child or young person

Health assessment Health plan

No: Hazard Further controls necessary Actioned By: New Risk

Completed by Date:

Date of risk assessment review

Appendix 3: Collection and delivery of equipment checklist for risk assessment

Integrated Service for Children with Disabilities: Health and Therapies

Areas for consideration Level of risk / impact Does this require a different solution

Equipment Weight

Size

Shape

Pick up point Location of equipment

Ease getting equipment in and out of car

Ease to move to car or other vehicle

Drop off point How close can vehicle get to point of drop off point

Is drop off point on the ground floor

How many flights of stairs (if relevant)

Any other issues about location

Will equipment be received by recipient

Appendix 4: Existing controls for moving and handling practice

Integrated Service for Children with a Disability and Health Teams moving and handling controls in place for all children accessing services

All qualified staff HCPC or NMC registered

Unqualified staff work to a care plan under delegated responsibility

Moving and handling policy in place for Achieving for Children

Moving and handling risk assessment forms included in case notes

Specific individualised risk assessment where assessed as required

Availability of equipment to support moving and handling

Assessment of the environment to ensure it is suitable for moving and handling

Manual handling equipment used to move children, where risk is identified as medium or high

Annual training of staff

Therapeutic handling is planned and delivered within the context of a care plan and includes roles and contexts for other staff or carers working with the child or young person

All staff to report any injury or health changes to their line manager (to assess the impact on ability to move and handle children)

Appendix 5: Generic Personal Emergency Evacuation Plan

Personal Emergency Evacuation Plan (PEEP)

Name

Building covered by this plan

Alarm system

I am informed of an emergency by(tick all that apply)

Existing alarm system Any other notes or comments

Visual alarm system

Pager device

My carer or buddy

Other: please specify

Designated assistance

The following people will give assistance when I need to get out of a building

Name(s) Contact Phone number

1.

2.

Equipment provided

I need to use the following equipment: (please tick all that apply)

Evachair Any other comments:

ResQmat

Mechanical Hoist

Vibrating Pager(Deaf Alerter System)

Other: Please specify below

Evacuation procedure

These are step-by-step instructions beginning from the sound of the first alarm.

NB: The following is an example that might be appropriate for someone who is a wheelchair user and needs assistance to evacuate using the stairs

1. Head for pre-arranged location or head to the refuge point unaided

2. Move without delay to the nearest safe refuge. Operate fixed radio by pressing the button

3. Precinct number to report our location

4. Fire may enter the refuge report to security

Appendix 6: Risk assessment for physiotherapists (as part of initial assessment template)

Risk assessment (circle as appropriate)

(Not necessary to complete for pre-mobile infants)

Risk rating (total score)

5 +

High Requires additional individualised risk assessment and multi-disciplinary or specialist advice. Please affix completed risk assessment form.

3-5

Medium Requires additional individualised risk assessment. Please affix completed risk assessment form.

0-2

Low Covered by standard practice of the service. Does not require risk assessment form to be completed.

Date risk rating to be reviewed Staff and signature (if separate from full assessment template)

Child’s ability Child’s environment Handling task 0 Child able to move

independently

0 No attachments 0 No assistance needed

1 Child needs minimal assistance or supervision

1 One attachment such as a catheter, gastrostomy, oxygen mask

1 Minimal assistance from carer

2 Child able to co-operate and can move with assistance

2 Multiple attachments such as awheelchair, bed or other equipment

2 Dependent on carer and mechanical aids such as a hoist

3 Child aware of surroundings and able to co-operate to a moderate degree

4 Child able to assist to a limited degree but may not co-operate, be confused or have physical limitations

5 Child unable to assist in any way

Membership of Policy Development Group

Heather Anderson Health and Therapies Manager Deputy Head of Service Teresa Candfield Associate Director Health Partnerships Consultation This policy was distributed to the following people during the consultation phase: Heather Anderson Health and Therapies Manager (Deputy Head of ISCD) Caroline Baxter Head of Integrated Service for Children with a Disability Geraldine Burgess Home and Community Support Manager Ian Dodds Director of Standards and Improvement Pat Folkerd Social Care Occupational Therapist Kingston Mary Head Deputy Head of Service Emotional Health Service (EHS) Robert Henderson Deputy Chief Executive Caroline Jager Short Breaks and Aiming High Manager Simon James Associate Director SEND Catherine Johnson Lead Occupational Therapist (ISCD) Beverley Kennedy Social Care Occupational Therapist Richmond Sandhya Kenyon Community Paediatrician KHFT Henry Kilpin Senior Policy Analyst Enno Kuettner Acting Head of Service Emotional Health Service (EHS) Lynn Lock Young People Substance Misuse Service Manager Heidi Mansfield Crofters Manager/Interim Croft Cottage Manager Lorna Mansell Occupational Health Lead Suzanne Payne Head of Strategy and Programmes Ivana Price Strategic Head of Integrated Youth Support Services Candice Raymond Lead Physiotherapist (ISCD) Nicola Rocca Team Leader, Disabled Children's Nursing Team Clive Seall Interim Strategic Head of Family Support Services Jo Steer Head of Service Emotional Health Service (EHS) James Thurston SPA (including Annie Benning, HV) Alison Tywnam Director of Social Care Lesley Yexley Business Support Manager, Integrated Service for Children with Disability

Peer review

Peer reviewed for policy components by: Teresa Candfield

Peer reviewed for specialist content by: Lorna Mansell/Beverley Kennedy