The Newcastle upon Tyne Hospitals NHS Foundation Trust. Strategy for the Prevention of Slips, Trips and Falls

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The Newcastle upon Tyne Hospitals NHS Foundation Trust Strategy for the Prevention of Slips, Trips and Falls Version No.: 3.1

Effective From: 25 February 2015 Expiry Date: 18th September 2016 Date Ratified: 18th February 2015

Ratified By: Trust Health and Safety Committee / Falls Task Force Group 1 Introduction

The Trust is committed to reducing the risk to patients, visitors and staff of slipping or falling in our hospitals and external community premises. Furthermore the Trust recognises the requirement to ensure that floors and traffic routes within our buildings are free from the risks of slips as required by the Workplace (Health, Safety and Welfare) Regulations 1992.

Every year thousands of workers are involved in slips, trips and falls incidents, many employees are left with injuries and although it is rare, in some instances falls can be fatal. Slips, trips and falls account for over a third of all major injuries in the United Kingdom. Moreover patient falls are one of the most frequently reported patient

incidents, which in a small number of cases does result in serious injury. Some of these accidents are preventable and the incidence can be dramatically reduced through risk assessment and pro-active management together with good housekeeping and control of wet or contaminated surfaces.

2 Scope

This strategy is intended to be a working document for all staff to utilise throughout the Trust, laying down a template for the reduction of slips, trips and falls to patients, visitors and staff. The action plan of the strategy is intended to be a living document and will be reviewed on an annual basis and when ongoing and immediate changes are made to the management of slips, trips and falls within the Trust. To ensure that this is achieved, working with staff side representatives the Newcastle upon Tyne Hospitals NHS

Foundation Trust will take all reasonably practicable measures to ensure that

workplaces under its control are safe and without unnecessary risk. Recognising the importance of on-going risk assessment, both managers and employees are required to be familiar with this strategy and understand their role and responsibilities.

3 Aims

The aim of this strategy document is to provide a framework to highlight specific areas where action is necessary to adequately assess the risks of slips and falls associated with floors and flooring design. In addition it is intended to consider areas where

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intervention is required to control risks from slips and falls and to provide an up to date action plan which will be monitored and reviewed by the Trust Health and Safety Committee and the Falls Taskforce, in accordance with Regulation 5 of the Management of Health and Safety at Work Regulations 1999.

4 Duties (Roles and responsibilities) 4.1 The Trust Board

The Trust Board is ultimately responsible for fulfilling all Health and Safety duties as an employer, including all Statute Health and Safety Law requirements. 4.2 Executive Directors

The Chief Executive has overall responsibility to the Trust Board for ensuring that appropriate and effective health and safety management systems are in place. The Chief Executive delegates responsibility for health and safety to the Director of Quality and Effectiveness. In practice the Director of Quality and Effectiveness deals with matters of health and safety in close association with Executive

Directors, Clinical Directors, Senior Managers and the Health and Safety Lead.

4.3 Clinical Directors and Heads of Services

Clinical Directors and Heads of Services are responsible for ensuring that the day-to-day activities of the Directorate/Department are conducted in as safe and suitable manner. That Trust Health & Safety Policies are effectively and correctly implemented within their own Directorate/Departments and that sufficient priority and management support is given to matters of health and safety to ensure effective action and to promote a safety culture among all staff.

4.4 Directorate/Department Managers

Directorate/Department managers have the ultimate responsibility for all health and safety issues within their directorate/department. They must ensure that there is a sound local health and safety function as well developed health and safety awareness and culture within their remit. They will ensure that risk assessments are undertaken and reviewed and there is a health and safety strategy to address identified issues, they must also enable effective

communication links for the dissemination health and safety information within their directorate/department; this extends to the risks of slips, trips and falls. 4.5 Health and Safety Department

The Health and Safety Lead will review the overall Strategy on an annual basis and ensure that the action plan is updated annually and as required through-out

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the year. All changes to the action plan will be discussed and reviewed by interested parties involved who will be responsible for the implementation of any actions. All changes to the strategy will be ratified through the Trust Health and Safety Committee and the Falls Task Force

4.6 General responsibilities

A number of specific responsibilities for individuals, teams and departments are contained within section 6 and the action plan at Appendix 1.

5 Definitions

Risk assessment is simply a careful examination of what, in the workplace, could cause harm to people, and review to determine if sufficient precautions are in place or should more be done to prevent harm.

6 Risk assessment

6.1 Risk Assessment (environment)

6.1.1 The Health and Safety Operational Policy details management

responsibility to ensure that a robust risk assessment process is in place. Risk assessors must be appointed, trained and given the opportunity and time to undertake risk assessments within the local

directorates/departments. All Managers are responsible for ensuring that risk assessments are undertaken to reduce the risk of Slips, Trips and Falls assessments for all areas within their directorate/Dep. and should include:

 Identification of types of hazard and how likely it is to occur

 Characteristics, quality and condition of the flooring and use

 Influence of the weather and other external elements

 Programmes for maintenance, renewal and cleaning procedures

 Timing and method of floor cleaning processes

 Work-place users

 Education and training provision

 Outcomes, suitable controls and monitoring effectiveness.

 Review date.

6.1.2 All managers are responsible for ensuring that slips trips and falls incidents have a thorough investigation carried out and that suitable proactive initiatives are put in place to reduce falls and where appropriate, including a review of the risk assessment.

6.1.3 All department risk assessors should be aware of the results of the Floor Review Programme in their locality, ensuring that floor surfaces are tested

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for wear, slipperiness, roughness and suitability to the proposed

environment and use. Floor testing information is available under health and safety information on the intranet.

6.1.4 Floor review programme will be undertaken by the Estates Department in consultation with the Health and Safety Team. To facilitate the floor review programme Estates staff will utilise the Surtronic Duo, roughness checker combined with the HSE SAT tool.

6.1.5 Where floors are identified as being of a particularly slippery/worn surface an action plan will be developed based on the HSE Risk Assessment Tool Outcomes to establish suitable controls to reduce the risk of slips, trips and falls will be implemented.

6.1.6 A report will be produced and presented detailing the Floor Review

Program outcomes and actions to the Trust Health and Safety Committee for review and discussion. The program will be repeated every 2 years or in specific areas where a risk has been identified.

6.1.7 Walk off matting in public areas, external weather conditions and cleaning regimes will also be considered as part of the risk assessment process HTM 61 should be followed.

6.1.8 Managers must ensure that regular environmental inspections are carried out and that any risks identified that pose a slip, trip or falls hazard have an appropriate risk assessment undertaken and action plans developed that identify processes to reduce the risk. Managers should ensure that all staff are involved in the risk assessment process and have an opportunity to identify hazards, potential risks or near miss events relating to the workplace.

6.1.9 The Estates Department will carry out monthly inspections , maintain records of those inspections as part of their regular monitoring the external grounds, roads, pathways and walkways, Identifying any hazards that may cause a slip, trip or a fall and ensure that suitable maintenance/action takes place to eliminate the risk. Where a hazard has been reported

directly to the Estates Department remedial inspection and intervention will take place as soon as is practicable to deal with the hazard.

6.1.10 Where there is inclement weather expected or ongoing, in particular snow / ice the Estates Department will monitor and assess the conditions to ensure that areas are salted/gritted in timely manner and that excessive snow/ice on footpaths and roads within the grounds is removed.

6.1.11 The risk assessment process for all wards and departments must take into consideration recommendations from the floor review programme. Where

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the need for floor replacement has been identified this should be

undertaken as soon as practically possible and as an interim additional controls should be put into place, such as:

 Alert notices and barriers

 Redirection and or reduction of volume and type of traffic including disabled pedestrians/patients

 Mop drying of floors

 Safety footwear for staff and patients.

6.1.12 Prior to floor replacement is being considered and undertaken by the Estates Department due attention will be given to available guidance, standards and legislation including the following:

 Health and Safety Executive Guidance

 Slips, Trips and Falls in the Health Service- Sheet No 2

 Assessing the Slip Resistance of Flooring (R Rating etc)

 Assessment of Pedestrian Slip Risk

 Health Care technical Memorandum HTM 61.

6.1.13 Any larger scale flooring works that meet tender criteria should include the requirement for the type of flooring be tested by Health and Safety

Laboratories or other organisation nominated by the Trust at cost to those tendering.

6.1.14 The Health and Safety Team will provide advice and guidance for Managers and Risk Assessors on the prevention of slips, trips and falls, and assist in the procurement of finding safe solutions/outcomes. 6.1.15 Where a risk assessment has identified specific hazards/risks the risk

assessors have responsibility to ensure that their direct line manager is informed of the outcome of the assessment, and what controls are required to resolve/reduce the risk of slips, trips and falls. The risk

assessor should ensure that there is a realistic review date included in the risk assessment, once the review is undertaken that managers are aware of any further action that is required.

6.1.16 The manager must ensure that action is taken in accordance with the risk assessment outcomes to reduce/control the risk of slips trips and falls. 6.1.17 Slip resistant flooring can be an effective measure in reducing the risk of

falls; consideration should be given to its use, in particular those areas where it may be difficult to maintain a dry surface. Consultation with health and safety and IP&C should be undertaken where slip resistant flooring is being considered.

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6.2 Risk Assessment (patient)

6.2.1 All adult patients admitted to the Trust must have an assessment carried out by a suitably experienced clinical member of staff within 12 hours of admission (except where there is an exemption in place; Maternity Services, day case patients, and critical care)

6.2.2 All clinical nursing staff should be familiar with the use of the Falls Risk Assessment Screening Tool (NUTH374) and the Falls Care Bundle (NUTH375) which is specifically designed for patient use.

6.2.3 Where patients are identified as “at risk” of falls using the Falls Risk Assessment Screening Tool, a clear intervention plan must be implemented using the using the Falls Care Bundle.

6.2.4 All staff who will be participating in the patients care should be aware of the patient’s specific needs so the patient is not exposed to undue risk of falls.

6.2.5 Where a patient is identified as being at risk of the falls the Falls Care Bundle should be repeated weekly, on change of condition or if the patient falls.

6.2.6 Following initial assessment with the Falls Risk assessment Screening Tool, if the patient in not assessed as being “at risk” of falls, screening should be repeated weekly, on change of condition or if the patient falls. Please refer to the Management and Prevention of Patient Slips, Trips and Falls Policy.

6.3 Safety Footwear 6.3.1 Patients

When patients are identified as being at risk of falls careful consideration should be given to the type of footwear worn.

A Trust supply of slippers (available from the Supplies Department) and slipper socks (available on all adult in-patient wards) are available for those patients who do not have any access to suitable footwear of their own.

As a general principle all patients should be encouraged to wear footwear that has a tread or is of a slip resistant nature.

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6.3.2 Staff

Where there is a risk of slipping which cannot be reduced to an acceptable level by any other means then slip resistant footwear will be provided to the staff exposed to the risk as part of the Personal Protective Equipment (PPE) Regulations, based on a Risk Assessment.

All footwear provided by the Trust will have a slip resistant sole and be the subject of a risk assessment to ensure that the most appropriate footwear is provided for the task and that the risk and subsequent outcomes and actions are fully documented.

Where safety footwear is not provided or required under the PPE Regulations, but staff wish to purchase non-slip footwear of their own volition, the Trust will provide information on slip resistant footwear providers.

6.4 General principle

As a general principle all staff should be aware of their obligation to be attired in suitable footwear for the working environment. Any member of staff wearing inappropriate footwear will be advised that they are in breach of the Trust Dress Code Policy.

6.5 Floor Cleaning Process

6.5.1 Wherever reasonably practicable floor cleaning will take place at quieter times of the working day, however where this cannot be achieved, due care and attention will be given to the floor cleaning process ensuring suitable controls are in place to reduce the risk of falls.

6.5.2 The current system of cleaning with micro-fibre mops must be followed as outlined in the hotel services procedure and infection control national guidelines, however the following safety controls must be in place, during any floor washing process:

Safety barriers must be in place to ensure that there is no access to the wet floor and to warn staff, patients and visitors of any impending dangers.

 Hazard chains will also be used in conjunction with warning signs and safety barriers so there is a clear demarcation of the floor area being cleaned (See Appendix 2).

 Where a dry lane or area is difficult to maintain for pedestrians, such as doorways, narrow passageways, nurses stations or where

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half and half cleaning is not possible the floor should be cleaned in sections, and dried taking into account the contact time requirement of the cleaning product being used.

 In all cases excessive moisture should be kept to a minimum during the floor cleaning process and micro-fibre mops will be used for drying the excess water

 Cleaning of the floor must not extend beyond the safety barriers/chains/cones

 Prior to removing the barriers/chains, hotel service staff must observe the cleaned area and ensure that it is dry for access

 Floor cleaning regimes should be planned wherever possible to coincide with quiet periods in departments.

 ITU/HDU areas have the floors dried following floor cleaning. This is carried out to reduce the risk of falls should a patient require

immediate/emergency intervention.

 Theatre suites will continue to have the floor cleaned at night/out of hours as part of the overall theatre cleaning schedule.

7 Training

7.1 Training will be given to all Trust employees at induction on the prevention and dangers of slips and falls.

7.2 All Hotel Services Staff receive specific floor cleaning training and slips, trips and falls prevention training as outlined in Appendix 2

7.3 All managers must ensure that specific slips trips and falls prevention information is part of local induction for all employees within their directorate/department. 7.4 All clinical nursing staff should complete the patient falls reduction mandatory

training package.

7.5 An e-learning package on general aspects of Slips, Trips and Falls Prevention has been developed. The training package is mandatory for all staff that may be exposed to the risk of falls.

8 Equality and Diversity

The 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

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needs and does not discriminate against individuals or groups on any grounds. This document has been appropriately assessed.

9 Monitoring Compliance

Standard / process / issue

Monitoring and audit

Method By Committee Frequency

 Risk

assessment completion

 Action plan completion

 That all slips, trips and fall Incidents are reported.

Action Plan Update and Review

H&S Team

Falls Group & Trust H&S Committee

Annual H&S Compliance Audit

of risk assessments H&S Team Trust H&S Committee Quarterly Review of Incidents recorded on datix H&S Team Trust H&S Committee Annual Leadership Walkabouts

CGARD Trust H&S Committee

Monthly

10 Consultation and Review The policy has been circulated to:

 Trust Health and Safety Committee

 Falls Task Group

 Chief Building Officer- Estates

 Senior Building Officers RVI & FH

 Hotel Services Manager RVI

 Hotel Services Manager FH

 CPG

11 Implementation (including raising awareness)

A summary of the key changes will be notified to managers following implementation. Further advice and guidance will be available from the Health and Safety Team. Staff will be informed of slips trips and falls prevention information through regular Trust wide campaigns and any specific issues through the Communications meeting. This

approach will include reminding staff of the need to report near miss events and those incidents which do not result in injury in addition to those where injury is incurred. Staff Side will have open access to Falls Task Force and the Trust Health and Safety

Committee to raise concerns relating to identified hazards. In addition staff side

representatives will be involved and consulted on the compliance with this strategy and any subsequent reviews/updated of the strategy through the Trust Health and Safety Committee. Where appropriate staff side will be involved with working projects to address slips, trips and falls issues at a local level.

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12 References

 Health and Safety at Work Act 1974

 The Management of Health and Safety at Work Regulations 1992/1999

 Trust Intranet Health and Safety site

 Learning Zone for e learning Site for the Slips, trips and Falls Prevention training

 HSE Website- Shattered Lives Campaign. 13 Associated documentation

 Health and Safety Operational Policy

 Management and Prevention of Patient Slips, Trips, Falls Policy

Author: Programme Lead Safety Risk Review: Health and Safety Lead

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Appendix 1 Strategy Action Plan for the Prevention of Slips, Trips and Falls

Key action How best to achieve Person/Group

Responsible

Time Frame Risk Assessment

(environment)

As part of the ongoing risk assessment process

managers must ensure that regular risk assessments are undertaken relating to the potential of slips, trips and falls and always following a serious incident or where hazards have been identified.

Managers must ensure that they are aware of

hazards/near miss events identified by staff.

All Directorate and

Departmental managers will appoint suitably trained Risk Assessors and will ensure that risk assessments are undertaken to identify slips, trips and falls hazards

including assessment of floor covering.

Controls will be developed by the Risk Assessors to deal with the hazards. It is the Manager’s responsibility to ensure these controls are effectively implemented and regularly reviewed

Directorate/Departmental Managers.

Risk Assessors acting on behalf of above.

Health and Safety Team will conduct Risk Assessor training

throughout the year and on demand. . At

Present all Clinical and None Directorates will have a Risk assessor available within each Directorate/

Department. Monitoring of risk

assessment compliance with be undertaken quarterly by the Health and safety Compliance Floor Testing Programme

To ensure that floor surfaces are tested for damage, slipperiness, roughness and suitability for the working environment.

Managers should ensure that suitable preventative controls are in place to prevent

recurrence/injury and be aware of the results of the

Estates Department use a surface roughness meter (Surtronic Floor Testing Meter). All surfaces will be re-assessed where a risk has been identified or following an incident.

Surface testing information available on the Health and Safety Section of the Intranet.

Senior Estates Officers supported by Health and Safety Advisors.

A Floor Risk

Assessment review and floor testing programme is completed and be repeated on a Annual basis.

The results of the floor testing programme to be presented and discussed at the Falls

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Key action How best to achieve Person/Group Responsible

Time Frame replacement plan will establish

any deteriorating coverings.

Committee.

1st Programme 2011 2nd Programme To commence 3rd Qtr 2014 New/Replacement Flooring

Slip resistance qualities of new or replacement flooring to be established and considered.

Slip resistant flooring to be considered on

refurbishments/replacement in consultation with IP&C and the Health and Safety

Department.

Tenders to include provision of floor testing by HSL or other nominated body at cost to those tendering.

Senior Estates Officers and Directorate/Departmental Managers Replacement or Refurbishment Replacement areas identified, Programme discussed with Estates/Health and Safety Depts. August 2014 Outstanding issues to be tabled at the Falls Task Force Walk off Matting

Suitable and appropriate walk off matting in all main

entrances into Trust properties has been provided

Some entrance matting has been previously extended to comply other areas are under review.

All Entrances to reviewed by the Estates Dept and extend appropriate matting as required in accordance with HTM 61

Senior Estates Officers and PFI Contactors

Hotel Services

Walk off matting at main access points has been assessed. Work

required to NVW East Atrium, NCCC and A&E access. Information passed to PFI (LOR) to extend in their areas of control, not undertaken, Dec 12.

Walk Off Matting

requires replacement in all main entrance areas. Replacement

programme to be

discussed with PFI Link Person Sept 2014 Additional temporary matting and cones positioned during

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Time Frame Inspection of External

Grounds.

Where there is inclement weather expected or ongoing in particular snow/ice the Estates Dept will monitor and assess the conditions to ensure that areas are salted/ gritted in a timely manner and that excessive snow and ice on footpaths and roads in removed

Monthly inspections of the grounds will be carried out by the Estates Department to identify any Slips, Trips or falls hazards and ensure that suitable action takes place to eliminate the risk. (Inspection records maintained for a minimum of 3 years)

Estates Dept will monitor Weather conditions and act accordingly to maintain ground safety in inclement weather

Estates to carry out grounds maintenance/action on identified hazards

Estates Officers responsible for external grounds

Ongoing as and when required careful monitoring of weather conditions

Monthly Ongoing Inspections or as hazards are reported

Risk Assessment (patient). Fall Risk Assessment

Screening Tool Falls Care Bundle

Matrons and Clinical Directors must ensure that all inpatients are assessed within 12 hours of admission using the Falls Risk Assessment tool and where Risks of falling have been identified there should be implementation of the Falls

Nursing staff will ensure that all inpatients are assessed within 12 hours of admission and that any necessary interventions are

implemented, evaluated and monitored.

Matrons, Clinical Directors, Sisters/Charge Nurses.

The Falls Risk

Assessment Tool and the Falls Care Bundle is available throughout the Trust and E learning training package on their implementation. Further presentations on Prevention of Falls is ongoing as part of clinical education in

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Time Frame change of condition or if

patient falls . All patients regardless of fall risk rating should be assessed for any changes weekly.

Safety Footwear Patient Footwear

A trial of safety slippers and slipper socks has been undertaken and

completed

All footwear provided to staff by the Trust will be reviewed for suitability and slip

resistance

All other areas will be reviewed to assess if it is necessary to provide footwear as part of the ongoing Risk assessment process

Advice and guidance will be provided for all staff that are not part of any PPE

requirements but wish to purchase slip resistant footwear.

Review of footwear trials to establish suitable patient footwear.

Evaluation outcomes will decide the most appropriate footwear to purchase.

Risk assessments will determine if additional PPE footwear needs to be provided.

Provide Information

Fall Task Force Supplies Officer

Suitable External provider Patient Falls Co-ordinator

Department/Directorate Managers (as part of PPE compliance)

Supplies Officer. Further advice and guidance can be sought from the Health and Safety Advisors

Risk Assessors Directorate and Local managers

Program Lead -Safety And Risk

Health and safety Advisors Patient Falls Co-ordinator Falls Task Force

Non-slip safety slipper socks for patients will be provided. Ongoing review taking place to find other suitable products

Manufacturers of non- slips footwear have been reviewed and comply with Theatres requirements Anti-static and Electrical Safety. Suitable slip resistant footwear will be

provided in accordance with Risk assessment outcomes if and when they are identified as a risk associated with falls Slip resistant footwear information is available on the health and safety section of the intranet and

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Time Frame information Floor Cleaning Process

The approved floor cleaning process will be reviewed. In HDU/ITUS the floor will be mop dried following cleaning rather than air dried. Contact time for substance to be observed.

Where half and half cleaning or a dry lane is difficult to maintain, wet and dry machine and/or mop drying should be undertaken.

In all cases excessive

moisture should be kept to a minimum during the floor cleaning process and micro-fibre mops will be used for drying the excess water.

Domestic staff trained in use of micro fibre system.

Hotel Services in association with microbiology to consider where a system for drying the floor as standard can be safely implemented. (These areas being in the main Critical Care and HDU, however other floor areas can be dried as part of local

arrangements if there is risk of falls in emergencies)

Hotel Services

Infection Prevention and Control Committee.

Hotel Services

Review of floor cleaning process annually and as a response to the outcome of risk assessments and/or Incident investigations. Areas that have been found to be

slippery/shiny are being de-buffed.

The buffing process will continue to remove surface dirt and grime only

Barrier Controls

Hazard Chains to use with the warning barriers supported by signage.

Provide safety barriers to wards, departments and circulation areas. Provide door barriers to restrict access into single use areas. Provide signage to support the use of barriers and direct away from areas being cleaned.

Hotel Services Managers Health & Safety Committee Falls Task Force

(Monitoring)

Health and Safety Advisors (Provide advice and

guidance)

Cone Connectors and plastic hazards chains have are in use. Continued use to be monitored and

reinforced as required.

Slips, Trips and Falls and Floor Cleaning Process Training:

Provided induction and additional update training by supervisors and provide staff

Hotel Services Managers and Supervisors

Programme Lead -Safety &

Training is ongoing and provided for all Hotel Services staff on

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Time Frame Falls and Floor Cleaning

Process Training is required for all Hotel Services

Employees to reinforce Trust Policy and HSE Requirements

Floor Cleaning Process. Hotel Services staff have all been supplied with a training hand-out outlining the flooring cleaning safety and requirements Training and Education

Slips, Trips and Falls training and education is provided at induction (corporate and local).

Training to reduce incidence of patient falls must be

undertaken by all nursing staff.

An e-learning package on the prevention of Slips, Trips and falls is available.

Hotel Services Staff have received Specific Slips, Trips and Falls training and Further training on the Floor Cleaning process. This will be ongoing in the form of a handout and as part of there the induction

Staff are receiving training on slips, trips and falls as part of the Health and Safety

programme provided at induction.

Nursing staff are receiving training for the prevention of patient falls

Matrons will ensure that all nursing staff complete the trust e-Learning package on patient falls reduction

A Separate e-learning Slips, Trips a Falls training package is available has been

developed. ALL staff to undertake training package Provide and update on an annual basis and ensure all new staff receive induction training as part of the slips, trips and falls reduction programme

Training Manager Health and Safety/Risk Management Team Patient Falls Co-ordinator Matrons/ Sisters/ Managers Patient Falls Co-ordinator

Programme Lead - Safety and Risk

Hotel Services Managers and Supervisors

Programme Lead- Safety & Risk ( Will provide safety training information for training package as required)

Attendance figures will be monitored quarterly by the Health and Safety Committee. Training completion monitored.

Repeat Training :- Hotel Services March 2015

All staff advised to complete the training package as part of their IPR.

Training Undertaken, hand-out provided and ongoing for permanent and all new staff

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Time Frame Services staff.

Monitoring

Falls Task Force will monitor all aspects of Slips Trips and Falls prevention and

management as outlined in the strategy.

The Trust Health & Safety Committee will have

responsibility for monitoring compliance with this strategy and action plan through risk assessment compliance, Incidents reports, Floor testing programme results and

specific verbal and written reports.

Monthly meetings will consider progress with all aspects of the action plan.

An update report on compliance with implementation of the strategy action plan and effectiveness of the initiatives will be a standing item at every Health & Safety Committee meeting

Falls Coordinator

Programme Lead- Safety & Risk

Health and Safety Lead Health and Safety Advisors Director of Quality and Effectiveness (Chair)

Falls Statistics (Patient and Staff) to be

reviewed. Identified risks will be reviewed through the Key action groups as well as updating any progress and full compliance of this strategy

Risk assessment compliance monitored. All risks identified are reviewed through the group as well as updating progress of this strategy.

Leadership walkabouts will monitor compliance in the workplace

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Appendix 2 Safety during Floor Cleaning

The Newcastle upon Tyne Hospitals

NHS Trust

Prevention of Slips, Trips and Falls

Safety During Floor Cleaning Process

NHS Foundation Trust

Prevention of Slips, Trips and Falls

Some Facts:

• In the health care environment injuries to healthcare workers and member of the public are frequent

• Trips account for almost 62% of major injuries to member of the public • They cause 8% of fatalities to members

of the public in the health care industry • The total estimate of civil claims for

slips and trips injuries to employees and the public on NHS premises over the last 4 years exceeds £25 million

The four main causes of slips and trips accidents in health care

are:-• Slippery/wet surfaces- caused by water or other fluids

• Slippery surfaces caused by dry or dusty floor contamination, such as plastic, lint or talcum powder

• Obstruction, both temporary and permanent

• Uneven surfaces, slopes and changes of level, such as unmarked ramps and steps

Slip Hazards

:-• Spills and flashes of liquid and solids

• Wet Floors following cleaning

• Unsuitable footwear

• Loose mats on polished floors

• Inclement weather – Rain, Leaves and Snow

• Change from a wet to a dry surface (footwear still wet)

• Unsuitable flooring surfaces / coverings

• Improper cleaning regimes & highly polished floors

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Trip

Hazards:-• Loose tiles and floorboards

• Loose and worn carpets and mats

• Uneven outdoor surfaces

• Changes in surface levels - ramps and steps

• Holes and cracks

• Bumps, ridges and protruding nails

• Electrical and telephone cables across walking areas

• Obstruction in walkways

• Low wall and floor fixtures - door catches, door stops

Falls Hazards

:-• Over reaching

• Climbing on furniture and shelves

• Jumping from staging

• Incorrect use of stepladders and kick stools

• Rushing down stairs and steps

• Carrying heavy/cumbersome objects without assistance

• Pushing or pulling a load incorrectly

• Poor positioning on chairs and chair castors on polished surfaces

Factor that Increase the Risk of Slips, Trips and

Falls:-• Poor or unsuitable lighting • Human Factors such as rushing,

running, fatigue and distraction • Poor housekeeping and use of

storage facilities

• Incompatible cleaning regimes and cleaning materials

• Lack of organisation in store rooms and work areas

• Effects of alcohol, drugs and medication

Simple measures to reduce the risk

How to Avoid

Slips:-• Adhere to effective flooring cleaning processes • Ensure main walkways and entrances are kept

clean, dry and free from contaminants • Floor covering are suitable for use • Wear suitable footwear to avoid slipping • Outside walkways are well maintained and free

hazards

• Pathways are gritted in inclement weather conditions

• Appropriate warning signage is in place for steps and slopes

How to Avoid

Trips:-• Arrange furniture so that an obstacle course is avoided

• Do not store materials in hallways and corridors.

• If materials are in the way, move them avoid clambering over things.

• Do not store materials on stairs

• Keep drawers closed

• Keep electrical extension leads close to the wall to avoid tripping yourself and others.

• Store personal belongings in lockers or drawers.

• Ensure floors are clean, tidy, dry and free of

How to Avoid

Falls:-• Check stairways for loose treads or handrails • Do not use makeshift ladders use a kick stool or

stepladder

• Do not jump from platforms or staging. Climb down.

• Sit square on chairs.

• Do not over stretch to reach something, you could fall.

• Dress sensibly.

• When carrying a load either negotiating stairs or opening doors etc, Get help if you cannot see where you are going.

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Simple measures to reduce the risk:-Floor Cleaning Processes

• Clean up spills immediately

• Use appropriate signage, cones and hazard chains to warn people that the floor may be wet

• Only clean half width of floor to allow dry side for access

• Only clean half of a door way at a time

• Adhere to the correct cleaning method

• Only use approved cleaning products

• If staff walk over wet floor areas speak to your supervisor

• In ITUs and HDUs dry the floor after cleaning

• Effective deep cleaning must be undertaken to remove dirt and restore original slip resistance

Hazard Cones Hazard Chains Doorway 2 Metre Length Area Being Cleaned Safe Floor Cleaning Process

Fig 1

And finally

• Managers must ensure that Risk assessment are carried out within their Directorate/Depts to ensure that all hazards have been identified and suitable actions and controls are in place to

reduce/eliminate any Slips, Trips and Falls incident • Employees must report any hazards to their

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The Newcastle upon Tyne Hospitals NHS Foundation Trust Equality Analysis Form A

This form must be completed and attached to any procedural document when submitted to the appropriate committee for consideration and approval.

PART 1

1. Assessment Date:

2. Name of policy / strategy / service:

Strategy for the Prevention of Slips ,Trips and Falls 3. Name and designation of Author:

Dru Parnaby

4. Names & designations of those involved in the impact analysis screening process: Dru Parnaby

5. Is this a: Policy Strategy X _Service

Is this: New Revised X

Who is affected Employees x Service Users X _{Wider Community}

6. What are the main aims, objectives of the policy, strategy, or service and the intended outcomes? (These can be cut and pasted from your policy)

Prevention of Slips, Trips and Falls and the education of Trust Staff in the general principles of safety in relation to prevention. 7. Does this policy, strategy, or service have any equality implications? Yes x No

These have been considered and incorporated into the policy

If No, state reasons and the information used to make this decision, please refer to paragraph 2.3 of the Equality Analysis Guidance before providing reasons:

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8. Summary of evidence related to protected characteristics

Protected Characteristic Evidence, i.e. What

evidence do you have that the Trust is meeting the needs of people in various protected Groups

Does evidence/engagement highlight areas of direct or indirect discrimination? If yes describe steps to be taken to address (by whom, completion date and review date)

Does the evidence highlight any areas to advance opportunities or foster good relations. If yes what steps will be taken? (by whom, completion date and review date)

Race / Ethnic origin (including gypsies and travellers)

None relevant to this policy

No No

Sex (male/ female) _{As Above} _No _No

Religion and Belief _{As Above} _No _No

Sexual orientation including lesbian, gay and bisexual people

As Above No No

Age _{Dementia friendly}

environments

People who have dementia may be more at risk of slips trips and falls. This is incorporated into the risk

assessment.

No

Disability – learning difficulties, physical disability, sensory impairment and mental health. Consider the needs of carers in this section

Disability has been considered within the policy and the risk assessment tool

People who are blind, have a visual impairment or a physical disability may be more at risk of slips trips and falls. Although vision is not incorporated into the initial risk assessment the Falls Prevention Coordinator has advised that this would be identified as a falls risk through other processes.

No

Gender Re-assignment _{As Above} _No _No

Marriage and Civil

Partnership As Above No No

Maternity / Pregnancy _{As Above} _No _No

9. Are there any gaps in the evidence outlined above? If ‘yes’ how will these be rectified? No

10. Engagement has taken place with people who have protected characteristics and will continue through the Equality Delivery System and the Equality Diversity and Human Rights Group. Please note you may require further engagement in respect of any significant changes to policies, new developments and or changes to service delivery. In such circumstances please contact

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Do you require further engagement? Yes No X

11. Could the policy, strategy or service have a negative impact on human rights? (E.g. the right to respect for private and family life, the right to a fair hearing and the right to education?

No PART 2 Name: Dru Parnaby Date of completion: 18th February 2015

(If any reader of this procedural document identifies a potential discriminatory impact that has not been identified, please refer to the Policy Author identified above, together with any suggestions for action required to avoid/reduce the impact.)