Working at External Locations

Source – ‘DSOP’ Project 2006

Case Example Working in a Clients Home

A client who is cared for in his own home by his parents requires in-home respite while his parents have a weekend away. The client is able to stay at home alone but needs assistance with some personal care and organising meals. A home assessment was completed and while the client was known to the service, this was the first time support was being provided in the client’s home. No hazards were identified as the home was well maintained. On the first support visit, when the worker was assisting the client out of the bathroom, the worker noticed a step of approximately 3 cm at the entrance to the bathroom necessitating lifting the wheel chair. In addition to the hazard in the bathroom area the client was also is a smoker who usually smokes in his home.

How would you proceed?

Discuss the hazards identified with the client and advise that you cannot work whilst the client is smoking in the same room.

Report immediately to your supervisor the hazards and actions taken so that options for either elimination or control of the hazards can be considered.

Possible Solution

  1. With your supervisor, other workers and the client, discuss ways to reduce the hazards now identified. With the step on exiting the bathroom, consider short term alternate arrangements eg is there a second bathroom in the house that could be utilised, can a small ramp be fitted to remove the need to lift the chair, can an alternate location for the service e.g. laundry be organised. In the long term can modifications be made to the environment.
  2. With the smoking it may be appropriate to implement a contract with the client regarding their smoking for the duration of the support. The contract may be for the client to smoke outside on the veranda or not smoke while support workers are present. Have an exit plan allowing workers to discontinue service if the client does not adhere to the contract regarding smoking.
  3. Review the organisation’s home assessment process as it did not identify two significant hazards with the supervisor/manager and other team members.

How would the solution look in the I’M OK approach?

/
  • I am fully aware of the outcomes of risk assessment of the client and their home
  • I have stopped and thought about the clients needs and any activity we are to undertake
  • I have considered my safety
  • I have controls defined and a planned approach
  • I am complying with work procedures
  • I am aware of clients contract about smoking
  • My supervisor is aware of my concerns
  • I have brought my mobile phone with me and it is switched on
  • I know where the exits are
  • The car is parked in an accessible place.
I’m OK
/
  • I have considered my client’s needs, safety and issues of dignity
  • I have been risk assessed my needs have been identified and a plan agreed to
  • We have talked about the client contract and identification of when things are not OK
  • I have checked that the client is ready for any activity we are about to undertake
You’re OK
/
  • We have work strategies and systems to support our activity
  • Our activity has agreed ‘Not OK’ safety actions and responses
  • Any additional controls/support required are in place.
We’re OK

Case Example Working in the Community

A client with a physical disability who required a wheelchair for mobility asked her service provider to help her try a new hairdresser in a local shopping centre. It was not a regular venue that was attended by the service provider and the majority of support staff had no familiarity with the location. The hairdresser’s shop was small and could not accommodate a wheelchair and one transfer requiring the employee’s assistance would be necessary from the wheelchair to a regular chair.

How would you proceed?

  1. Consult with the staff and client about the activity.
  2. Conduct a risk assessment of the activity and the venue.
  3. Identify the hazards and assess the risks in order to implement controls.

Possible Solution

After discussion with the staff and client, it is agreed the local shopping centre is wheelchair accessible and presents no major manual handling risks. The exception is the need for one transfer from the wheelchair to a seat in the salon, which requires the employee’s assistance. Negotiate with the hairdresser for some furniture to be moved so that the client can remain in the wheelchair.

How would the solution look in the I’M OK approach?

/
  • I have undertaken a Venue and activity assessment
  • I am aware of the controls implemented related to transfers
  • I have received appropriate training in safe work procedures
I’m OK
/
  • I have considered my client’s needs, safety and issues of dignity
  • Service includes my choice of hairdresser
You’re OK
/
  • No unsafe activity undertaken whilst client’s needs met.
  • Our activity has agreed ‘Not OK’ safety actions and responses.
We’re OK

The ‘Reasonably Practicable’ Approach

The ‘Reasonably Practicable’ Approach is a tool to check if your organisation’s approach to working in external locations is reasonably practicable. The six components indicate whether your organisation has taken ‘reasonably practicable’ steps in ensuring workplace safety.

In the case of working in external locations the form may look like this:

‘Reasonably Practicable’ Steps
1. Active involvement and commitment by senior management /
  • Does your organisation have policies and procedures for working in the community and in clients’ homes?
  • Do the policies and procedures outline procedures for conducting risk assessments and managing risks associated with working in external locations?
  • Are policies and procedures easily understood and accessible to everybody in the organisation?
  • Are sufficient resources available to effectively implement controls and prevention strategies?
  • Does your organisation have a Critical Incident Response procedure?

2. A consultative culture /
  • Were policies for working in clients’ homes and in the community developed in consultation with staff and client representatives?
  • Are policies reviewed regularly consultation with staff to ensure effectiveness?
  • Do workplace safety meeting minutes and staff meeting minutes reflect a consultative process for identifying, assessing and controlling risks when working in the community?
  • Are employees encouraged to report near misses and minor incidents?
  • Is there a process for recording and reporting incidents?
  • Do front-line workers participate in risk assessments of clients’ homes and public places?

3. Simple work procedures or tasks with identified risks /
  • Does your organisation have a written service entry and exit policy?
  • Do client files clearly identify high-risk behaviours and events?
  • Does your organisation have written procedures for the assessment of community locations and clients’ homes?
  • Does your organisation have comprehensive checklists for conducting inspections and risk assessments on locations in which services are delivered?
  • Does your organisation have clear emergency procedures for staff working in the community?
  • Do front-line employees carry mobile phones?

4. Training and supervision based on assessment of competence /
  • Does your organisation have a training plan for induction and skills development which includes safe work practices for working at external locations?
  • Is there regular and ongoing training for staff in the management of emergencies which may be encountered working in clients’ homes or public places?
  • Do management and staff receive regular training in managing violence hazards identification, staff and management responsibilities, workplace risk reporting, and reporting of work-related injuries?

5. Hazard and incident reporting systems /
  • Does your organisation have a risk reporting and management plan that covers working in clients’ homes and community venues?
  • Do employees know how to report hazards?
  • Are minor incidents and near misses reported?
  • Is this information developed into actions plans which are subsequently implemented by management and staff?
  • Are employees able to use you organisations hazard identification and reporting procedures to control workplace injury risks?

6. Workers compensation and injury management. /
  • Does your organisation track injuries related to working in clients’ homes and public places through its workplace injury records and workers compensation claims history?
  • Does your organisation take a pro-active management approach through trend analysis of injuries and claims? Are the risks identified through these processes addressed? Has your organisation included client-related violence in any risk assessments for injured employees returning to work?
  • Do employees know how to report near misses, injuries and incidents?
  • Does your organisation offer support or assistance programs for employees such including, counselling and debriefing?

‘Reasonably Practicable’ Steps

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Version 2,

March 2009