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Lone Worker Policy.

Lone Worker Policy

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Policy and Key Information

Policy Intention

The intention of this policy is to ensure the safety of lone workers or staff or Atrium consultants who sometimes work alone, by minimising the risks they face and putting in place appropriate control measures to improve their safety.

Purpose and Aim
The main aim of this policy and associated procedures is to:
  • raise staff awareness of safety issues relating to lone working
  • ensure that lone working is risk-assessed in an appropriate and dynamic way and that safe systems and methods of work are put in place to reduce the risk, so far as is reasonably practicable
  • ensure that appropriate training is available to all staff to equip them to recognise risks and provide practical advice on safety when working alone, including, where appropriate, how to use technology
  • ensure that there are the organisational structure, defined roles and responsibilities, communication links and support in place to help lone workers if they need assistance
  • demonstrate to managers and their colleagues that lone working staff are safe and have procedures in place to protect them
  • encourage full reporting and recording of any adverse incidents relating to lone working to the line manager by email and telephone; email ensures a record.
  • reduce the incidents of violence and abuse and injuries to staff related to lone working.
Definitions

For the purposes of this policy lone workers includes those who work by themselves, either regularly or occasionally, without close or direct supervision e.g. without access to immediate support from work colleagues, managers or others. This could be in GP/ client consultation areas or similar, where someone may be working out of sight or earshot of another, or in a community setting, and such staff may face increased risks to their security and safety.

Examples of lone workers in Atrium include:
  • Counsellors/Psychotherapists working in GP consultation rooms.
  • Practitioners delivering training or sessional work in community venues
  • Receptionists/Administrators working alone on front desk.
Legislation

Health and safety law applies to risks of violence, just as it does to other work-related risks. Atrium staff and managers need to be aware of the following important pieces of relevant legislation:

Secretary of State Directions

Depending on our contract, our healthcare contractor may have responsibilities to manage security, which includes the protection of lone workers in accordance with the Directions to health bodies on measures to deal with violence against NHS staff and Directions to health bodies on security management measures, 2003 and 2004 respectively and as amended 2006.

Health and Safety at Work Act 1974

Atrium has responsibilities under the Health and Safety at Work Act 1974, particularly in relation to employers ensuring, as far as is reasonably practicable, the health, safety and welfare of employees at work.

The Management of Health and Safety at Work Regulations 1999

These regulations require employers to assess risks to employees and non-employees and make arrangements for effective planning, organisation, control, monitoring and review of health and safety risks.

Safety Representatives and Safety Committees Regulations 1977 (as amended) (a) and The Health and Safety (Consultation with Employees) Regulations 1996 (as amended) (b)

Atrium will inform, and consult with, employees in good time on matters relating to their health and safety and employees and consultants are required to inform Atrium of any changes in the H & S in their operating environment so we can continue to monitor risk.

Responsibilities

Atrium has a legal duty to ensure the health, safety and welfare of those employees who work for the organisation including the protection of lone workers. The Director has overall responsibility to make this happen.

This section outlines the responsibilities of our healthcare contractors and Atrium managers and practitioners to help everyone stay safe.

1.0 Atrium:
  • is responsible for ensuring that appropriate security management provisions are made to protect lone working staff working on other Agency sites
  • is responsible for ensuring that measures to protect lone workers complies with all relevant health and safety legislation
  • has overall responsibility for the protection of lone workers by gaining assurance that policies, procedures and systems to protect lone workers are implemented
  • has responsibility for raising the profile of security management work with our agency partners and with our own directors.
  • should oversee the effectiveness of risk reporting, assessment and management processes for the protection of lone worker Where there are foreseeable risks, Atrium should take the necessary steps to protect consultants and employees and mitigate risk.
Local security senior practitioner duties:
  • should ensure that our policies and procedures for the safety of lone workers and (in liaison with line managers) are up to date in each site we work
  • utilize Atrium’s Risk assessment template in each site and advise manager and consider action plan and advice for colleagues accordingly
  • advises Atrium management on systems, processes and procedures to improve personal safety of lone workers and make sure that proper preventative measures are in place
  • advises the organisation on appropriate and proportionate physical security, technology and support systems that improves personal safety of lone workers. Ensure that this is appropriate, proportionate and meets the needs of the organisation and lone worker
  • ensures that any technology used to protect lone workers meets legal requirements
  • lays an active part in identifying hazards, assessment and management of the risks.
  • advises on the proper security provisions needed to mitigate the risks and protect lone workers. E.G in GP surgeries adopt local lone worker guidance
  • should assist in the investigation of incidents in line with Atrium’s Critical incident Management Policy and Procedures and where necessary liaise with the police to allow follow up action to be taken
  • should work with management to conduct a full post-incident review to see what lessons can be learnt and that appropriate measures are implemented before staff enter a lone working situation.
1.2 Line management duties:

All managers have responsibilities to safeguard the health, safety and welfare of staff responsible to them.

  • identify all staff who are lone workers, based on the definition within this policy (see Definitions).
  • ensure that all relevant policies and procedures are disseminated to lone working staff.
  • ensure that staff are not deliberately placed in situations in which there is a significant risk of violence (including lone staff working in conditions in which more than one member of staff is deemed to be a minimum requirement)
  • ensure that a proper risk assessment is conducted (in consultation with the relevant personnel) to ensure that all risks from lone working are identified and that proper control measures have been introduced to minimise or mitigate the risks before staff enter a lone working situation. This should be carried out in association with appropriate staff or their appointed representative.
  • ensure the risk assessment is completed and a copy returned to the manager of the service. If circumstances change e.g. change of office, use or environment, the risk assessment should be reviewed again. Separate risk assessments are provided for both the inpatient and community services.
  • Ensure that there is a system enables the manager to trace the whereabouts of staff.
  • Ensure the safe system of work is reviewed annually.
  • ensure that lone workers are provided with sufficient information, training, instruction and supervision before entering a lone worker situation
  • maintain records of training provided.
  • maintain minimum staffing levels, especially where the risks are high
  • provide appropriate personal safety equipment and ensuring physical measures are put in place and appropriate technology is made available to ensure the safety of lone workers
  • Ensure appropriate action is taken where devices are not being used without justification. The users should be informed of the importance of the device and this should be documented, if the employee still refuses to use the device, further information should be sought from Human Resources and the Disciplinary procedure followed if appropriate.
  • ensure that all the relevant staff undertake regular reviews of hazards and associated risks to make sure that all measures are effective and continue to meet the requirements of the lone worker.
  • where an incident has occurred, should make sure that the employee sends an email marked important to the line manager completes an incident reporting form which is sent to pathway team
  • should carry out a full investigation of any incident to learn from it and improve
    where someone has been assaulted, should ensure that the individual is properly de- briefed, undergoes a physical assessment, any injuries are documented, and they receive access to appropriate post incident support. Counselling all staff affected by violent or aggressive acts, whether directly or indirectly affected,
  • where necessary reporting to the Police, all instances of violence or aggressive acts which result in injury to staff or damage to equipment or property, without delay and prosecuting, where appropriate, all perpetrators
  • reporting to the Police all instances where community staff appear to be absent from their scheduled daily work activities for an unreasonable time, after exploring all avenues of communication with the staff concerned
  • should ensure that following an incident, any risk assessments are reviewed/a risk assessment is carried out as soon as possible and immediate control measures are put in place. This is prior to a formalised review of lessons learnt following an incident.
Assistant Manager with Clinical service manager oversight:

Ensure a written safe system of work for lone-working, including communication, is implemented and monitored in every site. This could include emailing the practitioner on how lone and safe working is organized on each site or the sites that impact them

The Atrium assistant manager reports on risk to staff and escalating risk to the Atrium CEO and to our commissioners in our quarterly meeting and reports.

Where an unacceptable risk is posed to the personal safety of staff, Atrium managers will work with our Service contractor to agree action such as:

  • consider increasing staffing levels
  • consider relocating the service to a safer environment
  • consider requesting police presence during the work activity
  • consider removing the specific service until such time as the risks are reduced to acceptable levels
  • consider postponing the task(s) until risks can be reduced.
  • ensure regular, meaningful risk assessments are carried out in their areas of responsibility, to identify areas of high risk.
  • ensure safe systems of work are implemented and training provided.
  • investigate any serious or untoward incident in accordance with the Guidelines on Reporting Adverse Incidents
1.4 Lone working staff duties:

All Atrium practitioners have a responsibility to do all they can to ensure their own safety and that of their colleagues and those served by the Healthcare Team and site team management. This is in line with current health and safety legislation.

To ensure this staff:
  • Should have a working knowledge of the content of this policy
  • should consider scenarios with their clinical supervisor where they could be at risk and action they would take and read Lone worker guidance below as part of their should seek advice from their line manager, action guidance, procedures and instruction to avoid putting themselves or their colleagues at risk
  • should conduct proper planning prior to a visit and utilise continual dynamic risk assessment during a visit. It is important that staff understand that they should never put themselves or their colleagues at risk and if they feel at risk, they should withdraw immediately and seek further advice or assistance.
  • should not willingly or knowingly place themselves in a situation likely to cause injury or harm to any person.
  • should comply with safe systems of work, safety precautions and procedures agreed and adopted by Atrium.
  • should use and maintain, in a fit state, personal safety equipment provided.
  • Should attend all site training pertaining to Health and safety and lone working
  • should properly utilise all appropriate technology which has been provided for their own personal safety, ensure that they attend training in the use of the technology and associated support services.
  • must ensure that they are contactable whilst on duty.
  • should report all incidents on Email to their manager followed up by the Critical incident form. Should let their supervisor or forensic prison lead know if they are at risk so action can be taken
Risk management processes
  • identify risks in relation to lone working
  • assess the risks to lone workers
  • implement measures to reduce the risks to lone workers
  • evaluate the control measures and ensure that risks to lone workers are properly managed
  • feed into the corporate risk register and quality assurance framework

It is for managers, service managers, team leaders, in fact anyone managing staff to ensure the risk assessments are carried out and safe systems of work developed and implemented.

The importance of supervision cannot be underestimated, as a means to ensure safe systems of work are working and to gain feedback to learn and develop.

Risk assessments are reviewed every two years or when circumstances change e.g. relocation of team to another base, environmental or sociological change. Reviews take into account actual incidents that have occurred or near missesPractitioners must make the reporting of incidents or unsafe working a priority.

Finally and importantly, self employed practitioners must ensure that they have the insurance cover to undertake this work in community or GP surgeries as claims for incidents will need to be made through their insurance. That insurance cover should include public, professional and personal injury liability. The Atrium office can offer further advice but only insured self employed practitioners can work within the Atrium community of practice.

Training and information

Staff follow the Mandatory Training Policy set out by our Healthcare partner. Training has been identified as being important in reducing incidents concerning Personal Safety. Therefore, it is important that records of training given should be kept by all managers. Atrium will ensure that appropriate and effective training, instruction and information relevant to their work environment is provided to all staff and this will include the following areas:

  • Personal safety
  • Working alone
  • Communication skills
  • Accident and incident reporting
  • Managing violence and aggression
  • Dynamic risk assessment

Should you have any specific training requirements, please liaise with your line manager.

When in a lone working situation

The procedures and arrangements that should be in place locally to protect lone workers is outlined in the safe system of work, and includes:

  • Information about dynamic risk assessment, as it enables lone workers to anticipate and recognise early warning signs of suspected risks and enable safe early interventions to minimise or negate the risk to themselves and others. Dynamic risk assessment should be an on-going process as situations change rapidly as do associated risks.
  • Recognising warning signs
  • Management of a violent or abusive incident
  • Escorting clients/service users
  • Lone working and travelling by foot

Under no circumstances should a lone worker put themselves, their colleagues, other patients or service users in any danger.

Dynamic risk assessment

During a lone working visit a dynamic risk assessment focuses on reducing the prevalence of a problem. This is done by minimising known or suspected risk factors and by early intervention. The dynamic risk assessment involves staff:

  • being alert to warning signs as covered in conflict resolution training
  • consider PET – People, Environment and Task
    • People – who is involved
    • Environment – what is the environment that I am now in
    • Task – what am I here to do.
  • Consider the hazards related to these and what you can do on the spot to minimise the risk and decide whether to continue with your work or withdraw.
  • Be alert to risks presented by those who are under the influence of drugs/alcohol or are confused.
  • carrying out a ‘10-second risk assessment’; if staff feel there is a risk of harm to themselves, they should leave immediately.
  • placing themselves in a position to make a good escape, i.e. where possible, being the closest to an exit
    do not spread-out papers etc. so that if you need to get away you can do so quickly.
  • being aware of all entrances and exits
  • being aware of the positioning of items, including those belonging to the lone worker (scissors, scalpels, etc), that could be used as a weapon.
  • making a judgment as to the best possible course of action – for example, whether to continue working or withdraw.
  • utilising appropriate physical security measures (e.g., triggering panic buttons to call assistance from staff nearby/security/the police or using a lone worker device to raise an alarm)
  • ensuring that when they enter a confined area or room, they can operate the door lock in case they need to make an emergency exit.
  • avoiding walking in front of a patient/service user, and not positioning themselves in a corner or in a situation where it may be difficult to escape.
  • remaining calm and focused during an incident in order to make rational judgements.
  • being aware of their body language (as well as that of the patient/service user), as there is a risk of
  • exacerbating the situation.
  • At no point should the lone worker place themselves, their colleagues or their service users at risk.
IN THE EVENT OF AN INCIDENT
Reporting All incidents of assault, as well as ‘near misses’ should be reported as soon as possible by email to the manager.

In addition to the procedures outlined in the above documents it may be necessary to:

  • report to the Police, all incidents where community staff appear to be absent from duty for an unreasonable time, once all reasonable avenues to trace the individual have been exhausted.
  • implement counter measures and remedial actions identified by senior manager’s investigations,
  • immediately, to prevent re-occurrence of the incident.
  • Incidents of violence are to the police
Post incident support, action and review
  • Post incident support is provided to support staff and help individuals and teams to process unpleasant or traumatic event
  • Counselling and support to be offered to those individuals subject to an incident either physical or verbal aggression, attack or harassment. The appropriate route to care will be decided between the practitioner, their forensic manager and within the framework of our Healthcare contractor’s provisions.
  • A post incident review is undertaken to determine how and why any incident took place and review the risk assessment to see whether additional measures need to be put in place to prevent a recurrence.
Overview of Objectives for our healthcare partners in keeping us safe in prisons:

To reduce all incidents arising where the personal safety of staff is threatened, whether it be by violence against the person or exposure to risks through working alone.

These objectives will be met by:
  • Prosecuting offenders where appropriate, including those that unduly harass staff
  • Carrying out required Risk Assessments, which lead to the development of written procedures, setting out safe systems of work
  • Analysis and investigation of all incidents, developing procedures or taking measures to enhance personal safety measures
  • Implementing control measures (e.g. managing entry to premises, issuing personal safety equipment such as alarms)
  • Supporting staff known to be at risk whilst at work
  • Providing training in the management of aggression and personal safety
  • Providing counselling to staff involved in or witnessing an incident
  • ensuring effective incident reporting procedures are in place, in our case to Atrium Clinical Lead
Critical incident report including Near Miss

Name:
……………………………………………………………………….

Telephone and email contact
……………………………………………………………………….

Consultant or Employee
……………………………………………………………………….

Date of incident and date of report
……………………………………………………………………….

Location of incident/full address and contact details
……………………………………………………………………….
……………………………………………………………………….
……………………………………………………………………….
……………………………………………………………………….

Type of incident – Please tick

  • Death
  • Injury
  • Abuse/Harassment
  • Corruption
  • Disease outbreak
  • H& S
  • Service management
  • Cyber security breach
  • Crime/theft
  • Other

Near miss? Actually happened?
……………………………………………………………………….

What happened?
……………………………………………………………………….

Who else is involved? Site managers, perpetrators, clients
……………………………………………………………………….

Has manager been informed?
……………………………………………………………………….

Pathway team
……………………………………………………………………….

Have you followed advice given?
……………………………………………………………………….

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Atrium Clinic
642 London Road
Essex
SS0 9HW

Telephone: 01702-332857

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