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Explore procedures to maintain health and

safety and respond to accidents and
emergencies in health and social care
settings
Procedures to maintain health and safety
There are a variety of procedural steps and obligations that health and social care services
must abide by to maintain health and safety. From here, responses to accidental injuries and
emergency situations can be made allowing health professionals to ensure that physical and
emotional harm does not occur. The intended purpose of upholding the positive health and
safety of health care settings is to guarantee that any form of risk to health and safety of all
individuals within a health environment is void from that setting. This implements a standard
of care that denies the opportunity for malpractice or poor care provision from individual
service providers. Identifying the need for health and safety is not just a social responsibility
forced upon them as a requirement of their job that states their need to prevent risks from
occurring; by being educated about health and safety procedures.
There are four primary steps that are followed within health services to ensure that the
health and safety of all individuals within that setting is protected. Merryvale Residence
proves to be one such health service that identifies the importance of these steps; in which
the elderly clients residing there need to have their health and safety ensured, as the
individuals lie within the vulnerable age group of later adulthood. Firstly, Merryvale employs
the use of polices, highlighting how care is planned, organised, controlled and monitored;
which provides clarity, making it easier for the care assistants and manager to understand
and learn health and safety regulations. A sound framework to how the health and safety of
these clients should be met in accordance to meeting their individual needs allows their
carers to swiftly implement care around strategic polices and do so in a correct manner. As
a result, accidental harm does not arise from lack of understanding and the vulnerable
elderly clients living within Merryvale are safeguarded. The step continuing from here would
be to then recognise and prevent all risks that are present within a health service.
Secondly, Merryvale Residence and other service providers perform the next step of
highlighting and preventing all risks to ensure health and safety is maintained. Ensuring that
risk assessments are carried out to find underlying risks and avoid them from causing harm
allows care provision to be performed in a fashion that doesn’t pose risks to clients or
service providers involved. Care settings following this improves physical health dramatically
and effectively removes hazards within an environment from occurring in the future. Health
and social settings must then perform the step of reporting and being able to recall accidents
caused by risks assessed as this allows a record of risks to be tracked and monitored. If an
accident does occur, then the fault of the incident can be identified from the risks being
tracked by date and who recorded them. Health and safety can then be maintained in the
future efficiently in removing the cause of accident. Finally, care settings like Merryvale must
follow the step of consulting every individual involved within the care setting. This provides
care workers within services to gain new opinions and perspectives on what all care
providers view as risks and ensures that individual needs are met, promoting each clients
and health professionals’ requirements to ensure that the health safety of everyone involved
is upheld.
Safe moving and handling equipment and individuals

Manual Handling Operations Regulations 1992
The process of safely moving and handling both equipment and the clients is crucial in care
settings and is covered within the Manual Handling Operations Regulations 1992. This
procedure is the first of its kind in being a legislation designed individually for the physical
and manual handling of objects and service users within health and safety environments. It
can be confidently suggested that this law has been hugely efficient in how it has remained
in use for 25 years with health professionals using it religiously. The success of this
legislation then places a colossal amount of responsibility on employers expected to uphold
the correct handling and movement of clients and equipment through having the
responsibility to educate all employees on how to motion and handle people and load. This
requires the service providers to understand what to perform prior to attempting a moving or
handling task within their health and social care environment. Health professionals need to
be able to assess a situation and use their intellect developed from their training to complete
the task to a safe standard. Managers prevent avoidable occurrences of individuals and
loads being dropped through incorrect methodology, such as the positioning of a client being
hoisted out of bed or the transportation of safety equipment itself. Complaints from clients,
staff and visitors are avoided in how the safety of all these groups is protected; by the
employees understanding how to move loads and individuals correctly.
If actions based around moving and handling within Merryvale Residence were to be
referred to, it would be immediately noted the handling of the elderly clients is used to assist
the clients around their accommodation safely. It may not be necessary for service users
within life stages equal to or below middle adulthood to receive aid in moving, but it is of
utmost significance for the physically impaired individuals at Merryvale to get support when
getting in and out of their beds, sitting up, turning over, showering, standing up or walking
using their carers for support. The skeletal and muscular structure of individuals within later
adulthood can be found to struggle to withstand prolonged movement whilst possessing
severe arthritis or muscle deprivation. Therefore, the staff at Merryvale offer their time to
help individuals perform everyday domestic activities which not only promotes their safety
from not falling from exhaustion, but also promotes their dignity in encouraging them to still
have their hygiene and equal rights fulfilled. Moving and handling behaviour can be further
witnessed within Merryvale Residence in how the care assistants help their elderly clients to
not be bedbound or restricted to their bedrooms using lifting equipment. It is necessary for
the physically disabled individuals dwelling within the service to exploit technology such as
bed hoists, bath lifts, wheelchairs and transfer boards in how each different task requires
equipment suitable for moving the client. For instance, the challenge of moving an elderly,
physically unstable client out of a bed; they may be reliant on the use of a bed hoist. Using
specialist equipment which is used to move and handle clients can greatly reduce stress and
accidental injury in how the way in which a moving task is completed is planned in the need
to keep the elderly clients safe from injury and hazards.
For the Manual Handling Operations Regulations 1992 to function efficiently, service
providers must assess an operation that may involve a sustained level of risk or possible
injury. The act incorporates any physical movement of clients and loads to be safely
managed in which would not be achieved if the service provider completing a task opts to
ignore risks or injuries. Both the service provider and the client may be placed at risk of
injury from the worker leaving obvious risks unacknowledged, meaning they are risk to all
individuals within their workplace as their behaviour is treacherous and unprofessional. If an
operation cannot be avoided as it’s benefits to a client are prioritised over its risks to health
and safety, then the legislation continues to declare how health professionals should attempt
to review all activities to discover if any immediate risks can be minimised. This may be
when a client is being lifted up after falling over in hospital and need to be moved with the
use of a stretcher to move them to a different ward to monitor their condition. There is a risk
involved with conforming to this in how doctors and nurses present will have very little
understanding whether or not the client has an injury to the spinal column or hip area. Yet
the client still needs to be moved as being off of the floor will prevent a number of health
complications: the possibility of being tripped over, obtaining a bacterial or viral infection or
even developing severe nerve damage (which can effectively impair or cease the function of
movement) can be prevented because of doing this. Coincidently, this scenario highlights
how Manual Handling Operations Regulations 1992 requires for injury to be avoided when
carrying out any inevitable moving tasks. Additional staff, equipment and strenuous effort are
just some ways in which a precarious situation can be acknowledged with various care
providers being able to offer new perspectives when observing the task being completed.
Any unforeseen hazards or risks not previously recorded when performing the risk
assessment can be exposed by extra care workers noticing them, providing the opportunity
to address the risk and further prevent injury from occurring.
Safe moving and handling procedures are significant within Merryvale Residence as the
providers need to fully reduce risks posed to clients and carers. These guidelines allow the
service providers within the elderly homes to understand how to identify hazardous factors
within the same environments as individuals and be able to remove them to ensure clients
don’t receive physical harm. At the same time, service providers are not made vulnerable to
harming themselves when completing a task and can perform their job safely. Procedures
prove further as useful because these injuries and accidents are avoided. Unintentional
problems are not presented to clients or service providers when care provision is being
implemented and so no individual gets harmed. If an accident does occur, then the dignity of
a client may deteriorate and requires reference to handling and moving procedures is
needed. When the elderly clients who remain in their baths for long periods of time are
removed, then their dignity is respected through handling procedure stating how the client
must be provided with a certain level of privacy when being lifted out of their bath using a
bath lift, such as placing a towel over them. The benefits of client’s dignity being respected
from this highlights how Merryvale needs moving and handling procedures put in place in
how care must be made more efficient. The transportation of elderly clients around the
service whilst in wheelchairs need to be executed one client at a time along a hallway or
narrow passage. This is to avoid the risk of two different wheelchairs colliding, clients falling
over and remaining in an uncomfortable position or having to stay in their wheel chairs for
too long as they can’t reach their rooms. The health and safety of clients and the service
providers moving them is protected as a result.
To meet the requirements of the Manual Handling Operations Regulations 1992, the Health
and Safety Executive (HSE) highlight various risk assessment procedures associated with
promoting health and safety in the manual handling of clients and equipment used to treat
them. One procedure that is designed for manual handling in health environments includes
‘Avoid, Assess, Reduce and Review’. The first of this quadruplet of actions is ‘Avoid’ which
identifies the need for risks to be avoided. Extracting all risks from an environment before
performing a moving or handling task so the operation can be completed without any harm
being inflicted upon the client or the service users involved. Individual’s safety is promoted
by doing this and is achieved through service providers questioning if the tasks is required to
be fulfilled. If not, then the task does not need to be completed as it would promote safety for
individuals involved whilst moving or handling than if the operation was attempted. Service
providers must then identify if there is an alternative way of reaching a desired outcome
without risks being involved. Using initiative in this case allows a new option of handling or
moving an individual to be found, such as moving an individual using a spinal board which
requires only two individuals to carry it instead of having five or more health professionals
use strenuous effort to lift a client.
The ‘avoid’ step can be identified within Merryvale Residence through service providers
allowing their clients some independency and time to attempt getting out of their chairs. All
the elderly residents living in Merryvale struggle with age-related mobility impairments with
such individuals being granted dignity. This is from the care assistants helping clients grant
permission for their service users to try this as it might prove to be effective as an alternative
method of reaching an outcome, such as causing physical strain on carers to lift up clients
when they can complete the tasks themselves. Both health and providers and clients are not
exposed to as much risk, that could cause harmful accidents and evidently improves
wellbeing in. The client will have their right to move upheld and harm can be prevented
during movement.
Another action that the HSE declares as important to perform whilst following handling and
moving procedures would be ‘Assess’. The individual needs of clients need to be assessed
allowing health professionals to suggest what injuries could be sustained if they are not met.
It should be queried by service providers what precisely are the needs of the service user
that must be met as these vary with everyone when moving clients. Prioritising the individual
needs of clients is a significant part of the care process in how incorrect understanding of the
importance of different needs may improve one area of care provision for a client, but could
put their health and wellbeing at risk overall. Not including assessments in a risk assessment
defeats the aim of the procedure being performed initially in how risks associated with not
meeting individual needs would come from this, imposing serious physical harm upon
individuals being cared for. To ensure that such harm does not occur whilst maintaining
safety and wellbeing, health professionals must understand if a moving or handling situation
requires the use of equipment in relation to their client’s and their own needs. Equipment
within a service may help a client to be moved safely without having to move their limbs
which prevents injury of limbs hitting objects whilst in transport. Service providers can then
make sure that equipment is present whilst a handling task is happening or ensure it is
prioritized to others if not entirely necessary. Even then, you as a health professional would
have to identify whether the equipment is even available for use as alternative tools would
have to be sought out if they are not present in the service. Moving a client could highlight
the need for a specialised piece of equipment to be ordered for the task or the need for
available tools to be adapted as best as possible to prevent injury from occurring. Once the
equipment is made available for a service and its clients to benefit from, health professionals
tasked with operating it must be able to understand how to use it and lift the client in doing
so. Attempting to use specialised or heavy machinery may result in a client or work
colleague being injured as the operator would be venturing outside of their professional
boundaries and understanding, devaluing health and safety standards. The injuries which
could arise in a situation like this must further be included in a risk assessment when
needing to handle or move clients as individual needs bring rise to individual risks.
Differentiation between client’s weight, physical capabilities and mental health can all
influence the range of injuries that moving a client could bring to themselves and the people
caring for them. Appropriately, health professionals would then assess what could cause
injury and how this could be resolved.
The ’Assess’ stage is relevant in Merryvale in how care assistants should identify how much
assistance their dementia clients need if they choose to walk to the bathroom in
acknowledgement to their risk of tripping and falling on the way. Individuals may forget why
they have motioned outside of their room which may make them feel secure, beginning to
panic and flee from their carers to feel safe. A sudden burst of movement could cause a trip
to happen, so the different extents of client’s dementia needs to be assessed so their health
and safety is promoted. Potential trip hazards along the way, such as leaning objects and
litter on the floor, need to be assessed to see if they should be removed or not. Walking
frames can be provided if the risks posed to an individual are too high to let them walk
independently, ensuring that the clients do not feel vulnerable to injury and do not
experience physical harm.
The next step in handling and moving procedures for clients is ‘Reduce’. The stages after a
risk assessment are for a health professional to address all risks revealed and minimise
them as far as professionally possible for service providers and users, based on experience
and resources. Decreasing the quantity and severity of risks involved when moving and
handling individuals is initially begun from deciding if additional carers are needed. A client’s
behaviour may be unpredictable due to their mental condition, so extra staff members may
have to be made available to ensure that new views can be gathered to understand how
injuries could occur whilst moving the client. Increased numbers of health professionals may
be positive in how moving and handling individuals can be made a much safer and easier
process, but all workers involved in a task must relate this to the possibility of injury being
reduced. A higher concentration of service providers in close quarters with a client being
transported always threatens the physical safety of the employees in how there are more
surrounding a client if that individual chooses to become hostile and aggressive. From here,
the need for some health professionals can be reviewed and some can be relieved of their
duty in that task and safeguard their physical wellbeing. Awareness of a task being
conducted must be developed as well in how misunderstanding of a health professional’s
role may lead to an incomplete and hazardous approach to the task. Responsibilities, such
as moving a client, operating a piece of equipment, or assessing from a distance, can be
confused between employees and may lead to disputes about roles and delay the time
efficiency of the operation.
Reducing risk can be achieved through several basic ideals being performed whilst moving
and handling clients. Avoiding twisting your torso as a care provider enables clients to be
more carefully moved with less strength having to be used to move the client as there is less
strain on the backs of health professionals. Twisting your body when holding a client may
lead them to be dropped and be injured as stretching is required to avoid them from falling,
or grip on a client’s limbs may be lost if they are needing to be restrained which would allow
an agitated client to thrash their arms and legs. Ensuring that clients are not raised from the
floor is another rule that all health professionals respect in how a client can experience more
injury than benefit to their health. For example, a client who has been in a car crash and is
lying on the road might appear to be in sound condition, but must remain motionless on the
ground until the local ambulance and air ambulance service arrive. Paramedics possess the
experience and equipment they need to be able to reduce the chance of the service user
being dropped onto the hard road or receiving severe nerve damage in the spinal column
through using spinal boards and professional communication skills. Service providers must
then reduce risk in dropping a client by holding them close and tight to their bodies. Holding
a client out at arm’s length means that more energy is having to be used by more service
providers to transport a client. Following this method denies this from occurring and means
that less individuals must be employed to move a client when they could be attending to
other health situations. Finally, health professionals reduce risks of injury towards
themselves and their clients by not lifting individuals in short, repetitive bursts. Once again,
this means that a client may be dropped in how the weight of the load coming back down on
a worker’s arms will overwhelm their physical strength with the clients possibly suffering from
spinal and head trauma therefore. Service providers may have their hands and legs
damaged which means they cannot care for other clients, only emphasising the importance
of lifting loads in one attempt planned thoroughly through worker-worker communication.
Whilst the ‘Reduce’ stage is being used in Merryvale, the stage allows service providers see
if they understand their roles in a handling task. Moving a physically impaired individual
requires sophisticated communication to be conducted to ensure that no worker performs a
roll they are not trained to do, reducing the chance of neglect occurring. Risk reduction is
further extended to deaf clients when informing them that they are going to be turned in their
beds. This is a compulsory need as they have the equal right to not develop bed sores or
bacterial infections whilst remaining in bed for prolonged periods of time. The risk of them
not understanding what is about to occur is reduced from health professionals using hand
gestures and possibly sign language. This reduces risk through clients being more informed
of why they are being turned onto their sides which prevents individuals from becoming
emotionally distressed, reducing the risk of clients being injured from not staying still and
prevents service providers from being injured after a client not hitting out or kicking to
prevent the procedure from occurring.
The last procedural phase addressed when moving and lifting clients is ‘Review’ which
declares how health professionals must perform reviews after manual handling tasks have
been carried out whilst upholding the ever-changing needs of individuals. These reviews
allow services to identify where they acted correctly, where they failed to behave
appropriately and how this can be resolved for future cases. Employees must note if the
operation incorporated the use of additional or decreased support in the form of carers or
equipment. This may have been down to the experience and training that health
professionals involved possess and the need for specialised equipment to be used because
of this. Services can then provide staff with the training and tools they need to be able to
perform a task of the same requirements in the future using less service providers as a
benefit. When reviewing the quality of equipment used whilst moving or handling individuals,
workers must understand if a piece of apparatus was suitable for its purpose. Any electrical
faulting, difficulty in use or previously-sustained damage would be taken into consideration
and can suggest whether an alternative or new piece of equipment needs to be sourced to
ensure that lifting tasks are made as simple as possible. This links to how reviews of the
events in a handling or moving task should be queried by reviewers if they can be completed
in amore satisfactory fashion in future references. Cooperation between service providers,
use of equipment or exploitation of available staff contributes to the conclusion of this area
as a more efficient method decreases the use of valuable resources, staff and risks across
the service. It must further be questioned if a client’s needs have changed because of their
moving or handling. The initial need for this implies that a client may need to remain in a
fixed position-possibly using a full body lift-or must have their uncontrollable movements or
behaviour managed to prevent damage to themselves and their surroundings, altering if they
seem to have benefited from a task being approached correctly. The client will have their
needs reviewed to see what procedures should be employed if the task needs to be
addressed once more. Health professionals should then attempt to improve the care that
individuals receive whilst being transported by highlighting if their risks can be reduced even
further. Ignoring the potential for this to occur could result in an unsuitable approach to
moving a client still being practiced despite how it does not entirely meet their individual
needs. Once all this information and been gathered and analysed, health professionals
should review whether a client should have their handling plan replaced with a new one.
General care would still be provided at the same time whilst individualised care is being
designed for them which means that any new needs or health conditions would be
acknowledged and catered for.
After employees in Merryvale must move their elderly clients in and out of bed, the
individuals involved must review whether the task was executed professionally and if the
procedure used requires change. A client may have been moved successfully in and out of
bed using a bed lift when their mattress is being changed, but the mattress itself was only
moved using one individual. The health professional tasked with identifying the need for
change would record this in the risk assessment and would suggest that two service
providers move a mattress so no physical strain is experienced. Care needs may change
after a client begins to develop their ability to move out of their bed possibly after a physical
injury which means that the client would be able to exit the bed independently and require
less staff to move the client when performing the task.
The ‘Avoid, Assess, Reduce and Review’ procedure should promote safe practice in
Merryvale Residence through providing the care workers with the guidance they need to
address the service’s moving and handling needs. The reality of the cleaner being relieved
of her duties means that the care assistants and nurses present on a shift must balance
responsibilities both within and outside their job description, using this procedure to move
clients in and out of their baths in a time-effective fashion. The individual needs of clients in
terms of staff and equipment can be assessed and provided for after following the ‘Assess’
stage, in a fashion that is straightforward and does not require the staff to receive advanced,
time-consuming training. Health professionals required for the moving of the elderly in and
out of their baths can be managed in relation to the client’s need for mobility assistance
upholds ‘Avoid’ by avoiding the risk of tripping over litter. This meaning that some staff can
be made available to balance cleaning duties and other care tasks to attempt to provide as
much of an equal standard of care as possible. Clients benefit from this procedure as their
hygiene needs are still promoted to reduce the risk of harm from infection occurring after
cutting themselves on sharp litter accidently. Their fragile health is not placed at risk as their
weak immunity to infections is safeguarded, avoiding hospital admittance or even death.
Merryvale Residence has been unsuccessful when performing the procedure to promote the
health and safety of the woman in the same-sex relationship who has sustained suspicious
bruises around her neck area. It can be suggested that the procedure has been rejected in
how the female could have received her bruising from one of her carers incorrectly
attempting to handle her which is classified as gross misconduct, regardless if the carer
needed to restrain her due to her dementia making her irritable. Her physical wellbeing has
been completely disregarded in this case in how risks with her being moved has not been
avoided or assessed, along with how these risks haven’t been reduced to a satisfactory
level. It resonates from here that the ‘Avoid’ and ‘Reduce’ stages are not being upheld with
the ‘Avoid’ phase being failed through the service providers not correctly identifying whether
a task needs to be done. Getting elderly clients out of their baths is a vital task that needs to
be performed, yet the care assistants have ignored this necessity and leave their clients in
their bathroom facilities for several hours at a time. Care assistants have identified this task
as not needed and have jeopardised their client’s hygiene. In terms of ‘Reduce’, the risk of
clients tripping over litter scattered across the service’s walking space has not been
effectively by the manager. His risk regular risk assessment has failed to identify the need
for a new cleaner to be hired to prevent clients from tripping over objects or slipping due to
their impaired eyesight. His professional obligation to do this has placed all the elderly clients
in the residence at risk of sustaining hip or head injuries, making them feel unsafe in their
environment.
Procedures for responding to accidents and emergencies

There are various emergency procedures that are set in place for different accident and
emergency situations. The Merryvale Residence ensure that the common emergency
procedure of evacuating residents from the complex when an alarm is being raised is
upheld. Informing clients and staff of how they should act in cases such as a fire or an
individual beginning to be aggressive in their environment is essential. The coordination of
health professionals present to safely remove the clients from that area to protect their safety
and wellbeing is crucial. Another general procedure that is extremely important is infection
control in the events of an outbreak. Elderly clients are at higher risk of contracting viruses
such as influenza due to their deteriorating immune systems, implying that health
professionals should isolate infected individuals and do health assessments of all residents
to be able to identify which clients pose a risk to other’s health. A specific sequence of steps
is also required when first aid and medical assistance is required for an individual if they fall
over in the service. Elderly people are frail in bone density and are prone to fractures and
breakages, so it is advised by health services to not move the individuals if they are lying on
the floor to avoid any further trauma or stress. From incidences, such as this, it is a statutory
obligation for the care assistants or manager to contact the local hospital so the ambulance
services can aid. Paramedics possess the training and equipment to safely approach injured
clients which is sought after immediately by carers to ensure the safety of their clients.
In terms of following common accident procedures in Merryvale, it is once again necessary
to effectively use first aid equipment. Slips and trips over scattered litter or wet bathroom
facilities require first aid in how minor cuts or bruises can be treated for in the service by a
trained first aid medic. This means that the client doesn’t have to be relocated to the local
hospital service and physical strain, time and resources do not have to be exhausted from
following this procedure. Another procedure that the care assistants in Merryvale must
respect is to record accidents. A general correlation in the frequency and causes of
accidents of the residents can be investigated as to why there could be a high amount of
accidents occurring and the origin of this cause. Investigation into accidents is a procedure
within itself that is used to resolve accidental occurrences so future incidences. The quality
of life in the service will improve immediately if the manager investigated accidents caused
by scattered letter and being left in their baths for extensive time periods. These accident
and emergencies procedures at work must be a part of a recording and reporting processes
a legal obligation held by all health professionals. Service providers operating within a health
service are required to record and report exact incidents, injuries, disease and dangerous
occurrences in relation to employees, self-employed workers and members of the publics
such as visitors.
Reporting and record keeping

The precise and detailed keeping of records is essential for the promotion of safe practice as
it applies to all health professions. A universal standard of tracking incidences and accidents,
along with the general medical records that clients possess, allows health professionals to
fully understand what needs to be implemented in a client’s care plan to meet their individual
needs. Information gathered and conveyed with service users provides the care that they are
dependent on maintain their positive safety and wellbeing. The care does not pose risk to
individuals receiving treatment and is delivered in a manner that I professional and suitable
for the client.
In health and social care settings such as the Merryvale Residence, it should be an
obligatory performance that the service providers record any bruising. Both clients and
carers must be assessed for bruises whilst providing and receiving care as this suggests that
malpractice or neglect is occurring or physical conflict between clients and their carers is the
result of dispute. Recording bruises can suggest whether the nature of the injury is abusive,
malpractice or fighting and can suggest the culprit in relation to the severity of the bruises.
Trips and slips induced by discarded items around bins and surfaces in the elderly home
also portrays a sound need to be recorded. Sluggish attempts to clean up the bins around
the premises increases the risk of elderly clients cutting or bruising themselves on sharp,
blunt or scattered objects as their decreased eye sight and mobility does not prevent this.
Recording these events allows the manager to identify which care assistants are choosing to
not follow their additional duty (regardless if it is outside their professional requirements) and
sanction them to ensure the future safety.
Obvious neglect upon clients in the service should also be recorded to identify a corrupt
carer that needs to be removed from the environment. This may be due to poor training
when beginning at the residency or a loss of motivation to promote client satisfaction, so
begin to deliberately leave clients in their baths for prolonged periods. Discrimination must
be recorded when witnessed to promote their protected characteristics. Clients who have
dementia might be a viewed as humorous to a client in the service and so should be
recorded by the manager to be able to review that individual’s efficiency when wishing to
safely care for their service users. The individuals may be penalised or permanently
removed from their role to protect all the clients living in Merryvale Residence. In a case
emphasising the worsened skin conditions that a client has developed, a care assistant
would have to inform the manager about the emergency. Severe bacterial or viral infection
could have entered through the open sores in a client’s skin which would require the
manager to ask for permission to photograph the injury. Recording photographic evidence
allows the manager to be able to support the individual if they wish to make a legal claim
against the service, working in collaboration with the police to ensure that the culprit is
punished appropriately and the safety of others is safeguarded.
Furthermore, a key principle to acknowledge when record keeping in a health service such
as Merryvale Residence would be to consistently report in the same fashion in an accident
book. This denies any information being stored incorrectly in the accident book from being
placed in the same place on a page and being written formally. Referring to the records in
the future is made an easy process and allows any accidents to be tracked in a professional
manner. The date of an accident report will also be required in how it promotes accurate
tracking of negative events. How recent an report was conducted in a health service, such
as after a client falling over their clothes that have been left in their room, can inform a health
professional of how common a specific accident might be and can then correlate the date
with that of others. Record keeping is used effectively from this in how all reports made are
fully traceable and emphasise the consistent effort made by workers to identify negatives in
care provision. The method itself needs to be taken into consideration as the approach to
record keeping can influence the validity of information collected. This might be in how a
method identifies whether to question a client instantly after an accident or emergency has
occurred whilst their recalling of the event is still fresh, or to question them after the full
report has been completed to assess their condition after the investigation has been made.
The correct method to suit a service can be made from reviewing such differences between
methods and avoids any necessary information being lost.
Precise noting of the date, time and place of an event can further inform health professionals
of the contributing factors to an accident or emergency. For instance, an elderly client getting
up at 3AM to go to the toilet without calling for assistance led to the individual falling over the
tubing attached to their oxygen tanks. This is due to how the person could not see clearly-a
trademark event often experienced in the night time. This information can be linked to any
known events that might be occurring at a specific time and protects workers when record
keeping as they can be proved to have not ignored an incident prior to it happening. Another
key principle that is kept in mind by health professionals is to collect the personal details of
individual involved. Phone numbers, medical conditions and age can be used when
attempting to contact individuals involved later to assess if the response to an incident has
improved their health and safety by any measure. Sharing personal details allows all
individuals to understand how they may have possibly contributed to the event as any
scenario must be recorded. Finally, health professionals must provide a clear, but brief
description of the nature of the occurrence. Any detailed explanation would increase the
chance of any reader becoming confused or instantly provide a biased support for an
individual involved. The information about an event is kept to a standard that is easy to read
and does not cause readers to be confused by detailed content.
The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014-Regulation 20
has the purpose of highlighting the importance of correct data handling during record
keeping. This would be performed by ensuring that a qualified and listed person is granted
the responsibility for reporting and keeping, along with storing all recorded information in a
health and social care environment. By only having one individual for this task, it means that
the chance of confidential information being incorrectly managed and possibly lost,
endangering the physical and emotional wellbeing of clients through their past experiences
no longer being able to be studied and worked upon. The registered individual, often being a
legal secretary, is responsible for ensuring that all data is only accessible by them and is not
shared with unauthorised individuals who may wish to impose abusive behaviour or neglect
on specific clients.
Safeguarding clients from the risk of unsafe and unacceptable care is of substantial
importance when considering the health and wellbeing of individuals. Recordings made
around this must be made in acknowledgement to this, with precise records of the
individual’s needs, care provision and specific treatment within a service; also known as a
care plan. A greater understanding if how to behave around and care for a service user is
achieved and identifies the individual boundaries that they should not cross to promote their
safety. If safety is breached, the specific event and client can be reviewed to identify why
their safety was jeopardised and which service provider was responsible for the incorrect
practice which caused the event to happen. Protecting service users from unsafe and
inappropriate care can also be achieved from how all accidental incidents must be recorded
and reviewed correctly. Having stored information about an accident allows health
professionals to understand why an accident occurred and who may be to blame for the
event occurring. Whether it be inappropriate practice or misuse of equipment, a review
further identifies how an operation or procedure could have been performed more effectively
and how this can be achieved next time to ensure that the health and safety of clients
remains unthreatened. Finally, job descriptions can be gathered regarding what actions are
permitted and prohibited by the staff. Some activities may be the responsibility of the
manager of a health and social service, such as arranging regular training sessions for staff
members so they can practice their skills and acquire new abilities when providing care.
Unapproved tasks and activities can be recorded by employees which keeps them within
their professional and qualificative boundaries, ensuring that clients receive no accidental
bruising or cuts from their care worker not understanding how to perform a care task of high
specificity and training requirements. It is important that this is recorded as it can show why
an accident or emergency may have occurred by correctly showing that a member of staff
may have been at fault for a client developing injuries, allowing those workers to be
punished to prevent the unauthorised action being made again.
In relation to Merryvale Residence, it is stated by the manager and the service’s regulatory
bodies that members of staff cannot provide care for later-stage dementia patients if they do
not possess the academic or professional credentials to do so. Some health professionals in
the work place can be assumed to have university degrees in dementia care along with the
basic training they receive when beginning work at Merryvale, suggesting that they are
skilfully accepted to care for individuals who may express unpredictable and radical
behaviour. Stating that this is a statutory requirement when applying for a job at Merryvale
suggests to potential staff members that they will not be accepted unless they assure the
service, clients and their families that they will effectively promote safe practice for the
elderly service users present. Their risk of receiving physical harm is reduced from
professional care being provided for them as trained service providers possess a greater
understanding of hazards posed to elderly individuals and their associated conditions.
Moreover, Regulation 20 declares how it is a statutory duty for health professionals to uphold
an open and transparent manner to their clients about aspects of their care and treatment.
Honesty denies misunderstanding about how a client wishes to act in response to being
aware of their health and promotes ease of treatment when clients hold faith in their service
that they will not withhold any information about their health. Being legislative in its design
and purpose, Regulation 20 implies that the legal importance of itself benefits service users
through reminding service providers that this duty is a compulsory job requirement and not a
personal choice, also referred to as Duty of Candour. Information is recorded in written
format and is stored in a secure location in the form of hazard documentation or detailing
within a care plan. The registered person who perform this always asked by other health
professionals in relation to conditions of clients and their risks associated with their care,
preventing confusion and delay in care provision from staff only having to ask one person for
the details.
Being a relatively recent legislation, Duty of Candour is defined as the legal need to be open,
honest and truthful to all clients who have received severe harm whilst in health and social
care settings. Such incidents noted by this duty focus on various scenarios: cases where
clients have experienced moderate harm, severe harm, unexpected death or prolonged
psychological harm must all receive a sincere and professional apology. Affected individuals
are assured that their harm has been acknowledged as the fault of their service, by their
service and admit that the client had no role in their own predicament. The clients’ mental
stability and emotional wellbeing is protected as they do not experience guilt from believing
that their rights do not entitle them to receive an apology. Additionally, the procedure for
reporting links to how health and social care services must abide by a fixed procedure to
report to clients about any ‘regulated activity’. This focusses on ensuring that health
professionals record and report incidences following the set time limit that policies and
procedures state which this should be performed in. Any new or significant evidence within
an investigation must be recorded as soon as possible to ensure that a fully informed and
understood investigation to benefit a client’s wellbeing and safety.
The Duty of Candour relates heavily to Merryvale Residence through the manager’s obvious
failure to seek out and employ a new full-time cleaner. The manager has forced the staff
population within the service to complete the task that the previous cleaner had the
knowledge and experience to perform, leaving the elderly residents at risk of injury when
having to care for themselves. Little spare time is made available for the residents because
of the lack of staff and their overwhelming responsibilities which leaves individuals
vulnerable to the risk of slipping when getting out of their baths or tripping when walking
round their litter-filled environment. Consequently, the manager is obliged to inform the
services users and their families about his/her failure to hire a new cleaner to reinstate a
high standard of care provision and his honest apology for this. In terms of the employee’s
need to apologise, the Duty of Candour highlights their legal requirement to explain their
failure to promote the hygiene of clients when being washed. Clients poor hygiene may have
been compromised when the carers have had to reschedule client’s bed and bath washes,
encouraging fungal and bacterial infection to occur from client’s skin remaining dirty. Despite
how the Duty of Candour explains to the public how healthcare is intricate and
circumstances can change rapidly, the care assistants must express their truthful regret
about not being able to meet their client’s care needs to ensure that their health, safety and
wellbeing is protected.
The procedure (according to Regulation 20)
Health services should as soon as possible, after becoming informed that a safety incident
has risen, orally and personally inform and provide support to the client affiliated with the
event. Firstly, the announcement must be provided in person by a member of staff in the
service. They have the legal and ethical right and obligation to inform the individuals of what
has occurred in concern to their service user’s health and wellbeing, promoting client-worker
relationships in the service making the effort to inform an individual professionally of what
has happened. The notification must also grant clients an honest account referring to all the
facts based around the incident. Informing an individual, the truth about how an incident
might affect a clients’ safety and wellbeing ensures that all people involved in the occurrence
share an understanding of what measures and procedures must be followed to protect a
client from harm. Once again, the client of interest is assured that their care after the event
will be in exact accordance to their specific care needs. Advice for further enquiries into the
accident that follow must be stated themselves to empower the client with their right to
influence their investigation. Their interests and beliefs are at the centre of the investigation
process with health professionals informing individuals that service users possess the
ultimate right to decide what areas of an incident should be addressed to protect their
emotional and physical wellbeing. Finally, the process of notifying a client of an incident that
they are involved in must ensure that the explanation is recorded in written format and
placed in possession of a registered individual. This allows the incident and its notification to
be easily stored physically and then electronically after being transferred onto a computer
database which is kept by a single registered person. Only one line of enquiry is then
needed for the information to be retrieved so health professionals can re-educate
themselves about a client’s needs after incident, possibly relating to the psychological and
physical impacts an individual has suffered with.
When a written notification is provided to a client within an incident, the information required
to be conveyed must be done orally. Written communication enables a more factually
expressive account of an incident and enforces a service provider’s professional opinion on
the case to the person of concern. Informing a client through written speech allows quick and
precise information to be portrayed whilst any recent knowledge is still fresh in a worker’s
mind, promoting their client’s right to be fully knowledgeable of their experience. Details of
enquiries must further be incorporated into written notification as the client can follow the
events of their investigation with confidence. No unexpected actions are predicted to be
seen from the health professionals of the client and makes service users feel empowered
after having a solidified understanding of what is being done to ensure their health and
safety is protected. Any results or data for further enquiries that are required to be taken into
the incident must also be noted in written files so the client is consistently updated about
their care situation. Highlighting the reason for additional investigations can allow clients to
feel that their opinion and interests matter and the client’s wellbeing is of utmost importance
when ensuring that individuals are pleased with the progress of an investigation into an
incident involving them. Finally, an apology needs to be provided to further emphasise the
honest concern and remorse that a service has in regards to an incident involving one of
their service users. This shows that the investigation into an incident was not performed
purely out of legal obligation, but out of moral concern for the current and future safety of the
client because of the service’s failings.
It is the registered person’s responsibility to keep all records around accidents and
emergencies, through both paper-based and electronic copies; which are kept securely and
can be easily located. Following procedures that restrict access to the record to only one
individual decreases the chance of clients experiencing discriminative, abusive or neglecting
behaviour from unauthorised individuals disclosing service user’s confidential information.
However, the registered person has the responsibility to be able to retrieve any information
from a secure record store if a case needs to be reviewed further; which informs both health
services and service users that no gaps in an investigation process could jeopardise the
desired outcome of an investigation. Listed individuals are also obliged to store information
for an appropriate period of time. Data and results from emergency and accident
investigations must be stored by the empowered individual to be held for a time span which
allows services to re-open investigations to review enquiry processes and outcomes, but is
then destroyed appropriately once the time limit has been breached. Both confidentiality is
upheld for those involved in an investigation whilst ensuring that professional approaches
can still be conducted into incidences to protect the future safety and wellbeing of
individuals. Destroying data when an investigation has been concluded and all involved are
happy with the outcome ensures that individuals remain anonymous and fully unaccountable
for investigation outcomes.
Finally, registered people in relation to data handling is relevant to Merryvale Residence in
how all accidents and emergencies should be reported as soon as possible. This denies any
key information being lost from forgetting the events within an incident or individuals involved
deciding to withdraw their alleged involvement in the occurrence entirely. This supports both
clients and their service providers in terms of resolving issues regarding safe practice as
care failure can either be proved or denied in a case, promoting the innocence and
professionalism of an individual involved. One example where this is identified would be in
the case of the elderly dementia female patient possessing bruises. Her injuries can be
recorded in her care plan and stored securely so any sudden problems can be confronted
with factual or photographic evidence. This important for the client in how she is taken
seriously in relation to her sustained injuries, whilst health professionals can prove the
presence of bruising despite how bruises eventually heal over a shirt amount of time.
Within Merryvale Residence, the Duty of Candour promotes safe practice through ensuring
that health professionals are fully aware of the wrongdoing that they have been committed.
Being unaware of how care needs to be improved will not inform the care assistants of their
wrongdoing in terms of not ensuring that there are no trip hazards from overflowing bins and
that clients having their hygiene upheld through being washed in a timely fashion. The Duty
of Candour enforces an ethical and moral requirement for the manager to ensure that the
employees in Merryvale express a sound and honest apology in response to a client’s
accident or emergency which was not the client’s fault. Positively, clients’ will be reassured
that they are not to blame for an emergency or accident occurring and ensures that they are
made to feel respected and important, reassuring them that Merryvale still wishes to provide
high-quality service for affected individuals.
Merryvale Residence has shown little to no effort in attempting to promote the health and
safety of the elderly clients present there in accordance to the Duty of Candour. No
recording practices have been performed in relation to the bruised woman in the same-sex
couple and through the emergency for all clients when being left for hours on end in their
baths. Client’s neglect is not being encouraged to be recorded and makes investigating
incidents and emergencies increasingly difficult and denies a client’s right to be protected for
their current and future accidents and emergencies. No points around the need to record
incidences can be noted and is emphasised in terms of the bruised client in the same-sex
relationship. Despite the client’s injuries being easily noticeable to health professionals, yet
the incident has not had a formal inquiry conducted into the case in acknowledgment of the
client’s risk of being in an abusive or neglecting situation.
Responsibilities of the employers, employees and others

Responsibilities of employers - Health and safety management
Within health services, such as Merryvale Residence, managerial positions have the
responsibility to monitor policies needing to be put into effect in their service. This assures
clients and employees that risks posed to them whilst providing care have been eliminated,
further ensuring that care provision further advances and improves alongside adaptations
being proposed for health and social policies. Quality of life for the elderly clients in
Merryvale would improve from manual handling policies used when moving clients in and out
of baths being reviewed, suggesting that more service providers and appropriate bath lifts
should be used to make the task more efficient. Employers must also promote safe practice
through using their risk assessment skills to identify hazards in their services and allows the
origins of harm to be addressed. Discarded items left around unemptied bins and the lack of
staff in Merryvale to care for clients possess the risk of service users being harmed, needing
to be removed as soon as possible to avoid such an impact on client’s physical wellbeing.
Finally, managers in health services should investigate protocols and policies to identify
where they may possess faults and how they can be improved. Specialised services that
care for children, the elderly or the mentally and physically incapacitated require their leading
positions to identify whether a policy still upholds the changing individual needs of these
clients. Safe practice is still promoted through policies being modified or replaced to benefit
the safety and wellbeing of clients.
Within Merryvale Residence, it is required by the manager to promote safe practice through
teaching the employees of how to perform care policies for the elderly. Visually
demonstrating to the staff how to ensure clients are cared for safety promotes a greater
overall understanding of how to handle accidents and emergencies. The state of emergency
that the health service is in would benefit from the manager reminding the limited workforce
of how to manage care duties for the elderly clients with cleaning duties in the absence of a
professional, full-time cleaner. Service providers would benefit from being informed of how
incident policies should be addressed as the workers become aware of how they are entitled
to behave in such scenarios. Professional boundaries can be respected which doesn’t
worsen the quality of care provision that clients are already receiving, protecting them from
unprofessional and avoidable physical harm. Managers managing health and safety for
service users and providers is beneficial as the manager has a greater understanding of how
health and safety policy and procedure should be performed. This means that clients are not
injured after receiving incorrect care from workers whilst service providers do not place
themselves in danger by providing care in an unsafe manner, as the result of the manager
informing staff of how to perform care tasks correctly. Another benefit would be that the
manager as more competency in being able to guide other health professionals through
experience and understanding of all service users’ individual needs and care plans,
promoting health and safety through clients not being placed at risk of health deterioration
after receiving the incorrect care whilst ensuring workers do not provide care for clients
which they are not fully trained to do so.
Responsibilities of employers - Risk Management
The Health and Safety at Work Act 1974 identifies that employers are legally obliged to
perform risk assessment to ensure that client’s health and safety is not being threatened.
Hazards may not be present in a health service, yet individual needs of a client are dynamic
and change unexpectedly which requires the manager to respond with an organised and
precise risk assessment. This ensures that service users are treated as individuals and each
individual risk is assessed. Making justified alterations to a service’s environment or
equipment prevents accidents from occurring and promotes the positive physical wellbeing
of client and carers alike. Care can continue at a satisfactory standard and encourages
effective risk health and safety practices to be performed in order to prevent harm from
becoming a regular event.
Similarly, employers must have their care and managerial duties explained to them, being
provided in various examples of the requirements they must uphold. Within Merryvale, the
manager must carry out effective and appropriate assessments of risks posed to the health
and safety of all clients, employees, visitors, volunteers and members of the public. This
would be performed daily to encourage risk assessments to become a habit rather than a
statutory task. For instance, before the manager allocates staff members to specific
individuals, the supervisor ensures that a thorough inspection of the surroundings is
undertaken to discover reoccurring or previously unknown hazards that could impact the
physical wellbeing of individuals within the environment. A collection of tangled electrical
wiring with one of the bed hoists was identified in one of the resident’s living spaces,
identifying that this poses a trip hazard to individuals walking past it in a very active area of
the service. Subsequently, the manager records the risk’s presence and continues to put into
effect defensive and protective measures to address this. Such procedures are important in
ensuring that an accident or emergency does not become a common reoccurrence and
improves health and safety as a benefit. This responsibility is granted to the manager as
measures vary with different risks and benefits from experienced-based training to eliminate
a hazard. When the manager identifies that the litter around the bins and across floors, the
professional should respond to the problem through immediately getting an available health
professional to clean up the mess in the short-term and continue to advertise a cleaner’s
vacancy for the long-term. The supply and demand of the care assistants and elderly nurses
in Merryvale has led to the uneven distribution of care and maintenance, with the manager
being able to recognise this and seek to hire a professional cleaner to ensure that the
chance of clients and workers tripping over is fully reduced.
As suggested previously, employers should continue to keep written recordings of
assessments, risks identified within them and accidents caused from risks. Being able to
prove the validity and existence of a risk allows a manager to observe if the advice they have
given their employees has been rehearsed and that staff cannot deny the effectiveness of a
risk assessment. The manager in Merryvale Residence must uphold the duty to formally
record the risk of clients being left in their baths for unacceptable periods of time, writing
details of events in a risk assessment book. It is then suggested that the employees routinely
wash their clients instead of attempting to fit it in with other tasks, stating the consequence of
sanctioning if the client’s hygiene and dignity is compromised once again. Being that the
event has arisen several times in the case study, the manager can then present to the staff
the recorded time, date and nature of the event in the risk assessment book, along with the
response taken to ensure duty of care is followed. Finally, the duty to guarantee consistent
training for workers and the need to promote a continuous standard of care (especially in
recognition to new procedures and legislation), which is up to date, must further be
conducted by employers. Information about proposed approaches and policies to care reflect
the advance in care provision; which benefits clients’ individual needs better. The manager
in Merryvale must organise staff training days led by the chief professional himself/herself as
an attempt to improve the quality of client handling and moving practices. The bruised
dementia woman with bruises around her neck can be seen as a more suspicious case to
investigate, yet proper handling education ensures that all care workers operating in the
service are aware of how clients benefit from correct practice and from not receiving injury
due to incorrect practice.
The manager within Merryvale should promote safe practice through performing risk
assessments and ensuring that the employees are included within the processes of
addressing hazards. The risk to clients and health professionals within the service being
harmed from not ensuring that handling equipment is stored correctly requires the manager
to visually explain to the workers how to avoid this. A response needs to be recorded in a
risk assessment book or the risk assessment process will not be complete, with the manager
showing the employees how to correctly store bed hoists and bath lifts to ensure that it is.
Client’s emotional wellbeing improves from observing how all members of staff wish to
contribute to ensuring their safety and wellbeing, along with their physical health being
protected from the obscure and regular movement of heavy machinery in their surroundings.
The manager further benefits the care workers in Merryvale from upholding responsibilities
in how more members of staff are educated on how to respond to risks when they occur,
preventing the possible future harm of clients and colleagues when working in the service.
The confidence of care assistants increases from being mire knowledgeable of how to care
for the elderly clients and improves their self-esteem and work motive.
Responsibility of Employers - Providing relevant equipment
It is stated by the Health and Safety Executive (2013) that managerial positions should
ensure that all necessary equipment to meet individual’s needs are available to employees
in a care service. Having the correct tools to provide care can prevent delays in care
provision and decreases the possibility of any sudden accidents or emergencies in the future
from a client attempting to wash or move by themselves; if they have physical impairments,
causing them to harm themselves. Having equipment to support these clients prevents risk
of harm. Therefore, there are three primary responsibilities that employers should
continuously meet, first being to provide suitable equipment; this would be to ensure the
equipment is appropriate, maintained and inspected. When ensuring that the equipment is
suitable, the manager must question whether the apparatus is suitable. The equipment must
be in working condition and should be able to be used without any queries; if it could
experience electrical failure during care provision, incurring physical harm to both client and
service provider then it should not be used. Through the manager reassuring employees that
the equipment is suitable for use, conflicts of interests will not arise from care workers
possessing different views on whether to even exploit the equipment present. All equipment
must be identified as fit for its function and the environment in which it will be used. Any
alternative equipment for an original piece of apparatus must be deemed worthy to suit its
proposed intentions for use in acknowledgement to its surroundings, frequency of use and
the individuals operating it. Being confident that a piece of equipment is suitable informs all
employees and clients that a leading individual has approved it for use and will not
jeopardise them through increasing the risk of accidents or emergencies occurring.
Secondly, equipment should be certified that it is perfectly safe for use. Equipment must not
have any damage or unusual condition to it as the structural change could encourage
malfunction or even fire risk if the apparatus is electrically powered. Employee and client
safety is of the highest concern when using equipment so harm from dangerous equipment
contradicting its purpose. Employers must also understand whether the equipment reduces
risks involved with care and further promotes safe care that has a minimal chance of causing
an accident or emergency. If so, this would convey to service users and health professionals
within a service that the piece of equipment does not simply perform a required task, but
contributes to the medical excellence that clients seek out when requiring treatment.
Finally, employers must highlight if their staff members are capable of operating specific
equipment. Competency in service providers when using equipment is a crucial in declaring
if a task can or cannot be used if it is dependent on a specific item; portraying how a task
may have to be delayed or abandoned if employees do not possess the skills, knowledge
and experience needed to use equipment. Employers can adapt their staff to suit the
requirements of a piece of equipment through either training them to use it which sustains
client’s safety when their care needs are being upheld. Health service managers must also
fulfil their responsibility to query whether a piece of machinery is comparable to the its
recommended use guidelines through inspections. Manufacturers and legislative bodies
impose guidelines on how to operate equipment to inform the user of how and why to use
the item, with the manager performing inspections periodically to review how well equipment
matches up to its proposed procedures. This prevents accidents and emergencies from
being addressed through how employers can see how effective apparatus is in meeting its
expected benefits of use. If equipment fail an inspection, then the item can be removed from
the environment for reparation or replacement to ensure clients and employees do not
receive harm from using equipment that does not meet its purpose.
The manager working in Merryvale should promote safe practice through providing relevant
equipment by the manager inspecting all full body hoist, baths lights and stair lifts. This
allows care assistants to know that the elderly clients they are caring or are safe, promoting
the regular assessment of equipment to which increases the probability that problems and
risks are to be noted. This benefits the service providers with Merryvale through care
workers feeling confident that they are providing safe care and that they will not harm clients
as a benefit of this. No emotional stress or guilt is endured and care assistants can continue
to provide complete and effective care. Furthermore, the elderly service users benefit from
the manager doing this as they can view their surroundings as a safe environment to live in.
Elderly individuals can personally observe that health and safety equipment is not fault and
is approved for professionals use and reassures clients that risks to their physical wellbeing
is fully minimised.
Responsibility if employers - Information and training
Employers possess the responsibility of providing information and training to their employees
to decrease the possibility of accidental harm from arising. Staff members of a service can
possess the knowledge of how to respond to accidents and emergencies to ensure that the
correct course of action is decided; when needing to improve client health. Malpractice does
not occur as a result and informs employees that their reaction to an incident was correct
where they followed their employer’s professional guidance. There are various forms of
training that employers must provide for their employees in health settings such as
Merryvale Residence, with manual handling being one. Health professionals need to be
aware of when manual handling is appropriate and how it should be executed; which means
that fewer individuals are required when moving clients as staff members will be able to use
a greater understanding of how to perform the tasks safely. Clients are not dropped and do
not receive injuries from hitting objects during movements which prevents physical and
emotional trauma. This can be observed when the care workers within Merryvale Residence
are able to use only two workers to move client in and out if their baths using a bath lift.
Employers must also provide training for confidentiality in how staff members should handle
and respond to private information. Service providers are responsible for ensuring that they
know what information should be stored where to prevent unlawful disclosure of confidential
information. Clients will not experience stress from being paranoid about their information
being easily accessible and handled incorrectly, not reacting with irrational emotions. No
accidents or emergencies then occur from this. Anti-discriminatory practice must then be
taught to employees by employers to promote cultural, sexual, age and ethnic equality for all
service users and providers. This upholds the self-esteem and self-concept of individuals
within the workplace from all people being valued as equals, with an uneven distribution of
care being avoided in health services. No care emergencies arise because of discrimination
and so no inquiries into incidences need to be conducted. Employers inform employees of
the risks associated with experiencing discrimination as the result of personal views clouding
professional judgement.
Employers must then educate their staff on how to report and respond to accidents, abuse
and neglect. Managers and head positions inform their employees of how reporting and
responding to incidents benefits clients through acknowledging their situation. Employers
present procedures to their staff members which allow situations to be highlighted calmly
and professionally. In Merryvale, a client might fall out of a bath after attempting to move
themselves out of the bath as no health professionals were present to help the client. When
the care assistants are made aware of the emergency, they respond by reporting the
incident to the manager and do not attempt to move the client until an ambulance has
arrived. The client does not sustain any further harm from drastic actions being taken to
move them. Employers must also provide training on how to handle medication. Medicine
must not be damaged, disorganised or given to the incorrect clients for medical use as such
failures would jeopardise the health and safety of clients. Service users are protected from
overdose and from not receiving their medication because from employees not receiving
correct training from the manager and become misunderstood about how to handle
medication.
Finally, employers must provide their staff with training in how to follow emergency
procedures. Knowing how to react to emergencies within services, such as fires and hostile
individuals, is necessary when considering how to evacuate clients and colleagues from an
area to ensure their safety; requiring reference to log books and recordings of who is present
in the service at that time. Anyone missing can be noted and sought after to reassure that
they are safe, with Merryvale doing this in fire incidents. This may be down to an electrical
fault with one of the bed lifts from poor condition, causing the sparks from an open wire to
ignite a fire in a client’s bedroom. Health professionals would then evacuate all individuals
from the residence outside to an allocated fire assembly point, requiring the employees to
understand how to coordinate this effectively and understand how to use time login books for
staff to see who is missing and present.
The employer in Merryvale should promote safe practice through information and training
through keeping records of training and information shared with employees. This will
highlight what staff are responsible for upholding through already being educated about
something and that still needs to be taught to ensure they provide the highest standard of
care possible. Health professionals can then be provided with the specific training they
require for the deaf, blind, physically impaired and those who suffer from dementia; which
encourages safe practice whilst meeting client’s individual needs. The care workers in
Merryvale benefit from the manager upholding this responsibility in how they can
independently state where they need improvement in care skills as they can influence what
training they need to receive. They understand that not possessing any adequate training
could result in disciplinary action after them knowing that they need specific training from
studying training records, yet do not correct this and allows them to feel empowered from
being responsible for their own actions and the training that they receive. Service users
benefit from the manager’s responsibility being met through their varying conditions being
constantly reviewed and referenced with the training that staff have been provided, allowing
changes to training to be put into effect and allows individual needs to be greater met
through correct training being practiced.
Responsibility of Employees - Care of selves and others
Employees have the health and safety responsibility to promote safe practice in Merryvale
through ensuring that they take care of their own health and safety before assisting others.
Risk-free care cannot be provided if there is a chance that a health professional could not
effectively perform a task due to injury or illness. This could be the result of not possessing
the strength to move objects and the potential of dropping equipment is when they attempt
to use or move it. For example, Merryvale employees would have to ensure that they are not
placing physical strain or stress on their backs when changing client’s mattresses when
following bed changing procedures. Following the procedure ensures that a load isn’t
dropped due to pain experienced in the back when lifting mattresses and prevents tripping
hazards from the mattresses being left on the floor from not being able lean down to lift it
again. To ensure their own safety, it is advised that the care workers request at least one
other staff helps them to change a mattress so no colleague is harmed during the process.
Employees must also be responsible for their own health through understanding when to
stop work and vacate areas where they or others are at immediate risk of injury. This
prevents physical harm from stopping dangerous activities being performed with service
providers removing themselves and others to reduce the risk of harm posed to them. In
Merryvale, sharp objects being left around the bin and litter on the floor poses a risk of
lacerations to the skin for clients and care workers around it in the living area. A health
professional who identifies this will then remove other staff and clients form the living area to
remove the any immediate risk of physical injury and ensures there are enough staff with the
clients so one staff member can clean the mess up. Employees must also raise any
concerns of health and safety to promote safe practice in Merryvale through informing others
to encourage action due to a greater awareness of a problem within the service. The risk of
harm is then feared more by health professionals when providing care and emphasises a
greater need for the danger to be removed or at least minimised. This would be performed
through the joint communication of the care workers, protecting emotional and physical
wellbeing and allows care provision to continue without concerns towards the health of
individuals within the workplace.
Lastly, employees must ensure they uphold their obligation to ensure suitable and sufficient
toilets, washing facilities and drinking water are available to individuals within Merryvale.
This prevents harm and disease contraction from service users and staff using damaged
toilets or drinking unsanitary water, along with how this promotes the basic rights to good
hygiene and drinking water. Merryvale would promote safe practice by ensuring the toilets in
the service are safe. Damaged seats, and absence of toilet railings and ensuring that
bathrooms are an appropriate distance from client’s bedrooms must all be taken into
consideration. By the care workers doing this, they can take measures to prevent the
distress of elderly clients not being able to get up off a toilet as they cannot use any toilet
rails to raise themselves. Also, damaged toilet seats increase the risk is clients getting cut
and contracting disease from the toilet itself.
Additionally, employers must look after their own health before helping other in Merryvale in
how they can only perform tasks which they are legally trained to complete. Limiting the care
workers in Merryvale about their professional capabilities prevents the endangerment of
themselves and can continue to provide care that they are confident in doing effectively.
Clients are not seen to be harmed from care assistants being found to be not educated on a
task they are not permitted to do by experience. The staff do not threaten their own health
and safety from remaining within their professional boundaries. Merryvale staff members
must also cater for their own health and safety needs through ensuring that they complete all
tasks to a high standard. Illness and injury impairs physical and intellectual ability to regard
tasks fully and competently with injuries, such as arm muscles, states a need for different
service providers to complete a task to make sure it is completed to a high standard. This
means that clients are not suddenly dropped when they are being moved around in their
beds when being washed due to the poor physical capabilities of their carers and their health
and safety is promoted through protecting the muscles in the neck from not snapping back
suddenly. Finally, employees take care of their own health in Merryvale through not
interfering or misusing health and safety policies. The incorrect use of legislation will go
against experience-based suggestions on how to care for clients and not upholding health
would be a procedural requirement that is being failed. Fact-based care provision is not
provided to the elderly service users who are especially vulnerable to changes in their care
and their carers when they must take time off from poor health; which states how the regular
presence of health professionals is vital for promoting individualised and effective care.
The employees of Merryvale residence should promote safe practice by upholding theirs and
others’ health through ensuring there is a staff member present to observe how a client is
moved out of bed with a bed hoist. An individual assessing the process of moving a client in
and out of bed allows risks to be identified through watching the process progress. Changes
can then be made to make the task safe and performed to its highest ability through
understanding the individual you have requested to overlook the moving of a client will
identify hazards. The care workers in Merryvale benefit from this in how they can exploit an
additional perspective as the extra worker can update them on how the moving task is
developing and allows the health professionals to understand how much risk is being posed
to their physical wellbeing. Clients being moved using the bed hoist benefit from this as risks
to their health is more likely to be addressed, making a seemingly delicate task safer from a
service provider being able to track the emotional and physical state of service users
throughout.
Responsibility of Employees - Guidance from health and safety training
Health and safety training is crucial during care provision for others as procedures are put
into effect to protect employees and service users. One benefit of employees having training
in manual handling in Merryvale is that it ensures that staff do not experience physical harm
throughout the handling of elderly clients. Correct handling methods are used to move
individuals from being explained by the manager, allowing information about how manual
handling should be performed to be shared between staff members. Safe practice is
promoted from this in instances where elderly service users in Merryvale need assistance
getting up and out of their chairs. The manager would have informed the staff that their
backs should remain straight when standing on either side of an individual to reduce back
strain and so the client does not fall on the floor or them, preventing the acquisition on bone
fractures or bruising by landing on the floor. Another positive of employees having training
for manual as this makes sure that the care workers are well educated in the skills required
to perform manual handling. Clients are not placed in the hands of ill-educated health
professionals who may make risky decisions through guess work. The dos and don’ts that
care workers in Merryvale must abide are clearly outlined, allowing employees to reduce the
risks posed to them and their clients whilst safe practice is being promoted. Health
professionals will understand what they are authorised to provide for clients, and follow clear
procedure to ensure that clients feel safe knowing that their service providers are aware of
what they cannot perform to uphold their health and safety.
One potential impact of employees not abiding by training procedures in Merryvale
Residence would be how clients may feel discriminated against. Service users will feel that
their individual needs and rights are not being met due to personal views that their carers
have of them and drives them to fail training procedures from a strong disliking of an
individual. Despite being unlikely, discriminatory behaviour could lead to a health
professional unintentionally focussing more on not caring for one of their clients rather than
protecting them from harm. This leaves victims in constant fear of abuse and neglect due to
their care worker’s consistent failure to uphold the requirements stated in their training
procedure. Clients may also be put at increasing risk of potential physical harm from their
health deteriorating. The elderly are especially physically frail and delicate due to their
extreme age in contrast to younger ages and are more likely to experience bruising and
fractures from training policy failures.
Unstrict procedure abidance and poor training increases the chance of clients being handled
or cared for incorrectly due to a lack of skills acquired from training sessions. Such an impact
can be observed if the Merryvale care workers poorly follow training procedures whilst trying
to help move a client out of a wheelchair. Two staff members present may unanimously
decide that one should tend to cleaning tasks around the ground floor of the residency,
despite this being against the training policy they were informed of; to always have one
employee hold the wheelchair to stabilise it whilst another worker helps the client up and out
of the wheelchair. Another impact is expressed as how employees may harm their own
health through negative care provision, such as straining their back. Poor respect to the
training that employees have been provided with leads to individuals not correctly positioning
their arms and back when helping clients to move, or were simply not explained in enough
detail on how to. This may be the result of the health professionals not acknowledging their
manager’s warning seriously enough through the manager failing to truly emphasise the
importance of following client moving procedure during training; causing staff members to
feel empowered to make their own approaches to care. Care workers will not assess the
potential harm that they may obtain during tasks and will result in the damage of their
muscles when moving equipment and lifting clients.
Employees promote safe practice through guidance through consistently following training
requirements and encourage staff to do so, promoting greater long-term understanding of
how to uphold safe practice. An example of this would be a staff member observing one of
their colleagues manually handling a client incorrectly when helping them out of a chair,
informing the worker that they should keep their back straight when la resident to prevent
physical strain. This reduces the chance of a client being dropped and prevents physical
strain occurring in staff members. This would benefit Merryvale’s health professionals as
they are less likely to forget useful skills from training which causes tasks to be performed
quicker. Subsequently, service user’s meet more of their responsibilities to uphold their duty
to follow training procedures. On the other hands, service users benefit from feeling more
accepted as human being who deserve adequate care in the service, improving their
wellbeing. No fear of physical harm or unexpected death is experienced by the residents in
how their care does not vary which is the result procedure being followed to promote stable
care conditions.
Responsibilities of Employees - Identifying potential hazards
It is significant for potential hazards to be identified by Merryvale employees as their
responsibility as care workers must sustain and maintain health and safety in the workplace.
Workers should not be threatened by dangerous surroundings and equipment whilst
providing care; as jeopardising their own health means that incomplete or poor care is
provided to Merryvale’s clients. It is further important for care assistants to take the
appropriate steps on a daily basis to control hazards and reduce the risks that they pose.
Risks are more likely to be identified if sought after and addressed regularly which allows
care workers to record hazards and remove them immediately. Health and safety is
promoted through the possibility of physical harm being removed.
The Health and Safety Executive deigned five steps used to address hazards and potential
risks in health services, with the first being the need to identify hazards through asking other
employees what they think and how they can see expected harm. Colleagues can share
knowledge of risks and explain why they possess specific thoughts of how hazards could
cause harm, leading health professionals to decide on action based on the severity of a risk.
The next step stated by the Health and Safety Executive is to decide who might be harmed
and how. Service providers must discuss whether the risk of harm is immediate to all health
professionals or users as a risk either needs to be removed instantly to protect health and
safety or at next present opportunity; which allows the prioritisation of dangerous risks.
Wellbeing is prioritised correctly along with this.
Thirdly, health professionals must evaluate the risks and decide on precautions that should
be made so individuals can answer whether they can eliminate a hazard completely or
create a barrier to prevent further harm. Workers must decide whether a permanent or
temporary solution is best to address hazards in consideration to time availability with
precautionary action towards risks highlighting a service’s responsibility to acknowledge
risks posed to clients. This reassures procedure is met and continues to uphold safe
practice. Fourthly, the HSE states how employees should record their findings and
implement them to distribute information to other staff members and ensure the manger is
aware of potential harm. This ensures that a collection of skills and resources are put
together effectively to collect information and promotes a better understanding of how to
address a risk. The manager provides structure to data collection and further benefits an
investigation through allocating specific roles which allows more information to be obtained
and shared. Finally, the HSE declares how service providers should review the assessments
they have performed and update them where it is necessary through checking changes have
been made, with policies altering. Services ensuring this presents themselves as fully trained
to change polices to reduce risks and protect clients’ health and wellbeing. Health
professionals can understand if the risk assessment they performed was efficient and can
plan what improvements need to be practiced next time.
Employees should promote safe practice through identifying potential hazards in Merryvale
by acknowledging the alarming lack of staff. Care needs are being met to an unsatisfactory
standard due to the minimalistic staff population in comparison to the work load upon it with
the risk of health deterioration being the negative multiplier effect of this. Highlighting this
allows the manager to achieve safe practice through agency workers being hired and
improves care provision through a suitable number of staff being present in Merryvale. This
benefits Merryvale’s health professional’s as their emotional and intellectual wellbeing

improves from less stress being placed on them and do not feel rushed to perform more
jobs. This makes the care workers feel that their opinion is considered as an additional
benefit. Clients benefit from employees responding to the lack of staff in Merryvale as their
individual needs are upheld more greatly as specific staff can be provided for specific clients.
This also improves professional relationships between Merryvale and its residents from the
service users seeing that the employees have attempted to maintain individualised care.
Responsibility of Others - Guidance
Health and safety guidance extends to others in Merryvale so all service users, service
providers and the public are protected. Visitors within Merryvale should follow the health and
safety guidance of signing in and out so all individuals can be accounted for in the
occurrence of a fire or incident. People can be identified because of this with the visitors
having the responsibility to ensure that clients are not distressed during such events from
their family member being accounted for. In the case of a fire, staff members or local
services do not have to endanger themselves to find a missing individual. Secondly, visitors
should wear the identification badges provided to them at all times so staff and service users
can recognise them, with the visitor’s roles in the service being clear. Visitors can
understand that they are obliged to allow others to see that they are able to be in the service
to visit their family members and are not authorised by the service to care for individuals.
Wearing badges also means that health professionals and clients do not mistake individuals
as new members of staff and do not unintentionally pressure them to assist with care as
visitors are not trained to care for clients; possibly causing the harm of the residents in
Merryvale. Visitors are further inclined to always be accompanied by one of the staff
members in Merryvale to safeguard all service users, health professionals and visors within
the service. Having a worker present with visitors ensures that no physical or emotional
harm comes to clients. Accompanying visitors prevents individuals from attempting to help
client as they are not directly or trained hired by Merryvale and may jeopardise the
relationships services users share with providers through medical failure. The final
responsibility of visitors in Merryvale is to follow guidance to prevent entering out of bounds
areas of the service to protect staff members and service users from harm. Visitors must
ensure they do not venture into areas of Merryvale which visually state that they are only
accessible by staff members as they may jeopardise the confidential information or
medication of clients by attempting to interact with it. This means that staff member and
service users do not experience harm from their information not being shared with
unauthorised members of the public and their medication cannot be disorganised from
visitors moving medication in its storage area.
Other individuals present in Merryvale should promote safe practice by following guidance
through ensuring that other individuals outside of the service sign in and follow all
emergency procedures such as fire alarms. Communicating each responsibility to other
members of the public allows them to understand that they are not inclined to explore the
service at their will as they will be threatening the physical and emotional wellbeing of clients
by interfering with resources and areas intended for their personal use. Safe practice is
promoted by existing visitors informing potential visitors of how the elderly can have their
private information and medication (and thus, their emotional and physical health), benefiting
all individuals through being reassured that new visitors will not threaten safe practice in
Merryvale whilst visitor’s emotional need to see their family members is upheld.
Responsibility of Others - Emergency procedures
All visitors, volunteers and contractors present in Merryvale must abide by several
emergency procedures, with reception workers informing them of documented procedures in
effect. Reception workers will remind these individuals that they must follow evacuation
procedures if they wish to continue visiting Merryvale. The service is accountable for the
health and safety of all members of the public during emergency situations in which no one
can be present during a fire or a possible danger presented during restoration projects by
contractors. Individuals must remove themselves from a hazardous environment to ensure
that they do not receive physical harm and Merryvale staff do not have to abandon their
tasks during an evacuation to search for missing individuals. Such individuals must further
sign in and out using a visitor’s book so they can be located. Easily sourcing individuals
helps the Merryvale staff to see who is at immediate danger during an emergency and who
still requires locating or assistance to remove them from an area. No unintentional or
irrational emotions are expressed by the clients of Merryvale if their family members can be
located and no health professionals will portray suspicions about the activities of a stranger
which may have caused an incident to occur. Visitors, contractors and volunteers must then
report any unusual behaviour they observe whilst operating in Merryvale to care workers or
the manager. Any neglect or abusive behaviour between service users and providers should
be shared to health professionals as they are authorised to address risks and remove them
using professional approaches. Finally, all individuals must keep exit routes clear. Blocking
fire exits with people or equipment delays the time required to evacuate people within
Merryvale to reduce the risk to their health as any fires or aggressive behaviour can be
isolated from the residency’s population. External workers or visitors promote others and
their own safety by encouraging safe evacuation to be achieved, reducing the risk of panic
and emotional distress occurring from not being able to vacate the service.
Notably, visitors, volunteers and contractors should uphold their responsibility to respond to
procedures, emergency sound and behave appropriately during evacuations. Not reacting to
these emergency indicators shows their lack of consideration for the health and safety of
individuals present in Merryvale and will make the evacuation process more challenging
through either not using the correct exits or attempting to finish their tasks before choosing to
remove themselves from the service. Them and others are more likely to experience
physical harm during fires if their activities are preventing health professionals from keeping
clients tranquil and evacuating them.
Others should promote safe practice in Merryvale during emergency procedures by
immediately stopping their activities so they do not present themselves as barriers to the
procedures being executed effectively. Volunteers moving equipment and contractors
moving equipment must ensure that their activities are not left in a hazardous state when
leaving them to evacuate as the area they are in might be a shared evacuation route for the
care workers to move clients down. Wheelchair users will not be able to move past large or
scattered objects and so external individuals should place their items aside safely where
they know they will not hinder the extensive movement of individuals, promoting a safe
environment to move in. This benefits all individuals in Merryvale by service users and
providers being able to move quickly move themselves away from a dangerous area, yet will
not be exposed to tripping hazards which will injure them and delay the evacuation process.
Responsibility of Others - Abiding by relevant regulations
One function of individuals respecting visiting hours is so care assistants are aware of when
someone is present with a client. This allows health professionals to understand who is
available to help during an evacuation process and who they instantly must help move
during an incident to prioritise care and can respond to situations quickly to ensure client
safety. It can also be decided which clients need to be checked up on periodically to ensure
that visitors are not acting inappropriately and are only present within the stated visiting
hours. Visitors must also abide by visiting hours so health professionals can monitor the
potential risks presented to individuals through abuse, neglect, risk and harm. Care workers
can identify when clients are most likely to be harmed when in the presence of external
visitors, with individuals staying after visiting hours encouraging the elderly clients to become
emotionally or socially attached to visitors. Staying within the hours required by Merryvale
allows incidences and emergencies to be referenced with the presence of visitors and
identify if abusive or harmful family members are the cause of physical injury. Similarly,
visitors can be monitored by visitors following visiting times and can be asked to leave
Merryvale if the pose a risk to the residents or staff. Their activities or the way the address
other individuals may be viewed as unsocial or jeopardise the emotional wellbeing of clients
from becoming upset or frightened; with health professionals being able to ask visitors to
leave as their presence may intimidate clients and make them feel vulnerable in their own
surroundings.
One benefit of having visitors who follow safeguarding procedures in Merryvale by visitors
being more vigilant to signs of abuse. Being more aware of abusive signs allows more
unlawful behaviour to be addressed and stopped from continuing so future harm does not
arise in the form of an accident or emergency; promoting the safeguarding of individuals’
physical and emotional wellbeing from not feeling unvalued and having a low self-esteem.
Visitors may also be able to notice minute changes in clients which could indicate more
serious implications which health professionals may not notice on a daily basis. These may
not be noticed by health professionals as they are consistently having to tend between
various individuals and performing cleaning duties, so they can be informed by visitors who
return to Merryvale regularly and make inquiries into why a client may be experiencing
increased anxieties or discomfort in their surroundings. Finally, visitors are beneficial to
Merryvale when following safeguarding procedure by making complaints or suggestions to
protect and safeguard vulnerable adults. Visitors can identify from anon-biased perspective
that the staffing problem in Merryvale is an emergency within itself and can be provided
suggestions through public feedback. The service can analyse their feedback and make
changes through advertising job vacancies from them being reminded by visitors that the
service still possesses a responsibility to protect not just client, but visitors also.
In Merryvale, others should promote safe practice through abiding by relevant regulations in
how visitors should complain to the manager about the overflowing bins in the service.
Visitors may have almost tripped or even injure themselves on discarded items whilst
moving around the service and can complain about their health being so inconsiderately
regarded by the service. Subsequently, the service can address such complaints through
attempting hire a new full-time cleaner, or several part-time cleaners, to remove the hazard
of the public and their residents from injuring themselves on sharp or scattered litter. This
benefits all individuals from how everyone is aware that they are in a setting that promotes
safeguarding practice and understand that accidents and emergencies are greatly reduced
through visitors upholding their responsibility to identify potential risks.
Evaluate the importance of safe practice

principles in maintaining and promoting
the health, safety and welfare of service
users in a selected health or social care

setting
The importance of maintaining and promoting the health, safety
and welfare of service users at Merryvale
Legal duties and obligations
All members of staff within Merryvale Residence, including all carers, cleaners and
managerial positions, possess duties to abide by to ensure health, safety and welfare of
clients are upheld and met. This is presented through the service employing various policies
to address these responsibilities through referring to the HASAWA and the Care Act. This is
first observed in the HASAWA in how the act states that the service needs to write up a
policy regarding the safe use of equipment whilst providing care. This is relevant for
Merryvale in how the safety of clients is placed at risk from equipment being used or stored
incorrectly could jeopardise the health of clients through possibly being dropped from body
hoists and bed lifts. An example of this could be that the staff in Merryvale have a
responsibility to uphold the service’s policy for safe use of equipment when lifting clients in
and out of bed. A client may have to be moved due to being disabled from the neck down,
requiring their care givers to use the full-body hoist safely and in the presence of other
workers to ensure that the procedure is being performed safely and does not pose the risk of
the client suddenly dropping. An advantage of the workers following this policy in Merryvale
is that the health professionals can ensure clients are safe by being able to refer to several
perspectives and opinions when such a procedure is being performed, allowing risks
previously unidentified to be removed from the environment to ensure the client doesn’t
become physically harmed from either falling or being positioned incorrectly in their hoist.
However, the policy’s weakness is in Merryvale is that the policy does not consider that the
staff may be agency staff or new staff who do not have the experience or complete training
required to effectively use heavy or specific equipment, possibly leading to the clients having
their health and safety jeopardised from being incorrectly lifted in bed lifts.
Furthermore, the Care Act states how services must create and follow policies regarding
adult safeguarding in the need for vulnerable adults to be protected from abuse and neglect.
This is seen in Merryvale when the carers in Merryvale must ensure that all clients with
dementia must have their health, safety and welfare protected, especially in the case of the
bruised woman who cannot remember (or does not want to reveal) how she received the
harm. Staff failed to promote the safety of the client through not making sure that service
users are provided with a regular care giver as the uncoordinated allocation of staff
members leads to tracking an abuser difficult. Subsequently, the significance of this policy is
that it allows the workers to understand that dementia patients must be supervised by one
staff member to reassure the woman that their health and safety is being upheld through
professional guidance written by the manager. The staff can then take action to allocate a
limited number of staff to each client to track where staff have been in the service and
prevent possible abuse and neglect through identifying staff causing malpractice. An
advantage of following the policy to maintain and promote health, safety and welfare is that
clients are made to feel happy and protected from harm, as the staff members are abiding by
their legal obligation to prevent the risks posed to the bruised woman of being abused from
not remembering what harm is incurred. A weakness of adult safe guarding policy proposed
by the Care Act is that clients cannot be kept safe and healthy if individuals do not inform
their carers of threats towards their vulnerability. This may be due to dementia leading to
service users forgetting about incidences where they have been abused or neglected,
alongside abusers telling the victims that their injuries were the client’s fault. This may make
them feel embarrassed for complaining to staff to improve their safeguarding and lowers the
state of their welfare from becoming depressed from viewing themselves as a nuisance to
others.
Effective health and safety policies must clearly guide organisation a direction to follow when
maintaining and promoting health, safety and welfare. Service users are provided with safe
practice through various procedures, such as manual handling procedures. Staff are
required to physically help clients when they need help getting in and out of chairs, beds and
baths in Merryvale whilst ensuring that clients are helped around the service so they do not
trip or slip around overflowing bins. This procedure is significant as it ensures that service
users do not harm themselves from falling over or slipping when moving around and
promotes their safety by preventing accidents and consequential physical injury. A strength
of this procedure is that it is easily to remember and follow from all service users requiring
manual handling in Merryvale to move safely around the service. Memorising the
requirement becomes general practice and means that all residents’ health and safety will be
protected from not falling over, tripping and slipping. A weakness of manual handling
procedure is that it is easy for clients to receive bruising or breakages in Merryvale due to
the high number of new staff not yet receiving the training required to understand how to
handle clients without harming them. Service users who are handled incorrectly will be left
unhappy from the manager allowing their staff to help client when they do not have the
correct understanding of the manual handling procedure being used.
The health and Social Act, but more specifically regulation 20, is also used in Merryvale to
ensure safe practice to share information between a service user, their health professionals
and other appropriate people when regarding health and treatment. This guides the
Merryvale staff to behave in a way which allows workers to be transparent with information
and allows the clients to be told of information around their health, in addition to informing
residents of when staff have failed to provide safe treatment or care. Clients who are
developing bed sores from not receiving baths in bed is an example where the Duty of
Candour become relevant when informing a client that the service is truly sorry for their
failure to promote health, safety and welfare. The manager and care workers must honestly
apologise for their incompetency to uphold their service users’ hygiene and that the
individual is made to feel humiliated that they have developed bed sores which all care
workers can see when providing care. This procedure is relevant in Merryvale as the
managerial team and workforce have allowed care failings to develop without compromise,
action or report to the local council or Care Quality Commission which causes residents to
feel that their health and safety is irrelevant. A positive of this act is that is prevents care
failures from being left unacknowledged through requiring information about clients’ health
and treatment and staffs’ failings to provide these must be shared. Emphasis is placed on
how safe practice must be upheld constantly to promote client satisfaction and prevent ill
health, leading to staff continuously following the act to reduce the need for treatment and
early intervention into poor health. Moreover, the procedure to share information has the
weakness by only being effective if the staff record information so action can later be made
to improve safe practice, yet Merryvale may fail to do so as the staff are too preoccupied
with performing cleaning and client care duties.
Practicing health, safety and welfare policies and procedures contributes to all aspects of
Merryvale Residence’s performance and presents dedication to continuous improvement.
The individual needs of clients are dynamic which can be met through the service ensuring
that individual needs and risk associated with different needs are managed. Health, safety
and welfare are all protected for clients by the staff upholding their duty to continuously
adapt to and change these policies to ensure that care standards do not fluctuate in a way
that jeopardises stable health for clients.
Core principles of maintaining and promoting health, safety and

welfare in Merryvale
Working practices and rules for effectively controlling hazards
Merryvale Residence must learn from what is occurring within the service to alter the way
win which the service provides care and practices safely. It is only possible for the service
provider to develop satisfactory improvements to safe working practices by the manager and
staff making themselves more informed of near misses and accidents through careful
analysis. Having a greater understanding of why incidences occur can identify hazards
within the service and allow action to be taken to remove them to prevent health, safety or
welfare being decreased in clients in the long term.
One instance where Merryvale carers could learn from to promote the health, safety and
welfare of clients would be from where clients have slipped or tripped whilst moving around
the service without identifying slip, trip and cut hazards. The bins overflowing may be the
initially caused by the full-time cleaner being relieved of her duties, yet the care workers
have a duty to maintain health and safety through at least removing spilled liquids or litter
from around bins and surfaces. This prevents the clients from feeling uncomfortable, let
alone possibly have their health threatened through sharp litter being left where the clients
could mistake them for safe or fail to recognise that they could get cut. Alternatively, staff
members could request the manager to install more bins around the service instead of
allowing service users to be exposed to danger that they cannot recognise. An advantage of
this action is that it makes clients feel that their health and safety is respected and of high
importance and encourages individuals to feel empowered to intervene with the conditions
they must be cared for in. A disadvantage of this is that health professionals’ efforts to rectify
their failure to prevent harm to health and wellbeing may be costly and time-consuming,
meaning that safe practice is further delayed from workers choosing to wait instead of
removing waste whilst simply allocating one individual to empty bins removes the hazards
previously stated. Safe practice being promoted through Merryvale care workers ensuring
this is performed is highly significant as this allows the service users to move more freely
around their service, promoting dignity by being informed that clients’ past accidents and
near misses are always acknowledged, investigated and addressed to prevent health, safety
and welfare from deteriorating in the future.
It is important to for Merryvale to consider all minor or near misses to benefit services users
as these suggest to care workers the potential for clients to be harmed. Acknowledging the
cause of a near miss allows early intervention through investigation to be performed into a
potential hazard, reducing the chances of service users’ health and safety being put at risk
when receiving care. An example of this is observed when a client almost asphyxiated
themselves with the tubing attached to their oxygen tanks for breathing after choosing to
clean themselves. This is because the client had waited for several hours to be bathed and
chose to take their care into their own hands despite their care plan stating the individual
needs to be washed regularly as their severe arthritis restricts the clients’ ability to do so
themselves. Subsequently, the staff in Merryvale should consider the near miss to
understand that action needs to be taken to prevent physical harm from reoccurring not just
in this client, but others with breathing apparatus also. The workers can either choose to
ensure that a member of staff remains within close proximity of the client’s bedroom so
bathing duties can be performed quickly, ensuring safe practice through a care giver being
able to check the client is not being strangled by their breathing tubes. This makes the client
feel that their individual needs are understood and feel valued through staff arranging such
support. An alternative action could be that the staff could synchronise that clients’ cleaning
schedule with that of others so their individual need to be cleaned will not be forgotten from
more staff being equipped with equipment ready to wash the service users. An advantage of
considering all minor and near misses is that hazards, such as the clients’ tangled breathing
tubing, can be discussed with colleagues before they are removed and to promote safe
practice through identifying whether a risk poses an immediate or minor threat to service
user’s health, safety and welfare. However, a negative would be that clients might be made
to feel that they are being made a fuss of when the service users have a strong desire to
have dignity upheld, wanting to remove hazards when the client personally recognises them
to reduce stress incurred from the investigation process.
The staff members in Merryvale ignoring near misses and accidents could make service
users feel worthless and lower their self-concept from making individuals believe that their
poor health, safety and welfare is not worth investigation. Clients are made to feel vulnerable
in the service whilst around staff as the residents are put under the impression that their care
givers do not care for hazards that seem minor or insignificant, potentially harming the client
at a later date. This is relevant in Merryvale Residence as the entire service is currently
struggling to prioritise the need for risks and hazards to be identified and addressed through
investigations in relation to the spare time left over from cleaning duties. An example of this
would be if the bruised female in the same-sex couple was to fall over in the night after
forgetting where she is and begin to panic, almost breaking her neck after hitting it on the
bedside rail. The request to share a bedroom after the incident which was rejected may have
not been analysed as to why this occurred due to the lack of staff and time, leading the
bruised woman to develop more bruises and to feel afraid that she is being abused after not
remembering how she developed the injury. Subsequently, the vulnerable woman is not
safeguarded as her risk of accidental injury is allowed to remain high. Ignoring such near
misses is disadvantaged in how practice remains unsafe after staff showing little
consideration towards addressing problems and assuming that the event is highly unlikely to
occur. The judgement of staff is mad inaccurate whilst placed under stress from additional
cleaning tasks and makes clients fear that hazards personally identified which puts their
health and safety at risk will not be regarded in a professional, nor urgent attitude.
One factor which could hinder improving safe working practices in Merryvale would be the
high staff turnover. Service users cannot have their health, safety or welfare holistically
promoted of there are a minimal number of staff to meet various individual needs at different
times. The significance of high staff turnover is paramount in how the number of permanent
staff can influence client wellbeing through service users responding to care based on their
relationship with their care giver, alongside not being able to have their health and safety
upheld adequately from a high number of new workers not fully understanding care plans or
how to uphold them without experience. This could be seen when a service user’s regular
carer leaves Merryvale and is replaced with a new member of staff who has received basic
training and is restricted to what care they are authorised to currently provide. The client
needs to be reassured that they are safe in the presence of staff through workers being able
to provide medication confidently and with knowledge of how to follow medication handling
procedures. The care assistant cannot provide such care yet as they have not received the
training for it as more experienced staff members are busy tending to other duties around
the service, distressing the client from fearing that their health could deteriorate from not
understanding how to administer daily medication independently. A weakness of a high staff
turnover is that many new employees only provide a low standard of care across the service,
with the manager failing to improve safe practice from increasing the chance of clients
experiencing accidental injury after staff use equipment or handle individuals unsafely.
A positive attitude towards risk management and compliance with the

control processes
Merryvale requires managers and staff to be truthful in safety inspections and reports so that
managers understand where they need to focus their efforts. This allows risks to be more
effectively removed in the service and emphasises the importance of the manager to
acknowledge near misses within this analysis to allow improvement plans to be put into
effect. Compliance with this process promotes service users’ health, safety and welfare
through ensuring that the impacts on the clients from a near miss is understood, making
clients feel that their health and safety is important by the manager showing true dedication
to the risk management and control process. In order for the information to flow freely, the
care givers at Merryvale must be willing to take part and be prepared to report their failures,
near misses and accidents so areas of improvements can be identified universally which
means risk can be managed and controlled across the service.
An instance here Merryvale should follow risk management and comply with the health and
safety procedures is where clients could be accidently injured through their surroundings
being dangerous. Residents are especially vulnerable to health deterioration from easily
being bruised or breaking bones when falling or slipping after moving near overflowing bins,
requiring the care workers to be honest about why they believe a bin keeps overflowing and
why the risk has not been removed to promote health, safety and welfare. Significance is
high whilst upholding a positive attitude when bins are changed to ensure clients are not
exposed to hazardous litter through staff following health and safety procedure to wear latex
gloves when changing bins. This is so staff do not cut themselves on sharp objects, meaning
that Merryvale staff promote health of clients through preventing possible infection through
service users accidently touching blood, alongside clients being made to feel safe as trip and
slip hazards are removed. Workers following risk management and health and safety
procedure is an advantage as it prevents client ill health by staff identifying risk of leaving
bins to overflow as this allows staff to prevent failure to inform the manager as to why they
believe the bins may harm clients. On the other hand, risk managements and health and
safety procedure whilst changing bins must be performed more often in Merryvale to uphold
a positive attitude. Staff understand that bins will not be changed daily, posing more long-
term hazards to service users when moving around the service and encourages them to
perform regular risk assessments and promote health and safety procedure to other staff
members so risks are fully reduced.
Following risk management and complying with health and safety procedures to promote
health, safety and welfare of clients in Merryvale is important whilst addressing overflowing
bins as it allows clients to be cared for correctly. Staff are guided by structure in health and
safety procedure when changing bins to reduce the chance of clients harming themselves,
suggesting that the staff begin to become more competent in being able to perform the task
without having to place their clients at risk in their environment. Subsequently, service users
have their health, safety and welfare promoted by staff ensuring that bins are only changed if
they understand how to change bins in accordance to the importance of risk management
and health and safety procedure.
Staff in Merryvale could impact service users through not having a positive attitude towards
risk management or following control processes as the standard of care that clients receive
will decrease. Staff mat view following procedure and performing risk assessments as a
waste of time when trying to tend to all clients and cleaning duties, expressing a negative
attitude by staff believing that they have the right to not follow such guidance whilst the
service has a shortage of staff. Service users are forced to have risks posed to them left
completely unidentified which means the manager cannot be informed of them by not all
members of staff participating in reporting near misses, mistakes or accidents. This is
significant in Merryvale as the service is already struggling to acknowledge several cases of
neglect, such clients being left without bathes for days or being left on their own for
prolonged periods of time. Residents’ health will continue to deteriorate after their accidental
injuries being left unanalysed and ignored through workers identifying from colleagues that it
is supposedly acceptable to not comply with risk inspections, further leading to a loss of
client safety from no competent staff members being present in the service. Service users
will feel fearful land worried that their possible abuse and neglect will continue to be ignored
which causes clients to have a lowered self-concept from thinking that their health, safety
and wellbeing is unimportant. A negative attitude in Merryvale towards risk management or
following control processes would disadvantage Merryvale through the attitude encouraging
other members of staff to share the same attitude, being put under the impression that the
management and control processes for risks are ineffective when they are. This means
clients are put at risk of being left in an unsafe environment where they could injure
themselves through accidents as their care givers choose to not comply with a positive
attitude due to believing that clients should have their risks reduced through alternative
methods.
Furthermore, all care staff failing to report their mistakes or near misses could cause an
issue to arise in the form risks not being correctly identified within care. Other staff members
will be made to think that injuries from accidents observed in service users are entirely
random and not likely to be seen elsewhere across the service, yet it could due to staff
members repeatedly choosing to not report their mistakes and continue to provide an unsafe
standard of care. An example of this could be that one staff member accidently held up the
woman with dementia by the neck when the worker was struggling to manual handle the
client, having no support available at the time. The care giver chose to not report the incident
to the manager as they feared they may lose their job, causing the woman to develop
bruising and a fear for the staff members around her. The woman’s safety could also be
jeopardised from the worker informing other colleagues that the injury was not their fault,
leading staff members to fail to identify the risks associated with only providing one member
of staff for a client that requires specialised support and care. Relevance of this can be found
in Merryvale due to the female client not being able to report the incident herself due to
either her dementia causing her to forget how she developed the bruises or is too afraid that
the injury will be repeated in the form of abuse, requiring staff to report their mistakes
immediately to prevent clients their elderly residents becoming confused or distressed. All
staff members choosing to not report their mistakes or near misses could lead to the
malpractice developing into neglect, making clients unsafe in the long term from their carers
continuously choosing to not identify where they need to improve care provision.
The capacity to learn from accidents, near misses and safety

performance indicators and bring about continual improvement
Merryvale Residence must show willingness to investigate incidents and how to handle
instances where blame arises. One incident where the service could learn from an accident
to promote health and safety for service users is where the elderly female could have
developed bruises around her neck due to being handled incorrectly or unconfidently. A staff
member may have tried to restrain the individual when she began to become aggressive due
to her dementia, with the worker possibly being new and tried to stop the client from getting
hurt by restraining her in a manner they deemed suitable. This could have been to one of the
senior staff members failing to train the trainee due to being pressured to complete other
tasks themselves, informing the manager that he or she should learn from the failure and
ensure that all induction training is performed personally so no unsuitable staff members are
allowed to perform manual handling tasks on their own. Alternatively, staff members who are
required to assist new employees could ensure that new staff members are never left on
their own so accidental harm to the client does not occur. Learning through this instance is
an advantage as it decreases the number of abuse and neglect cases arising in the service
due to untrained staff and potential abusers constantly being observed by well-trained
colleagues, reducing bruising and discomfort to clients when being moved and promotes
their safety by preventing clients from being put in situations where they are at risk of
receiving incorrect care. The relevance of this would be that it ensures continuous
improvements are being made by staff understanding that failures in client health, safety and
wellbeing are unacceptable and need to be addressed immediately. A disadvantage of
learning through this method would be that that staff are more restricted to specific areas
across Merryvale at different times of the day, reducing client health through having their
care plans irregularly upheld whilst their safety is jeopardised by being placed at a higher
risk of harming themselves without being checked regularly by care givers.
It is important that staff members learn from accidents to promote health, safety and welfare
as this suggests to workers what changes to care approach need to be made. The manager
can be consulted about the accidents and be fully informed of what a staff member thinks
needs to change, allowing the manager to either hire new agency staff to address the
staffing shortages or change manual handling procedure to suit the poor number of staff in
the service. A strength of staff reporting accidents to the manager is that it increases staff
morale from informing colleagues that they have the right to raise concerns around why
accidents arise and about poor continual improvement. A weakness of this is that clients
might become distressed from understanding that their care is ineffective which could
eventually lead them to reject care attempts and lead health to deteriorate.
One impact that a blame culture could have in Merryvale on service users is that clients will
have their poor care ineffectively resolved whilst disputes arise between workers. A blame
culture is one where all members of the culture choose to blame and punish others when
things go wrong which discourages accidents being reported. Workers’ competency in being
able to work as a team to promote health, safety and welfare decreasing could lead to
individuals failing to work effectively alongside each other, preventing accidents from being
reduced by health professionals not behaving professionally after they allowed their
emotions to affect the quality of care they provide to their clients. The aim to report accidents
will be replaced with blaming individuals to identify who is at fault for the injury of a client,
possibly being observed if a client injures themselves after slipping on spilt liquid around an
overflowing bin in Merryvale. The staff may choose to blame each other after not
understanding who was responsible for changing the bins in the service, rather than
choosing to report the incident to the manager or consistently check up on the client to
ensure their physical health had not worsened. This is incredibly relevant to Merryvale in
how the staff are currently under tremendous stress and pressure due to their increased
workload, encouraging staff to lose control of their emotions which clouds their ability handle
instances of blame effectively to prevent poor reporting. Blame culture in Merryvale would
be an advantage for service users as their health and safety will be addressed through
concerns being raised about specific workers not behaving safely or competently,
encouraging early intervention into areas of failures regarding workers allowing bins to
overflow and clients to not be washed. A blame culture is a disadvantage for Merryvale in
how it fails to promote health, safety and wellbeing of clients after staff members choose to
focus on irrelevant disputes, rather than choosing to report incidences in a timely fashion to
reduce long-term ill health and worries that clients have around their safety.
Finally, service users in Merryvale could be impacted by no-blame culture by having their
accidents and incurred injuries investigated more thoroughly by staff. A no-blame culture is
one which discourages punishments towards all mistakes and errors, including those which
are reckless or negligent in nature. This culture would most likely be rejected by Merryvale in
how the health, safety and welfare of clients is vulnerable to change due workers showing a
lack of concern for failing to identify risks to service users. An example where this could be
identified is where not punishment is implemented to members of staff who allowed clients to
develop bed sores from not being washed, despite workers understanding who was at fault
for the neglect. The significance of this in Merryvale is that service users are at risk of their
health, safety and welfare being ineffectively upheld through staff being informed that it is
acceptable to let clients develop ill health, be fearful of their carer givers and not be
safeguarded from malpractice. Although a strength of allowing staff do to this is that they can
concentrate on care and cleaning tasks without having to become emotionally unstable from
blaming colleagues, a no-blame culture is a disadvantage for Merryvale in how the clients’
health will continue to deteriorate after bed sores being allowed to develop continuously in
clients from carers not acknowledging the neglect seriously.

SV'D Distinction Learner Work LA D

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SV'D Distinction Learner Work LA D

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SV’d Distinction Learner Work

Explore procedures to maintain health and

Safe moving and handling equipment and individuals

Procedures for responding to accidents and emergencies

Reporting and record keeping

Responsibilities of the employers, employees and others

benefits Merryvale’s health professional’s as their emotional and intellectual wellbeing

Evaluate the importance of safe practice

users in a selected health or social care

Core principles of maintaining and promoting health, safety and

A positive attitude towards risk management and compliance with the

The capacity to learn from accidents, near misses and safety

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