Ageing, Disability & Home Care

Home and Community Care - Work safety
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Care and service planning

Client referral and assessment Service planning and delivery

Step 1
Referral

Step 2
Assessment

Step 3 
Care and service planning

Step 4 
During service

Step 5 
Review of service

A staff member talks about a plan with clientsWork Health and Safety (WHS) must be considered at the care planning stage to ensure a safe workplace is provided for your workers.

 

Preparing a care plan including WHS considerations

The information gathered about the client’s needs from referral and assessment is used to prepare a care plan. Care plans are given to the support workers to inform them about the client, the services they are to provide, any WHS risks identified and control measures in place.  

Included on care plan

Example WHS considerations

Client details

Are there cultural factors which may influence choice of worker?  Are there infection control issues?  Is assessment from another professional, eg occupational therapist, required due to the client's condition, special needs or level of function?

Types of services

Specific tasks

Do services / tasks to be performed require specific attributes of workers?  Is a safe work procedure or training required? Is equipment required to minimise risks associated with tasks due to factors such as client’s weight / physical condition?

Equipment required

Do workers need training in use of equipment?  Is equipment appropriate to task and in good condition?  Are there issues around moving / storing equipment?

Number of workers

Is one worker safe to undertake the service due to client or environmental factors?

Time and days of service

Are night services required?  If so, this creates additional security risks for workers.

Duration of service

Is service for an extended duration that may require breaks for workers?

Care Manager’s contact details

Allows urgent communication with supervisors.

Special notes

These may highlight other risk factors.

 
 

WHS & the client

Your clients have rights and responsibilities under WHS legislation.  Principally, your work should not place the client at risk.  However, they are also required to not place your workers at risk.

Clients should be informed of their WHS rights and responsibilities.  This can be included in documents such as:

  • client handbook
  • standard information sheets/brochures provided to clients at assessment (eg Make your home safe for you and your support workers and volunteers – foreign language versions are also available)
  • service agreement - examples provided
  • care plan

Ensure you inform clients of your organisation’s policies regarding:

  • smoking
  • cleaning products
  • animals
  • equipment
  • dignity and respect
  • hazard and incident reporting 

Equipment

During assessment, and at the planning stage, equipment needs are identified. It is important to ensure all equipment is available, appropriate to the task and in good working order to ensure efficient service delivery and the safety of support workers and the client.

Equipment may be required for:
  • personal care
  • mobility
  • home cleaning
  • maintenance 
  • transporting clients 

Equipment used for cleaning can present WHS risks to support workers. Use the Safe cleaning equipment - guidance in conjunction with the Home Safety Check to conduct a thorough risk assessment of equipment used for cleaning tasks. Provide clients with the Safe cleaning equipment for you and your support workers brochure so they can check their cleaning equipment is suitable for your workers to use.

Some mobility and daily living equipment may require client assessment by an Occupational Therapist and the trialling several pieces of equipment over time.  The process of assessment, trial and acquisition of this kind of equipment may be lengthy and can impact on service delivery. Interim options for personal care and mobility equipment may need to be considered to provide a suitable and safe service.  These include:
  • equipment loan pools from hospitals, community, disability and home care organisations
  • equipment hire from pharmacies and/or equipment supply companies
  • direct purchase of equipment by the client or through seeking financial support from family members or charities
  • ILC Second-hand AT Register advertised on the Independent Living Centre of NSW  

The Home Care Service of NSW has developed an equipment list  so that home support workers, managers, service co-ordinators and therapists all refer to equipment in the same way and avoid possible confusion.

Mobility and personal care equipment may also need to be used around or in conjunction with existing client furniture. You should consider how the client's furniture may impact on service delivery. If clients and their carers are considering replacing or purchasing furniture they should read the Choosing furniture guidelines to ensure WHS is considered in the purchasing decision.

Remember, equipment may require development of a safe work procedure and training of staff in its correct use. (See Staff Training and Supervision).

Home modifications 

The work environment also needs to be safe for providing services. This may require modifications to be completed prior to commencement of service delivery.  

Interim options may need to be considered so a suitable and safe service can be provided whilst home modifications are completed. Interim options may include:

  • providing the parts of the service that can be done safely
  • providing the service in another area of the house that is safe
  • doing tasks in a different way until the modifications are completed
  • providing the service away from the home e.g. at school, day program, relative’s house, community centre

If you are considering temporary arrangements for showering clients whilst their bathroom is modified refer to the factsheet Managing water in the bathroom for information and advice.

Home modifications should only be undertaken after assessment by an occupational therapist. 

Common examples of home modifications to improve safety include:

  • bathroom modification to allow support workers safe access to assist with bathing;
  • installation of railings at stairs to assist clients with mobility issues;
  • installation of ramps to assist support workers required to transport clients in wheelchairs.

For information on the NSW Home Modification and Maintenance Service visit the HMMS State Council website -  NSW Home Modifications and Maintenance Services.


Further information on equipment and home modifications is included under manual handling strategies.

Assignment of the support worker to the client

The matching of a suitable support worker to the client’s needs is a critical element of the care planning process. A good match is the first step in creating an enjoyable working relationship between support worker and client. It is also good risk management. 

Consider client factors such as:  
  • geographical location
  • physical and behavioural needs
  • social needs and background
  • cultural and religious background
  • service preferences
Consider support worker factors such as:
  • geographical location
  • workload
  • cultural and religious background
  • health requirements
  • skills, knowledge and experience  

This process begins with good recruiting procedures.  Worker selection should take into account the:

  • nature of the work
  • physical demands of the work
  • psycho-social demands of the work
  • skills and experience
  • training and qualifications

You should provide information to prospective workers about the requirements of the job to help them decide if they are suited to the work.

Position descriptions should include documented WHS responsibilities for support workers, which should be communicated to workers and potential applicants.

 

Excerpt from Feros Care – Home Care Worker– Domestic PD

Workplace Health and Safety:

  • ensure a safe working environment in clients’ homes
  • working within workplace health and safety requirements including the use of personal protective equipment as required
  • report all incidents and hazards and correct minor hazards as applicable
  • comply with infection control and food safety requirements
  • undertake correct manual handling using assistive devices as applicable.

 

The home care worker is responsible for:

  • participating in training related to WHS and safe work procedures
  • protecting themselves and others from injury by adhering to policies and procedures relating to health and safety and working in a safe manner
  • reporting any health and safety hazards, incidents or near misses using the incident reporting system
  • reporting any changes or concerns in relation to the clients well being.

  
Job design and rostering

Good job design and rostering practices can assist in reducing WHS risks. Home care tasks such as vacuuming and mopping are physically demanding as they involve the same actions and movements and are done repetitively by support workers over extended periods of time. Without proper management these tasks may contribute to the onset of musculo skeletal injuries. 

In order to minimise such risks, consider spreading the physical demands across different activities. Planning housework tasks provides an example of how to vary light and heavy tasks throughout a service. 

Another example is the balanced roster, which generally includes a mixture of housekeeping, shopping, transport, personal care and respite tasks, with a limit on the number of hours that a support worker can undertake some duties. 

Good job design can also minimise other risks such as stress. Clear job roles, adequate resources to do the job, suitable backup and support will all help to minimise any stress support workers experience in their job. 

 

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