Moving and handling in health and social care

3. Moving and handling equipment

The type and amount of equipment needed will vary according to the specific needs of care service users. When providing equipment, providers should consider:

• the needs of the individual – helping to maintain independence, wherever possible,
• the safety of the individual and staff

Equipment you may need

Examples of the types of equipment you may need to provide include:

• a selection of hoists, for example hoists to raise people from the floor when they have fallen, standing hoists, mobile hoists
• bath hoists or lifts and/or adjustable-height baths
• a sufficient number of slings of different types and sizes
• slide sheets
• transfer boards used to assist in moving from and to different furniture (such as a seat to wheelchair)
• turntables to help turn people around
• electric profiling beds – for dependent/immobile residents
• wheelchairs
• handling belts to assist residents who can support their own weight, for example to help them stand up – they should not be used for lifting
• lifting cushions used to assist people to get up from the floor or bath
• bed levers and support rails/poles
• emergency evacuation equipment
• suitable walking aids, hand rails etc for people needing minor assistance
• bariatric equipment (for use with very heavy people)

You may also need other homecare handling equipment – the Living Made Easy website has some examples.

Introduce equipment only after assessment and use in accordance with the care plan and manufacturer's instructions.

Moving and handling equipment used for health and social care may be classified as medical devices. The supply and design of such devices or equipment is regulated by the Medicines and Healthcare Products Regulatory Agency (MHRA). You can find guidance on managing medical devices and information on how to report defects, adverse incidents or problems with equipment on the MHRA website.

When a patient arrives in hospital in a wheelchair with their own lifting sling

The organisation must balance the risks of using the patient's own sling with the risks to their wellbeing or recovery of not replacing it with one tested in line with the Lifting Operations and Lifting Equipment Regulations (LOLER).

If a patient is taken into care with an unverified sling of their own then the employer should make a decision about the risks of using the sling.

If the risks to the patient in changing the sling, ie the delays in urgent treatment, discomfort or disturbance etc outweigh the risks of using the sling, it would be appropriate to use it until it can be changed at the earliest opportunity. Before making this decision, an experienced person should check the sling for obvious damage.

Using hoists safely

It is important that safe working procedures are followed during hoisting to avoid accidents that can result in serious or fatal injuries.

Problems with hoists include:

• selecting the wrong size sling, which can result in discomfort if the sling is too small, and/or the person slipping through if it is too large. Staff should be aware that sling sizes and coding vary between manufacturers
• the wrong type of hoist or sling for the individual or task, which can lead to inadequate support and a risk of falling. For example, toileting slings give a great degree of access, but little support
• incompatibility of hoist and sling can result in insecure attachment between the two. Follow the manufacturer's advice and refer any concerns about sling/hoist design, supply, manufacturer's instructions or compatibility to the regulator for medical devices MHRA
• failure of equipment due to lack of maintenance/inspection
• leaving a vulnerable person unattended in a hoist, or in a position where they might be at risk of falling
• overturning of the hoist due to difficult surfaces, transporting an individual over a long distance on a hoist, or not following the manufacturer's instructions
• failure to use a safety harness, belt or attachment appropriately. Some slings come with different length loops for attachment to the hoist to increase comfort or the range of positions. You must choose the correct loops so that an individual is not at risk of slipping from the sling. Use the same loop configuration on both sides to reduce the risk of sideways falling

The individual's risk assessment and care plan for hoisting should specify:

• which hoist to use for which task
• type and size of sling and any configurations of loops or leg attachments
• use of any additional safety devices such as safety belts
• number of carers needed to carry out the task
• any other relevant information specific to the person being hoisted

You must communicate this information to staff and keep it accessible for easy reference. It is common practice to:

• include assessments in individual care plans or profiles and
• provide an additional quick reference guide in a convenient place, for example on the inside of the resident's wardrobe door

Number of carers needed for hoisting

The number of carers required for hoisting can vary depending on the needs of the individual service user and the specific hoisting transfers required. Some individuals can safely use a hoist in their own home without assistance, others may need assistance from a number of carers.

The employer responsible for delivering the care must ensure that a suitable and sufficient risk assessment has been carried out. It must consider:

• the individual being assisted and their needs
• the environment
• the specific hoisting transfers
• the equipment provided
• how the sling is to be applied
• the individuals who are carrying out the moving and handling tasks

In some cases assessment will show that at least 2 carers are needed, one to operate the hoist and the other to help keep the individual in a safe position while moving, to maintain co-operation and provide direct reassurance.

If you have concerns about moving and handling you should ask your care agency to provide a copy of their risk assessment and discuss your concerns with them.

Lifting an individual without a hoist

The Manual Handling Operations Regulations require employers to avoid hazardous manual handling tasks so far as is reasonably practicable. The Regulations do not prohibit workers from assisting people without a hoist, but do require them to put measures in place to carry out moving and handling tasks safely.

An across the board 'no lifting' policy, while eliminating some handling risks, overlooks the needs of the individual and the benefits to them from receiving appropriate assistance with mobility. Such assistance can enable rehabilitation and help people to enjoy more active and independent lives.

Where individuals need moving and handling assistance, the care provider must ensure that a suitable and sufficient risk assessment has been carried out. Carers and those they care for should not be put at risk from unsafe handling practices. A diverse range of handling aids and techniques are available which, when used by appropriately trained carers, can assist people to move safely.

For further information on using hoists safely, please see our information sheet Getting to grips with hoisting (HSIS3).

Maintenance of lifting equipment

Where lifting equipment, including hoists and slings, is used by people who are at work, the Lifting Operations and Lifting Equipment Regulations (LOLER) apply. For further information please see our equipment safety pages.

Ensuring slings for lifting people are uniquely identifiable for maintenance and inspection

Under LOLER anyone using lifting equipment should be able to check that it has been thoroughly examined and is safe to use. This means that lifting equipment and accessories such as slings need to be uniquely identifiable.

Manufacturers often label slings with a serial number, although these can fade over time or during laundering. Some also provide space on the sling label for recording thorough examination dates.

While it is fine to write on the label, there is a potential problem with using some permanent markers on the fabric and load bearing webbing of slings. Most permanent markers do not state their chemical composition. If they contain solvents, such as Xylene, this can weaken the fabric. Attaching some other identifying label (for example by using a robust cable tie) is acceptable. Users should avoid sewing labels onto the sling fabric or attachments as this can also weaken the fabric. If in doubt, contact your supplier or manufacturer.

More information on safe hoisting and maintaining lifting equipment can be found in How LOLER applies to health and social care (HSE information sheet HSIS4).