the Kingfisher Community Special School A Place of Learning Hydrotherapy (an In-School Swimming Management) Policy

Transcription

1 the Kingfisher Community Special School A Place of Learning Hydrotherapy (an In-School Swimming Management) Policy Review Due: Spring Term 2017

2 Philosophy We believe that: The pool at Kingfisher School provides hydrotherapy opportunities for pupils who have an identified need for such additional support. The responsibility for the management of the pool is delegated by the Local Authority to the Governors and Strategic Leadership Team. Pupils who have difficulty accessing community pools will be given the opportunity to develop water safety and early swimming skills within the familiarity and structure of the school environment and its pool. These classes will follow this same guidance, taking into account that the pool is not primarily designed for active swimming, and that time procedures etc. still need to be adhered to. Pupils who can access Oldham Community Leisure pool community facilities for swimming tuition will do so as part of the school s curriculum and to meet the statutory curriculum requirements. Year 6 and Year 5 pupils will be given priority and children will attend on a rolling programme throughout Key Stage 2 or Key Stage 1 as appropriate. The following guidance is given in order to ensure that the highest level of Health and Safety is maintained for all pupils and staff. The guidance has taken into account the information contained within the following documents: - HSG179 MANAGING HEALTH AND SAFETY IN SWIMMING POOLS - HSE POLICY ON CHILD ADMISSIONS TO SWIMMING POOLS CIMSPA PWTAG SWIMMING POOL WATER TREATMENT AND QUALITY STANDARDS FOR POOLS AND SPAS - ISBN HEALTH AND SAFETY OF PUPILS ON EDUCATIONAL VISITS DfEE EVERY CHILD MATTERS DfEE CHARTERED SOCIETY OF PHYSIOTHERAPY, STANDARDS OF PRACTICE CSP ACUTE PHYSIOLOGICAL EFFECTS OF EXERCISE IN WATER Acute Physiological Effects of Exercise in Water Physical Therapy Reviews VO16 P Hall J, late David Garbutt G (2001) - 2 -

3 Procedures We will do this by: 1. Ensuring that no pool use is permitted unless a qualified Lifeguard is on duty at the pool. Automatic door locks prevent children from accessing the pool out of hours of use. 2. Hydrotherapy sessions Physiotherapy staff will be the lead personnel in planning interventions for pupils within the whole session. Children for these sessions will be identified through criteria agreed between Oldham Community Health Service/Pennine Care and school personnel. Parents will complete Physiotherapy child screening sheets to identify any medical needs. 3. Water sessions Teaching staff will be the lead personnel in planning interventions for pupils within these sessions. 4. Session leaders / parents / visitors must familiarise themselves with the pool rules and the safety information displayed around the pool, BEFORE pool use. 5. The Site Supervisor is responsible for the maintenance of the pool s water quality, and his decision regarding its suitability for purpose will be final. The water and air temperatures are set in line with Industry recognised guidelines (PWTAG) and encompass on acceptable range of pool chemicals and temperatures, not fixed points. In his absence, this decision will revert to the Headteacher / STL. The site supervisor will inform Physiotherapy of the daily water and air temperatures to ensure Health staff work within guidance. 6. Staff and pool users must follow advice given by identified Centaur trained staff, regarding the moving and handling of pupils in the pool area. Individual needs will be reassessed and necessary training on any changes will be given on a regular basis. The school s identified Moving & Handling Manager is Cath Croke who can be contacted for specialist advice. 7. The lifeguard must be positioned at the side of the pool (see diagram), to observe the children in the pool throughout the session. A blind spot has been previously identified following a Health & Safety audit and visiting groups must take note of this information. The lifeguard conducts on-going head counts to ensure that all users are accounted for and has the ability to patrol to minimise the effect of blind spots. 8. Maximum time in the pool is 20 minutes for pupils. Staff time can be variable up to 60 minutes, with an additional 15 minute change over time to be taken ONLY if necessary. This is due to the high water temperature and its effect on the body s cardiovascular system. Pool users are advised to take note of this in light of their own personal health circumstances, making their own decisions about whether it is safe or not for them to use the pool. The lifeguard on duty will be responsible for logging people in and out of the pool and records entry and exit times on the white board

4 9. The number of people in the pool must not exceed 15. This number is based solely on the pool s dimensions, and does not take into account the particular needs of pupils / users involved. The final number of people in the pool must include the appropriate level of support required for that particular group of pupils. 10. Persons responsible for children are reminded of their duty to remain in full eye contact and within reach of their charge(s) at all times during their visit to the pool. This is particularly relevant for identified children with medical conditions such as epilepsy. In these circumstances the lifeguard must be notified of who these children are in advance of the session and there must be sufficient class staff to ensure 1:1 support with these children, as identified within their individual risk assessment. The Physiotherapy team to keep up to date care plans from School Health Advisors and these can be referred to where appropriate. 11. Children who are not supported 1:1 in the pool must wear armbands, unless otherwise agreed between the lifeguard and supervising adult prior to them entering the water. 12. The Pool Lifeguard will be responsible for ensuring that the pool area is secure both during and after the session. 13. The session leader must ensure that pupils and staff have appropriate opportunities to have a cold drink during and after the session, including staff involved with children in the changing rooms. The recommended time for a rest following time in the pool is minutes. 14. SLT will ensure that necessary levels of staffing will be available for pool use. Obviously it will be necessary to send children for Hydro at times when the relevant staff are available, and this will be incorporated into the time-tabling of sessions. Should the required level of staffing not be available the session will be cancelled. 15. In addition to ensuring necessary staffing levels in the pool, SLT will ensure that, in the event of classes having to be split for Hydrotherapy needs, sufficient staff will be available for class teaching to continue. In this way we can ensure that disruption for the children is kept to a minimum. Joining classes together will not be viewed as an appropriate alternative. Staffs cooperation in this is crucial for positive and safe outcomes for pupils and staff, and is highly valued. 16. Training and information on Safe Lifting and Handling is available from school staff. All pool users are required to seek advice for the children they will be supervising both in preparation for the pool i.e. changing and use of available equipment, as well as for safe means of access into and out of the pool. A tracked hoist from the assisted changing room is available and training for this, and in the use of a body-board for use in emergencies, can be accessed through school staff. By these means we can continue to minimise risks for everyone involved

5 17. Relevant Health and Safety Officers, Site Supervisor s and a representative from SLT undertake an annual audit of the pool and its area. 18. We aim to reduce the level of possible contamination around the pool by reducing access to the pool area during the day. Staff who are not part of the sessions should NOT be present in the pool area. The lifeguard and/or other staff supervising the sessions may ask other staff to leave the pool area. All adults that enter the pool area MUST wear shoe covers (dispenser located at each entrance to the pool), unless they have separate shoes for the pool area (e.g. lifeguard). 19. The school employs its own lifeguard and provides lifeguard cover for the Parent session on a Saturday morning. All other groups must provide their own lifeguard and qualifications and competence levels will be checked prior to permission being given. 20. The pool managers will regularly assess the risks for the pool, particularly if there are changing factors, and take any necessary action where appropriate, bringing such risks to the attention of users. In this way we can continue to maintain the high level of due safety required by such a potentially hazardous activity. (Pool Managers: The Governors with delegated powers to the Headteacher at Kingfisher). 21. The lifeguard is line managed by the Business Director, Michael Unsworth

6 Appendix 1 Normal Operating Procedures (NOP) NO ACCESS TO THE POOL AREA IS ALLOWED UNLESS A QUALIFIED POOL LIFEGUARD IS ON DUTY. A. Access to the pool is gained by steps into the shallow end besides the changing rooms, or, via a hoist situated in the assisted changing room. The weight limit for the hoist is 95.25kgs/15st. All staff are trained in the use of the hoist and written procedures for hoist use are displayed next to the hoist for reference. B. A telephone is situated within the pool hall (see diagram of swimming pool layout) which can be used in emergencies. The lifeguard can call for assistance before entering the water or can request that another member of the team calls for assistance if adequate supervision numbers are available. An ambulance can also be called directly from this telephone if required. C. Access to the pool area is via 2 doors, both of which have a key fob mechanism for entry. These doors must never be propped open. Please wait with the door until it closes to ensure that no-one gains unauthorised access. D. Changing rooms have changing beds and hoists to ensure safe moving and handling for both pupils and staff. Training in their use is an essential requirement and can be arranged with the Moving and Care Manager. E. School provides identified slings for individual pupils. These must not be tampered with. Should slings be needed for a session please check with the identified Moving and Care Manager prior to use. F. Lights for the main pool area are located on the wall above the hand basin in the Staff Changing Room. G. Fan switches are located on the same panel as the light switches. H. At the end of the session, the person in charge must check that everyone in his/her care has been accounted for. The lifeguard will conduct regular bather load checks throughout the session and will ensure the pool hall is empty before leaving the area. I. External doors must be closed and checked at the end of each session. J. Staff are trained in the use of the hoist and written instructions in the use of the hoist are posted on the wall adjacent to the hoist mounting. Any malfunction in the operation of the hoist should be reported immediately to either Cath Croke (Moving and Care Manager), Tony Whipp (Site Supervisor) or Michael Unsworth (Health & Safety)

7 K. The pool will be maintained by the Site Supervisor who is trained to National Pool Plant Operators Certificate standard. Pool tests are taken prior to the pool being used and periodically throughout the day, as per PWTAG recommended guidelines. If pool readings fall outside of the agreed set parameters the pool ids closed and bathers prevented access until adequate corrective action is undertaken. SWIMMING POOL LAYOUT Details of Pool: Dimension: 5m x 10m (area) 80cm 1m 18cm (depth) Pool sides 80cm high Pool rescue equipment Telephone Spine board Pool Hoist Tracking Hoist from changing rooms Pool Poo Entrance/Exit Pool steps s t e p Shallow End 0.8m Deep End 1.18m Pool Entrance/Exit - 7 -

8 Appendix 2 Potential Risk Factors 1. Glare - The lifeguard should be aware of glare which can prevent a clear view of the pool. The glazing has been given opaque film cover to reduce glare whilst not compromising the level of light. 2. Blind Spot - A blind spot has been identified at the deep end of the pool where the pool cover casts a shadow on the water. The lifeguard is aware of this and has the permission to patrol so to check the area at regular intervals. Staff/users are also made aware of the area and are requested to avoid it where possible. 3. The Pool Cover - should anyone climb on it and fall under. The lifeguard prevents users from climbing on the pool cover and ensures that the pool bottom is clear before putting the pool cover on. 4. Pool Gradient - Changes in pool depth. Users made aware and lifeguard supervises areas where gradient changes. Signage is visible detailing the deep and shallow ends of the pool. 5. Small steps into main pool from entry area entrapment, trip hazard. Users supervised and area monitored by staff during sessions. 6. Stone tiles on steps and poolside floor - slippery when wet. Regular cleaning in place and lifeguard prevents user from running. 7. Fall from height - Drop from pool wall to floor individuals not permitted to climb, stand or sit on surrounding wall. Staff inform users of rules and supervise when the pool is in use. 8. Trip hazard - Swimming aids/equipment stored near the changing rooms. The Lifeguard ensures correct storage and prevents users from running. 9. Entrapment hazards - A filter-cover on the floor of the pool in the deep end and uncovered small filters on the inside vertical wall at the deep end of the pool. Users and staff are made aware of the risk prior to use and staff supervise to ensure users comply with the rules. 10. Contamination hazard - Transmission of debris/contamination on bottom of footwear has been reduced through provision of overshoes which are provided at both entrances. Lifeguard enforces rules

9 Appendix 3 Safety Procedures 1. Fire Procedures for the pool area are provided for staff and users. Staff are trained in evacuation procedures. 2. Visitors to the pool for a Saturday morning session should ensure they have: a) signed in to comply with Health and Safety regulations b) read the Pool Policy which is available poolside. 3. Entry and exit into and from the pool must be via the steps or hoist, NEVER over the pool sides. 4. Pool users must always walk in the pool area. 5. Bathers must not sit or walk along the pool walls. 6. Bathers should make themselves aware of the deep/shallow ends. Signage is displayed. 7. Non/weak swimmers must wear armbands, unless otherwise agreed between the lifeguard and supervising adult prior to them entering the water. 8. Bathers are advised to wear swimming caps (and swim nappies where applicable) so to minimise the risk of pool contamination. 9. There is no diving or Jumping allowed in the pool. 10. Bathers and helpers must take fluids and rest following the session. The recommended rest period is 15 minutes. 11. The pool s rescue equipment and telephone will be checked daily and signed off by the Site Supervisor/lifeguard. 12. Copies of procedures/policies will be available on poolside. 13. The maximum number of swimmers must not exceed 15. Over this number, entry will be refused. 14. Pool users, behaving in a manner which endangers themself or others, should be removed from the water by the individuals support staff or the lifeguard. 15. The hoist will be checked and maintained regularly in accordance with LOLER and PUWER guidance. 16. Persons using the pool are advised that best practice is to ensure that any open wound or stomas are covered with a waterproof dressing to avoid any possibility of cross-infection

10 17. The pool operates a policy of 1 responsible adult supervising a maximum of 2 children under the age of 8, unless this is agreed between the lifeguard and supervising adult prior to them entering the water. 18. If the ratio of staff in the water and in the changing rooms is adequate for school sessions the extra member of staff may not be required. The lifeguard will complete a dynamic risk assessment, using their judgement to determine the exact ratio of staff required to ensure safe supervision within the pool hall and changing areas

11 Appendix 4 Emergency Action Plan The lifeguard is the trained and qualified individual who will lead in the event of any emergency occurring within the pool hall/tank. The lifeguard may require assistance from other responsible staff who will assist as advised. 1. Serious Injury of a Bather or Discovery of a Casualty in the Water. The lifeguard will a. ensure no further danger to the casualty b. evacuate the pool and call for assistance on the telephone positioned by the poolside (or ensure another responsible person completes this task if supervision numbers allow) c. effect an appropriate rescue and organise the safe transfer of the casualty from the water d. give immediate first aid if necessary e. organise responsible person/people to stay with casualty, or other pool users until help arrives 2. Lighting Failure Lifeguard immediately evacuates the pool and informs the site supervisor and their line manager. 3. Fire Alarm/Bomb Threat Lifeguard immediately evacuates the pool and pool area and directs staff and users to the collection point. (See fire notice in the pool area). 4. Emission of Toxic Gases/Structural Failure Lifeguard immediately evacuates the pool and pool area and informs the site supervisor and their line manager. 5. Water Clarity The Lifeguard is responsible for monitoring the clarity of the water. If the water begins to become cloudy and they cannot see pool floor clearly, the site supervisor should be contacted immediately. A water test will be carried out and remedial action should be taken. If remedial action is not possible or effective the lifeguard should then decide if the pool can remain open. If the bottom tiles cannot be seen in the deep end then the pool should be closed. If the pool is to re-open the following points should be considered: Throw in an object at the deepest point, to determine clarity. If it can be seen clearly, ensure the pool is within the correct parameters and then re-open

12 6. Faecal Contamination Information for pool users:- If any faecal matter is found, the Site Supervisor must be informed immediately. 1. If the release is a solid stool (which may, or may not have broken up) The matter should be removed quickly using a scoop or a mesh net, then flushed clean down a nearby toilet. The scoop or net must be disinfected with a proprietary bleach based detergent solution. The chlorine level/residual in the pool must be tested to ensure disinfection of the water. The pool may require one complete turnover and bathers asked to leave the pool. A full incident report must be completed stating the time and nature of the incident and the action taken. 2. If the release is in liquid form (diarrhoea) All bathers must leave the pool immediately and the pool must be closed for six complete turnovers (at least for the remainder of one day). As much of the matter as possible must be removed using a fine mesh sieve. This must be transferred to a yellow plastic bin liner, sealed and labelled. Protective gloves and a PVC apron must be worn. The chlorine level/residual must then be increased and the ph reduced, following the safe system of work for this task. The bottom of the pool should be swept, if possible using an automatic pool vacuum. Once complete the filter bag and vacuum should be carefully disinfected with a bleach based detergent. The pool should then be backwashed prior to opening. A full incident report must be completed stating the time and nature of the incident and the action taken. The pool use will then be at the discretion of the Site Supervisor who has the initial responsibility for the Health and Safety of the pool. NOTE:- It may be appropriate, if the person responsible for the accident is identified and found to have had diarrhoea for several days, to contact the local consultant in communicable disease control before a decision is reached on the re-opening of the pool. Failure to take the correct action could cause illness in a significant number of bathers and therefore your co-operation is appreciated

13 Appendix 5 Maintenance The hydrotherapy pool and environment should be maintained in a manner which ensures maximum comfort and protection of all users. We aim to meet the following criteria as described in standard 17 of Chartered Society of Physiotherapists (CSP) which states:- 1. The pool water temperature is maintained at within a range degrees Celsius, with the optimum being a thermo-neutral, i.e degrees Celsius. 2. The ambient temperature in the pool hall is maintained within the range of degrees Celsius. 3. The ambient temperature in the change and rest areas is maintained within the range degrees Celsius. 4. The atmospheric humidity level is maintained within the range of 50% to 65% with a preferred maximum of 60%. 5. The pool water is treated with a disinfectant agent maintained at a level which protects bathers from pathogens, as per PWTAG guidelines. 6. Disinfectant levels are maintained within the following parameters: Chlorine pools: Free chlorine within the range parts per million (ppm) PH between 7.2 and 7.8 Any decisions about the temperatures or water purity being a barrier to the use of the pool will be discussed by the Site Supervisor, lifeguard and the Headteacher (SLT), and their decision will determine whether the pool area is fit for purpose. Physiotherapy staff will liaise with SLT in the first instance if any concerns are raised

14 Appendix

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16 Appendix 7 HYDROTHERAPY GUIDELINES INTRODUCTION These guidelines apply to Oldham NHS staff using hydrotherapy pools based within a Local Education Authority School in the Oldham area. It should be noted that these pools are not health owned and therefore these guidelines should be used alongside local information and policies specific to the individual pool. BACKGROUND Hydrotherapy is the therapeutic use of water and is a modality to; develop gross motor skills, maintain muscle length, provide a sensory experience and allow freedom of movement. All users must be aware that working in water is potentially hazardous for both patients and physiotherapists (Guidance on Good Practice in Hydrotherapy, CSP, 2006). These guidelines are to ensure that appropriate precautions are put in place to minimise risks to all pool users. INFORMATION REQUIRED FOR HYDROTHERAPY 1) Pool users should have access to the following information prior to working in the pool environment. Fire procedure and evacuation plan Risk assessment of area Emergency procedures including procedures for those with epilepsy/gastrostomies Pupil/patient/clients assessment/hydrotherapy programme Manual handling assessments Pool entry and exit instructions All local policies to the individual pool 2) Screening questionnaires and consent letters should be returned by parents of all pupils/clients/patients accessing hydrotherapy to ensure that consent is gained. 3) Information should be requested from the appropriate medical agency e.g. consultant, where there is change in the pool user s health status e.g. recent surgery. 4) Contraindications and precautions for hydrotherapy should be documented for all service users. 5) Pupils/service users should be assessed prior to hydrotherapy sessions and a programme of exercises and goal of the sessions should be clearly documented

17 POOL MAINTENANCE It is the responsibility of the school to maintain the pool. The criteria in the chartered society physiotherapy standards of practice standard 17 (2005) should be met. The person(s) responsible for pool maintenance (Site Supervisor) should have undertaken and hold an in date National Pool Plant Operators certificate. PREPARATION FOR HYDROTHERAPY 1) Staff should be aware of all Emergency procedures, fire procedures, evacuation plans and manual handling guidelines. Staff should also familiarise themselves with the position of the emergency telephone. 2) Staffing levels in the pool must be appropriate for the level of assistance required by the pupil/service user. Children with complex needs will require a minimum ratio of 1:1. This ratio may be higher where deemed necessary in the risk assessment (CSP standard 18). 3) Staff must have completed all mandatory training including basic life support. 4) A physiotherapist or senior physiotherapy assistant must be in the pool for each hydrotherapy session. 5) Guidelines should be available for individuals with feeding tubes or epilepsy e.g. Care plans. 6) The physiotherapist should consider the temperature of the pool and the suitability of that temperature for individual pool users. The pool temperature should be maintained between degrees Celsius (CSP standard 17). However children who are passive throughout sessions may not benefit from sessions when the temperature of the pool drops below 34.5 degrees Celsius. 7) If the pool becomes polluted evacuation should be immediate and those for maintenance of the pool should be informed. 8) Judgements on the length of time spent in the pool should be made taking into account the water temperature, air temperature, and pupil/service users medical needs/condition. The maximum time spent in the pool during any given working day should not exceed 3 hours for members of staff. 9) Showering facilities should be available to all pool users following the session. 10) A risk assessment must be undertaken for any pregnant members of staff. 11) Any damaged or broken equipment should be reported to those responsible for maintaining the pool (Site Supervisor). 12) Staff should ensure that upon leaving the pool area all doors are locked securely

18 HYDROTHERAPY PROCEDURE 1) A qualified pool lifeguard and one other member of staff must be present on the poolside at all times and remain vigilant throughout the session (Please note that this only applies specifically to hydrotherapy sessions see Appendix 3, section 18 for information on school based sessions). 2) Manual handling guidelines must be followed throughout the session. 3) The treatment during the session should follow the documented hydrotherapy programme, but may be adapted by a qualified physiotherapist applying clinical reasoning skills. 4) Staff should be aware of specific medical conditions of pool user s and of individual care plans. 5) During a seizure in the water the pupil/service user should be supported safely in the water and evacuated once the seizure is over. If a pupil/service user is prescribed rescue medication this should be administered by trained staff following the individual care plan. 6) The number of those in the pool is determined by the size of the pool The recommended is 4sq metres of pool space per client receiving treatment. Audit the author will review on an annual basis any clinical incident forms from the use of the hydrotherapy pool. These guidelines are appropriate for use by all pool users both staff and service users they are equitable to all. Author Julie Battle, Team Leader Paediatric Physiotherapist, Children with Complex Needs Network