LOLER - an interpretation of how the regulations apply in health and social care. John Kershaw, Director, Simply Moving and Sleeping. Lois Lees, Moving and Handling Co-ordinator PG Dip Back Care, Loughborough, PG Cert VR, Salford. Cert Ed, Huddersfield. LGMBE
We are not the experts! This session is open for discussion and debate, please feel free to join in and give your thoughts and opinions. The information is taken from current legislation, guidance and best practice and is an interpretation.
Aims/outcomes of the session - Not to teach granny to suck eggs To probably have more questions than answers. Participants will hopefully, by the end of the session, be able to- Recognise their responsibilities in relation to LOLER in Health and Social Care settings, and that of other stakeholders. Identify key aspects of the regulations that relate to their own roles. Identify what should be expected from a service provider in relation to a LOLER inspection and a hoist service. Recognise the responsibility of individuals in relation to workplace pre-use checks. Visually inspect a hoist and sling to recognise potential LOLER failures pre-use. Define the role of a competent person in relation to LOLER checks.
LOLER what is it? Lifting Operations and Lifting Equipment Regulations second edition December 2014 it is entitled Safe Use of Lifting Equipment L113. LOLER originally came into force in the UK on the 5th December 1998. LOLER is a set of Health and Safety Executive regulations applying to all lifting equipment and lifting operations in the workplace - Regardless if it is patient lifting equipment or not. LOLER requires lifting equipment to be maintained so that it remains safe and that maintenance is carried out safely.
What is a lifting operation? The definition of a lifting operation in LOLER is an operation concerned with the lifting or lowering of a load. It applies to equipment which lifts or lowers loads as a principal function.
What equipment is covered by LOLER? Lifting Hoists (Mobile) - Including standing and raising aids Lifting Hoists (Fixed/Ceiling) Bath Hoists - A device which lifts/lowers a person from outside of the bath Bath Lifts - A device which raises/lowers a person within the confines of the bath Slings Lifting Platforms Stair lifts
What is NOT covered by LOLER? Riser / Recliner chairs Beds (Height adjustable) Baths (Recliner / Height adjustable) Pillow Risers Mattress Elevators Lifting Cushions NOTE: The requirements of PUWER to adequately maintain the equipment still apply.
Who is the guidance aimed at? (HSE 2014) Any people who work with, represent or employ staff who work with lifting equipment. Also those who act as a competent person in the examination of lifting equipment. If you follow the advice within the document, you will be doing enough to comply with the law in respect of those specific matters on which the Code gives advice. LOLER applies to the use of lifting equipment provided as work equipment.
How often? Unless there is an 'examination scheme' specifying other intervals, thorough examinations should be conducted every: 6 months, or less for lifting equipment used to lift people 6 months, for all lifting accessories used to lift people (slings) 12 months, for all other lifting equipment The periods stated are the maximum periods between each examination unless there is an examination scheme produced by a competent person in place, which can specify longer or shorter periods depending on the risk of defects arising.
Pre-use checks. Employers should ensure that their employees have appropriate training and instruction so that they are able to ensure that the lifting equipment is safe to use. The pre use check carried out by staff does not constitute a LOLER thorough examination carried out by the deemed competent person.
Other requirements.. sufficiently strong, stable and suitable for the proposed use. Similarly, the load and anything attached (eg timber pallets, lifting points) must be suitably positioned or installed to prevent the risk of injury, eg from the equipment or the load falling or striking people. visibly marked with any appropriate information to be taken into account for its safe use, e.g. safe working loads. Accessories, e.g. slings, clamps etc., should be similarly marked.
More requirements.. Lifting operations are planned, supervised and carried out in a safe manner by people who are competent; Where equipment is used for lifting people it is marked accordingly, and it should be safe for such a purpose, e.g. all necessary precautions have been taken to eliminate or reduce any risk; where appropriate, before lifting equipment (including accessories) is used for the first time, it is thoroughly examined. Lifting equipment may need to be thoroughly examined in use at periods specified in the Regulations (ie at least six-monthly for accessories and equipment used for lifting people and, at a minimum, annually for all other equipment) or at intervals laid down in an examination scheme drawn up by a competent person. All examination work should be performed by a competent person (someone with the necessary skills, knowledge and experience); Following a thorough examination or inspection of any lifting equipment, a report is submitted by the competent person to the employer to take the appropriate action.
Lifting equipment not owned by your employer. Where a member of the public (e.g. a user of care e.g. services) purchases equipment for their use at home, as it is not defined as work equipment; Where equipment has been loaned by an employer or community equipment provider for individuals solely to be used by themselves, family or unpaid carers, as it is not defined as work equipment during the loan period. In these cases LOLER will not apply. HOWEVER, in the latter case the more general duties under the Health and Safety At Work etc Act 1974 section 3 (to provide safe equipment and maintain it, so far as is reasonably practicable) will apply. If you are an employer, and your staff work with people who have purchased their own lifting equipment, you must have assurance that the equipment is up to date with the relevant checks. You will need documentary evidence before use. If the equipment is not in date or checked, you must not use it. It may be necessary to adopt the equipment into a maintenance scheme or contract.
NPSA/MHRA alert 2015 A National Reporting and Learning System (NRLS) search identified 15 occurrences in a recent four year period where a person has come to harm through falls from hoists, including one death and three severe injuries. Injuries included hip, leg and ankle fractures, head injuries, lacerations and haematomas
The alert states.. Checks by frontline staff are not a substitute for systematic local programmes to provide routine maintenance checks plus the six-monthly thorough examination required by Lifting Operations and Lifting Equipment Regulations (LOLER). Staff should be trained to check the hoists for evidence that maintenance checks are in date (e.g. checking labels attached by maintenance staff with a clear date when maintenance will become overdue). (recent sticker applied to a hoist in my trust, spot the deliberate mistake!)
CQC Regulation 12 and 15 Providers must make sure that the premises and any equipment used is safe and where applicable, available in sufficient quantities. Providers must make sure that equipment is suitable for its purpose, properly maintained and used correctly and safely. This includes making sure that staff using the equipment have the training, competency and skills needed Where the person using the service owns the equipment needed to deliver their care and treatment, or the provider does not provide it, the provider should make every effort to make sure that it is clean, safe and suitable for use.
Thorough Examination The person carrying out the thorough examination must make a written report of the thorough examination and must notify the employer of any defect, which in their opinion is or could become a danger to people. You should keep records of thorough examinations and instruct staff to check that equipment is within date of examination before use. Some organisations also use colour-coded tags to indicate equipment is within its examination period. In respect of thorough examination of accessories, such as slings, the person should have sufficient understanding and ability to identify any wear, deterioration or damage to such equipment.
Competent Person is that you? A competent person must determine the scope of the thorough examination. They should have enough practical and theoretical knowledge and experience of the lifting equipment to detect defects or weaknesses, and assess how important they are in relation to the safety and continued use of the equipment. In respect of thorough examination of accessories, such as slings, the person should have sufficient understanding and ability to identify any wear, deterioration or damage to such equipment. There may be sufficient in-house expertise to appoint a competent person. This is particularly likely with the simpler and lower-risk devices and accessories. An employee nominated to carry out this work should not generally be the same person who performs routine maintenance, as they would be responsible for assessing their own work. Competent persons should be able to act with impartiality and independence. The employer should consider independent verification of any in-house competent person s work.
HSE.. It is the employer s duty to ensure that they employ a suitably qualified competent person to carry out the thorough examination. LOLER does not expressly preclude the person carrying out the maintenance from also conducting the thorough examination. However, the competent person who carries out the thorough examination should not normally be the same person who performs routine maintenance operations on the equipment except where the risk of injury to others is low. This is to ensure that there is independence between the thorough examination and the maintenance and to avoid an individual examining their own work. When these functions are carried out by different people, the additional safety aspect of having a second person checking the equipment makes it more likely that defects will be identified and rectified.
National Association for Safety and Health in Care Services taken from a HSE inspectors report sent to one of their consultants.. The person undertaking these thorough examinations should be competent as described in paragraph 8. I would expect them to have a number of years experience at looking at fabric slings and be able to detect defects and deterioration and to assess the significance of any found. I would expect them to have sufficient independence so as to be able to exercise their judgement without fear and to have appropriate knowledge of the reporting requirements of LOLER. Such a person might be employed by a company who has experience of maintaining and examining other lifting equipment, or an insurance company.
CQC Competent persons Staff must only work within the scope of their qualifications, competence, skills and experience and should be encouraged to seek help when they feel they are being asked to do something that they are not prepared or trained for.
Recent survey LGMBE and NAEP members regarding LOLER. Consultation results from 11 local health and social care providers. All respondents have their slings checked every 6 months, mainly by contractors, whilst carrying out the hoist checks. 10 out of the 11 have their hoists LOLER checked every 6 months. 7 out of the 11 respondents have their hoists load tested every 6 months. 1 every 12 months and 3 were not clear. 9 of the 11 felt that hoists should be weight tested every 12 months.
Manufacturers consultation 5 of the main hoist and sling manufacturers were questioned. All agreed slings require a 6 monthly LOLER check. All agreed the slings should be checked by a competent person. All agreed a pre use visual check is not sufficient to meet LOLER requirements. 4 stated that specific LOLER training is required to carry out these checks to cover the regulations. 4 companies recommend that hoists are load tested annually.
BS EN ISO 10535:2006 Hoists for the transfer of disabled persons Requirements and test methods. The standard for Hoists for the transfer of disabled persons, BS EN 10535 states in Annex B Periodic inspection. B1 Periodic inspection should be undertaken at the time intervals stated by the manufacturer but at least once a year. By periodic inspection is meant a visual examination (particularly of the hoist load bearing structure and lifting mechanism with attachments, brakes, controls, safety devices and person support devices) and whatever function tests and maintenance measures may be required, e.g. adjustment of brakes, tightening of fasteners. Every inspection should include a working load test of one (1) lifting cycle with the maximum load. How are contractors doing this? Are they using the correct methods?
Load testing how should it be done? Noooooooo!
The recommended method is to use dead weights, but a calibrated spring balance can be used.
Pre use visual checks what are the recommendations? 288 You should ensure that people who use lifting equipment have received appropriate training, information and instruction so that they can carry out pre-use checks on the lifting equipment. The user or operator is best placed to identify faults or damage to equipment. These pre-use checks are not the same as maintenance or thorough examination but where defects are found they should be reported to the maintenance team so they can maintain a full record of identified faults for each piece of equipment. 289 The purpose of these pre-use checks is to identify faulty equipment. The operator of the equipment should act as the first line of defence in identifying any faults or damage. Such checks should be carried out before the lifting equipment is used during each working day or at the beginning of each shift.
Sling pre use visual checks Key areas for inspection.. Sling strap attachment points All seams and stitching Handle attachment points End loops on sling straps or clips The body of the sling Velcro or belts The label, safe working load, serial number.
Under the Lifting Operations and Lifting Equipment Regulations 1998/2014, BS ISO 10535 2006 and PUWER it is a legal requirement that each sling has its own identification with essential information such as: Model reference number Type of sling Size Testing mark (CE or similar) Date of manufacture Care instructions Safe working load (SWL) Bar code (not shown*) Identification picture Each sling will have a unique serial number to enable traceability. This is useful when completing inspection and audit records. If the label is missing or cannot be read the sling should not be used.
These slings were in use and had passed a recent competent person LOLER inspection
Slings ensure that they are assessed for, and provided by a competent person Hoists and slings (LOLER pg 29) Where people are lifted using mobile or fixed hoists, the slings used should be of a suitable design to work with the type of hoist available. The sling should also be of the correct size and type for the person and activity being undertaken. For further information see Getting to grips with hoisting people HSIS3.20
What is the life expectancy of a sling? This can be dependent on a number of things The weight being lifted How often the sling is used Where it is stored (sunlight, humidity etc.) Laundering temperatures, detergent used. Chemicals in the environment.
Moving and re-assembling a hoist Equipment must be examined before it is put into service for the first time, unless it is supplied assembled and ready for use, has not been used at another location and has a declaration of conformity. If safety depends upon the installation conditions, then the hoist should be inspected after installation is complete and before it is put into service for the first time. If the equipment has been moved, it should be inspected after assembly and before it is put into service in it s new location. Note this does not apply to different areas of the same site. The general consensus is, if tools are needed to reassemble the hoist, then it will need a thorough examination before use.
Patient specific slings These slings are covered by the LOLER regs and should not be used for longer than 6 months unless they are then subject to a competent person, thorough examination which has cost implications. It is important to write the date of first use on the sling, as soon as it is in use, so that it can be disposed of accordingly. There is limited manufacturers guidance in relation to patient specific slings and the LOLER regs. Arjo - Flites are designed to be used for a limited period only and by their nature of design must be treated as a disposable product. Silvalea - Disposable slings are just that, they are designed for short term use and should be inspected regularly for end user safety. Can be stored for a maximum of two years before use. Spectra Care Group - They can be reused for up to 6 months if not washed or up to 1 month with unlimited washes
Routine Maintenance Routine maintenance typically involves checking and replacing worn or damaged parts, lubrication, and making routine adjustments. This is to ensure the equipment continues to operate as intended, and risks associated with wear or deterioration are avoided. Note that new equipment should be CE marked and be supplied with a Declaration of Conformity and instructions in English.
Schedule 1 - LOLER
Hoist and sling court cases Two nursing home owners have been ordered to pay a total of 140,000 after a pensioner died following a fall from a hoist. The elderly lady fell while being moved from her bed to a chair at a Nursing Home, in Leicester. The 78-year-old banged her head and died the next day, on July 20, 2008. The hoist was 15 years old and the sling 9. They had not been properly checked or serviced. HSE inspector Dr Richenda Dixon said: With properly-maintained equipment, better training and supervision, this incident was easily preventable.
Disabled pensioner died following care-home lifting fall The Catholic Blind Institute, which runs the Christopher Grange nursing home in Liverpool, was prosecuted by the HSE for failing to carry out regular checks on lifting equipment. Liverpool Crown Court heard that Frances Shannon, 81, was a permanent resident at the home. On 4 December 2008, carers were attempting to move her from her bed to a wheelchair using a sling. But as she was being moved, the sling s straps broke free, causing Mrs Shannon to be tipped out of the device and fall three feet to the ground. She suffered a broken shoulder and injuries to her back and elbow, and died in hospital the following day. There should have been regular checks of the sling and it should have been thoroughly examined at least once every six months. Sadly, this did not happen. (HSE inspector) 18,000 fine.
Summary HSE guidance CQC guidance Competent person definition Thorough Examination definition LOLER description of responsibilities Sling and hoist information and checks Testing and maintenance Schedule 1 Court cases
Thank you for listening and joining in Any Questions? John Kershaw john@simplymovingandsleeping.co.uk www.simplymovingandsleeping.co.uk Lois Lees lois.lees@nhs.net
References Safe use of lifting equipment (2014) Lifting Operations and Lifting Equipment Regulations 1998. Approved Code of Practice and guidance, 2 nd Edition Regulation 5, page 27. http://www.hse.gov.uk/pubns/books/l113.htm Health and Safety at Work Act 1974 (c.37) The Stationery Office 1974 ISBN 978 0 10 543774 1 Thorough examination of lifting equipment: A simple guide for employers Leaflet INDG422 HSE Books 2008 www.hse.gov.uk/pubns/indg422.htm BS 10535 2006 Hoists for the Transfer of Disabled Persons requirements and test methods. HSE (2013) Lifting Equipment at Work, a brief guide. http://www.hse.gov.uk/pubns/indg290.pdf HSE (2011) Getting to Grips with Hoisting People - http://www.hse.gov.uk/pubns/hsis3.pdf Arjo sling user guide http://www.medicaleshop.com/media/pdfs/arjohuntleigh/arjo-slinguser-guide.pdf MHRA/NPSA patient Safety Alert (2015) https://www.england.nhs.uk/patientsafety/wpcontent/uploads/sites/32/2015/10/psa-falling-from-hoists-1015.pdf
HSE (2014) Health and safety in care homes http://www.hse.gov.uk/pubns/priced/hsg220.pdf HSE (2012) How the LOLER apply to health and social care http://www.hse.gov.uk/pubns/hsis4.pdf CQC, (2015) Essential Standards of quality and safety. Regulations 12 and15. http://www.cqc.org.uk/content/regulationsservice-providers-and-managers HSE FAQ http://www.hse.gov.uk/healthservices/faqs.htm HSE PUWER regulations (2014) http://www.hse.gov.uk/pubns/books/l22.htm
National Association for Safety and Health in Care Services (2011): http://www.nashics.org/wpcontent/uploads/2011/05/slings-must-beinspected.pdf Cecops.org. uk (2012) court case report http://www.cecops.org.uk/2012/09/carehome-fined-140000-for-equipment-relateddeath/ SHP online (2008) sling death report http://www.shponline.co.uk/disabledpensioner-died-following-care-home-liftingfall/