HSC 2028 - Move and position individuals in accordance with their plan of care by Gaël Romanet
Move and position
individuals in accordance
with their plan of care
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HSC 2028 - Move and position individuals in accordance with their plan of care by Gaël Romanet
Level 2 Diploma in Health and Social Care
Unit HSC 2028
Tutor Name: Akua Quao
Thursday 12th September 2013
Release Date: 29/08/2013 18:53
Assignment task – HSC 2028 Move and
position individuals in accordance with
their plan of care
Unit purpose and aim
This unit is aimed at those working in a wide range of settings.
It provides the learner with the knowledge and skills required to move and
position individuals as part of their plan of care according to their specific
needs.
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HSC 2028 - Move and position individuals in accordance with their plan of care by Gaël Romanet
Task ① Understand anatomy and physiology in relation to moving and
positioning individuals
Outline the anatomy and physiology of the human body in relation to the importance
of correct moving and positioning of individuals
Describe the impact of specific conditions on the correct movement and positioning
of an individual
Task ② Understand legislation and agreed ways of working when moving
and positioning individuals
Information: Agreed ways of working will include policies and
procedures and guidelines where these exist
Describe how legislation and agreed ways of working affect working practices
related to moving and positioning individuals
Describe what health and safety factors need to be taken into account when moving
and positioning individuals and any equipment used to do this
Task ③ Be able to minimise risk before moving and positioning individuals
Access up-to-date copies of risk assessment documentation
Carry out preparatory checks using: the individual’s care plan, and the moving and
handling risk assessment
Identify any immediate risks to the individual
Describe actions to take in relation to identified risks
Describe what action should be taken if the individual’s wishes conflict with their
plan of care in relation to health and safety and their risk assessment
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HSC 2028 - Move and position individuals in accordance with their plan of care by Gaël Romanet
Prepare the immediate environment ensuring; adequate space for the move in
agreement with all concerned; and that potential hazards are removed
Apply standard precautions for infection prevention and control
Task ④ Be able to prepare individuals before moving and positioning
Demonstrate effective communication with the individual to ensure that they:
understand the details and reasons for the action/activity being undertaken; and agree
the level of support required
Obtain valid consent for the planned activity
Information: Valid consent must be in line with agreed UK country
definition
Task ⑤ Be able to move and position an individual
Follow the care plan to ensure that the individual is positioned: using the agreed
technique, and in a way that will avoid causing undue pain or discomfort
Demonstrate effective communication with any others involved in the manoeuvre
Describe the aids and equipment that may be used for moving and positioning
Use equipment to maintain the individual in the appropriate position
Encourage the individual’s active participation in the manoeuvre
Information: Active participation is a way of working that recognises
an individual’s right to participate in the activities and relationships of
everyday life as independently as possible; the individual is regarded as an
active partner in their own care or support, rather than a passive recipient
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HSC 2028 - Move and position individuals in accordance with their plan of care by Gaël Romanet
Monitor the individual throughout the activity so that the procedure can be stopped if
there is any adverse reaction
Demonstrate how to report and record the activity noting when the next positioning
manoeuvre is due
Task ⑥ Know when to seek advice from and/or involve others when moving
and positioning an individual
Describe when advice and/or assistance should be sought to move or handle an
individual safely
Describe what sources of information are available about moving and positioning
individuals
Assignment task – HSC 2028 Answers
Task ① Understand anatomy and physiology in relation to moving and
positioning individuals
Outline the anatomy and physiology of the human body in relation to the importance
of correct moving and positioning of individuals
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HSC 2028 - Move and position individuals in accordance with their plan of care by Gaël Romanet
Table of the anatomy and physiology of the
human body in relation to the importance of correct
moving and positioning of individuals
Musculoskeletal
System
Moving and
Positioning of
Individuals
The spinal column is made up of
individual bones called vertebrae. In
between the bones there are joints that
connect these together. A ligament
connects bone to support joints
Not moving an individual correctly
can cause ligaments to sprain. This
is why individuals must never be
dragged when being moved as this
can cause joints to over stretch and
then sprain the ligaments
Muscles work by the fibres they contain When an individual is moved and
contracting; this makes the muscle
positioned it is important this
shorten. When the muscle shortens it
happens smoothly. Sudden
pulls on the tendon and then on the bone movements or pulling in any
to which it is attached. Muscles are
direction of an individual’s limbs
connected to bones by tendons
or body can cause pulled muscles
or tear tendons which can cause a
lot of pain
Bones in limbs are covered with tissue
Putting pressure on an individual’s
hand or arm when they are moving
from one position to another can
cause a bone to fracture. Fractures
can also happen if there is an
accident with for example
equipment like a hoist and this
falls onto the individual when
moving and positioning them or
using the wrong sling size and the
individual falls out
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Describe the impact of specific conditions on the correct movement and positioning
of an individual
The impact of specific conditions on the correct movement and positioning of an
individual is important when working with individuals with different conditions because
this affects how we support them to move and change positions.
For example, an individual living with dementia who is confused might not understand
what we are saying during supporting the individual.
It is very important to take time to show to the individual living with dementia what we will
do before to do it.
Individuals with arthritis have to be supported to move gently as they may be in a lot of
pain and positioning or moving may be uncomfortable.
An individual that has had a stroke might have one arm or leg stronger than the other so
this needs to be taken into account when weight bearing or moving so as to avoid
putting pressure on the weak side.
Individuals who are blind might need more reassurance and speaking explanations
about the move and what is around them as they cannot see.
Task ② Understand legislation and agreed ways of working when moving
and positioning individuals
Information: Agreed ways of working will include policies and
procedures and guidelines where these exist
Describe how legislation and agreed ways of working affect working practices
related to moving and positioning individuals
How legislation affect working practices related to moving and positioning individuals.
Legislation that is relevant includes the Management of Health and Safety at Work
Regulations; this introduced the requirement for risk assessment, risks when moving and
positioning individuals must be assessed, acted on and reviewed; also all staff must be
trained in moving and positioning individuals.
The Lifting Operations and Lifting Equipment Regulations (LOLER) introduced the
requirement for employers to provide lifting equipment that is safe to use and
maintained; staff must also be provided with training.
The Manual handling Operations Regulations for employers states that they must carry
out risk assessments for all moves and reduce the risk of injuries from happening and
avoid dangerous moving and handling; the employees’ responsibilities include using all
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equipment as trained to do so, follow all health and safety working practices and avoid
putting themselves or other staff, individuals or visitors at risk, reporting any hazards or
risks to their employer.
How agreed ways of working affect working practices related to moving and positioning
individuals.
Agreed ways of working mean that employers must have workplace policies and
procedures for moving and handling; these must be explained to staff and staff provided
with training and supervision.
It is also important that all employees, read these procedures, if they do not understand
ask, that they attend training, are supported with understanding all individuals’ needs,
the moves needed and all equipment being used.
Describe what health and safety factors need to be taken into account when moving
and positioning individuals and any equipment used to do this
Health and safety factors that need to be taken into account when moving and
positioning individuals and any equipment mean; before moving and positioning
individuals I have to take responsibility for the health and safety of the individuals, others
and myself and while doing this adhere to the organisational policies in place and meet
all health and safety obligations.
I only move and positions individuals where I have had training to do so.
I do this by ensuring that I am wearing appropriate clothing and foot wear when I move
the individuals or when I am supporting them to change position to avoid any risk of
being harmed; for example when using a hoist I must not wear open shoes or sandals,
and always work with my colleague.
I also make sure that I do a manual risk assessment before performing any move or
reposition.
I do not use any equipment that I have not been trained to use and I check that there is
enough space around me to carry out the move.
All equipment needs to be checked that it is working correctly, if a hoist that it is charged,
and all equipment must be clean and safe to use.
I look out for any obstacles, like loose rugs, clothes and move them to one side. It is
important the space around me is clean and comfortable. All moving and positioning
must not be rushed.
Infection control is also important, washing of hands before and after and wearing of
personal protective equipment according to my workplace policy.
I also check with the individual their needs and preferences and check this against their
plan.
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HSC 2028 - Move and position individuals in accordance with their plan of care by Gaël Romanet
I ask the individuals for their agreement before the move and make sure I am using the
correct equipment, that the sling and hoist are clean and safe to use and the correct
ones for the individual; these must then be stored away safely to avoid any accidents or
them being used for someone else.
In the plan it includes the individual’s weight and the sling and hoist to use for their
weight and for some individuals who are tall.
For example, individuals who are tall need a much longer sling to support their head and
body.
Also to take into account is whether the individual will keep their arms in the sling or
whether they may decide not to or may become anxious when being moved.
Task ③ Be able to minimise risk before moving and positioning individuals
Access up-to-date copies of risk assessment documentation
To access up-to-date copies of risk assessment documentation, I need to ask to my line
manager if I don't know.
Usually, up-to-date copies of risk assessment documentation are kept in a separate file
in the main office with a copy in the individual's care plan.
Carry out preparatory checks using: the individual’s care plan, and the moving and
handling risk assessment
To carry out preparatory checks using the individual’s care plan, and the moving and
handling risk assessment, mean to have access to the individual’s care plan, and to
have access to the moving and handing risk assessment.
If I don't know where individual's care plan is, I need to ask to my line manager.
Usually, individual’s care plan is kept in a separate file in the main office with a copy of
the up-to-date copies of risk assessment documentation.
Moving and handling risk assessment is a basic tool to allow you to identify hazards,
evaluate risks and decide on the safest way to do your work.
Managers and principal investigators are responsible for risk assessments.
Identify any immediate risks to the individual
When moving and positioning an individual, it is very important to be able to minimise
risk before moving and positioning the individual.
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First, I will washes and dry my hands, with the full hand washing technique, before using
the hoist for example. Then I will wear an apron and gloves.
Before to move an individual with the hoist, I always make sure the hoist is working by
checking the battery is fully charged, checking the hoist is clean and checking the
correct sling size I will use to hoist the individual is also recorded in the plan and
assessment of the individual, and fit the individual correctly.
Of course, I will explain with my colleague, to the individual what we will do before
moving and positioning the individual.
For example during to transfer the individual from the bed to the wheelchair, I make sure
this is what it's has been agreed with the individual and I make sure the way we will
transfer the individual is written down in the individual's care plan and risk assessment.
I also make sure to look around the individual’s room to be sure my colleague and I have
enough space before to process moving the hoist.
If needed, I will ask to the individual if I can move the small table until the move with the
hoist is over. I will explain this is to avoid anyone slipping or falling over and having
injuries.
During moving and positioning an individual with the hoist, immediate risks for the
individual mean risk to fall on the floor, risk hurting an object, and risk having injuries.
What is risk?
Risk is the chance of harm happening to someone. Risk assessment and the prevention
of harm to people is naturally an important part of providing health and social care,
particularly to vulnerable people such as living with dementia.
However, fear of any risk, and therefore complete prevention of risk, has become the
focus in some cases. In reality we all take assessed risks every day. We take part in
sports and activities; we cross busy roads and drive our cars. Life would be boring if we
never did anything that had risks attached to it. Acceptable risk can bring benefits into
individual’s lives.
Risk and individuals living with dementia
In considering risk in relation to caring for individuals living with dementia, it is important
that we are aware of, and assess for, risks. We need to do what we can to prevent
accidents and harm to the individuals we care. However, this has to be weighted up
against the individuals we care for being able to do things that are enjoyable and that
promote well being and quality of life.
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Sometimes things individuals living with dementia may want to do may carry some level
of risk, however, preventing an individual from doing something may carry greater risks
for social, emotional and physical well being.
All individuals living with dementia have rights. Rights are the freedoms to which all
people are entitled.
Risk is a concern in providing care to individuals living with dementia. Care homes have
a duty to ensure individuals are not at risk of harm.
Risk of physical harm has to be balanced against risk to well being and quality of life
where activity and movement is restricted because of potential risks.
Individual’s rights are protected by law, particularly where individual are vulnerable and
do not have capacity to make decisions about their own care.
Laws of individual’s rights are The Human Rights Act 1998, Dignity in Care, Mental
Capacity Act 2005, and Deprivation of liberty safeguards (DOLS) in England.
The issue of rights and risk are not straightforward. There are often no clear answers.
This is why discussion, assessment and carful thought are required.
Describe actions to take in relation to identified risks
Actions to take in relation to identified risks are:
-
First Step = identify any risk
-
Next Step = decide what can be done to be protected from the risk
For example: There is a carpet on the floor, in an individual room, that may open chance
of fall for the individual with limited mobility.
Action to take: Remove the carpet.
Describe what action should be taken if the individual’s wishes conflict with their
plan of care in relation to health and safety and their risk assessment
If the individual’s wishes conflict with their plan of care in relation to health and safety
and their risk assessment, action should be taken.
When I come across risks before moving and positioning an individual my actions will
depend on what the risks are.
For example, if there are risks in the environment from hazards that I can move like an
item on the floor then I will do so with the individual’s agreement.
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HSC 2028 - Move and position individuals in accordance with their plan of care by Gaël Romanet
If there is a risk in terms of the equipment I’m using if it is faulty or from the individual it
may be that I think they are unwell or I see a change in their behaviour then I would not
carry out the move but first would report the risks to my manager and seek advice.
The equipment if faulty is removed from the immediate area and an out of order sign
placed on it until it is replaced to make others aware that it is not working or safe to use.
If an individual asks me to move them in a different way than is stated in their care plan
and risk assessment I will explain to the individual what their care plan and risk
assessment says, the risks involved and my responsibilities to only follow the care plan.
If the individual still insisted then I would explain that I would need to report this to my
manager.
I must also record the risks, the date and the action to take.
Prepare the immediate environment ensuring; adequate space for the move in
agreement with all concerned; and that potential hazards are removed
Like I wrote above:
I also make sure to look around the individual’s room to be sure my colleague and I have
enough space before to process moving the hoist.
If needed, I will ask to the individual if I can move the small table until the move with the
hoist is over. I will explain this is to avoid anyone slipping or falling over and having
injuries.
During moving and positioning an individual with the hoist, immediate risks for the
individual mean risk to fall on the floor, risk hurting an object, and risk having injuries.
For example, if there are risks in the environment from hazards that I can move like an
item on the floor then I will do so with the individual’s agreement.
If there is a risk in terms of the equipment I’m using if it is faulty or from the individual it
may be that I think they are unwell or I see a change in their behaviour then I would not
carry out the move but first would report the risks to my manager and seek advice.
The equipment if faulty is removed from the immediate area and an out of order sign
placed on it until it is replaced to make others aware that it is not working or safe to use.
I must also record the risks, the date and the action to take.
Apply standard precautions for infection prevention and control
Standard precautions for infection prevention and control mean to work in a way to
prevent staff exposure to blood and body fluids, and to minimise transmission of
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healthcare associated infection (HCAI) including blood borne viruses, and to prevent
injuries and minimise transmission of blood borne viruses.
Standard precautions for infection prevention and control mean to ensure all staff is
aware of safer practise, and to ensure staff is aware of and adhere to the guidance
issued in the prevention of injuries policy and the actions to be taken following an
exposure.
Working in a way to prevent staff exposure to blood and body fluids, and to minimise
transmission of blood borne viruses, mean the perfectly wash hand hygiene, washing
and drying hands with the full hand washing technique, mean wearing personal
protective equipment, eg an apron, mask and gloves.
To apply standard precautions for infection prevention and control mean to disposed of
apron, mask and gloves in the adapted clinical waste bin (yellow bin with yellow bag,
and red bin with red bag), and then to wash and dry again hands thoroughly.
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Standard precautions for infection and control
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HSC 2028 - Move and position individuals in accordance with their plan of care by Gaël Romanet
Task ④ Be able to prepare individuals before moving and positioning
Demonstrate effective communication with the individual to ensure that they:
understand the details and reasons for the action/activity being undertaken; and agree
the level of support required
Effective communication with the individual to ensure that they understand the details
and reasons for the action/activity being undertaken can be demonstrated with this
example:
An individual got one pressure sore on the bottom skin, and need a new air mattress
bed that will help to remove, little by little, the pressure sore on the bottom skin of the
individual.
This new air mattress bed fit more for the individual's need, compared to the previous air
mattress.
In this example, effective communication with the individual help to ensure the individual
understand the details and reasons for the action/activity being undertaken, by agreeing
the new air mattress bed, that fit more for the individual's need and well being.
Also in this example, the individual agree the level of support required by agreeing the
new air mattress bed, that fit more for the individual's need and well being, because the
individual got one pressure sore on the bottom skin, and can't sleep correctly during the
night due of pain and discomfort.
This new air mattress bed will help to ensure the individual well being.
Obtain valid consent for the planned activity
Information: Valid consent must be in line with agreed UK country
definition
To obtain valid consent for planned activity one must:
1 Complete the valid consent form according to local policy, procedures and protocols
2 Check the individual or relevant others clear understanding and confirm valid consent
and authorization
3 Explain the reasons for the clinical option covered in the valid consent form
4 Check the individual identification details according to local guidelines before
commencement of the valid consent authorization process
5 Refer to managers for advice and information when you are unable to resolve issues
around the valid consent and authorization
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Task ⑤ Be able to move and position an individual
Follow the care plan to ensure that the individual is positioned: using the agreed
technique, and in a way that will avoid causing undue pain or discomfort
and
Demonstrate effective communication with any others involved in the manoeuvre
and
Use equipment to maintain the individual in the appropriate position
and
Encourage the individual’s active participation in the manoeuvre
Information: Active participation is a way of working that recognises
an individual’s right to participate in the activities and relationships of
everyday life as independently as possible; the individual is regarded as an
active partner in their own care or support, rather than a passive recipient
and
Monitor the individual throughout the activity so that the procedure can be stopped if
there is any adverse reaction
and
Demonstrate how to report and record the activity noting when the next positioning
manoeuvre is due
Example of providing help for an individual to stand up using the Turner aid and
to sit on a wheelchair to go for breakfast
To ensure the individual is positioned using the agreed technique, and in a way that will
avoid causing undue pain or discomfort, my colleague and I will follow the care plan and
risk assessment folders.
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HSC 2028 - Move and position individuals in accordance with their plan of care by Gaël Romanet
My colleague and I will discuss the care plan of the individual with the individual to have
the agreement of the individual to stand, and of course my colleague to stand next to the
individual to provide guidance for the individual.
The individual’s room door is closed and the individual is already washed and dressed.
Before putting our personal protective equipment, by wearing disposable aprons and
gloves, my colleague and I take time to wash and dry hands thoroughly, with the full
hand washing technique.
To demonstrate effective communication with my colleague and the individual involved
in the manoeuvre, it is very important to explain what will happen to the individual about
what my colleague and I want to provide the care by positioning the individual, using the
agreed technique and in a way that will avoid causing undue pain or discomfort for the
individual involved in the manoeuvre.
My colleague and I will ensure the individual know what will happen, and will take time to
explain to the individual the manoeuvre by count of three words; ready, steady, go!
My colleague and I will use appropriate equipment to maintain the individual in the
appropriate position, following the care plan and risk assessment folder, and using the
agreed technique.
I will place the Turner in front of the individual and then asks to the individual to place
the feet on the middle part of the turning plate and checks with the individual if it is
comfortable.
My colleague and I will visually check that the individual understand how to position
correctly the knees in the correct angle.
To encourage the individual’s active participation in the manoeuvre when positioning the
individual in an appropriate position is essential to let know what will happen to the
individual.
To monitor the individual throughout the manoeuvre so that the procedure can be
stopped if there is any adverse reaction from the individual during the manoeuvre is very
important to avoid causing pain or discomfort.
Then I will moves the handle to the correct height, places both hands on the handle and
steps onto the turning plate and then asks the individual to place the hands on the
handle and stand up and checks if the individual is comfortable, waiting a few moments.
Then I will turns the disk round, steps onto the pedal and asks the individual to sit back
down onto the wheelchair and checks if the individual is safe and comfortable.
How to report and record the manoeuvre noting when the next positioning is due mean,
my colleague and I will record in the individual's care plan the move of the manoeuvre
and the checks we made of the individual whilst using the Turner aid and reports this to
my manager.
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Describe the aids and equipment that may be used for moving and positioning
The aids and equipment that may be used for moving and positioning an individual, are
the utilisation of the hoists and slings that are used to move individuals who cannot
move by themselves from one position to another position.
The slings come in different sizes and types depending on the height and weight of the
individual.
Slide boards are used for individuals who are quite independent and who just need a
little support with moving for example from their bed to a wheelchair or from a chair back
to their bed.
Lifting handles are used with some individuals to can help them to sit up in bed
independently; they hold onto to these to move themselves.
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Handling belts are used when an individual might be a little unsteady when getting up
and so by holding onto the handles on the belt you can help steadies the individuals so
that they don’t fall over.
There also grab handles placed in individuals’ bathrooms for individuals to be
independent when standing up, walking frames with and without wheels can also help
individuals move themselves independently.
Moving individuals living with dementia require the utilisation of the Oxford Advance
Hoist and Oxford Elevate electric stand aid for the individuals that can't stand and can't
walk due to dementia.
The utilisation of the turner aid and walker provides a great help for the individual with
low mobility.
Task ⑥ Know when to seek advice from and/or involve others when moving
and positioning an individual
Describe when advice and/or assistance should be sought to move or handle an
individual safely
Advice and/or assistance should be sought to move or handle an individual safely;
-
when the manoeuvre is difficult and risky to the health and safety of both the
individual and the carer as this is against the law and can cause injury
-
when the wrong equipment is available
-
when the equipment is faulty again against the law and can cause injuries
-
when the individual’s care plan indicates that two carers have to assist with a
specific manoeuvre and no-one is available
-
when the carer is not sure how to complete the tasks or use the equipment
-
when the individual asks you to carry out the manoeuvre that is outside of the
care plan and that may harm them or the carer as we are not allowed to go
outside the care plan this will be unsafe for the carers and individual
Describe what sources of information are available about moving and positioning
individuals
There are lots of different sources of information who are available about moving and
positioning individuals, on internet, in my workplace the moving and handling procedures
and guidelines about the correct practices to follow, in the individuals’ risk assessment
and care plans about their needs and practices agreed to follow.
The individuals and their families can also help with what they find useful.
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I can also ask my colleagues and manager for information and advice.
Sometimes we can also ask other health care professionals such as physiotherapists
and moving and handling specialist specific questions or advice about issues.
Sources of information are available about moving and positioning individuals during
training courses and on the information leaflets.
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