Nothing to see here...

Not wanting to admit there is a problem in the first place is well, often a problem in many establishments. Especially where health and safety is concerned and especially where physical interventions are used or not. Organisations stonewalling their staff’s requests to have physical skills training to help them manage the behaviour of those they come into contact with, is something I have come across on many occasions. Lately I have been advising some care homes and it's been a case of waking people up to what has nearly happened and to take their heads away from assault statistics.

Near misses

Often despite numerous actual assaults and attempted assaults (near misses in health and safety terms) care plans aren’t altered even though they may contain a catalogue of incidents that staff are expected to deal with sometimes, on a daily basis.

The Inspector Guidance Note (IGN) 1.08, states that according to the HSE:

“Recording non-reportable near misses … may help to prevent a re-occurrence. Recording these near misses can also help identify any weaknesses in operational procedures as deviations from normal good practice may only happen infrequently but could have potentially high consequences.

A review of near misses over time may reveal patterns from which lessons can be learned.”

It also defines a near miss as;

“any incident, accident or emergency which did not result in an injury”

It goes on to explain that particular types of near miss are defined under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) as “dangerous occurrences” and must therefore be reported to the HSE.

RIDDOR does not define an accident, it does however include acts of non-consensual physical violence done to a person at work. Definitions incorporating the idea that an accident is “unintended” are therefore inconsistent with RIDDOR, since suicide and violence are clearly intended by someone.

So by the HSE's very definition and that of RIDDOR, an assault is an accident?

Individual reasons why people don't see incidents as well, incidents in the first place are varied but can often include the misconception that;

> because a service lacks understanding or capacity of what they are doing or has special education needs that staff should be able to manage these challenging behaviours by alternate means.

> it hasn’t happened before so is the staff members “fault”

> this provision doesn’t have people there that exhibit that kind of behaviour so it can’t actually be happening

>staff have had manual handling or conflict resolution training so that’s sufficient

> staff can make their own decisions & choose to defend themselves so it's on them

Don't get involved...

Balancing the best interests of staff against that of our service users is something that a lot of organisations get wrong. There exists a duty of care for staff to be protected to protect others in their care and to protect others. If you look at safeguarding guidance it states that abuse and neglect includes:

“…hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating or otherwise causing physical harm.”

Rightly so, staff are asked to try and prevent this from happening to the service users who may be children or vulnerable adults, they are asked to ensure the safety of themselves and to protect others exposed from the risk. As let us not forget;

“…failing to… protect a <child> from physical and emotional harm or danger”

Is also a failure in your duty or the duty of care an organisation owes to staff, service users and to others.

So when many staff we speak with are told not to get involved & if watching someone one to one they are just to “safeguard” them which seems to just be a phrase people coin.

What do you mean "safeguard?"

What exactly do you mean by “to safeguard”? If someone is working one to one what do you expect of them when the behaviour of a service users starts to become extreme?

• to observe?
• intervene? If so alone?
• call for assistance?

Let us not forget that included in all guidance on safeguarding is the provision that organisations shall;

“…ensure adequate supervision (including the use of inadequate care-givers)”

If there are then two members of staff - have they been trained in how to physically intervene? Have they also been given safe methods to allow them to disengage when for example they may be grabbed, bitten, having their clothing grabbed or when lunged at? If they have then the training sourced - is it fit for purpose? Or just politically expedient.

Preventing the problem

Assaults in workplaces are on the up, it's time we looked proactively at not just what is happening but what could happen and what has already nearly happened. Briefing staff on their rights and responsibilities and on their power to use force is essential and can often open up channels of discussion that lead to sensible procedures.

This lies in staff discussions and in the sharing off information - not in number crunching and standardised written policy handouts.

About the author : A neuraliser is the cigar shaped, mind altering, signature tool carried by the MIB agents. With a noisy camera like flash it wipes the memory of its target, putting them under a hypnotic state implanting new memories in place of the old ones.

Doug Melia is not a secret government agent (we think some days he's sure he is) he can often be found in a set of Ray Bans in his car or in a suit with his neuraliser (wireless presenter) in hand overwriting the inconsistencies & implanting the truth into the memories of audiences throughout the modern world.