The following information is mainly aimed at PCBUs and workers in home-based care. However, PCBUs and workers within nursing homes, hospitals or other care organisations may also find this information useful.
People receiving home care services are diverse and have specific needs. The processes for managing work health and safety in these environments provide the foundation for safe practices, but they must also be able to adapt to the individual circumstances of the client. These processes and practices must also respect the dignity, privacy and independence of clients.
When workers are working in a private home, the home is considered a workplace, and therefore the usual work health and safety obligations for workers and PCBUs apply.
If you’re a Person Conducting a Business or Undertaking (PCBU), you must manage the hazards associated to health and safety of your workers by providing:
- a safe working environment: for example, providing safe access in and out of the client’s home, making sure there are no trip hazards, ensuring there are grab rails in bathroom and toilet areas
- safe systems of work: for example, developing and implementing (with your workers’ input) specific safety policy and safe work procedures that reduce the risk of body strain injuries from lifting/moving people. This should include identifying when two people are needed and how team handling is done safely. You must enforce these, and review them to make sure they’re making a difference or if they need further improvements
- equipment in a safe condition: for example, making sure lifting equipment/aids are maintained in safe working order, ensuring access ramps are secure and non-slip
- information, instruction, training and supervision: for example, about safe lifting/moving techniques. Inductions are one way to cover this information.
- facilities: for example, mobile first aid kit/equipment in the worker’s vehicle, a mobile phone to make contact with base, and processes for check-ins, especially for workers in remote or isolated areas.
Your duty of care applies not just to your worker but to anyone else present in the client’s home when the worker is working.
When workers are working in a private home, the home is considered a workplace, and the client also has a duty of care under work health and safety laws.
Therefore the client must notify workers and the PCBU of any changes to their home, and any hazards associated with the house as soon as they become aware of them.
You have a duty to take reasonable care of your health and safety and that of others who may be affected by your actions while at work.
Between 2015 and 2019, more than 450 carers of aged people and people with a disability were seriously injured at work in Tasmania, with the majority of these injuries occurring while working with clients in their homes.
65% of these injuries were musculoskeletal disorders which most commonly include traumatic joint/ligament and muscle/tendon injuries, and musculoskeletal and connective tissue diseases.
Risks of lifting/moving people
High risk tasks include transferring clients from one place to another, changing a client’s position, and showering/bathing clients. These tasks involved pushing, pulling, bending and lifting, which can cause muscle injury. Specific sources of risk include:
- using inappropriate or poorly maintained lifting equipment/aids
- having inadequate space to operate the lifting equipment/aids
- not using lifting equipment/aids due to lack of training
- lifting/moving people when there are no lifting equipment/aids
- not having the appropriate number of workers (if more than one person is needed to lift/move the client)
- wet and slippery floors
- managing unpredictable client movements or behaviours, including falls, seizures, expressions of strong emotion or self-harm
- changes in client mobility that require excess exertion by workers to assist them.
You should consider the issues listed above during your initial assessment of the client’s needs. If they pose a risk, you must put control measures in place before your workers makes their first visit to the client.
You should do a risk assessment of the client’s home and the tasks your worker will do there. Take into account the level of support the person requires. Any risks should be addressed to support both the client and your worker.
You must also consult with your workers and their health and safety representatives as you do your risk assessment.
- Keep lifting equipment/aids maintained in safe working order. Make sure they are suitable for the task, appropriate for the space, and easy for the worker to access and use.
- Make sure workers wear non-slip shoes.
- Keep the floors in wet areas (like bathrooms) as dry as possible. Provide slip-proof/non-slip mats.
- Where two workers are required for lifting/moving clients, make sure you have a process for replacement staff if one worker is absent. Lifting/moving clients should not take place until a replacement worker is present.
- Encourage the client to actively participate where possible.
Training and consultation
- Provide workers with information, instruction and training on the client’s physical support needs and the control measures that will be implemented.
- Develop safe work procedures and provide training in safe lifting techniques, team handling and how to use the equipment/aids.
- Consult with workers and their health and safety representatives as you conduct risk assessments and develop safe work procedures.
- Have a system for workers to report any changes or safety issues to you. Regularly ask your workers about their work environment, tasks or client’s needs. Address these matters as soon as possible.