Moving and Handling: Why helping Mum out of a chair can be a dangerous thing to do

Published: 22/05/2019

‘Moving and Handling’ is a phrase you don’t generally hear outside the care profession. Surely if you want to help someone out of a chair or put them into a more comfortable position in bed, you just move them don’t you?   No. You don’t. In fact, you mustn’t. That’s because the consequences of getting it wrong when you’re moving or handling a vulnerable person can be disastrous.

‘Moving and Handling’ is a phrase you don’t generally hear outside the care profession. Surely if you want to help someone out of a chair or put them into a more comfortable position in bed, you just move them don’t you?
 
No. You don’t. In fact, you mustn’t. That’s because the consequences of getting it wrong when you’re moving or handling a vulnerable person can be disastrous.


 
What can happen?
 
In later life our bones, ligaments and skin are nowhere near as resilient as they were in our youth. Moving someone in the wrong way can cause untold damage. Even when the mover is trying their utmost to be gentle and careful, with the wrong techniques an older person can readily sustain painful injuries including dislocated joints, fractured bones, ruptured ligaments and broken skin.


 
Physical and emotional impact
 
Think about the emotional implications of not being able to move your own body. When our body is fragile, it’s alarming to be moved about by others. It can also feel demeaning. So as well as knowing exactly the right physical techniques to move and handle people, it’s vital to understand the emotional implications of these processes. People need to know they are in safe hands – literally – and feel their dignity is respected.
 
These are the foundations of skilled moving and handling.
 
Moving and handling expertise is a marker of a great care company
 
Moving and handling that meets current best practice requires exceptionally detailed training. A great deal of time and expense is involved. Where many homecare companies fall short, I insist my team is trained above and beyond our statutory obligations.
 
As in most areas of care, medical science moves on rapidly and best practice advances all the time. Old techniques are discredited and better, safer techniques emerge along with innovative new technology and equipment.
 
This is definitely the case with moving and handling which has progressed dramatically in recent years. We can now move and handle people in less invasive and much more effective ways than before.
 
Dangerous, outdated methods are still in daily use
 
The problem is, not all care environments are implementing this knowledge for the benefit of their patients and customers.
 
Old methods are used daily in hospitals, care homes and care agencies across the country. Maybe it’s because the old methods are the quickest way to ‘get the job done’. Or maybe it’s because care staff simply haven’t been trained in best practice methods. Either way, it’s a disgrace.
 
Drag lifting – it’s as bad as it sounds
 
Drag lifting is a good example. This involves, as the name suggests, pulling people up and into position. It often means grabbing a person under the armpits and hoiking them into a sitting position in bed.
 
Unprofessional carers use drag lifting every day. Drag lifting should never be done. It’s dangerous and can result in serious injuries. 
 
Here’s why:
 
The shoulder joint is a very unstable joint. It’s a ball and socket joint. The pelvis is a ball and socket joint as well but the ball in the pelvis fits very snugly into the socket. The shoulder ball is bigger and at higher risk of dislocating.
 
This is the diagram we use in the training room to explain the danger of drag lifting:


As well as the shoulder joint, you can see all the brachial nerves running through the joint. These can also be damaged very easily. So too can the shoulder cartilage and capsule. And the underarm skin, which is delicate in the extreme in older people, bruises and tears under only minimal pressure.
 
These painful and distressing injuries are all totally avoidable when the right moving and handling techniques are used. There’s never an excuse for putting customers at risk.
 
So what does best practice look like?
 
Correct moving and handling is an extensive area and requires in-depth training over time to cover the multitude of scenarios involving moving people safely.
 
We take training further than any other homecare agency we know. In fact, new staff often comment on the depth and range of our moving and handling training. They say it’s a far cry from the flimsy training they received from their previous employer.
 
The ‘Handling of People’ book is the moving and handling bible and the basis of our training. This weighty tome is updated every few years and features the latest best practices as defined by the absolute experts in moving and handling including BackCare, the National Back Exchange, the Royal College of Nursing, the Chartered Society of Physiotherapy and the College of Occupational Therapists.


 
Above and beyond 
 
Our training starts with the quality of the people doing our training. All our senior managers are trained to the highest level possible. They are ‘Train the Trainer’ qualified meaning they have the expertise to train not only our carers but also external people who want to be trained in moving and handling.
 
Our classroom training covers all the theory as well as the practice of moving and handling. Carers learn about every moving and handling scenario and how to deal with it correctly. They learn how to use every piece of equipment involved in moving and handling. They master the use of slide sheets, for example, which effectively ‘move people without moving them’. They also find out for themselves what it’s like to be lifted in a hoist to give them an insight into what it feels like to be in the vulnerable position of having others move you around.
 
Theory, practice, and supervision
 
The next step is shadowing. New carers accompany and assist experienced carers to see the techniques in action and gain real practical experience. After time, their performance is evaluated by a supervisor and they’re able to apply their skills independently only when they’re passed as fully confident and competent to do so.
 
Annual refresher training
 
As moving and handling knowledge moves on, so does our training. All our carers receive full refresher training in moving and handling every year.
 
In many companies, this refresher training is done quickly in order to tick it off a ‘to do’ list. At Bluebird Care Birmingham East we take our time. We use refresher training as an opportunity to fully re-visit the area of moving and handling and take our staff through the latest updates in great detail.
 
So why doesn’t every homecare company do moving and handling this way? 
 
The answer is simple. It’s because the highest quality moving and handling training is time-consuming and very expensive. Not everyone shares our priorities.
 
I’m sorry to say this means there’s a serious knowledge gap when it comes to moving and handling. My team is on a mission to change this. We all need to know the real risks when it comes to moving and handling so our vulnerable people receive the care they deserve.
 
If you’d like to know more about moving or handling or any other aspect of care at home, please get in touch. We’d be delighted to talk to you. Call us on 01213893500 or email birminghameast@bluebirdcare.co.uk.