Risks affecting community health and wellbeing providers

Charities should not be blasé about managing risks, even though fines are unlikely to be as severe as other sectors, the reputational damage alone, could put many charities out of action. In this blog, we highlight the key risks that need to be managed by community health and wellbeing providers.

Health & Wellbeing

Whilst it is commendable, and indeed aligns to the UK government’s focus of addressing sport and wellbeing challenges amongst communities, there are risks that need to be managed by any health and wellbeing provider.

In theory, running a community hall should be relatively straightforward. The Health and Safety Executive (HSE) provides basic guidance of what providers should consider, including a simple checklist.

“Risk is an everyday part of a charitable activity and managing it effectively is essential if the trustees are to achieve their key objectives and safeguard their charity’s funds and assets.”

Charities and risk management (CC26) Charity Commission for England and Wales

Housing

Asbestos

Providers in this sector typically have multiple premises to manage. These could be charity shops, office premises, leisure premises or residential accommodation. The difficulty many providers have is the widespread geographical spread and makeup of properties under their control. The HSE provides guidance regarding the management of asbestos in domestic premises, which suggests:

The grouping of similar properties together in terms of style and age etc. This allows management surveys to be undertaken of some of the grouped property in order to determine the wide spread nature of asbestos amongst the housing stock.

A Manchester hostel was fined £44,000 after failing to undertake an asbestos Refurbishment and Demolition (R&D) survey prior to renovation works. The cost of an asbestos survey is relatively reasonable compared to the death or long-lasting illness from an asbestos disease.

It’s important to:

Ensure that an asbestos management survey is in place for all premises likely to contain asbestos. This also requires employers to act on the recommendations and undertake all reasonable steps to avoid exposure.

Undertake asbestos R&D surveys prior to starting works in properties that are likely to contain asbestos.

Remove asbestos safely and in accordance with HSE guidance

Ensure staff have undertaken asbestos training.

A hostel was fined £39,000 when items containing asbestos had been removed by an unlicensed asbestos contractor.

Falls from height

Due to restricted budgets, some organisations have internal maintenance teams or allow residents or volunteers to work on maintenance projects from height. Falls from height remain one of the biggest causes of workplace fatalities and major injuries. Therefore, it is imperative that third sector organisations ensure those working at height are not exposed to this unnecessary risk.

A Bristol hostel was fined £20,000 after a builder fell 25 foot and died as a result of his injuries due to the organisation failing to protect the health, safety and welfare of non-employees and ensuring that work at height is properly planned, supervised and carried out in a safe manner.

Practical steps to manage fall from height risks:

Ensure that persons undertaking work are trained.

Make sure risks are suitably assessed, and control measures established.

Regularly check scaffold in accordance with industry standards.

Fragile roofs are suitably demarcated to warn others of the risk of falls.

Do not let people access any sort of roof unless there are measures in place to prevent a fall from height (such as edge protection) or minimise a fall from height (such as work restraint or fall arrest systems).

Ladders and stepladders can be used; however organisations need to ensure they are fit for purpose, that users are trained, and ladders and stepladders are used safely and appropriately as per guidance.

Fire

The fire rescue service attended more than 620,000 incidents in the year ending September 2022. This is the largest total of incidents for a 12-month period in over a decade. Out of these, 276 were fire-related fatalities. These statistics serve as a timely reminder of the importance of having fire risk assessments in place.

Strictly speaking, fire risk assessments are legally required for all non-domestic premises and Houses of Multiple Occupancies (HMO’s) within the UK, however providers of domestic housing, should also consider basic fire risk assessments of their housing stock.

Practical steps to manage fire related risks:

Ensure that an updated fire risk assessment is in place for the premises in question and that this reviews Automatic Fire Detection (AFD) systems, arson risks, the compartmentation including fire doors that would allow smoke or fire to spread undetected or blocking fire escape routes before those asleep have time to evacuate.

The AFD sounders provide 75Db(A) at the bed head with all doors shut, in order to wake a sleeping person.

Fire resistant mattresses are provided to limit the risks of fires starting whilst sleeping.

Assessment of individuals for specific risks, such as drug or alcohol dependencies and other personal health conditions.

N.B. This article is not aimed at housing associations of whom have domestic premises within their stock whereby the above steps would not apply.

Sharps

It is not uncommon in certain organisations, particularly those who deal with vulnerable people to deal with sharps and the potential risk of staff sharps injuries.

Practical steps for managing sharps:

Assess the risk of sharps and injuries.

Maintain a known sharps intelligence list of areas where sharps will be located.

Provide a sharps box, tweezers and gloves.

Provide sharps awareness training to staff, including what to do should a sharps injury happen.

Window blinds

Window blinds must be assessed for common areas of refuges for vulnerable people, where staff live in, or work sleeping nights, and areas where services are provided for young children. These points are for providers supplying housing, but not for domestic properties that we all live in. Around two children every year are strangled to death after becoming entangled with blind cords. In 2023, it is reasonable to ensure that safer blinds are used to prevent this.

Practical steps to manage window blind related risks:

Tie up blind cords out of reach of young children.

Move cots, beds, highchairs, and playpens away from looped blinds.

Move other furniture away from looped blinds, to avoid children climbing up.

Install a safety device on your looped blinds.

Consider buying non-looped blinds.

Since 2004, RoSPA has been working with partners including the Department for Business, Energy and Industrial Strategy (BEIS), CEN (the European Committee for Standardisation) and the British Blind and Shutter Association (BBSA) to raise awareness of blind cord safety through the Make it Safe campaign.

An amended safety standard (EN13120:2009+A1:2014) was introduced in 2014, which required new blinds to be safe by design or be supplied with the appropriate child safety devices. This means that where there is a loop that is present, or could be created, a safety device must be installed at the point of manufacture. These safety devices either break under pressure, tension the cord or chain, or provide the facility to store the cord(s) out of reach.

Window restrictors

Any organisation that manages housing from a social care perspective, must assess the risk of vulnerable persons (children, those under the influence of substances and the elderly) falling from windows and put in place reasonable control measures to prevent this.

Typically, window restrictors are used across premises to prevent falls and systematic checks are undertaken to ensure that restrictors have not been damaged/removed or overcome. A balance does need to be struck here, in that organisations must remain hospitable and not appear institutionalised.

In 2020, a care home provider in Norwich was fined £100,000 after one of its 70-year-old residents fell from a first-floor window. It was found the window restrictors were not fit for purpose and could easily be overcome manually.

Every year more than 4,200 children are involved in falls on the stairs and 4,000 children under the age of 15 are injured falling from windows.

Training & Education

Renovations

Some organisations in the charity sector, encourage volunteers or residents to undertake renovation work of properties. Whilst this allows for new skills and experiences to be gained, there are risks to which volunteers may be exposed and organisations could be in breach of various legislation.

To ensure that this does not occur, charities and not-for-profit organisations should ensure that hazards such as using tools and equipment as well as exposure to dusts like asbestos and wood is avoided and minimised through sensible risk assessment. Prior to larger pieces of renovation work, staff, volunteers and residents should be briefed on the risk assessment and safety precautions that need to be taken to prevent harm.

Support & Advice

Violence and Aggression (V&A) and lone working

Under the Management of Health and Safety at Work Regulations, you must put the right controls in place to prevent violence and aggression and to support lone workers. The following are examples of controls but it is best to use a variety of approaches. The design of your workplace can also play a part in increasing the risk of violence happening to your workers.

Space and layout, for example ensuring good visibility throughout your workplace and providing good lighting to remove blind spots and ensure workers and others can be seen.

Places where tension could grow, for example implementing a suitable queuing system.

Security measures, like CCTV, trained security personnel, body-worn cameras, alarm systems, building security – they can act as a deterrent but also provide evidence for the police to convict offenders.

Carefully worded signage and visual displays as these can remind people to respect each other and not abuse workers.

It’s also important to consider the type of work your employees do and ensure there are relevant control measures in place:

Have good communication between you and your workers.

Consider how workers engage with the public and what might trigger people to act aggressively.

Manage lone working by making arrangements to keep in touch with people who work away from their base, for example using mobile phones and personal alarms. Keep in touch with them and respond to any incident.

Train, supervise and monitor lone workers.

Ensure you have adequate staffing levels to manage violence and respond to incidents.

A local authority in London was fined £100,000 and ordered to pay costs of £10,918.88 after two of its social workers were assaulted on a home visit by the mother of a vulnerable child they were visiting. While note-taking, both social workers were struck over the head with a metal object resulting in one being knocked temporarily unconscious. While both received serious wounds to the head, the social worker knocked unconscious was later diagnosed with Post Traumatic Stress Disorder (PTSD).

An investigation by the Health and Safety Executive found the local authority failed to follow its corporate lone working policy or violence and aggression guidance. No risk assessment had been completed and staff were not trained accordingly.

In situations where lone working and home visits are an essential part of a person’s working day, it’s essential to ensure that:

Violence and aggression, particularly lone working and home visits within the community, are suitably and sufficiently risk assessed. Individual risk assessments should be undertaken for service users, where these hazards are reviewed.

Staff should be aware of the organisation lone working policy and procedures, and must follow the policies.

Staff are encouraged to visit in pairs and where this is not reasonably practicable, ensure that as part of the assessment, lone working devices or safety apps have been considered as control measures to alert others to a pending crisis.

Encourage feedback from staff of near misses and ‘what if’ hypothetical scenarios which will enable organisations to continually improve risk profiles.

Ensure that staff have undertaken conflict resolution training and de-escalation training.

Build a GDPR compliant database of addresses where there is a known risk of inappropriate behaviour and violence to provide forewarning to colleagues.

Host meetings in mutually convenient locations such as the organisations premises or public places, such as coffee shops.

Provide employee assistance programmes and counselling for employees of whom have experienced violence and aggression during their work.

For organisations that also have retail shops as part of their organisation, please refer to our article on risks in charity shops.

Call to action

Howden believes in the practical management of risk. Our risk management consultant will work with you and your community health and wellbeing organisation to ensure that suitable strategies are in place to manage risks. We can help you in multiple ways:

H&S Audit

Our audit covers over 30+ pieces of legislation. We will tell you what you must, should and could do to manage risk. We tell you what you do and don’t need to do, why (whether it’s legislative or best practice), how to achieve safety and compliance and we will provide you with supportive solutions. You can avoid the above incidents within your organisation, by having our specialists to review your risk management systems.

Fire Risk Assessment

Our fire risk assessor is experienced at undertaking assessments in third party sector premises. On your instruction, we will help you meet your legal duties under the Regulatory Reform (Fire Safety) Order 2005 (for sleeping areas we may use one of our partners to conduct the fire risk assessment).

Security

We can support your organisation(s) with a review of security measures in place and establish whether further controls should be introduced.

Consultancy Time

We offer time in which our consultant can come alongside you, to work on enhancing your risk management practices and strategies. This can include reviews of policies, risk assessments, safe systems of work, and a reviewing of specific practices and training.

Training for your trustees

An area often overlooked by employers, is health and safety awareness training for trustees. We can provide your board of trustees with sufficient information to make informed decisions with risk management in mind.

Do you need health insurance? If so, get in touch with Howden today. We can help you find a policy that ticks all your boxes.