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Manual Handling in Nursing and Residential Homes [Hardfacts]


Fifty per cent of the serious accidents occurring in nursing and residential care homes that are reported to the Health and Safety Executive in accordance with the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR) are as a result of manual handling.

Legal Requirements

The Manual Handling Operations Regulations 1992 use the description "manual handling operations" which is defined as:

"...transporting or supporting a load (including lifting, putting down, pushing, pulling, carrying or moving) by hand or bodily force."

Employers are required to eliminate the risk of injury by avoiding manual handling where possible. If the risk can not be eliminated a systematic assessment of manual handling activities must be carried out and of the action taken to reduce risks to the lowest level reasonably practicable. As a first step, employers will be required to make a judgement as to the existence of risk of injury. If no evidence of risk of injury for a particular manual handling task is found, no further action will be necessary. However, where the initial judgement identifies a risk of injury, and that manual handling task cannot reasonably be avoided, a more detailed assessment will be needed. Assessments must be reviewed regularly and kept up to date.

The health and safety policy of the home should already include a section on manual handling of residents by nursing and other staff groups.

The policy should readily identify those individuals who undertake manual handling or have particular responsibilities for training or the purchasing of equipment and mechanical lifting aids. Policies and procedures must be effectively communicated to those affected or involved.

Commissioning Organisations and Care Provider

Commissioning organisations should provide the care provider with any information gained during the care assessment with implications to health and safety. This must be done in time for it to feed into the initial care plan.  

Manual Handling Assessments

The duty to carry out an assessment of manual handling operations is placed on the employer. In practice, the assessment task may be delegated to competent individuals within the organisation.

The first step must be to identify where manual handling operations can be avoided.  This does not mean that a "no lifting" policy is should be automatically adopted irrespective of the client wishes and needs.

In addition to the assessments carried out in order to comply with the legislation the individual Care Plans prepared for each client will make reference to manual handling and/or the need for aids/appliances. The Care Plan will also indicate whether two people are need/must be available for client handling

An assessment will still need to be made even where mechanical handling equipment is available, because the use of such equipment may not totally avoid the need for manual handling.

The approach can be varied, especially when assessing risks from moving and handling people. In this respect, an assessment form for this purpose has been developed as part of a package of measures for manual handling by HSE. The assessment should be user focused and where possible, user-led so that the individual client has more control over their personal needs. A co-operative approach is required with due sensitivity to the client needs.

Handling Aids

The assessment process should identify those manual handling tasks for which mechanical aids should be used. Examples include Slide sheets; Stand-aid hoists; and adjustable height beds. Manual handling equipment selected for a particular task should reduce the manual handling load of staff; be easy to operate; be capable of lifting the load in safety; be capable of being used in the intended location; be in sound condition and properly maintained. It should also be suitable for the condition and comfort of the resident.


Training in manual lifting techniques has often been inappropriately regarded as the primary means of avoiding injury. The provision of training in manual lifting techniques in isolation can be misleading. Those trained find themselves trying to apply the techniques in given situations irrespective of other relevant factors, e.g. the patient or the environment.

Appropriate training must be provided to all staff groups before any manual handling tasks are undertaken. Training is an ongoing process and the continuation of training by review or refresher courses must be planned and implemented. Appropriate supervision must be provided to ensure training is put into practice.  As a minimum, training programmes should include:

  • Back care - This should cover spinal mechanics so that the causes of back pain, of posture and movements likely to contribute to pain or injury can be readily identified.
  • Ergonomics - Guidance on evaluation of the environment, task, load and individual capability should be included, along with advice on how employees can alter their own environment to make work safer.
  • Mechanical handling aids - The training should cover the practical use and care of such equipment and reference should be made to the supplier's handbook. Advice on how to gain the co-operation of residents and when to offer reassurance should also be covered.
  • Manual handling techniques - Guidance on manual handling techniques. The procedures to be followed if the designated system of work cannot be applied and how to secure additional assistance when it is required.
  • Fitness - Increasingly recognised as important in the avoidance of injury. General fitness, the effect of obesity and other physical conditions such as pregnancy are relevant considerations.

Audit and Review

All of the precautions put into place through the risk assessments and training will have no effect if they are not used in practice. Systems should be put in place to regularly review the actual practices taking place and act upon the findings. This will include investigating any injuries or incidents.

Key Action Steps

The following steps need to be taken to manage the manual handling risks:

  • Appoint a competent person to carry out the manual handling assessments and ensure that they are adequately trained and resourced for the task
  • Assess the tasks and identify how to reduce the risks as far as is reasonably practicable
  • Provide handling aids and equipment
  • Provide a competent trainer and decide what training should be provided. Carry out training
  • Record the assessment and training
  • Audit and review


Priced publications from HSE Books Tel. 01787 881165 or

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Please Note: This document contains general information and guidance and is not and should not be relied on as specific advice. The document may not cover every risk, exposure or hazard that may arise and Aviva recommend that you obtain specific advice relevant to the circumstances. AVIVA accepts no responsibility or liability towards any person who may rely upon this document.

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