Contractor Health and Safety

Managing Contractors from a Health and Safety Perspective

Managing Contractors from a Health and Safety Perspective is a vital component of having external trades people at your workplace.

The use of contractors  is unavoidable in retirement villages and any aged care facility as we look to engage external expertise for specialised work and maintenance tasks.

Section 34 of The Health and Safety at Work Act 2015 provides that all persons conducting a business or undertaking (PCBU) who have duties imposed by the Act in relation to the same matter must, so far as is reasonably practicable, consult, co-operate and co-ordinate their activities with all the other PCBUs who have duties that overlap with them.

There are four main points to remember about overlapping duties:

  • You have a duty to consult, cooperate with and coordinate activities with all other PCBUs you share overlapping duties with, so far as is reasonably practicable.
  • You can’t contract out of your health and safety duties, or push risk onto others in a contracting chain.
  • You can enter into reasonable agreements with other PCBUs to make sure that everyone’s health and safety duties are met.
  • The more influence and control your business has over a workplace or a health and safety matter, the more responsibility you are likely to have.

WorkSafe have made it clear that they expect PCBUs at the top of a contracting chain to be leaders in encouraging good health and safety practices throughout the chain. They also expect these PCBUs to use sound contract management processes.

 

There are six key health and safety steps when it comes to managing your contractors: 

  • Scoping – understand what the body of works is, the risks involved, the training and competencies required, the working environment and any additional measures required.
  • Selection – select the right contractor for job, utilise a contractor selection process that considers the values and systems of the contractor from a safety perspective.
  • Induction – provide the contractor with basic information regarding site hazards, site rules and emergency evacuation procedures.
  • Safe system of work – the contractor must provide (and you must review) safety management information for the job. You must be confident that the contractor has appropriately controlled the risks associated with their works.
  • Monitoring – while the contractor is on site, check that they are carrying out their works in accordance with the safety management information they provided.
  • Review – Examine what went right as well as what can be improved so that both parties may continually improve on their health and safety performance, this should fed-back into future scoping and selection decisions.

 

WorkSafe (New Zealand) have developed Good Practice Guidelines for ‘PCBUs Working Together: Advice When Contracting (June 2019) in order to provide advice on how you can meet your duties under the Health and Safety at Work Act 2015, illustrate different contractual relationships between parties, and provide examples of ways you can build health and safety into contract management.

Author:

Thanks to Shannon Wright, from Imprint Safety Limited for contributing this article. 

Cosman, M., Tooma, M., Butler, A., Marriott, C., Schmidt-McCleave, R. (2018). Safeguard Health & Safety Handbook 2019. Wellington, New Zealand: Thomson Reuters.

WorkSafe. (2019). PCBUs Working Together: Advice When Contracting. Retrieved from https://worksafe.govt.nz/managing-health-and-safety/getting-started/understanding-the-law/overlapping-duties/pcbus-working-together-advice-when-contracting/

Risk Managing Contractors On-site

It’s easy to forget to check contractors staff changes and ensure your risk managing contractors on site is ongoing. Recently I was on site at a care facility when a sub-contractor was working there.  When spoken to, he appeared to speak very limited English. He left empty boxes, a Stanley knife in the main hallway and wet glue and loose carpet at the entrance to a resident’s room. No signage, no clean-up.  I couldn’t help but ask the provider what the contractor knew about health & safety legislation, his responsibilities and risks to residents as a result of his work practices.

The Health and Safety at Work 2015 increased the responsibility on PCBU’s in relation to risk management in the workplace.  When using the services of contractors, there are likely to be overlapping responsibilities. While residents reside in residential care facilities and therefore it’s their home, the legislation defines residential care as a workplace.  As such, contractors coming into your environment must provide evidence of following a health and safety policy and processes which reflects current legislation.

A copy of their document should be kept on file along with verification of contractors (and sub-contractors) orientation to site and confirmation of their acknowledgement of health & safety responsibilities.  These documents are included in the Safe and Appropriate Environment policy manual for services using HCSL in hardcopy and in-the-cloud online. Documents should be re-signed by contractors annually or when changes to the environment occur or a contractors personnel have changed.

Consumer Directed Services

Consumer directed services are core business for retirement villages. The aged care sector has been talking about ‘person centred’ care’ in health and specifically aged care services for a long time now.  Some services express a practice and philosophy of care based on residents being at the centre of all choices. Unfortunately sometimes when you ask the residents in those services, they may not share this view.

An increased focus on consumer directed care was part of the discussion at the Health and Disability Services Standards review workshop I attended recently.  Residents know what they want.  They are not always involved in service development discussions or asked what they need by service providers. When people set their own goals for clear reasons, they are more likely to engage and achieve. Where the support of others to achieve goals is needed, this is reliant on communication.

Retirement and aged care services are in a position to support not only the maintenance of health and well-being but also rehabilitation of those coming into residential based services. “We found that when you engage and motivate people, they do better,” said one of a study’s authors, Eric J. Lenze, MD, a professor of psychiatry.

In Australia “Aged care reforms continue to shift towards increasing choice, control and tailored services for older people and their families. To deliver more innovative and individual services, providers will need to think about their future workforce models and ask which industrial frameworks are best suited to their market and long term goals.”  To read more on this subject, click here.

As always with research, there are other views which should be considered.  These include individual preference for making choices and residents’ ability to make a specific choice in relation to one or multiple aspects of their health.   Read more here on this topic.  Regardless of what decisions are made, I believe we can be sure the time ahead will include challenges.  How those are resolved will be interesting and lead hopefully to more learning.

Clinical Nurse Manager

Bethsaida Retirement Village is a medium sized facility in Blenheim (Marlborough) offering resthome and hospital level of care servicing the Blenheim community.  Our services comprise of 57 care beds and 33 villas in our independent living Village.

We have recently undergone an exciting period of expansion and redevelopment at Bethsaida. Due to this we are seeking the services of an experienced Registered Nurse for the role of Clinical Nurse Manager. This is a full-time Monday to Friday position.

Having achieved four years certification, this is your opportunity to be part of a highly successful team. We are offering competitive remuneration and the opportunity to work with a friendly, caring and competent health care team.  You will have the support of the Facility Manager and contracted Nurse Consultant.  You will also have access to use of the latest New Zealand designed aged care software to streamline and reduce paperwork.

 

To maintain our high standards of clinical care we require a person who:

  • Preferably has experience in aged care
  • Can lead a team of Health care assistants
  • Can communicate effectively with family and allied health professionals
  • A sense of humour
  • Has a current NZ Annual Practising Certificate as Registered Nurse
  • An interest in education
  • Would like to attend the national New Zealand Aged Care Association Conference

 

We value all our staff equally and offer a comprehensive orientation and ongoing education and support. Financial support for relocation will be met where relevant up to the value of $3,500

Applicants for this position should have NZ residency or a valid NZ work visa.

Please supply your CV with a cover letter to Tracy Holdaway, the Facility Nurse Manager  or call at reception for an application form.

Bethsaida Resthome, Hospital and Retirement Village Testimonial

We are very pleased to have recently been granted 4 year MOH Certification! No corrective actions and three Continuous Improvements.

This follows on from a fully attained Partial Provisional Audit that was required prior to opening our two new wings earlier this year with no corrective actions.

Make no mistake!  HCSL policies, software and support have played a major part in these accomplishments.  The HCSL software we use means we have easy access to information in real time.

I started working with Gillian of HCSL shortly after I took on the role of Facility Nurse Manager at Bethsaida Retirement Village six years ago. The facility was not using Healthcare Compliance Solutions policies at the time and perhaps this was reflected in the previous audit results.

Gillian is always responsive to emails and phone calls which is critical when timely advice is required.

The HCSL regular newsletters are interesting with relevant and up to date information on issues affecting aged care.

Gillian is a lovely person to deal with. She is thoughtful, professional, pragmatic and I have always found her to be keen to help, with practical advice on any issues that might arise in the management of a retirement facility.

I thoroughly recommend HCSL to all aged care facilities.

 

Tracy Holdaway RN BN

Facility Nurse Manager

Bethsaida Retirement Village

August 2019

Mandated minimum nursing hours – will it work to ensure safety and productivity?

The question of whether mandated minimum nursing hours would work has been asked previously. The workload of care and nursing staff is frequently discussed with staff reporting they are pressured for time to complete all the necessary duties assigned.  The Nursing staff have different but over-lapping functions to care staff.  When reviewing your staffing, it’s important to include a number of factors into any review when looking at the productivity and efficiency of your team.

We suggest you look at not only leadership and skill-mix, which are vital for safe services but also consider other factors. These can include the location of high acuity needs residents within your service.  With an increase in the use of dual beds, the mix between rest home and higher acuity hospital level of care are now intermingled and not specifically allocated to one area of the building.  This means the Registered Nurses providing clinical monitoring and oversight may have to spread their attention to a much more fragmented and broader geographical area in your service than was previously the case.

The location of resources and time spent looking for items of use and equipment could be minimised if more thought was put into the design of new facilities and the locating and management of replenishing stores for ready access by staff as and where they need them.  Who does the running and fetching could also be considered in work roles so staff with high end clinical skills are spending the bulk of their time on performing functions specific to their role and skill.  Not doing tasks that could be better delegated to others.

After the recent sudden closure of a care facility in Australia without apparent planning or communication with families, there has been outrage that such a thing could happen.  The “Queensland Premier Annastacia Palaszczuk announced her Government would order fixed nurse-to-resident ratios in state-owned aged-care facilities.”  The ABC news report (19th July 2019) goes on to say “at least 50 per cent of staff having contact with residents in 16 publicly run aged-care centres to be nurses.”  I don’t know if by nurses they mean Registered Nurses only and not Enrolled nurses but I can’t help wonder if this alone will ensure safety.

One year on from Simon Wallace (NZACA CEO) reporting on staffing shortages, we haven’t seen any improvement it would seem!  In New Zealand an increasing proportion of our Registered Nurses have come to New Zealand to practice with no prior working knowledge of aged care services. They frequently have limited aged care related experience to conduct the complex assessment and clinical management of high acuity residents in a residential care setting.  This is not to diminish their value as we can’t provide the services needed otherwise.

What I’m trying to highlight in the current circumstances is, we’re frequently seeing nurses set up to fail or provide less than safe care as they simply don’t have the experience in this specialised field of nursing.  I recall conversations in the early 1990’s predicting a massive nursing shortage.  It appears that in the time-span between then and now, we haven’t addressed this issue.

We welcome comments and suggestions of how this could be addressed here in New Zealand before we end up in the depths of a staffing crisis which halts care.

Facility Manager for Award Winning Aged Care Facility

We are an award winning Aged Care Facility in Christchurch compromising of a Hospital Unit; a specialised Hospital Unit and a Secure Dementia Unit. 66 beds in total.

 

What you can expect:

  • Excellent remuneration package
  • Well respected supportive, reflective private company
  • Professional development support
  • A great team of staff
  • Audit & Standards compliance requirements met

 

What will you do:

  • Overall day to day management of the facility working to long term goals
  • work Monday to Friday, with some on-call responsibilities
  • Lead, coach and manage the team successfully
  • Ensure a high level of clinical care and resident satisfaction
  • Manage the budgets and financial aspects to maintain profitability

 

What you need to have:

  • Experience as an Aged Care Manager – preferably a Registered Nurse
  • Knowledge of the Aged Sector and relevant legislation is extremely advantageous
  • Strong experience in a leadership role
  • Great financial knowledge and proven results
  • Excellent communication skills at all levels, both internally and externally
  • Willing to roll up your sleeves and pitch in when needed
  • A good sense of humour

 

Please apply with CV and cover letter via this link.

If you have any questions or would like to discuss this great opportunity please call Lucie Kaal on (+64) 0210707777 – Rosewood Rest Home and Hospital

Testimonial – Home and Community Support Standards audit

Hi Gillian

Just passed our two day audit – NO NON COMPLIANCES; NO PARTIAL COMPLIANCES !!!!!!!!!!!!!!!!  –  thank you so much for your efforts.

The auditor praised your system – said it was a really good system – met all the requirements of the standards, is written in plain language, all the documentation relating to my job ie quality, risk management is outstanding and more than meets the standards and is very well used in the context it should be – thanks!

Lois Lash

Quality Assurance

Ascot House – Tainui Village

Testimonial – Rhonda Sherriff – Chatswood Resthome and Hospital

Testimonial – Chatswood Resthome and Hospital owner (and Clinical Advisor for NZ Aged Care Association)

I am very happy to endorse your system as the information is invaluable for CNMs to analyse the data/information and make informed decisions on best practice and innovation to decrease hazards, improve outcomes, and mitigating factors for resident welfare. I’m pleased you are delving into the data to the level you are, as it’s time saving for sites in many respects, and so easy to dice and slice the information to get the trends.

CNM’s used to spend hours just writing up the collective information before the analysis, so this system is hugely time saving.

 

Rhonda Sherriff

Chatswood Resthome and Hospital

(Clinical Advisor for NZ Aged Care Association)