health and safety

Staying Strong at Home
 by hcsl

Staying strong while staying Independent

Written By

Jessie Snowdon, New Zealand Registered Physiotherapist, Director On the Go Physio Limited, March 2022

Two years into New Zealand’s journey with COVID and these days can seem harder than ever.
We have endured lock downs and now we are in this strange no-man’s land where it feels for
many older adults, that in order to stay safe we must stay home.

Strength is IMPORTANT!

If you are not getting your usual physical activity, or if you have never been that keen on
exercise (!) then you should try and build in some structured exercise every day. Exercise can
come in many ways – gardening, bowls, walking – and although these are all excellent ways
to get in your recommended 150 minutes a week, the real hero of the story is building
strength.

As we age we naturally lose muscle strength, and our muscle fibres change – but age is NOT
a barrier to improving strength and muscle mass. We know that there is a direct link between
strengthening exercises and decreased risk of falls, and we all want that!

How can I strengthen my muscles?

In order to make change you must put your muscles under a certain load…and this means it
must be hard! The great news is that you don’t need to spend much time, if you hit the right
level of ‘hardness’. You can work through a strength programme in 10 minutes!

We recommend that you start with 10 repetitions of each exercise for a few days, and then
find the level at which doing 6-8 of the exercise feels “hard”. “Hard” means that you don’t
feel you could do any more without a rest.

When you have established that level you should work through your whole programme then
take a 2 minute rest. Then, guess what? Do it all again!

Which muscles should I strengthen?

You should strength the muscles you need for function. This means the ones you need for
every day activities like standing up from a chair, walking fast, picking up objects and helping
with balance.

The programme below covers off all of these.

Is there anything I should be careful of?

With all exercise you should be aware of and stop if you experience pain in your muscles or
joints, chest pain, severe shortness of breath or severe dizziness. Remember though that
when you work your muscles hard you can expect to have slight soreness the next day or so,
especially when you have just started.

Ok I’m ready! Show me the exercises!

As you are all individuals it is hard to prescribe one set of exercises for everyone. You will
need to apply some common sense and ensure you feel safe during each exercise. If you are
unsteady, or usually use a walking stick or frame, then ensure you are holding on to the bench
or table – or have your frame in front.

Ready….let’s go!

Exercise one – Standing up and sitting down This works the muscles you need to get from a chair but also to bend down, walk, climb stairs – it is an excellent all-round functional exercise.

❖ Start in a firm chair that you know you can stand up from.
❖ Using both hands lean forward and then stand up.
❖ Repeat this 6-8 times.

Exercise 1

Easy? Make it harder by…

• Speeding up.
• Just use one hand.

• Use no hands (cross arms across chest).
• Sitting on a lower seat.
• Holding something heavy in your arms such as bottled water, or some weights.

Exercise two – rising up onto tiptoes
As long as you aren’t hanging on for dear life this is an excellent whole leg work out.

You need strong calf muscles to walk and for balance.


❖ Hold onto a steady surface such as a kitchen bench or back of a chair.
❖ Rise up onto your tip toes, as high as you can.
❖ Try to go straight up, not forward.
❖ Repeat 6-8 times.

Exercise 2

Easy? Make it harder by…

• Decreasing your hand grip so you just use index fingers.
• Putting a back pack on with weights such as bottled water in it.
• Lift one leg off the ground and take all the weight on one side!

Exercise three – standing on one leg
This works the muscles around your hips and is excellent for stability and balance.

❖ Hold onto a steady surface.
❖ Make your left leg strong and gently lift your right.
❖ Focus hard to ensure your hips stay level – your trunk and shoulders shouldn’t move!
❖ Hold for 5 seconds then swap sides.
❖ Repeat 6-8 times on each side

Easy? Make it harder by

• Standing for 10 seconds
• Decreasing how much you use your hands, change to just index fingers, or no hands!

Exercise four – push ups!

Strong arms are essential for helping you pick up and carry objects, and to push yourself up from a chair, bed or the floor. We often neglect our arms so make sure to include this one!

❖ Stand with your hands against the wall, have a chair next to you if needed.
❖ With fingers spread and arms close to your body allow your elbows to bend so you
come closer to the wall.
❖ Breath out and push away back into standing.
❖ Repeat 6-8 times.

Easy? Make it harder by…

• Using the bench to lean on instead of the wall.
• Increase your speed.

This is an excellent starting point with four functional exercises. If you repeat all these then
you should have a good 10-minute daily walk out. If you would like so extra balance
exercises then read on!

EXTRA BALANCE EXERCISES


Balance exercises are harder to prescribe as everyone is at very different levels and you need to keep safe! Here are some options for balance work but ensure you are by a sturdy surface and work within your abilities.


Exercise one: Standing still balance
❖ Stand with your feet together, without holding on, for 10 seconds

 

Ex 5

Easy? Make it harder by…


• Turning your head slowly side to side.
• Closing your eyes (with care).
• Changing your foot position into “step”.
Exercise two: walking backwards
❖ Carefully walk backwards alongside your bench. If you normally use a frame or walking
stick then ensure you use if for this exercise.
❖ Focus on long, slow steps.

Exercise three: walking in a figure 8


❖ In an open space you can put down two objects (salt and pepper shakers, two water
bottles) about 1 metre apart.
❖ Weave around these in a figure 8.
❖ Use your walking frame or stick if this is normal for you.

Easy? Make it harder by…

• Moving the objects closer.
• Going faster!
Congratulations!

You are now carrying out a great exercise plan. If you are able to you
should include regular walking at a good pace out in the community. You should also
ensure that once you have done your daily exercises you don’t sit down the rest of day.
Every 30 minutes you should be up on your feet, even if just for a minute or two.
If you would like more advice or and individualised treatment plan then we offer clinic,
home and online appointments and would love to help you regain and maintain your
strength.

Original Article By: Jessie Snowdon, New Zealand Registered Physiotherapist, Director On the Go Physio Limited, March 2022
in News
merry christmas HCSL
 by hcsl

Merry Christmas and Happy New Year

We’ve reached the end of the year!

 

Thank you!

For giving us another fantastic and very busy year. We are proud to

have you as part of our community.

 
Your loyalty and feedback have powered meaningful discussions, as well as countless

improvements and additions to how our software can work best for all of our clients.

For that, we really appreciate your input. 

 

To the many new clients who have joined us this year,

we are so excited to have you on board and we look forward to what the

next year has to bring. 

 

In 2022

We have some exciting new updates and features coming to the

HCSL software, we are looking forward to showing you all when the time comes. 

 

 

 

We are officially closing the office on

23rd December and will be returning on 10th January.

 

We will continue to provide on-call support. 

For all other enquires CONTACT US and we will respond on our return.

 

 

We wish you all the best as we head into the Christmas and New Year break.

Take care of yourselves, your family and your friends and enjoy the summer.

 

in News
 by hcsl

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/

in News
 by hcsl

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.

in News
 by Gillian Robinson

Moving  and Handling People – Good Practice Guidelines – December 2017

The Draft Moving and Handling guidelines are currently being finalised with the view to be implemented from December 2017.  Developed by Worksafe, they cover Health and Safety at Work Act 2015 (HSWA) duties and risk management for PCBUs in the health care industry and supersede the 2012 guidelines.  There are a range of factors noted in these which need to be taken into consideration for those building new facilities or doing refurbishment of existing facilities. There is also a raft of information on Bariatric Care which is an increasing part of the services being provided in residential care.

The draft guidelines include the following:

Please note that there is not a complete consensus on the criteria for classifying a person as bariatric based on weight or Body Mass Index (BMI). However some examples include those people:

– with a body weight greater than 140 kilograms.

– with a BMI greater than 40 (severely obese), or a BMI greater than 35 (obese) with co‑morbidities.

– with restricted mobility, or is immobile, owing to their size in terms of height and girth.

– whose weight exceeds, or appears to exceed, the identified safe working loads (SWLs).

Health risks for bariatric clients

People who have been bariatric for a considerable time face chronic and serious health conditions, many of which should be considered before moving or handling them. Health conditions to take into account include:

– skin excoriation

– rashes or ulcers in the deep tissue folds of the perineum, breast, legs and abdominal areas

– fungal infection

– bodily congestion, including causing the leaking of fluid from pores throughout the body, a state called diaphoresis, which makes the skin even more vulnerable to infections and tearing

– diabetes

– respiratory problems

– added stress to the joints, which may result in osteoarthritis.

Planning for bariatric clients:

The planning process for bariatric clients in order to reduce moving and handling risks should include:

– admission planning

– client assessment

– communication

– room preparation

– mobilisation plan

– equipment needs

– space and facility design considerations

– planning for discharge.

Facility and equipment needs for bariatric clients

Health care and other facilities providing care for bariatric clients need to provide adequate spaces for these clients. Some considerations could include:

– ramps and handrails at entrances

– bariatric wheelchairs

– that the facility’s main entrance has sufficient clearance

– adequate door clearance and weight capacity in lifts

It must be remembered that the above comes from a draft but as drafts often end up being very close to the finished document, I felt it timely to share this information. To read more on Health and Safety in the Workplace go here. 

in News
 by Gillian Robinson

HCSL Mobile app for Internal Audits

Mobile app now available for conducting your residential care ARRC specific internal audits.

There are a full range of internal audits pre-loaded ready for use. Collectively, these audits reflect the criteria Certification auditors will be checking.

 

This process gives you the opportunity to be sure you’re on track with achieving compliance. The findings auto-populate into corrective action tables which prompt timely addressing of these corrective actions. This system syncs with your main computer system and makes reporting to management and Governance boards very easy.

 

The Certification auditors (after given specific access authority with your permission) are also able to access the results of the internal audits you’ve completed.

To view a brief video on the use of this system, click here.

in News / Services
 by Gillian Robinson

Influenza season

Prepared for winter coughs and colds?

Winter is fast approaching and now is the time to be preparing your facility for the season’s usual crop of influenza, coughs and colds.

Last year the elderly were hit hard with, not just influenza, but also other respiratory viral infections. Many were admitted to hospital with complications such as pneumonia.

The predominant circulating influenza strain in 2016 was Influenza A, H3N2, different from the previous year’s Influenza A, H1N1. Although covered by the vaccine, last year’s predominant strain changed slightly from what was covered in the vaccine and there were numerous reports of laboratory confirmed cases of young vaccinated adults who still acquired influenza. Despite this, vaccination still affords some protection and symptoms are less severe than without it. This is the same for the elderly whose uptake of the influenza vaccine is not so good – experts agree that there are still benefits from the elderly having an annual influenza vaccine.

Some of the other respiratory viruses last year that caused severe disease in our elderly included coronavirus, rhinovirus and parainfluenza.

 

Check list for winter virus planning

  • Encourage and offer seasonal influenza vaccination to both staff and residents
  • Ensure hand sanitiser is available for visitors at the entrance of the home
  • Consider displaying a poster discouraging visitors with symptoms – a poster is available from CDHB communications
  • Remind staff and residents about good cough etiquette / respiratory hygiene
  • Have a good stock of tissues and hand sanitiser for residents
  • Remind staff to stay off work if sick – no-one wants their germs!
  • Educate staff about S&S of influenza – not all residents will display fever or cough
  • Keep residents in their rooms if symptomatic and introduce droplet precautions, i.e. droplet masks for staff providing cares
  • If you suspect an outbreak then confirm the outbreak[1] and introduce control measures[2]

Ensure all infections are logged into you infection register (for HCSL QA online uses – this is part of your infection log process) – remember your outbreak notification requirements as per your policies and procedures.  If you would like more assistance with this please contact us.

 

This article kindly contributed by: Ruth Barratt RN, BSc, MAdvPrac (Hons) – Independent Infection Prevention & Control Advisor (Canterbury)

Infectprevent@gmail.com

[1]  Infection Prevention & Control Guidelines for the management of a respiratory outbreak in ARC / LTCF

[2] A Practical Guide to assist in the Prevention and Management of Influenza Outbreaks in Residential Care Facilities in Australia

in News
 by Gillian Robinson

Moving and Handling in residential age care

Moving and Handling and the Health and Safety Act

Thanks to Jessie Snowdon, Physiotherapist for contributing the below article – 

 

All managers will be acutely aware of the Health and Safety at Work Act 2015 (HSWA) and the responsibilities of, and potential penalties, for PCBUs (persons conducting a business or undertaking).

The HSWA requires businesses to ensure, as far as reasonably practicable, the health and safety of its workers. This includes safe systems of work, equipment, training and monitoring the health of workers. These processes are all included in the policies and procedures designed specifically for residential aged care facilities by HCSL.

Within the residential care industry staff are exposed to significant hazards daily in terms of patient handling and manual handling for kitchen/laundry staff.  Moving and handling is a hazardous task – it is repetitive, can involve high force (heavy residents) and frequently involves awkward postures. The likelihood of injury for both care staff and residents is high and the consequences can be serious, meaning that moving and handling is a high risk activity.

When we consider moving and handling in this light, managers need to be confident that they have safe systems. Consider how each resident’s transfer abilities are assessed. How is this documented and communicated? How do you know you have the correct equipment on site and how do you ensure that you have enough equipment in order for staff to be able to access it when they need it?

Our experience shows that often if the equipment is not available many staff will do an unsafe transfer in order to save time.  How do you ensure new staff are competent prior to undertaking moving and handling tasks? How do you ensure that existing staff are up-skilled? How do you implement the New Zealand guidelines? And how do you monitor your systems, equipment and training? These are questions all managers should be able to answer.

‘On the Go Physio’ carries out Moving and Handling training in over 15 facilities in Canterbury and offer training to representatives from many others. We offer tailored packages which can include up-skilling your whole team, or training your own moving and handling trainers and assessors. We can review your training and orientation systems and assist in equipment trials. If you are interested in discussing your facilities requirements to help you ensure your staff, and resident’s, health and safety contact us here.

For residential care specific policies and procedures related to safe moving and handling, along with related forms for use, contact HCSL here.

 

Contributed by: Jessie Snowdon (Senior Physiotherapist and Director)

‘On the Go Physio Ltd’

PO Box 32 004, Christchurch 8147

Ph: 0800 000 856 or Mobile: 021 030 9061

in News
 by Gillian Robinson

Health and Safety at Work 2015 implications for Aged care and Retirement Villages

I’ve been working through the new Health and Safety at Work 2015 legislation and have concerns about how this applies to not only care facilities and new reporting requirements, but also to Villages.  This legislation could cause all sorts of issues for you and in my view needs further clarification as to how it is to be applied to ARRC residential care setting and Villages that come under the RVA.

The Retirement Villages Association define a ‘Licence to Occupy’ as –

“Licence to occupy – This is the most common form of occupation right in New Zealand. A licence to occupy gives you the right to live in your residential unit and to use to village facilities according to the terms of the licence to occupy. The ownership of the land and building remain with the village operator.”

The new Health and Safety at Work Act 2015 which applies from the 4th of April 2016 requires a PCBU (Person Conducting a Business or Undertaking) to report notifiable injuries or illnesses and all notifiable incidents. Looking closer at the terminology used in the legislation is states in relation to responsibility to notify –

Health and Safety at Work Act 2015.
Sub Section part 2 – clause 37 Duty of PCBU who manages or controls workplace  (this appears to apply to Village operators as well as ARRC providers)

(4) In this section, a PCBU who manages or controls a workplace—

(a) means a PCBU to the extent that the business or undertaking involves the management or control (in whole or in part) of the workplace; but
(b) does not include—
(i) the occupier of a residence, unless the residence is occupied for the purposes of, or as part of, the conduct of a business or undertaking.

The red text seems to be the rationale for notifications being required from care facilities but it would seem it also applies to village units, studios and apartments.  How are you going to know if your village residents have had an injury or illness which is classified as notifiable?

Part 1 Section 23 –  Meaning of notifiable injury or illness –

(1) In this Act, unless the context otherwise requires, a notifiable injury or illness, in relation to a person, means—
(a) any of the following injuries or illnesses that require the person to have immediate treatment (other than first aid):

(i) the amputation of any part of his or her body:
(ii) a serious head injury: (This could apply in the case of a fall where a resident has a knock to their head?)
(iii) a serious eye injury:
(iv) a serious burn:
(v) the separation of his or her skin from an underlying tissue (such as
degloving or scalping): (Does this apply to skin tears of a particular size?)
(vi) a spinal injury:
(vii) the loss of a bodily function:  (Fall resulting in fracture?)
(viii) serious lacerations:

(b) an injury or illness that requires, or would usually require, the person to be admitted to a hospital for immediate treatment:
(c) an injury or illness that requires, or would usually require, the person to have medical treatment within 48 hours of exposure to a substance:

Implementing this into this sector may be difficult due to the rights to privacy of those living in ‘independent’ ORA situations. The key definer in this section is clause a) any of the following injuries or illnesses that require the person to have immediate treatment (other than first aid).  If an ambulance is called to attend to a village resident this could be deemed ‘immediate treatment’.

Part 1 Section 24 – Meaning of notifiable incident –

(1) In this Act, unless the context otherwise requires, a notifiable incident means an unplanned or uncontrolled incident in relation to a workplace that exposes a
worker or any other person to a serious risk to that person’s health or safety arising from an immediate or imminent exposure to—

(a) an escape, a spillage, or a leakage of a substance; or
(b) an implosion, explosion, or fire; or
(c) an escape of gas or steam; or
(d) an escape of a pressurised substance; or
(e) an electric shock; or
(f) the fall or release from a height of any plant, substance, or thing; or
(g) the collapse, overturning, failure, or malfunction of, or damage to, any
plant that is required to be authorised for use in accordance with regulations;
or
(h) the collapse or partial collapse of a structure; or
(i) the collapse or failure of an excavation or any shoring supporting an excavation;
or
(j) the inrush of water, mud, or gas in workings in an underground excavation or tunnel; or
(k) the interruption of the main system of ventilation in an underground excavation or tunnel; or
(l) a collision between 2 vessels, a vessel capsize, or the inrush of water into a vessel; or
(m) any other incident declared by regulations to be a notifiable incident for the purposes of this section.

Clearly the majority of these apply to manufacturing and industrial sites however some could potentially be applied to the care and village setting.

What do you see as your liabilities?  What is the responsibility for the operator in managing potential risk?  Which assessment tools and accompanying definitions are we best to apply if any?  If alcohol consumption by a resident or failing cognitive state is likely to contribute to their safety, where are the boundaries for responsibility between the resident and the operator? 

Share your comments ….

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