Moving and handling in the community policy (domiciliary care)

1. What the regulation says

The primary law for this policy is the Manual Handling Operations Regulations 1992 and the Health and Safety at Work etc. Act 1974. These sit outside the CQC regulations manifest, so the verbatim quotes below are from Regulation 12 (safe care and treatment), the CQC regulation that this policy engages.

Care and treatment must be provided in a safe way for service users. (Reg 12(1) (the headline duty))

assessing the risks to the health and safety of service users of receiving the care or treatment, (Reg 12(2)(a) (risk assessment))

doing all that is reasonably practicable to mitigate any such risks, (Reg 12(2)(b) (risk mitigation))

ensuring that persons providing care or treatment to service users have the qualifications, competence, skills and experience to do so safely, (Reg 12(2)(c) (staff competence))

ensuring that the premises used by the service provider are safe to use for their intended purpose and are used in a safe way, (Reg 12(2)(d) (premises safety))

ensuring that the equipment used by the service provider for providing care or treatment to a service user is safe for such use and is used in a safe way, (Reg 12(2)(e) (equipment safety))

where equipment or medicines are supplied by the service provider, ensuring that there are sufficient quantities of these to ensure the safety of service users and to meet their needs, (Reg 12(2)(f) (sufficient equipment + medicines supply))

The full text is at https://www.legislation.gov.uk/uksi/2014/2936/regulation/12, and the primary manual-handling law is at https://www.legislation.gov.uk/uksi/1992/2793/contents and https://www.legislation.gov.uk/ukpga/1974/37/section/2. Where this policy and the regulation diverge, the regulation wins.

2. Plain-English summary

Care and treatment must be provided in a safe way. The regulation lists the areas a provider must address, including risk assessment, risk mitigation, staff competence, safe premises, safe equipment, sufficient equipment and medicines, medicines safety, infection prevention and shared-care planning. Regulation 12 is central to CQC's safety expectations. For moving and handling, the Manual Handling Operations Regulations 1992 add a duty to avoid hazardous manual handling so far as is reasonably practicable, to assess the moves that cannot be avoided, and to reduce the risk of injury.

3. Purpose

Helping a person move, transfer or reposition is one of the most common and most risky tasks in home care. A person's home is not a designed care setting: space is tight, furniture is in the way, and the equipment a worker would have in a care home may not be there. This policy sets out how the Service assesses and carries out moving and handling safely in the person's own home, for both the person and the worker.

The Service must verify this policy against current health and safety law and HSE guidance before adoption.

4. Scope

This policy applies to:

• every move, transfer, reposition or support with mobility the Service provides in a person's home
• the equipment used to do it
• the workers who carry it out and the senior staff who assess and review it

5. Risk assessment in the person's home

Before a worker carries out any moving and handling, the Service completes a moving and handling assessment for that person in their own home. It is reviewed when the person's needs, the home or the equipment change, and after any incident. The assessment records:

• what the person can do for themselves and what help they need
• the specific moves and transfers needed, and how each is to be done
• the equipment to be used for each move
• whether the move can be done safely by one worker or needs two
• the space, furniture, flooring and any hazards in the rooms where moves happen
• the person's wishes, comfort and dignity

Each move is written up as a clear instruction so that every worker does it the same safe way.

6. The home environment

The home is assessed as the place the move actually happens. The Service:

• checks there is enough space to use the equipment and move safely
• agrees with the person any changes that make moves safer, such as moving furniture or clearing a route
• records where a hazard cannot be removed and how the risk is managed instead

7. Equipment in the home

Where equipment is needed, the Service:

• records which equipment is required and confirms it is in the home before the move is attempted
• checks that hoists, stand aids, slide sheets, slings and similar are the right type and size for the person and the move
• confirms equipment is serviced and in working order, and does not use equipment that is damaged or out of service
• ensures workers are trained on the specific equipment in that home, not equipment in general

If the right equipment is missing or unsafe, the worker does not improvise. They contact the office, and the move is not carried out unsafely.

8. One worker or two

The assessment states clearly whether each move needs one worker or two. The Service does not ask a worker to carry out a two-person move alone. Where a two-person move is needed, two workers are rostered for it.

9. What workers do and do not do

• Workers carry out moves only as set out in the person's assessment, using the named equipment and technique.
• Workers do not lift a person manually except where there is an immediate risk to life and no safe alternative.
• A worker who is asked or tempted to carry out a move that is unsafe, or for which the equipment is missing, stops and contacts the office.

10. When a person falls

If a person falls, the worker follows the post-fall steps in the falls guidance: check for injury, get medical help if needed, and do not lift the person manually. An uninjured person is helped up using the agreed safe method and equipment, not by manual lifting. The fall is recorded and reported.

11. Reporting and learning

• A worker reports any moving and handling incident, near miss, injury or equipment fault the same working day.
• The Service records it, checks whether the person or the worker was harmed, and acts on equipment faults at once.
• Incidents run through to a recorded outcome with actions completed, and are reviewed together to find patterns.

Operational controls to adapt

Roles and responsibilities

• Registered Manager: owns moving-and-handling governance, makes sure assessments, training, equipment checks and incident reviews happen, and escalates unresolved risks.
• Moving-and-handling assessor or lead: completes and reviews person-specific assessments, equipment instructions, staff competence checks and complex-move advice.
• Care coordinator or rostering lead: rosters the right number of trained workers and does not allocate one worker to a two-worker move.
• Care worker: follows the assessed method, checks equipment before use, preserves dignity, and stops if the move is unsafe or different from the plan.
• Governance lead: tracks incidents, near misses, equipment faults, injuries, training gaps, complaints and improvement actions.

Step-by-step operational procedure

1. Assess before care starts. Complete a moving-and-handling assessment in the person's home before any planned moving task is delivered.
2. Write each move as an instruction. Record the exact transfer, equipment, sling or aid, number of workers, route, dignity steps and what the person can do for themselves.
3. Check the environment. Record space, flooring, lighting, furniture, pets, clutter, stairs, bathroom access and any hazard that cannot be removed.
4. Check equipment before use. Confirm the equipment is present, the right type and size, clean, in working order and within service or LOLER check where relevant.
5. Roster safely. Match the visit plan to the assessment, including two workers where required and enough time for the move to be done without rushing.
6. Stop if the plan no longer fits. Workers contact the office if the person has changed, the equipment is missing, the room is unsafe, the second worker is absent or the move feels unsafe.
7. Act after falls and incidents. Do not manually lift after a fall. Follow the post-fall process, seek medical help where needed, record the event and review the care plan.
8. Review and improve. Review after changes in need, new equipment, falls, injury, complaints, hospital discharge, occupational therapy advice or repeated near misses.

Records and evidence fields

The moving-and-handling record should include:

• person-specific assessment date, assessor, review date and trigger for review
• each move, equipment, sling or aid, number of workers, technique, room, route and dignity steps
• person's ability, preferences, pain, communication needs and consent or cooperation considerations
• home-environment hazards, agreed changes, hazards left in place and mitigation
• equipment make, model, size, service status, fault reports and replacement requests
• worker competence, equipment-specific training and roster match to the assessed number of workers
• incident, near miss, fall, injury, equipment fault, complaint, risk or improvement-action reference

Links to registers and action tracking

Unsafe moves, missing equipment, one-worker attendance for a two-worker move, manual lifting after a fall, worker injury, repeated near misses and unresolved environmental hazards are logged on the incident, risk, training or improvement-actions register.

12. Training

Every worker who carries out moving and handling completes, at induction and on a refresher cadence:

• safe moving and handling, assessed in practice and not only in the classroom
• the use of the specific equipment they will use
• what to do when equipment is missing or unsafe, and after a fall

The Service records who is competent and when each refresher is due, and removes a worker from moving and handling tasks if a concern arises until it is resolved.

13. Audit cadence

The Service checks, on a stated cadence, that:

• every person needing moving and handling has a current assessment with clear instructions
• the equipment named in each assessment is present, serviced and safe
• two-person moves are rostered for two workers
• incidents and equipment faults are reported, recorded and learned from
• training and competency are up to date

The Registered Manager reviews the results and records the improvement actions that follow.

14. Sources and further reading

This template is based on CQC's guidance for providers and managers, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and other topic-specific legislation and guidance listed below. It is a starting point for adaptation, not a substitute for legal, clinical, HR, safeguarding or specialist professional advice.

• Manual Handling Operations Regulations 1992 (https://www.legislation.gov.uk/uksi/1992/2793/contents)
• Health and Safety at Work etc. Act 1974, section 2 (https://www.legislation.gov.uk/ukpga/1974/37/section/2)
• HSE, moving and handling in health and social care (https://www.hse.gov.uk/healthservices/moving-handling.htm)
• CQC Regulation 12: Safe care and treatment (https://www.legislation.gov.uk/uksi/2014/2936/regulation/12)
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 12 (safe care and treatment)

15. Related reading

• Guide: Domiciliary care compliance guide
• Article: CQC compliance for domiciliary care: the evidence inspectors expect
• Related policy: Lone working and personal safety policy
• Related policy: Travel, driving and mobile working policy
• Related policy: Incident reporting, investigation and learning policy
• Related policy: Risk management and risk register policy
• Related policy: Training, competency and mandatory training policy

16. When to seek further advice

Seek specialist advice where the issue involves serious harm, safeguarding, deprivation of liberty, restraint, children, professional misconduct, controlled drugs, radiation, termination of pregnancy, infection outbreak, water safety, employment dismissal, DBS barring referral, or regulatory enforcement.

17. Document control

This sample policy template was issued by Verivius. It is a template, not a substitute for legal advice or the tenant's own policy-development process. Where this template and live law or regulator guidance diverge, the live source wins.