Moving and handling

1. Justification for moving the person (clinical reasoning).
2. Completion of a risk assessment (risks associated with the Task, the Individual handler(s), the Load (person), the Environment (TILE).
3. Knowledge of relevant legislation and Professional standards for occupational therapy practice, conduct and ethics.
4. Handlers refer to relevant documentation such as previous risk/handling assessments, client records in accordance with local guidance.
5. Consideration given to reducing unnecessary movement, stooping and task repetition.  
6. Knowledge of good posture (postural management - see below).
7. Identify optimum start position from which the person is most likely to succeed in completing the task when given instruction or moved by the handlers.  
8. Hierarchy of approach: 
   * Consider and use normal movement patterns for the person when completing the task. 
   * Where possible, teach the person to do the manoeuvre unaided: where possible,  encourage the person to be able to complete the task themselves. 
   * If the person is unable, identify and provide equipment (see Equipment briefing below) that would mean the person could then complete the task themselves.
   * If the person is still unable, one or more handlers should give the minimum assistance possible, with or without handling equipment, to complete the task safely.
9. Preparation:
   * Preparation of the person - assessment of physical and cognitive abilities that a person needs to have in order to complete a manoeuvre or task.  
   * Preparation of handling equipment - the equipment must meet the requirements of legislation, be safe, and clean.  The equipment is assessed as suitable for the task, the handler(s), the person, and the environment.  
   * Handlers are trained in the assessment and use of the equipment in line with manufacturers’ instructions.  Handlers can demonstrate competence with the equipment within appropriate environments and with relevant client groups.
   * Handlers understand the safe system of work in place, including risks involved in performing the task where equipment is used, and know when not to proceed.
   * Preparation for the manoeuvre - to complete the task, the manoeuvre has the desired outcome; encourages the person to do as much for themselves as possible; includes clear and appropriate communication between the handler(s) and person throughout; comprises appropriate holds that offer the required support without causing physical, psychological or emotional discomfort or harm, e.g. musculoskeletal pain, discomfort or injury, stress or emotional discomfort, or harmful effects on tissue viability such as shearing, bruising, et cetera; is controlled and smooth, not jerky or rushed.
10. On completion the person is in a comfortable, safe position.

Adapted with kind permission from Backcare

Backcare (2011) The Guide to The Handling of People: a systems approach. Teddington: Backcare. 
 

• Sit to stand
• Chair to bed
• Bed transfers including lifting legs in and out of bed (plus equipment to help with this)
• Manoeuvring in the bed
• Wheelchair transfers
• Toileting
• Bathing / shower transfers
• Hoisting 
• Stand aids
• Turners

Transfers should be graded in order for them to be adapted for someone needing full assistance (i.e. totally dependent), assistance of two people, assistance of one person and independent safe transfers.
 
Occupational therapists using moving and handling techniques should be able to competently assess, advise and then be able to teach service-users, carers, family, and other professionals as appropriate.  The occupational therapists should also have knowledge of equipment related to the above, including risk assessment/management (e.g. provision of hoisting/standing or turning aids).
 

Postural Management is a multi-disciplinary approach that has the potential to assist in enhancing and maximising an individual’s abilities in a wide variety of ways including: communication, taking part in occupations and enabling choice.

Postural Management is a 24-hour approach involving the assessment and management of all positions that an individual uses i.e. lying in bed, sitting and standing, and is part of the rehabilitation process or disability management programme. (Hall S, Marshall K, 2016)

Hall S and  Marshall K (2016) A Beginners Guide to Postural Management (Lecture), Royal Hospital for Neuro-disability. Accessed 27/4/17.
 

• Disabled Living Foundation - Moving and handling people 

A range of factsheets providing general advice on topics such as features to look for when choosing different items of moving and handling equipment such as mobile or overhead hoists. 

• Health and Safety Executive - Moving and handling in health and social care 

These pages are for employers and employees in the health and social care sectors involved in moving and handling, particularly those who assess moving and handling needs and carry out handling activities.