Employers have a legal duty under the Health and Safety at Work Act 1974 to ensure, so far as is reasonably practicable, the health, safety and welfare at work of their employees. 

This act of parliament places a statutory duty on employers, besides their common law duty of care, to do ‘everything reasonable and practicable’ to minimise the risk of harm which arise from hazards to health in their working environment.

Lord Skelmersdale even clarified how this applies to the risk of aggression and violence in the Social-Care workplace:

“Where violent incidents are forseeable employers have a duty under section 2 to identify the nature and extent of the risk and to devise measures which provide a safe workplace and a system of work”

Lord Skelmersdale, DHSS Advisory Committee on Violence to Staff

The Employer’s Duty of Care to the Lone Worker

That Section 2 duty extends, in particular: “to the provision of such information, instruction, training and supervision as is necessary to ensure, so far as is reasonably practicable, the health and safety at work of his employees”

This implies that the employer must provide:

  • information
  • instruction
  • training
  • supervision

…sufficient to enable workers to complete their work in safety.

Lone Worker Information

Workers should be given information such as it pertains to their safety.   For example, a client’s history of violence or threatening behaviour towards workers assigned to them is a very good predictor of risk.   Knowing this, it stands to reason that a worker who is tasked with delivering services to that client must be aware of the possibility of violence and aggression.  This must be the case  if they are to have the right level of awareness and take appropriate precautions in situations which might arouse the person’s anger or frustration.   This is particularly the case in, for example, learning disability settings where often the triggers for anger, fear, anxiety or frustration may be well known to the client’s care team and fully documented in the client’s care plans and risk assessments.

Lone Worker Instruction

Workers should be able to depend on clear and helpful instructions from managers about what circumstances might arise and how they are expected to deal with them in order to control risk of harm.   A good example of a scenario where Instructions will be very important might be the those given to a worker who is doing an overnight shift in a house with a client with learning disabilities and a history of challenging behaviour.    The particular behavioural cues, trigger phrases or actions, responses which defuse the situation, responses which worsen the situation and emergency tactics to stay safe (such as removing themselves to a room with a lockable door to isolate them from any physical violence) would all be important instructional points to be given to the lone worker going into that shift.

Lone Worker Training

Where a worker might be called upon to deal with an incident of aggression, they should be able to call upon training received which is sufficient and relevant in assisting them to try to safely manage that situation and their client.   Likewise, if a worker is likely to need to protect themselves physically, or to restrain their client by immobilising them to prevent harm, then it is self-evident that they should have had training in how to do so effectively and safely.  Considering the risks inherent in physical intervention and restraint, including the risk that someone involved in the incident might be seriously injured or become a fatality, then the responsibilities of employers to provide training to workers who will forseeably be facing physical challenges increases exponentially.

Lone Worker Supervision

Where a worker is on their own and dealing with the complex needs of a service user, then it seems common-sense that they should be able to turn to a more experienced, knowledgable or authoritative person for advice and guidance, that that advice and guidance would be available and useful to them.

Supervision means more than just a 6-monthly meeting when both parties can fit it into their schedule.   In health and safety law, supervision means that the person working in a risky environment knows that they have support and assistance within ready reach when they need it in order to stay safe.

The meaning of “Reasonably Practicable” in regard to the Lone Worker

When considering management of health and safety and all that I wrote above about employers’ responsibilities, there must be a balance.  Any risk must be balanced against the resources required, whether in time, money or effort needed to mitigate that risk or eliminate it. By pragmatically assessing the risk versus the resources required, the employer can decide what steps are reasonable to take to maintain a sensible balance.   

The requirement for this balancing of risk and resource to be made implies the need for a formal, documented risk assessment to be carried out and evidenced, so that it can be clearly demonstrated that the risk was explored and the adequate control measures were put in place for it.

“Reasonably Practicable is a narrower term than physically possible and seems to me to imply that a computation must be made by the employer in which the quantum of risk is placed on one scale and the sacrifice involved in the measures necessary for averting the risk (whether in money, time or trouble) is placed in the other, and that, if it be shown that there is a gross disproportion between them – the risk being insignificant in relation to the sacrifice – the defendants discharge the onus on them.  Moreover, this computation falls to be made by the employer at a point of time anterior to the accident”

Lord Asquith Edwards v NCB [1949]

Let’s look for a moment at a case where all of these issues appear to have come into play together:

The story of Lorraine in Wales

In 2011, a lone care worker in Wales was awarded an out-of-court settlement following a case which demonstrates why the Section 2 requirements are so important for managers to understand.

Lorraine was working in a learning-disability setting and carried out sleepover-shifts in the client’s own home.   Lorraine was assigned a new client but her employer failed to tell her about the new client’s history of violence, which included assaults on 15 of her fellow workers when they worked with the client.   

At the time of the attacks, Lorraine and a male colleague were working in sheltered housing with the client, a woman, who had learning difficulties.  Consistent with her history, the client attacked Lorraine shortly after she arrived to start her first shift with her one evening.  Lorraine had not been trained in how to deal with violent or aggressive behaviour, nor had her colleague who was with her at the time.  Lorraine was attacked from behind, but her colleague was unable to stop the beating because he hadn’t been trained in effective restraint techniques.

When the support worker was finally able to free herself and call for help her calls were ignored.  Eventually she spoke to her off-duty boss, who was able to get in touch with the on-call officer and area manager.

Rather than travelling to the house to provide assistance in person, the manager told the off-duty boss to contact Mrs Morgan and tell her to lock herself in the staff room until the morning and told the male colleague to leave.   She obeyed this request, staying in a locked room with no food, water, toilet or assistance for many hours, even as the service user was battering the door trying to get at her.

Mother-of-three, Lorraine, said:    “The situation I was put in was unbelievable. I called for help and was ignored and then told to stay in a dangerous situation until morning. I felt abandoned and terrified in that room.”

In the morning when Lorraine answered the door to her colleague, there to take over the shift, the client attacked her for a second time.  Her colleague, again acting without any training, hesitated but eventually stepped in to assist her.

I invite you to examine this story and how it may demonstrate:

  • A failure to provide necessary information about a serious or imminent danger.
  • A failure to instruct the staff member how to deal with a risk to her safety
  • A failure to provide the kind of training reasonably practicable to deal with the likely risk.
  • A failure to adequately supervise and instruct an employee who is at risk.

Often I am asked, when reviewing this case with my trainees, why Lorraine never called the police to help her.  I can only speculate, however I do wonder whether the ‘culture’ of some social care work may have had an influence?   How many social workers would feel they have ‘failed’ their service users by losing control of a situation like this?   Is there a type of bravado at work that would preclude calling the police to handle a situation?  Or is there a pseudo-professionalism, or commercial reason for not taking the common-sense step of calling the police?  Was Lorraine simply being obedient to her instructions when she did not call the police?

Nevertheless, Lorraine won her case.  It would appear to be an easy one to prove – she was not given information which would have helped her prepare for or avoid the triggers which escalated this scenario.   She had no training anyway in dealing with the levels of violence that were a proven part of the client’s behaviour.   And finally, when faced with a crisis and calling for assistance, she was ignored at first, then finally given instruction which didn’t reduce her level of risk, in fact merely prolonging it.

One also has to wonder in this situation, upon telling Lorraine that she should just lock herself in and wait until her shift had finished, what, exactly did the responsible manager do for the rest of her evening?  Tuck her kids into bed?  Enjoy a film on TV?  Have a cocoa and forget all about it, while her colleague was enduring this intense personal safety scenario somewhere nearby?

Clearly this is a case where Information, Instruction, Training and Supervision were not adequately provided to ensure the worker’s health and safety at work.


Prevention and Management of Violence and Aggression 31

Gerard O’Dea is a professional violence-management trainer/consultant who has been active in personal safety training since 2006.  He regularly delivers training to local authority, housing organisation and other community-based staff teams who work with sometimes difficult, distressed or dangerous members of the public.  His approach to lone-worker training is pragmatic, functional and based on a keen analysis of the issues in the real world of community working.  Gerard published “Lone Worker Personal Safety:  A Guidebook for Health and Social Care Staff” (on Amazon in Paperback and on Kindle) in 2014.  For more information please visit:  https://www.dynamis.training/lone-worker-personal-safety/

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