Demonstrate why risk assessment is an important conceptual framework for health and social care practice
A phrase I have heard often is ‘health and safety gone mad’ and this has been said by people in the care sector when referring to procedures and training they believe is unnecessary, just creating extra work, to perform extra checks and it has been expressed that some employees felt as if it was creating more procedures and forms to fill that if not done the employee could be blamed if something goes wrong and management could avoid responsibility. I believe that these feeling are caused by introducing training and implementing new tasks without an explanation to their importance and not providing the risk assessment to show the research and past incidents that have led to new procedures being enforced.
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On the 4th April 2015 I was working as a casual support worker in a S.E.N school and a teacher there told me that herself and the other teachers had to attend ladder training and were forbidden from using chairs or anything else to reach for objects on school premises, the school now had a ladder that they described to be safer and would lessen the risk of an accident. The teacher I spoke to said “its health and safety gone mad.” She thought it was wasted effort having to have to get the ladder and impractical that they were told that no staff should use chairs for that purpose. She did not know about the numerous risk assessments that had been completed involving falls in school settings from chairs and tables; the National Union of Teachers researched and discovered that ‘Between 2002 and 2010 there was one death and nearly two thousand injuries in the education sector as a result of falls from height’. The National Union of teachers examined regulations that would support their results and the ‘Regulation 6(3) of the Work at Height Regulations states that employers must do all that is reasonably practicable to prevent anyone falling. They must avoid work at height being carried out wherever possible, and where it is unavoidable put in place measures (e.g. suitable work equipment and procedures) to minimise the risk of a fall, and the risk of injury should someone fall despite suitable measures being put in place’. So it is each employer’s obligation to provide training and equipment to ensure the safety of their employees when the probability of the risk happening becomes greater and new information is produced showing new procedures need to be implemented.
Risk assessment is the valuation of the harm or disease that could be caused by an object or the environment and this harmful substance is labelled a hazard and the level of harm that hazard can cause will affect how the hazard is controlled. The hazard could present a low or high risk to individuals or the environment; the extent of harm the hazard could cause and the probability of that harm happening is how the risk is measured.
The factors to consider when looking at a hazard are how it could cause harm, where does the hazard reside or kept, conditions surrounding the hazard, the frequency of exposure and how much exposure is safe (GreenFacts.org, 2014).
A qualitative risk assessment ‘produces findings that are applicable beyond the immediate boundaries of the study (G, Guest, 2005)’. A qualitative risk assessment has been defined as a ‘written photograph’ (Erlandson, Harris, Skipper, & Allen, 1993) as cited in Participant Observation as a Data Collection Method (2005), it observes an individual’s contradictory behaviours, beliefs, opinions, emotions, and relationships of individuals. Qualitative methods are also effective in identifying intangible factors, such as social norms, socioeconomic status, gender roles, ethnicity, and religion, whose role in the research issue may not be readily apparent. (G, Guest, 2005). The techniques of a qualitative risk assessment is to observe the subjective influences of the individual, to interview the person or other individuals that are necessary to the assessment to gain background information, contributing factors that has lead up to current conditions and the risk assessment, to strategies possible solutions and to try and have answers to any queries. Focus groups bring together a group of people to discuss and express their feelings on one topic. The focus group can assist in researching a sensitive subject, to gather preliminary data, aid in the development of surveys and interview guide, to clarify research findings from another method and to gain a large amount of information on the topic in a short time, access to topics that might be otherwise unobservable, can insure that data directly targets researcher’s topic and Provide access to comparisons that focus group participants make between their experiences (Cohen D, 2006).
Qualitative risk assessments assist with quantitative risk assessments as the conclusion of the qualitative risk assessment can provide the information needed to create a numeric value for the probability of the hazard causing harm or disease to individuals or the environment. A quantitative risk assessment identifies the level of risk by using an equation that would show if the risk has a high or low chance of harm or disease by evaluating the hazard, the environment and individuals that could be exposed. The equation used is R=C x E x P means: R is the total score of the risk for example; 20 or less=negligible, 21-69=low, 70-199=medium, 200-399=high and 400or more=very high. C means consequence, severity or disease for example; fatality=100, very serious=75, serious=50, important=10 and minor=5. E is for how often an individual is exposed to the hazard for example; continuous=10, frequent=6, occasional=3, unusual=2, rare=1 and very rare=0.5. P=probability of the hazard causing harm or disease, how often a person could come into contact with the hazard and how capable is the person to deal with the hazard for example; would be expected=10, quite possible=6, unusual but possible=3, only remotely possible=1, conceivable but unlikely=0.5, practically impossible=0.2 and virtually impossible (Tabithasonia, 2014).
Risk assessments are based on factual research but there are occasions when personal fears, media and inconclusive debates could lead people to believe that a hazard could cause more harm than studies show or create fears of unrealistic hazards.
A media coverage of a study reported serious risks on certain medicines causing unnecessary fear amongst consumers as many of the facts they stated were proven exaggerated or false. The study was based in the US and it was on whether the use of medicines that have anticholinergic effects links to the increased risk of Alzheimer’s at the University of Washington and Group Health Research Institute was published in the peer-reviewed medical journal. The study had some shortcomings and was US based but the British media published the findings in the newspapers and particular newspapers exaggerated statistics, several printed the name of the wrong drug, wrong information given about the focus group and failed to make people aware that the instant stopping of these medications could have adverse effects. The drugs that the study focused on was antihistamines such as Benadryl but the U.K form of Benadryl does not contain diphenhydramine which has a anticholinergic effect and diphenhydramine is not a chemical that is used in U.K in medicines as it is in the US so the risk of Benadryl in the U.K increasing the risk of Alzheimer’s would be risk assessed as very low as there is no hazard to cause the risk.
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The level of risk can be based on a person’s perception of the risk using their own knowledge of hazard gathered from word and mouth, personal dread of the hazard occurring and popular beliefs of the hazard and precautionary procedures are put in place using these values. In an elderly residential home there was a fear of Legionnaires’ disease but there was no evidence to support this fear as when tested there was no trace of legionella bacteria in the water system and the water system’s thermometer would ensure the water temperature stays at the levels where the Legionella bacteria is unable to spread and the caretaker checked the water system often ensuring it was up to health and safety standards but a senior member of staff believed that stagnant water was the cause of the spread Legionella bacteria and she thought the home did not use enough water daily to prevent this. An NHS article explains that the environment needed for Legionella bacteria is water temperature of 20-45C (68-113F) and impurities in the water that the bacteria can use for food – such as rust, algae and lime scale, the world health organisation also has the same information on the spread of legionella bacteria also that if there is stagnant water to test the quality of the water after three days and there still may be no detection of legionella bacteria but these facts were not taken into account when the senior member of staff did her risk assessment and requested that the caretaker would run the taps and showers for a few hours daily to empty the water tanks but if there was a risk of legionnaires disease running water is a risk as it affects people by breathing it in the small droplets of water and the constant refilling of the water tank can dilute the disinfectant chemicals in the tank that protects the water against bacteria proving that a risk assessment that is based on a personal opinion can be inaccurate and would need further investigation into the facts.
Epidemiology is the study of patterns of disease and mortality rates showing the diversities in areas, this helps target areas in the need of preventative healthcare and shows which areas or ages are more vulnerable to disease and what areas are people living the longest. The epidemiology study for Legionnaires’ disease shows that it ‘is rare in the UK. In 2013, 284 people were reported to have the infection in England and Wales. Of these cases, 88 people (31%) were exposed to the infection while travelling abroad – mainly to Mediterranean countries, but also tropical countries such as India. However, given the millions of trips made abroad each year, 88 cases is a very small number. Cases of Legionnaires’ disease arising in England and Wales usually peak between July and September. (NHS, 2015)’
In healthcare settings there are mandatory risk prevention measures in legislation on risk management and the health and safety of individuals and the environment that have been sanctioned by governing bodies and enforced by inspectors such as Care and Social Services Inspectorate Wales. The Health and Social Care (Safety and Quality) Act 2015 is a legislation that’s goal is to improve the safety and quality of those in care and explains what is expected of regulators of health and social care professions. Riddor or reporting of injuries, diseases and dangerous occurrences regulations 2013 is the regulation that explains to employers their duties on assessing risks and how to report incidents and these reports are important to assess the needed safety precautions to prevent incidents in the future. COSHH or Control of Substances Hazardous to Health is the law that enforces employers to ensure all hazardous substances are stored safely in appropriate storage rooms, necessary measures to be taken and risk assessments are completed to prevent any incidents.
The case study I am looking at is about Susan a 45 year old school teacher who three years ago lost her husband in a car accident when she had been driving and blames herself even though it was not her fault and since the accident she has turned to alcohol. Susan has been finding her job more stressful and is drinking more for as a coping mechanism but this had to stop as she arrived for work one day under the obvious influence of drink. She was sent home and warned if it happened again a formal disciplinary action would be taken. Her husband Rik was self-employed and had not made provision for a pension or insurance payment in the event of his death and Susan has not adapted her lifestyle following Rik’s death and she spends more than she earns. Her only income is her salary and child benefit; Susan did have some savings but these have now been spent. She has taken out a bank loan and has also just started taking out short term ‘pay day’ loans. The family live in their own home but it is subject to a mortgage. Susan is struggling to make payments and the last two have been paid late.
Susan’s daughter Lydia aged 16 has just started her A levels and is at risk of being excluded for lack of effort. She has also started a relationship with Lee, aged 27, who is unemployed and has 2 children from separate previous relationships.
Susan’s son Tom aged 14 has started to rebel against his mother. He defies her and stays out after dark and mixes with the ‘wrong people’. He was returned to the house recently by the police having been found drinking in the local park.
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