Lone Worker Personal Safety and Employee Responsibilities

Lone Worker Personal Safety - Under section 7 of Health and Safety at Work Act 1974, employees are required to take reasonable care for themselves and the people around them who may be affected by the things they do, or the things they fail to do.   The test of “reasonable care” is that the employee should do what a reasonable person would be expected to do in similar circumstances, with similar knowledge, training and experience.

This test - of what the ‘reasonable person’ would do in similar circumstances - is one that is potentially confusing for some care staff.   We often meet social care and healthcare staff who are under the impression that their job makes them somehow different, in the sense that because the people they look after are vulnerable by their nature, that the workers who work with them must take what we might call un-reasonable risks in order to deliver services to them.  This is the dangerous ‘Mother Teresa Syndrome’ alluded to earlier, which places workers at risk due to their unreasonable expectations of themselves.

For example, we meet lone workers who are convinced that, if working alone with a vulnerable person in their home and faced with violent behaviour (such as with the Lorraine story above) then the care staff MUST stay and defuse the situation rather than leave the situation (and the aggressive person).

Somehow, they have become convinced that they would get in trouble for leaving the vulnerable person “on their own”.

Lone Working Personal Safety and the question of Vulnerable People

One common-sense response to this is to ask:  “How many vulnerable people are there in this situation?”

I want you to carefully consider our answer:  there are at least two vulnerable people in that situation!   One, the vulnerable person who by their nature lacks emotional or cognitive capacity due to a learning disability, mental ill-health, dementia or medical condition.  Two, the vulnerable person who is in close contact with an aggressive, potentially violent human-being who wants to do them an injury during a rapidly-unfolding confrontation for which they are barely prepared and trained for!

Again, we need to remember this: there are TWO vulnerable people in the situation, and now we are going to ask our employee to take “reasonable care” for themselves and others who may be effected by their actions.

Would it be reasonable for the worker to disengage from this aggressive situation?  Could this involve leaving the room or house?  If this left the service user by themselves, would this still be ‘reasonable’?

If instead, in place of the violent, aggressive service user, there was a fire breaking out, which could expose our worker to risk of serious injury, what advice would be appropriate?

Why, we would certainly include the option to remove themselves from the burning building!  In fact our procedures for dealing with fires is to compel the worker to leave the building!

Regulation 8 of the Health and Safety At Work Regulations 1999 has provision for circumstances of serious and imminent danger and Lone Worker Personal Safety:

Section 8 Procedures for Serious and Imminent Danger

 - (1) Every employer shall - 

establish and where necessary give effect to appropriate procedures to be followed in the event of serious and imminent danger to persons at work in his undertaking;

(2) Without prejudice to the generality of paragraph (1)(a), the procedures referred to in that sub-paragraph shall -

(a) so far as is practicable, require any persons at work who are exposed to serious and imminent danger to be informed of the nature of the hazard and of the steps taken or to be taken to protect them from it;

(b) enable the persons concerned (if necessary by taking appropriate steps in the absence of guidance or instruction and in the light of their knowledge and the technical means at their disposal) to stop work and immediately proceed to a place of safety in the event of their being exposed to serious, imminent and unavoidable danger; and

(c) save in exceptional cases for reasons duly substantiated (which cases and reasons shall be specified in those procedures), require the persons concerned to be prevented from resuming work in any situation where there is still a serious and imminent danger.

    (3) A person shall be regarded as competent for the purposes of paragraph (1)(b) where he has sufficient training and experience or knowledge and other qualities to enable him properly to implement the evacuation procedures referred to in that sub-paragraph.

So, it seems clear that a lone social or health care worker who is faced with a serious and imminent and unavoidable danger (such as a service user who is being violent) has the right to withdraw and disengage from that particular danger (Regulation 8(2)B)  and should be prevented from returning to that workplace until the danger has been controlled or removed (Regulation 8 (2) C).

“But we have a Statutory Obligation to Deliver Services” - a story about Regulation 8 and Lone Working Personal Safety

Greater Manchester, circa 2009

A district nurse is tasked with visiting a man in his flat to re-dress an amputation wound on his leg.   He lives in a high-rise block of flats

When the district nurse arrives, she is let into the flat by the next-door neighbour, who has a key to the front door.   The man can’t come to the door himself.   She opens the front door and meets a strong smell of faeces and urine - the man’s pet dog has not been outside the flat for more than a week and has been using the hallway carpet as a toilet.

The nurse picks her way between the faces, down the hallway to the bedroom where she can hear the man in his bedroom.

When she enters the bedroom, she sees that he is sat upright in his bed, watching hardcore pornography on a large flatscreen TV.   In his left hand is a remote control.  She spots the dressing on his right leg which she needs to work with and moves around the bed to get access to it.

As she begins to re-dress the wound, the man begins to pause the video display at various points and ask the woman inappropriate questions about what is happening on the screen.  She stays focussed, but becomes aware that the man is holding a large steak knife in his right hand, just a foot away from her.

She struggles to stay focussed but completes her task quickly and professionally.

As she closes the door to the flat behind her, she feels all the energy go out of herself and begins to shudder as tears well up in her eyes and she begins to shake.   

She is experiencing a sudden onset of the ‘parasympathetic backlash’.   Without realising it, she has just had a massive dose of adrenaline and the ‘chemical cocktail’ of the survival stress response while she was in the flat.  Her body, keenly aware that the danger has passed, now ‘crashes’.

When she gets back to her office, still shaken by her experience, she tells her manager what happened and says “I am not going back to that man’s flat again - its on my schedule for tomorrow, but I was so frightened and disturbed that I’m sorry - I can not go back”

“Nurse” her manager responds in the immortal words known all over the country in meetings like this “we have a statutory obligation to deliver services to these vulnerable people.   I need you to get yourself together and go back to that client... I have no-one else to do it.”

In the above Lone Worker Personal Safety situation, if we apply the principles of Regulation 8, not only does the manger have the option to ‘allow’ the worker NOT to go back to this situation of danger, the manager in fact has an OBLIGATION to PREVENT his staff from going back into a workplace in which there is still a danger to her which he has not yet taken steps to adequately control!

When staff are completing tasks for their employer, they are at Work, and therefore covered by the ample provisions of the Health and Safety at Work Act and its associated Regulations.

There is virtually no set of circumstances under which another piece of statute law, regulation or guidance could supersede the requirements of the Health and Safety at Work statute law or the Human Rights Act Right to Life for a social or healthcare worker.

In simple terms, it may well be true that there are statutory obligations to provide services to vulnerable people in our society, however those obligations are themselves subject to the rules about safety at work and the protection of human life which should be the focus of any management team thinking about Lone Worker Personal Safety.

No manager should be thinking about the importance of providing their service and prioritising their Key Performance Indicator targets in favour of their obligations to ensure that all of their staff go home safely to their families after their shifts.

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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 Personal Safety 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/