Moving People Up and Down Stairs Under Restraint [Video]

I often get asked about techniques for moving people up and down stairs whilst under restraint and many years ago it was common for people to be moved up and down flights of stairs whilst being restrained.

But let’s be clear about this. A team will actually be moving someone who has possibly violently struggled with staff and who may still be capable of struggling whilst being moved so there is an ever-present risk of a slip, trip or a fall occurring.

According to the HSE Website “slips and trips are the most common cause of major injuries at work, 95% of major slips result in broken bones and they can also be the initial cause for a range of other types of accident”.

Under Health and Safety legislation, specifically the Workplace (Health, Safety and Welfare) Regulations 1992, there is a requirement to ensure that “people must be able to move around safely”.

In addition, under the Manual Handling Operations Regulations 1992, a load is defined as “a patient receiving medical attention” and the regulations apply to the “manual handling of loads by human effort”. The regulations go to state that “manual handling includes both transporting a load and supporting a load in a static posture”.

In a guidance document issued by the HSE, it states that:

“When trying to avoid manual handling the first questions to ask are whether the load/s need to be handled at all, or could the work be done in a different way? For example, can a process such as machining or wrapping be carried out in situ, without handling the loads? Can a treatment be brought to a patient rather than taking the patient to the treatment?”

The guidance document goes on to state that “if, so far as is reasonably practicable, handling of the load cannot be avoided, then can the operation/s be either:
(a) automated; or
(b) mechanised?”

In short, every employer has to consider the risks involved with manual handling and as physical restraint is the manual handling of another human being by human effort, then an employer has to consider the points above.

So, as opposed to simply moving someone up and down stairs under restraint by manual effort alone we have to ask the questions:

1. Do they have to be moved at all or can it wait until the person being restrained has calmed down for example?

2. If they have to be moved and there is a risk of a slip, trip or fall, can that risk be minimised by the use of a mechanical piece of equipment?

3. Is the environment “safe” for people to move around in or on?

And all of this has to be documented in a manual handling risk assessment and if it is a people handling issue then in a patients/service users behavioural management plan.

In short, no employer should just expect staff to physically restrain someone and then attempt to move them up and down stairs without considering all of the risks and all of the risk control options.

So, for the manager who recently told me that “they would never even consider the use of mechanical restraint equipment in their workplace” then all I have to say is that their physical restraint strategy is possibly outdated, certainly not holistic or strategically thought through, is possibly legally flawed and is probably influenced by an out of date attitude towards safety. Oh, and if someone dies from a slip or trip on stairs during an uncontrolled and poorly risk-managed restraint move, then stand-by to say hello to a Corporate Manslaughter charge of Gross Negligence Manslaughter.