Dorset HealthCare NHS Trust - Community Staff Safety Checklist Edn 2

PATIENT IDENTIFIABLE INFORMATION MUST NOT BE ENTERED THIS CHECKLIST

• Title:

• Community Base / Site:

• Date / Time completed:

  Date

• Checklist completed by (name & role):

PATIENT IDENTIFIABLE INFORMATION MUST NOT BE ENTERED THIS CHECKLIST

UNPREDICTABLE BEHAVIOUR OR VIOLENCE/AGGRESSION - PATIENT

• Does the patient have a known history of unpredictable behaviour or violence and aggression

  NO

  YES

  N/A

UNPREDICTABLE BEHAVIOUR OR VIOLENCE/AGGRESSION - OTHERS

• Has any member of staff felt threatened, intimidated or harrassed by any member of the household?

  NO

  YES

  N/A

KNOWN ADULT/CHILD PROTECTION ISSUES

• Is the patient or any member of the household on a register held by social services?

  NO

  YES

  N/A

ACCESS / EGRESS TO THE PROPERTY

• Is the property easy to locate? If not, document directions on how to find the property.

  Yes

  No

  N/A

• Is off road parking available?

  Yes

  No

  N/A

• Is the property to be visited less than 5 minutes walk from where the car can be parked?

  Yes

  No

  N/A

• Is the entry to the building well lit?

  Yes

  No

  N/A

• Is the entry to the building visible from the road?

  Yes

  No

  N/A

• Are external stairs / lifts in good condition?

  Yes

  No

  N/A

• Are there any additional hazards relating to the building detailed?

  Yes

  No

  N/A

• If the patient has a key safe to their property, is the access number and location documented?

  Yes

  No

  N/A

• Are doors locked whilst staff are inside the house/premises and therefore barring quick exits routes?

  NO

  YES

  N/A

SLIPS, TRIPS & FALLS

• Are floor surfaces including stairs, within the home in good condition?

  Yes

  No

  N/A

• Is the floor free from tripping hazards e.g. wires, objects, rugs?

  Yes

  No

  N/A

MANUAL HANDLING

• Has an individual patient handling assessment been completed?

  Yes

  No

  N/A

• Is there adequate and appropriate lifting equipment in situ in the house?

  Yes

  No

  N/A

• Where supplied, is the manual handling equipment maintained?

  Yes

  No

  N/A

• Does the amount/layout of the furniture increase the handling risk? (e.g. limits manoeuvrability and causes excessive stretching)

  NO

  YES

  N/A

ELECTRICAL SAFETY

• Is any electrical equipment that staff may come into contact with, in good condition? (visual check for frayed leads, damaged plugs or sockets?

  Yes

  No

  N/A

FIRE SAFETY

• Does the patient have smoke detectors fitted?

  Yes

  No

  N/A

INFECTION CONTROL

• If sharps are regularly used by the patient/carer, is there a sharps bin available?

  Yes

  No

  N/A

• Has the patient tested positive to MHRA? If so, ensure site is fully documented in notes.

  NO

  YES

  N/A

• If large amounts of contaminated dressings are being handled, are there adequate disposal arrangements in place?

  Yes

  No

  N/A

AT RISK GROUP

• Would this person be considered particularly at risk in certain situations i.e. Severe weather conditions (heat or cold) becuse of their health, home environment or support received?

  NO

  YES

  N/A

OTHER RISK FACTORS