It is an unfortunate reality but many disabled people who are wheelchair users lead quite sedentary lives and are likely to put on weight or become less fit as they get older, and shoulders suffer from wear and tear. This can cause issues for PAs needing to push and manoeuvre their employer in their wheelchair.
Whilst paid agency and residential carers are protected by employment regulations on moving and handling, PAs (who are also covered by employment law) usually do not receive the relevant training, either in moving and handling or in wheelchair management techniques. Pushing a load that is too heavy or not being aware of how to push safely can have serious consequences on PA’s own physical and mental health.
Whilst trying to find information on this subject for PAs, we came across a useful piece of research undertaken by Dundee University in 2011. “Keeping the wheels turning: a research project investigating the needs of carers supporting people who use wheelchairs”. This newsletter highlights some of the key points from this research that will be useful to PAs.
Most wheelchair users should have been given a proper assessment by an occupational therapist for their wheelchair. This should take into account all aspects of the person’s life to ensure the wheelchair best meets their needs.
The research, however, showed that most assessments do not take into account the needs of that person’s PA and, furthermore, that the PA was not given any information, advice or training on manoeuvring the wheelchair. As a result, carers were experiencing 3 times more back and wrist pain than those who had training.
Is there a safe pushing load?
It is difficult to identify safe loads that carers can be expected to push. Carers/PAs will have different levels of strength and stamina, and a safe load can vary dependent on gender as well as the carer’s size. Safe loads are based on guidelines set out in the Manual Handling Operations Regulations.
These regulations have been developed for the workplace and assume a fit and active individual of working age, and that the load will be moved just 20 meters on a flat smooth surface. It doesn’t take into account ramps, curbs, bumpy pavements or carpets. It also doesn’t take into account the speed of the wheelchair. All of these factors increase the likelihood of injury.
Let’s look at some numbers. The following figures include the combined weight of the person and their wheelchair, and you’ll see that the safe limit decreases dramatically as soon as a gradient is encountered.
On a level surface:
- A male PA is considered safe to push a weight of 200kg (31 stone)
- A female PA would be considered safe to push 150kg (23 stone)
On a gradient:
- A male PA is considered safe to push a weight of 110kg (17 stone)
- A female PA would be considered safe to push 60kg (9.5 stone)
So as an example, an 80kg adult (12 st 8lb) in a 15kg wheelchair will weigh a total of 95kg. You’ll see that this perfectly realistic weight is well beyond the safe limit for either a male or female PA to push up a 1 in 12 gradient without risking injury.
Keeping everyone safe from injury
- Have a conversation with your employer. If you think you are at risk of injury, or already in pain, from pushing their wheelchair. Many employers may not be aware that you are struggling so always try to discuss the issue with them 1st. (or the relevant family members if they lack capacity).
- Support your employer to ask for another wheelchair assessment. They need to be clear that this is about health and safety and not putting people at risk.
- Ask your employer if you can attend the assessment (along with any other PAs in the team and any family carers) to make sure anyone needing to push the wheelchair’s needs are also taken into account along with the persons home and lifestyle.
- Even if a wheelchair user is normally able to push themselves, there may be times at which they are tired or unwell and so you need to plan for these occasions.
- Find out about training – this is usually available free for carers and PAs from the local authority.
- If you have a temporary injury you should discuss with your employer the possibility of doing light work that doesn’t involve heavy lifting. If this is not possible you may have to consider taking sick leave until you are fully fit.
- If you have to leave your work because you feel your health and safety is at serious risk, then you could have a claim for unfair dismissal or constructive dismissal.
What the law says
At the end of the day your employer’s home is your place of work and therefore both you and your employer must comply with health and safety regulations (health and safety at work act 1974 and manual handling operations regulations 1992).
- To ensure so far as is reasonably practicable the health and safety and welfare at work of all employees.
- To provide information, instruction, training and supervision as is necessary to ensure as far as is reasonably practicable the health and safety and welfare of his employees.
- Avoid hazardous manual handling so far as is reasonably practicable.
- Assess those hazardous manual handling operations which cannot be avoided.
- Take action to reduce or eliminate the risk of injury.
- Provide information on the weight of the load.
- To assess the risks to staff
- To take reasonable care for their own health and safety and that of others who may be affected by their actions.
- To cooperate with their employer to enable their employer to comply with health and safety duties.
- Follow appropriate systems of work as laid down by the employer to promote safety during the handling of loads.
- To make use of appropriate equipment provided for them, in accordance with their training and the instructions the employer has given them . Equipment includes machinery and handling aids
Further information and advice
- PA Support Service
- ACAS telephone helpline: 03001231100
- Health and Safety Executive