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Wheelchair assistance in home care

The following information is mainly aimed at PCBUs and workers in home-based care. However, PCBUs and workers within nursing homes, hospitals or other care organisations may also find this information useful.

People receiving home care services are diverse and have specific needs. The processes for managing work health and safety in these environments provide the foundation for safe practices, but they must also be able to adapt to the individual circumstances of the client. These processes and practices must also respect the dignity, privacy and independence of clients.

PCBU responsibilities

When workers are working in a private home, the home is considered a workplace, and therefore the usual work health and safety obligations for workers and PCBUs apply.

If you’re a Person Conducting a Business or Undertaking (PCBU), you must manage the hazards associated with the health and safety of your workers by providing:

  • a safe working environment: for example, providing suitable ramps, grab rails, and vehicles for transporting wheelchairs and people; and by assessing all locations. For example, if using the wheelchair at activities held outside the home, what is the ground surface like?
  • safe systems of work: for example, developing and implementing (with your workers’ input) a specific safety policy and safe work procedure that reduce the risk of body strain injuries from moving clients in their wheelchair. You also need to enforce these, and regularly review them to make sure they’re making a difference or if they need further improvements
  • equipment in a safe condition: for example, making sure the wheelchair is maintained in safe working order and checked regularly
  • information, instruction, training and supervision: for example, about loading/unloading wheelchairs into transport vehicles. Inductions are one way to cover this information
  • facilities: for example, mobile first aid kit/equipment in the worker’s vehicle, a mobile phone to make contact with base, and processes for check-ins, especially for workers in remote or isolated areas.

Your duty of care applies not just to your worker but to anyone else present in the client’s home when the worker is working.

Client’s responsibilities

When workers are working in a private home, the home is considered a workplace, and the client also has a duty of care under work health and safety laws.

Therefore the client must notify workers and the PCBU of any changes to their home, and any hazards associated with the house as soon as they become aware of them.

Worker’s responsibilities

You have a duty to take reasonable care of your health and safety and that of others who may be affected by your actions while at work.

Safety risks

Between 2015 and 2019, more than 450 carers of aged people and people with a disability were seriously injured at work in Tasmania, with the majority of these injuries occurring while working with clients in their homes.

65% of these injuries were musculoskeletal disorders which most commonly include traumatic joint/ligament and muscle/tendon injuries, and musculoskeletal and connective tissue diseases.

Risks of providing wheelchair assistance

High risk tasks include assisting people in wheelchairs and moving wheelchairs in and out of transport vehicles. These tasks involved pushing, pulling, bending and lifting, which can cause muscle injury. Specific sources of risk include:

  • wheelchairs that aren’t maintained in safe working order
  • wheelchairs that aren’t suitable for the client or the environment
  • pushing the combined weight of the wheelchair and the client
  • pushing/controlling wheelchairs over steep or uneven surfaces, on soft carpets, up and down ramps, and over long distances
  • lack of appropriate transport vehicles/equipment to lift the wheelchair in and out of vehicles
  • transferring people out of wheelchairs
  • inadequate space to move the wheelchair
  • electric batteries not charged
  • inadequate information about access in venues outside the home.

Risk assessment

You should consider the issues listed above during your initial assessment of the client’s needs. If they pose a risk, you must put control measures in place before your worker makes their first visit to the client.

You should do a risk assessment of the client’s home and the tasks your worker will do there. Take into account the level of support the person requires. Any risks should be addressed to support both the client and your worker.

You must also consult with your workers and their health and safety representatives as you do your risk assessment.

Wheelchairs

  • Regularly maintain and inspect wheelchairs to ensure they are in safe working order. Check tyre pressure, brakes, controls, tyre wear, fabric/structure, charging point and battery condition. If the wheelchair is owned by the client, include this requirement in the service agreement.
  • Provide the lightest wheelchair that is suitable and safe for the client and activity.
  • Provide manual wheelchairs that are collapsible with quick release wheels.

Transport vehicles, transporting clients

  • Never lift electric wheelchairs manually. They should only be moved in a vehicle that is adapted for lifting/moving wheelchairs. For example, install electrically-operated wheelchair hoists that have a winch to raise and store the wheelchair on the back or in the boot of a vehicle. Provide wheelchair ramps so the wheelchair can be loaded into the transport vehicle (ramps can be freestanding or mounted on the tow bar). If using a bus or taxi service, make sure they have these features.
  • Ensure vehicle attachment points are installed by qualified/accredited professionals, to approved safety standards.

Surfaces and environment

  • Assess floor surfaces: can the wheel chair move across them easily? Where necessary, change the flooring.
  • Ensure there is adequate space to move; for example, make sure doorways are wide enough.
  • Avoid using indoor wheelchairs on sand, loose stone or dirt paths.
  • Assess the environment/venue for activities outside the home before the worker and client go there.

Training and consultation

  • Provide workers with information, instruction and training on the client’s physical support needs and the control measures that will be implemented.
  • Develop safe work procedures and provide training in the safe use of wheelchairs. This should include practical training and information in loading and unloading transport vehicles; operating on slopes, ramps, and curbs; turning; and disassembling the wheelchair into small parts. It should also cover the manufacturers’/suppliers’ information.
  • Consult with workers and their health and safety representatives as you conduct risk assessments and develop safe work procedures.
  • Have a system for workers to report any changes or safety issues to you. Regularly ask your workers about their work environment, tasks or client’s needs. Address these matters as soon as possible.

Resources and solutions

Hazardous manual tasks

How to manage health and safety risks code of practice

Managing the work environment and facilities code of practice

Work health and safety consultation, cooperation and coordination code of practice

Updated: 20th February 2020