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What is moving and handling in Home Care?

Learn more about moving and handling

If you have trained as a carer you will undoubtedly have heard of moving and handling, but unpaid carers looking after family members may not be familiar with best practices in this area. While it may seem like a simple task to help a loved one get up out of their chair, there are actually a lot of risks for both the mover and the person being moved, so it is crucial to understand the implications of unsafe moving and handling techniques. Here, we are diving into what moving and handling means, why it is so important in home care, the things you should consider if you are a family member caring for a loved one, ways to safely move those with mobility issues, and information on moving and handling training, and more. At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about moving and handling, we can help. 

What is moving and handling?

Moving and handlingin the context of home care involves the safe and efficient moving of people with limited mobility, such as older adults or those with a disability. Whether they require a transfer from bed to a chair, help getting in and out of bed, bathing and moving around the home, this all usually falls under the umbrella of moving and handling, and could include lifting or repositioning using equipment, and supporting people in performing certain daily activities using specialist equipment that has been assessed as appropriate for the person’s needs, such as hoists, transfer boards, gait belts, slings, patient turners and slide sheets.Moving and handling involves specific techniques employed by care workers to make moving safe, comfortable, and a smooth process for the individual. Helping prevent injuries to both the person being moved and the person moving them, and aims to preserve the individual’s privacy, dignity and independence. 

Why might someone need help being moved?

Those with limited mobility may need help moving around their home or repositioning if they feel uncomfortable, and this could be due to their age, weight, an injury, a recent surgery, a disability or a chronic health condition such as arthritis or stroke, or something else. A trained, experienced carer can assist them with moving and handling practices in order to prevent falls, reduce the risk of pressure ulcers or sores, and ensure they have proper body alignment to avoid future pain or discomfort. By paying attention to the person’s positioning and movement needs, carers can ensure safety and enhance the person’s quality of life. Some examples of things people with limited mobility may need help with include: 

  • Moving to sit in a chair 
  • Standing up 
  • Getting in and out of bed
  • Turning over or repositioning in bed (to avoid pressure ulcers or sores)
  • Sitting up in bed 
  • Bathing and showering 
  • Using the toilet 
  • Walking around the home 
  • Getting in and out of a car 
  • Getting up off the floor after a fall (using specialised training and lifting equipment, such as a raizer chair) 
what is moving and handling

Why is moving and handling important for people with limited mobility? 

Helping someone to move in the above ways may seem like an easy task, but the importance of ensuring this is done safely, and taking into account the person’s specific needs, cannot be overstated. Adhering to proper moving and handling practices and staying up to date with the latest training and techniques will benefit those with limited mobility by enhancing their safety and quality of life.It is also important to be mindful and precise when moving someone with mobility limitations as this can impact their self-esteem. Some people who cannot move around themselves find it uncomfortable, embarrassing and emotionally difficult when being moved by someone else, so taking time to ensure this is done correctly can help to foster trust, respect and a compassionate care environment in order to preserve their dignity. 

Why is moving and handling important for caregivers? 

Effective and safe moving and handling is important for carers because even small injuries could impact their ability to continue working, resulting in time off to heal. Poorly executed moving and handling practices can result in accidents, as well as things like back pain, musculoskeletal issues and discomfort. Manual handling injuries are common across all industries, with around 473,000 UK workers said to have suffered from a work-related musculoskeletal disorder in 2022/23 that contributed to the 35.2 million working days lost due to a work-related illness or injury. According to the British Journal of Nursing, work-related lower back pain and injuries are among the most common musculoskeletal disorders caused by manual handling, with back pain in health sector staff being considered a long-standing problem, and the NHS confirming back injuries are the most common during manual handling. There are also regulations to consider if you are planning to move someone, including:

If you are a care worker, it is important to form good habits around moving and handling practices to keep yourself safe and healthy at work.

what is moving and handling

What do you need to consider as an unpaid carer? 

If you are an unpaid carer helping a family member with mobility issues, you should be asking yourself questions relating to:

  • The safety of your loved one – What health conditions may be exacerbated by moving them?
  • The dignity of your loved one – Will moving them in this way affect their self-esteem? Is there an alternative that could empower them to move more independently?  
  • The comfort of your loved one – Will a move like this cause them any pain? 
  • The needs of your loved one – Have you organised a Care Needs Assessment with your local council to determine whether they can provide any assistance and training for the person you need to regularly move? Do they have any complex health needs that should be taken into account when being moved, such as wounds, a feeding tube, a stoma, or a catheter? 
  • Your safety – Could moving them in this way cause you any injuries or put strain on sensitive areas of your body, such as your lower back? 
  • The appropriate equipment – Do you require a hoist, transfer board, gait belt or something else to successfully move the person you are caring for?
  • The environment – Is there anything in the home that could pose a safety issue when undertaking moving and handling manoeuvres? Is there room to make these manoeuvres safely, or should items of furniture be cleared away to make space? 
  • Communication – Does the person you are moving understand how you plan to move them? Do they need to tell you any additional information beforehand (for example, any pain they are experiencing)?
  • Your own physical limitations – Will you need any additional help to successfully move the person, based on any limitations you have with your own mobility?
  • The latest advice – Are you up to date on the latest knowledge and skills needed to provide effective and safe care to the person you are moving? 

As an unpaid carer, you should still be seeking the latest guidance from your local council on the best practices for moving and handling. A Care Needs Assessment is a good place to begin with this, but you can also reach out to your local council to ask about what else they could offer. Many councils run free training courses on safe moving and handling, or they can provide assistance as you look for an appropriate course yourself. In addition, your local council may be able to provide you with equipment to help make moving and handling someone easier, safer and more comfortable for both of you. If you would like to buy equipment like this, it is always best to seek advice from a social worker or the person who conducts the Care Needs Assessment so they can help you order the most relevant items for your needs.

What are the biggest risks during moving and handling?

In the case of older adults in particular, their bodies are not as flexible and maybe more prone to injury, so it is important to understand the risks of moving and handling this age group, even if you believe you are being extremely careful. These might include: 

  • Falls – According to the NHS, an estimated 1 in 3 adults aged 65+, and 1 in 2 adults aged 80+ will have at least one fall a year. Some of these falls could be due to moving and handling attempts, which come with a risk of losing balance and falling. This can lead to things like head injuries, fractures and other serious complications. 
  • Skin tears – Skin tears are more common in older adultsdue to a loss in dermal thickness that occurs with age. Moving or repositioning an older person could lead to skin tears and other injuries like bruises or cuts. 
  • Pressure sores – Also known as pressure soresor pressure ulcers, these painful points on the skin are caused by pressure on particular areas of the body. This can happen if someone spends too long in the same position, and they can show up after just a few hours, so understanding how sores form and regularly repositioning the person is important. 
  • Musculoskeletal injuries – Incorrect lifting techniques can result in these injuries to both the person being moved and the person moving them, so proper practices should always be adhered to, and you should never cut corners to speed things up. 
  • Anxiety – Older adults may experience feelings of anxiety or worry when being moved regularly. Abrupt movements, lack of communication, and anticipation of pain can all contribute to this. 
  • Aggravating existing conditions – More than half of older adults live with at least three health conditions, so understanding what these may be and how to avoid exacerbating them is important when moving someone. For example, if they experience heart problems or respiratory issues, these could become inflamed due to physical strain.
  • Cognitive impairments – Those with cognitive conditions like dementia may not be able to understand why they are being moved, or communicate their preferences for this, which can make it more difficult to lift or move them safely and efficiently. They could also become agitated during the process, so having more than one carer present for these manoeuvres may be best. 

Carers performing lifts and moving and handling people could also experience strains, sprains, back pain, cuts and bruises, overexertion, or even psychological stress. Many care organisations believe you should avoid lifting people by yourself unless it is a life-threatening or extenuating circumstance. Instead, seek the help of other carers and equipment to ensure safety at all times.

what is moving and handling

Since the 1980s, drag lifts – the act of lifting someone from underneath their shoulders using your elbows – are no longer used due to safety issues. They are known to pose problems for both the carer and the person being moved, and can heighten the risk of skin tears, bruising, strain, shoulder injuries, discomfort and more due to a lack of control. Equipment such as hoists and transfer boards are considered much safer than drag lifts. 

Some other things to avoid include lifting people with their arms locked around your neck, manually lifting them back onto their feet from the floor after a fall, lifting them out of the bath without an aid, lifting them by the upper arms, and more. Despite manual lifting often being a quicker way to get a task done, this does not mean it is more effective or safer, so be patient and take the time to use the correct equipment. 

How can you safely move someone who is less mobile? 

Learning how to safely move a person with mobility issues requires appropriate training and relevant equipment. This might take place through your local council if you are caring for a loved one, or through a care agency if you are a professional carer. The latest manual handling techniques for your loved one will typically require an individual risk assessment followed by training in the specific areas that will be helpful for everyone involved. 

A few tips that may be helpful include:

  • Maintain good body mechanics during lifting. For example, align your spine, bend your knees and keep your back straight to avoid injury. 
  • Look after your health and fitness by engaging in exercise outside of work, such as weight training. 
  • Secure the working environment to prevent slips or falls, and plan movements carefully to avoid obstacles.
  • Work at a comfortable pace to avoid sudden, painful movements for the person, and to give you adequate time to assess your next move. 
  • Do not avoid using equipment, as studies on carers found their manual handling knowledge was adequate but that they did not utilise equipment enough due to factors such as over-reliance on their own strength and abilities, lack of suitable equipment, or a lack of familiarity with available equipment. Take the time to learn how each lifting aid works and use it to avoid injuries. 
  • Give yourself space to move and get close to the person who needs to be lifted. Many injuries happen when a carer must reach for the person and is too far away to properly balance and find their centre of gravity. Position yourself properly, finding the best foot position before lifting the person. 
  • Take time to plan the lift in advance, and warm up the muscles you will be using to avoid strain or injuries. 
  • Communicate with the person being lifted so they know what you plan to do, how they may be able to help make this easier, and when you will start the manoeuvre. 
  • Seek assistance if you need it or you think a particular move could cause an injury 
  • Consider home adaptations to help make lifting and moving easier and safer, as well as making the home safer for the person living there. You can read more about this in our guide to home adaptations for older people
what is moving and handling

What training do paid carers receive for moving and handling?

Carers typically receive comprehensive training for moving and handling through the agency they are employed with, in order to ensure safe and effective care. This training will be different depending on the agency, but will usually cover a range of topics such as proper lifting techniques, the use of assistive equipment (hoists, transfer belts, etc.), risk assessments for different transfer scenarios, causes of injury, legislation, and more. 

Carers will often be required to learn through a combination of classroom theory and practical experience, and may shadow other carers first to observe good techniques. Training is focused on the importance of maintaining their own physical health and safety to preserve their working abilities while also safely assisting their client. They may also be trained in things like communication skills to explain the moving and handling process to clients, and how to promote dignity and respect during manoeuvres. Following training, carers will also be required to demonstrate their competence in using the appropriate equipment for different scenarios. 

Overall, the goal of training is to prevent carer injuries, protect the people being moved, promote the use of mobility equipment, and adhere to the latest regulations. Do not hesitate to ask your care provider or agency about the training their carers go through, as this is an important part of care work and should be taken seriously.  

Training in moving and handling for carers is ongoing in nature, and continued education and updates will be required to ensure they are always aware of the latest knowledge and best practices recommended for safe and confident moving and handling. 

If you are caring for a loved one and require assistance with moving and handling, our experienced Care Professionals are the best of the best, and highly trained to deliver the services you need – whether this means an extra pair of trained hands to help you move your loved one on a daily basis, or a complete care package to help with their personal care, mobility, complex care needs and more. 

Feel free to reach out to your local Home Instead office to discuss your current situation and explore the many ways our Care Professionals could help. We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.