Injury case 'wake-up call' for sector on health

Aileen Cooper (right), who worked at Bright Horizons Rothamsted Little Stars Nursery in Harpenden, Hertfordshire, secured a legal victory on 31 July after the High Court found the nursery group to be liable for her severe disability, caused by placing a baby in a defective cot.

The incident caused Ms Cooper to develop a rare condition known as Cauda Equina Sydrome.

The judge ruled that Bright Horizons failed to follow its own health and safety risk assessments even though it knew Ms Cooper already had a bad back. The nursery group required her to use faulty cots, which also breached its own manual handling procedures.

Lorna Taylor, a chartered physiotherapist who works within primary and early years settings, believes the case will act as a wake-up call for the sector, which, she says, tends to 'sweep the issue under the carpet.'

Too often, she says, nurseries overlook posture and ergonomics - which aims to make sure that tasks, equipment, information and the environment fit each worker - and fail to provide staff with training on lifting equipment and children.

The chartered physiotherapist, who says that it is common for settings only to report accidents or absence because of sickness rather than an incident such as a back strain, recommends nurseries introduce a 'cumulative strain reporting system'.

Ms Taylor says Ofsted should consider incorporating workplace assessments within inspections, and the Health and Safety Executive (HSE) should be playing a much bigger role if things are to improve.

Currently, nurseries do not fall under the remit of the HSE, unlike schools. Local authorities are required to carry out health and safety inspections at early years settings, but inspections are mainly complaint driven.

Ms Taylor told Nursery World, 'Every member of staff working at child-height is at risk of musculoskeletal injuries.

'Nurseries often just think about the welfare of the children; they don't take into consideration that staff need to be fit and healthy to provide good care.'

A survey by the chartered physiotherapist carried out in conjunction with Voice the Union in 2011, found that more than 80 per cent of the 705 staff working in early years settings and primary schools had experienced work-related back pain and disorders such as joint and repetitive strain injuries.

More than 90 per cent reported discomfort caused by bending over low tables, 85 per cent from sitting on children's chairs and 71 per cent from kneeling at low tables/on the floor.

According to Sheenagh Parsons, partner and head of the personal injury department at Attwaters Jameson Hill Solicitors, back injury is one of the most common work-related injuries her firm deals with, mainly caused by lifting objects or people.

Ms Parsons told Nursery World, 'Most people think that back injuries only occur if you lift something heavy. However, the weight of the object or person you are lifting is only one consideration; of equal importance is the size of the person doing the lifting and the movement required while lifting, so walking, twisting, stretching, leaning are all factors that contribute to an injury.'

Similarly, David Brierley, a solicitor for Voice, says his organisation has had a number of members contact it after suffering an injury while at work as a result of lifting - most commonly staff that work in a setting caring for children with special needs. Staff are likely not to have received the right support, such as training or appropriate equipment.

He said, 'I hope this case will alert employers to the issue. The focus must be on prevention. Nurseries should have a risk assessment in place that they put into action. It is not good enough just to tick a box. They also need to appoint a member of staff who is responsible for this and ensure they receive training.'

Advice for nurseries

Jacqui Mann, managing director of HR4 Nurseries, advises that all early years settings should have a risk assessment in place for staff that have existing conditions.

To help create these risk assessments, she recommends settings contact the employee's GP, with their permission, who will be able to list what the member of staff can or cannot do as a result of their injury or condition.

According to Ms Mann, nurseries that fail to do a risk assessment for a member of staff with an existing condition could risk invalidating their insurance if they have taken out a policy.

Jerry Beere, director of Morton Michel insurers, said, 'Insurance companies are unlikely to make any immediate changes to either pricing or terms and conditions following a major award such as this. Workers' compensation is a very well understood insurance cover in the UK.

Underwriters would only reconsider their pricing or policy coverage in the event that a particular award reinterpreted the existing law to make claims more likely or more expensive. This does not seem to be the case in this instance.'

What nurseries are required to do by law

All childcare settings are required to follow the Health and Safety Act and the Manual Handling Operations Regulations 1992.

Under the regulations, employers have a duty to avoid manual handling as far as reasonably practical if there is a possibility of injury. If this is not possible, as in the case of early years settings where staff are required to lift and carry children, employers must put in place measures to minimise the risk, including carrying out a risk assessment and providing training.

Calvin Hanks, who is quality director of Acorn Childcare Training and delivers manual handling training, suggests nurseries use drop side cots to avoid injuries and encourage children who can walk to do so rather than carrying them.

Mr Hanks said, 'Early years settings are not exempt from the Health and Safety at Work Act.However, there is often a conflict between that and the EYFS. Under the Health and Safety Act it is safest to sit with a child on the lap with its back to you, although this means there is no face-to- face contact.'

Under the Manual Handling Operations Regulations, if an employee is complaining of discomfort, any changes to work to avoid or reduce manual handling must be monitored to check they are having a positive effect.

Advice from Voice

Advice from Voice the Union about the steps that employees who have become injured at work should take:

• Make sure the workplace has an accident report.
• Make your own account of the incident and note any witnesses.
• See a GP if it is a serious injury.
• Keep a diary of the impact of the injury, for instance any expenses incurred as a result such as medication.
• Apply for industrial injuries disablement benefit, which you can do independent of your employer.

More information

-Lorna Taylor's company, Jolly Back has a new resource for education and childcare professionals, Back Chat, with solutions for lifting, handling, back and voice care.