429116_U3_CG_L2_Adult_Care_01-48_244.pdf

Learning outcomes
LO1: Understand current legislation,
national guidelines, policies, procedures
and protocols in relation to moving and
positioning individuals
LO2: Understand anatomy and physiology in
relation to moving and positioning individuals
LO3: Be able to minimise risk before moving
and positioning individuals
LO4: Be able to move and position an individual
LO5: Know when to seek advice and/or
assistance from others when moving and
positioning an individual
About this unit
In this unit you will learn about the legislation,
national guidelines, policies and procedures that
underpin your working practices when moving
and positioning individuals to ensure you keep
yourself, individuals and others safe. You will
also explore the anatomy and physiology of the
human body as well as the different conditions
that individuals have and how these can impact
when they are moved and positioned.
Being able to minimise risk before moving and
positioning individuals is essential for you to
fulfil your duty of care and so this unit will equip
you with the knowledge you need to carry out
preparatory checks.
Finally, you will develop your skills around
moving and positioning individuals while being
respectful, communicating effectively and
encouraging individuals’ active participation.
You will also explore how to record and report
manoeuvres and when to seek advice and/
or assistance from others when moving and
positioning individuals.
Credit value: 4
Guided learning hours: 26
Move and position individuals
in accordance with their care
plan (244)
THIS UNIT HAS NOT BEEN ENDORSED BY CITY & GUILDS

Level 2 Diploma in Care
2
LO1 Understand current legislation, national guidelines,
policies, procedures and protocols in relation to moving and
Getting started
Think about your own day-to-day mobility –
how do you mobilise? When do you mobilise?
Why is it important you mobilise? How would
you feel if you were unable to move and
position safely? What are the potential risks of
not moving and positioning safely for you and
others around you?
AC 1.1 Identify current legislation,
national guidelines, policies,
procedures and protocols in
relation to moving and positioning
individuals
Adult care workers and personal assistants’
job roles involve providing care and support
to individuals to enable them to live as
independently and safely as possible. Some
individuals as part of their day-to-day
activities may also require assistance with
moving and changing positions. For example,
this may be due to an individual having a
physical disability that prevents them from
mobilising independently, a condition such
as osteoarthritis that means the individual
has limited movement, or being temporarily
unable to move unaided because of a fall that
has resulted in the individual fracturing their
leg. All these individuals will therefore require
assistance from care workers such as you to
enable them to move and position. Therefore
it is really important that you are aware of the
current UK legislation that is in place to enable
the safe moving and positioning of individuals,
so that you are able to promote individuals’
health, safety and well-being at all times as well
as your own and that of your colleagues.
Key terms
Individual refers to the person requiring care
or support.
Osteoarthritis refers to a condition that
damages your joints, preventing them from
moving smoothly and therefore causing pain
and stiffness.
Reflect on it
1.1 Moving and positioning
individuals in your setting
Reflect on your workplace and the individuals
you work with that require support from
you when moving and positioning. Why
do they require support from you? What
different types of support do you provide?
For example, perhaps you may prompt them
to stand up or use their walking aid or use
a hoist to move them from one position to
another.
Current legislation
Look at Table 1.1, which sets out the current key
pieces of legislation that are relevant to moving
and positioning individuals and that you need to
know about. The HSE’s website is a useful source
of information about relevant legislation for safe
moving and positioning.

Move and position individuals (244)
3
Table 1.1 Legislation relevant to moving and positioning individuals
➜
Legislation Relevance to moving and positioning individuals
Health and Safety at
Work Act 1974
• It is the basis of all current health and safety legislation and is known as the
‘enabling’ Act because it enables other health and safety regulations to be made.
• It established the Health & Safety Executive (HSE) as the regulator for the health,
safety and welfare of people in work settings in the UK to protect the health, safety
and well-being of everyone, including when moving and positioning individuals.
• It established the key duties and responsibilities of all employers and employees in
work settings. For example, it requires employers to have health and safety policies
and procedures in place, including those for moving and positioning individuals, and
requires employees to work in line with their employer’s agreed ways of working in
relation to moving and positioning individuals including attending training.
Manual Handling
Operations
Regulations 1992
(amended 2002)
• These Regulations explain how to avoid, assess and reduce the risk of injury from
manual handling activities such as lifting, lowering, pushing, pulling or carrying and
could be either in relation to individuals or objects, for example a box or piece of
moving and handling equipment such as a hoist.
• They require employers to avoid hazardous manual handling where possible, assess
the risk of injury from any hazardous manual handling that can’t be avoided and
reduce the risk of injury from hazardous manual handling where possible. For
example, employers can avoid hazardous activities such as the lifting of heavy items
and can use risk assessment for managing moving and handling tasks safely.
• They require employees to cooperate with their employer’s agreed ways of working
for moving and positioning individuals. For example, by using moving and handling
equipment provided such as hoists correctly and as they were trained to do so,
only carrying out moving and handling activities they are competent to carry out,
reporting to their employer if they observe any unsafe or hazardous work practices
in relation to moving and positioning, taking care to make sure their activities do not
put others at risk.
Personal Protective
Equipment (PPE) at
Work Regulations
1992
• These Regulations require employers to provide employees, free of charge, with
personal protective equipment (PPE) such as gloves and aprons to provide protection
against infections including when assisting individuals with moving and positioning.
• They require employers to ensure that PPE is available to employees and maintained
in good condition so that it is effective: employees must be able to use PPE as and
when they require it and it must not be damaged. It also requires employers to
provide training and supervision to employees in the use of PPE, in relation to when,
why and how to put it on and dispose of it safely.
• They require employees to comply with their employer’s agreed ways of working
when using and disposing of PPE, including during moving and positioning activities
with individuals. This includes attending training provided and following the guidance
provided by their employer.
Workplace (Health,
Safety and Welfare)
Regulations 1992
• These Regulations require employers to ensure that workplaces are environments
where risks to general health and safety are minimised. In relation to moving and
positioning individuals this includes, for example, ensuring moving and positioning
equipment and aids are clean and maintained correctly so that they are safe to use.
It also includes ensuring the environment where the moving and positioning activity
takes place is appropriate in terms of there being sufficient space to carry out the
activity safely, that it is clean, not hazardous (i.e. cluttered with items or a slippery
floor), well-lit and neither too hot or too cold.

4
Legislation Relevance to moving and positioning individuals
Lifting Operations
and Lifting
Equipment
Regulations (LOLER)
1998
• These Regulations require employers to ensure that all lifting equipment is used
safely in the workplace to avoid and minimise risks of injury and damage. For
example, when hoists and other lifting equipment are used to move and position
individuals it is important that they are safe to use, meaning it has been maintained
correctly, it is used only for the purpose and weight it was designed for, it is only
used by staff who have been trained and are competent, staff are supervised in its
use and records are maintained, i.e. of moves planned and agreed, of maintenance
checks of lifting equipment.
Provision and Use
of Work Equipment
Regulations
(PUWER) 1998
• These Regulations require employers who provide work equipment (such as that
used for moving and positioning individuals) to ensure that all equipment provided is
safe, maintained, used only for its intended use, used only by those who have been
trained and supervised in its use and includes visible health and safety warnings
such as how to stop it in an emergency.
Management of
Health and Safety at
Work Regulations
(MHSWR) 1999
• These Regulations require employers to assess the risks to the health and safety of
their employees and others in the workplace; this includes the risks from moving
and positioning individuals. For example, employers with five or more employees are
required to record the findings of their risk assessment.
• Employees are also required to take care of their own and others’ health and safety,
i.e. by using all equipment in line with their employer’s agreed ways of working,
attending training, reporting all unsafe practices.
Reporting of
Injuries, Diseases
and Dangerous
Occurrence
Regulations
(RIDDOR) 2013
• These Regulations require employers to report and keep records of work-related
accidents, which cause deaths, certain serious injuries (referred to as reportable
injuries), reportable work-related illnesses and certain ‘dangerous occurrences’ (i.e.
incidents with the potential to cause harm).
• In relation to moving and positioning individuals, this includes employers providing
training to employees on how to report accidents, injuries and work-related injuries.
National guidelines
There are a number of different organisations
across the UK that have developed guidelines
on safe practices for moving and positioning
individuals, the correct techniques to use and the
responsibilities that employers and employees
have when moving and positioning individuals.
Below are some examples of some national
guidelines that are in place:
● Royal College of Nursing (RCN): a professional
body for nurses, midwives and healthcare
assistants. The ‘Moving and handling - Advice
guides’ guidelines, for example, state that
manual lifting of individuals must not be
undertaken on a day-to-day basis (lifting
equipment such as hoists and bed lifts must be
used instead) and that the ‘shoulder lift’ must
not be used when moving individuals. You can
access the guidelines here: www.rcn.org.uk/
get-help/rcn-advice/moving-and-handling
● Health and Safety Executive (HSE): a
professional body responsible for workplace
health, safety and welfare. The ‘Manual
handling at Work’ guidelines describe how
employers and employees can together reduce
the risk of injury and accidents when moving
and positioning individuals. For example,
they describe how to use the risk assessment
process to control and minimise the risks
from moving and positioning activities. You
can access the guidelines here: www.hse.
gov.uk/pubns/indg143.pdf. The HSE also has
in place other guidance for safe moving and
handling in adult care settings such as their
web pages ‘Moving and handling in health and
social care’, which can be accessed here: www.
hse.gov.uk/healthservices/moving-handling.
htm and specific guidance such as how to use
hoists titled: ‘Getting to grips with hoisting
people’, www.hse.gov.uk/pubns/hsis3.pdf.
Table 1.1 Legislation relevant to moving and positioning individuals continued

5
● National Back Exchange (NBE): a voluntary
organisation that develops, shares and
promotes best practice in moving and
handling. For example, the ‘Safer use of
hoists leaflet – 2015’ provides information
about the uses of different hoist and sling
types as well as a checklist for what to check
before and during the use of a hoist. A copy
of the guidelines can be accessed here: www.
nationalbackexchange.org/images/Safer_
use_of_hoists.pdf.
Policies, procedures and protocols
Your employer will also have in place agreed ways
of working, policies, procedures and good practice
principles for you to follow when moving and
positioning individuals. You can move and position
individuals safely by following these good practice
principles that underpin all moving and handling
policies and procedures:
● Follow your work setting’s agreed ways of
working for moving and handling, e.g. by only
carrying out moving and handling activities
that you have been trained for. Not doing
so may mean that you or others may get
injured.
● Ensure you have read the moving and handling
guidelines that are in place for the individuals
you work with, e.g. read through individuals’
moving and handling risk assessments before
carrying out moving and handling activities
or using any moving and handling equipment
to ensure the safety and well-being of
individuals.
● Complete safety checks before using moving
and handling equipment. Is it clean? Is it
working? Have you noticed any faults? Not
doing so may result in a serious failure in the
equipment as you’re using it, which may then
cause unnecessary distress to an individual.
● Prepare to move an individual safely by
completing safety checks. Is there enough
space in the environment to carry out the
move? Is the load too heavy for one person?
Not doing so may mean that you will be putting
yourself, the individual and others in danger
and at risk of being harmed or injured.
● Report any concerns you have when carrying
out health and safety checks, e.g. if a piece
of equipment is not working, or if you witness
a colleague using unsafe practices when
moving an individual using lifting equipment.
Not doing so may mean that unsafe
equipment and practices continue in the
work setting.
● Always communicate clearly with those
involved in moving and handling activities,
e.g. explain to the individual how you are
going to support them with the move,
check that the individual is not in any
pain, encourage the individual to actively
participate in the move, check with your
colleagues who is going to take the lead with
carrying out the move. Not doing so will be
disrespectful towards individuals’ rights to
be actively involved in all care and support
activities. Poor communication between
you and colleagues may result in moves
becoming unsafe.
● Use a safe posture when moving and
positioning individuals, e.g. keep your legs and
feet slightly apart, keep your knees slightly
bent, do not stoop or twist, keep the load as
close to your body as possible. Not doing so
could result in you injuring your back and at
worst this may cause your body irreversible
damage.
● Be honest with yourself: if you’re unsure about
how to follow any of the above principles seek
advice from your manager and discuss these.
Not doing so could result in you not complying
with best practice and therefore not promoting
your health, safety and well-being as well as
that of the individuals and colleagues you work
alongside.
Research it
1.1 Sources of information
Research the range of sources of information
you can access in relation to moving and
positioning individuals you work with. For
example, this may include both internal and
external sources that are available to you.

6
Evidence opportunity
1.1 Current legislation, national
guidelines, policies, procedures and
protocols in relation to moving and
Write down the legislation, national guidelines,
policies, procedures and protocols relevant to
moving and positioning individuals.
AC 1.2 Summarise your
responsibilities and accountability
in relation to moving and
Moving and positioning individuals is a
skilled and complex task that should never
be underestimated. As an employee you have
important responsibilities when moving and
positioning individuals including:
● maintaining your own safety and those of
individuals and others who you work with, e.g.
by ensuring that the there is enough space to
carry out the move safely
● upholding the individuals’ rights to dignity
and privacy whilst moving and positioning,
e.g. by ensuring that you close the door when
assisting an individual to move from their bed
and protect their dignity by ensuring they are
covered with a towel when being assisted with
getting dressed or undressed
● attending moving and handling training
provided by your employer, e.g. by ensuring
you participate in the training provided and ask
questions if there is any information you do not
understand or are unsure about
● only carrying out moving and handling
activities that you have been trained in and that
you are competent to carry out, e.g. by refusing
requests to carry out any activities you have not
been trained in or are competent to carry out
and reporting this to your employer
● complying with your work setting’s moving
and handling procedures and agreed ways
of working at all times, e.g. this includes
complying with all information, instruction
and training you have received from your
employer and ensuring your work practices
reflect these
● reporting and recording all hazardous moving
and handling activities, e.g. this includes
when you have identified unsafe practices or
equipment.
It is important that you know what your
responsibilities are and how to carry them
out in line with your employer’s agreed ways
of working, because it is your duty of care to
ensure individuals are kept safe when being
moved and positioned. You can therefore be held
to account if you do not do so. For example, if
you do not check that the hoist is fully charged
before using it and then it stops working while
you are moving and positioning an individual
from the toilet to their wheelchair then you
will be held accountable for your actions. Your
actions may have led to the individual’s dignity
being compromised and them being caused
unnecessary distress. This could therefore
result in you being reprimanded and even being
dismissed from your job.
Reflect on it
1.1, 1.2 An individual you assist
Reflect on an individual you assist
with moving and positioning and the
responsibilities you have as an employee.
How do these compare with the listed
responsibilities above?
1.2 Your responsibilities and
accountability in relation to moving
and positioning individuals
Write a summary discussing the
responsibilities and accountability you
have in relation to moving and positioning
individuals. You could also discuss this with
your assessor.

7
AC 1.3 Describe health and safety
factors in relation to moving and
Maintaining your health and safety and those of
the individuals and others you work with is, as you
will have learned, very important when moving
and positioning individuals and part of your duty
of care. The health and safety factors to consider
when moving and positioning individuals involve
asking yourself some questions. A suggested
checklist that includes some of the key questions
is included in Figure 1.1.
Moving and positioning – health and safety factors checklist
1. The moving and positioning activity
• What activity are you supporting the individual with; i.e. to transfer from a sitting to a standing
position, to move up the bed to transfer out of the bath onto their wheelchair?
• What is the purpose of the activity; i.e. to make the individual feel comfortable, to sit, to stand?
• Does the activity involve you bending and twisting? If so, how are you going to ensure that you
do not injure your back during the activity?
• Will you require any equipment such as a hoist to carry out the activity? If so, what checks are
you going to complete to ensure the hoist is clean and safe to use?
2. The individual being moved and positioned
• What is the individual’s weight and height?
• Can the individual weight bear?
• How much support will the individual require?
• How will you ensure that you meet the individual’s needs and not place them at risk of getting injured?
• How can you promote the individual’s independence during the moving and positioning activity?
• How can you support the individual’s privacy and dignity during the moving and positioning activity?
3. The environment where the activity will take place
• Is the environment where the activity is going to take place suitable?
• Are there any hazards in the environment that you need to be aware of i.e. a lack of space to
move around in, furniture that may restrict or make your movements awkward, a slippery floor
that may lead to you slipping over, a noisy or busy environment such as in a communal lounge
area where it is difficult to hear and maintain the individual’s privacy.
• Is the environment at a suitable temperature and comfortable? Too hot and you and others may
feel unwell and too cold or you and others may find it difficult to concentrate on the moving and
positioning activity.
• Is the environment clean and free from dust and debris? A clean working environment will mean
that your welfare, the individual’s and everyone else’s will be maintained because there will be
less of a risk of infections being passed on. Working in this way will also mean that you will be
promoting the individual’s dignity and respecting their rights to be supported in a comfortable
environment.
4. Your competence and those of others you work with
• Have you been trained to carry out the moving and positioning activity?
• Do you feel confident in your own abilities to carry out the activity safely?
• Are your colleagues who may be assisting you with the moving and positioning activity trained
and competent to do so?
• Are you and your colleagues fit and in good health to carry out the activity?
• Are you and your colleagues wearing suitable clothing to carry out the activity? i.e. flat, enclosed
shoes that provide you with support and stability and therefore minimise the risk of falling or
injuring the back, comfortable clothes i.e. loose clothes may become tangled in equipment and
lead to an accident occurring. Tight clothes may restrict movements.
• Have you and your colleagues planned the activity and discussed what you will need for it to be
carried out safely? I.e. sufficient time to plan the activity and discuss it with the individual, not
recovering from a recent back injury, having the required equipment in place
Figure 1.1 Health and safety factors in moving and positioning: an example checklist

8
6Cs
Competence
Competence when moving and positioning
individuals involves ensuring that you have
attended the training provided to you by
your employer. If the individual you care for
is also your employer then the training may
be provided by the individual and/or the
local authority. To carry out all moving and
positioning activities to a high standard you
must ensure that you comply not only with
the training you have completed but also with
your employer’s agreed ways of working, such
as by ensuring that you involve the individual
you are assisting with moving and positioning
and by checking that all equipment you use is
in good working order, clean and safe to use.
If you do not feel able to assist an individual
to move and reposition due to perhaps feeling
unwell or not feeling confident to do so then
you must not continue with the activity. You
must inform your manager or employer and
explain what support you require to do so
effectively.
Reflect on it
1.3 Your abilities
Reflect on a situation when you did not feel
confident in your abilities to deal with it. For
example, this may have been in relation to
working in a different way or using a new piece
of equipment. How did you feel? Why? What
did you do in this situation? Why?
Case study
1.2 , 1.3 Your responsibilities and
health and safety responsibilities
Pauline is an older lady who has recently
gained a lot of weight due to mobilising less
as a result of fracturing her hip. You and your
colleague are domiciliary carers and visit
her at home every morning to assist her to
get washed and dressed. As Pauline finds it
difficult to mobilise independently she uses a
hoist when transferring in and out of the bath.
This morning, your colleague Milla arrives at
Pauline’s house late and is not pleased with
you because you have waited for her to begin
assisting Pauline. You explain to Milla that
you waited for her because two people are
required to hoist Pauline out of the bath. Milla
insists that on occasions like today when she
is running late that this is not necessary and
tells you to go ahead and hoist Pauline on your
own just for today. Pauline agrees with Milla
and tells you that she doesn’t mind if you hoist
her on her own just today.
Discuss
1 What are your responsibilities when moving
and positioning Pauline?
2 What should you do in this situation? Why?
3 Was the suggestion that Milla made
appropriate? Why?
1.3 Health and safety factors
relating to moving and positioning of
individuals
Provide a written account describing the
health and safety factors in relation to moving
and positioning of individuals.
You might like to think about the different health
and safety factors that you consider every time
you assist individuals to move and position.

9
LO1 Knowledge, skills, behaviours
Knowledge: what are the current legislation, national guidelines, policies, procedures and protocols relevant
for moving and positioning individuals?
Do you know what the Manual Handling Operations Regulations 1992 (amended 2002) say about moving and
positioning individuals?
Do you know of any national guidelines that are relevant for moving and positioning individuals?
Do you know what your employer’s policies and procedures say about your responsibilities when moving and
Do you know the good practice protocols to follow for maintaining individuals’ and your health and safety when
carrying out moving and positioning activities?
Did you know that you have just shown your knowledge of relevant legislation, guidelines, agreed ways of
working and good practice for moving and positioning individuals?
Skills: how can you show that you work in ways that comply with legislation, guidelines, agreed ways of
working and good practice?
Do you know how to minimise the risk of injuring your back when moving and positioning individuals?
Do you know what to do if you do not feel competent to use a hoist?
Do you understand your employer’s safe moving and handling procedures?
Did you know that you have just answered three questions about your skills when moving and positioning
individuals?
Behaviours: how can you show the personal qualities you have for supporting individuals with moving and
positioning?
Do you know how to enable an individual to be involved when moving and positioning them?
Do you know how to work safely with your colleagues when moving and positioning individuals?
Do you know how to respect an individual’s privacy and dignity during moving and positioning activities?
Did you know that you have just answered three questions about some of the essential behaviours that are
expected for supporting individuals with moving and positioning?
LO2 Understand anatomy and physiology in relation to
moving and positioning individuals
Getting started
Write down some brief notes about what you
understand from what is meant by ‘anatomy’
and ‘physiology’.
AC 2.1 Outline the anatomy and
physiology of the human body in
relation to moving and positioning
individuals
It is important that as an adult care worker
you are also aware of the related anatomy and
physiology of the human body so that you can
play an active role in reducing potential injuries
that may occur to, for example, your back and
joints when moving and positioning individuals.
Key terms
Anatomy refers to the physical structure of
the body that helps the body to move, i.e. the
bones, joints, muscles.
Physiology refers to the functions of the body.
Musculoskeletal system refers to the body’s
skeleton, bones, joints, ligaments, muscles.
The body’s skeleton
Two of the main functions of the skeleton are to
provide support to the body and enable balance
and movement. For example, without a spinal
column we would not be able to bend down or
stand up when moving and positioning individuals.
The spinal column consists of individual

10
bones called vertebrae stacked up one on top of the
other that give the spine a natural ‘S’ shaped curve.
Between the vertebrae there is cartilage, which
absorbs shock and allows the spine to move.
As shown in Figure 1.2, the vertebrae of the spine
are divided into the following regions: cervical,
thoracic, lumbar, sacrum and coccyx. The
vertebrae in the sacrum and coccyx are fixed and
do not allow movement, whereas the vertebrae in
the other regions do allow movement.
7 cervical vertebrae
12 thoracic vertebrae
5 lumbar vertebrae
Sacrum
Atlas
Axis
Coccyx
Figure 1.2 The spinal column
Bones
The body’s skeleton is made up of bones. There
are four types of bones in the human body:
1 Long bones are made up of compact bone
which means they are dense and sturdy and
therefore can bear the greatest load, e.g. the
bones in our forearms, thighs, feet.
2 Short bones are made up of spongy bone which
means that they are not dense and are much
thinner and therefore less sturdy than long
bones, e.g. the bones in our wrists, ankles.
3 Flat bones are made up of large, flat surfaces
that are designed to protect the body’s organs
and enable muscles to attach themselves, e.g.
the bones in our ribs, shoulders.
4 Irregular bones are made up of bones that
aren’t long, short or flat, e.g. the vertebrae in
the spinal column, the bones in our skull.
When bones break or become fractured it is very
painful. It is important to carry out all moving and
positioning activities carefully and in line with
your employer’s agreed ways of working because
if an individual isn’t moved correctly and therefore
safely then this may result in fractures occurring.
There are different types of fractures that may occur:
● Simple or closed fracture: when there is a clean
break in the bones and the bones remain under
the skin, e.g. by an individual being gripped too
tightly when being supported to reposition.
● Compound or open fracture: when there is a
break in the bones and they protrude the skin’s
exterior, e.g. by an individual falling when being
supported to move from one position to another.
● Comminuted or severe fractures: when bones
are broken into several pieces, e.g. by the hoist
falling onto an individual.
● Greenstick fractures: when bones are broken
along one side only and there is a partial break,
e.g. by the individual being knocked against
their wheelchair when being lowered into it.
● Avulsion fractures: when bones are broken
by a piece being torn off from the main bone,
e.g. by an individual being pulled when being
supported to stand from a sitting position.
Joints
The bones in the body are linked together by joints
and there are three types:
1 The synovial joints are those that allow the
body to have different types of flexible and
free movement and there are six types: the
hip and shoulder joints (referred to as the ball
and socket joints) allow movement backwards,
forwards and in rotation; the knee and elbow
joints allow movement in one direction only
and there is no rotation (referred to as hinge
joints); the wrist and ankle joints allow the
bones to slide over each other (referred to as
Reflect on it
2.1 Your own experience
Reflect on an occasion when you or someone
you know fractured a bone. How did this
happen? How could this have been avoided?

11
the sliding/gliding joints); the joint in the neck
allows the head to turn from side to side and in
rotation (referred to as the pivot joint); the joint
in the thumb allows movement downwards and
in rotation (referred to as the saddle joint); and
some joints in the wrist allow movement along
two axes (referred to as condyloid joints).
2 The cartilaginous joints are those where the
bones are joined together by cartilage and
allow the body to have some slight movement.
For example, the bones between the ribs and
the bones that make up the spinal column.
3 Fixed joints are those that do not allow any
movement to take place between some bones
in the body. For example, the bones that are in
the skull.
Ball and socket joint Hinge joint
Condyloid joint Pivot joint
Saddle joint Gliding joint
Figure 1.3 Types of synovial joint

12
Joints and bones are held together by ligaments
and forcing a joint beyond its natural range of
movement such as by twisting, dragging or
stretching can result in sprains occurring. It is
important therefore to avoid moving yourself and
individuals in this way when carrying out moving
and positioning activities.
Muscles
The bones and joints in the human body need
muscles to help them move. Muscles are
attached to bones by tendons and work by
contracting or becoming shorter, i.e. when a
muscle contracts it pulls on the bone which if
attached to a joint, causes the joint and therefore
the body to move. There are three different types
of muscles:
1 Skeletal: this muscle type moves the bones in
the body by contracting and relaxing.
2 Cardiac: this muscle type enables the heart
to pump blood around the body by contracting
and relaxing.
3 Smooth: this muscle type enables organs in
the body such as the stomach and the bladder
to carry out their functions by expanding and
relaxing.
If a muscle or tendon is forced to contract too
strongly then it may overstretch and become torn
such as by pulling or by making sudden movements
during a moving and positioning activity.
Key terms
Cartilage is tissue found in joints between
bones and acts as a cushion such as in elbows
and knees.
Muscles are attached to bones.
Ligaments connect bones to support a joint.
Tendons connect muscles and bones.
Research it
2.1 Types of muscles
Research one type of muscle that is found in
the body. Draw a diagram that shows how this
type of muscle works in one area of the body.
For example, you may choose to focus on the
muscles in your arm or in your leg.
You will find the following website a useful
source of information: www.innerbody.com/
image/musfov.html
2.1 Anatomy and physiology of the
human body in relation to moving and
Provide a written account outlining the
anatomy and physiology of the human body in
relation to moving and positioning individuals.
You might like to think about the role of
muscles, bones and joints when moving and
positioning individuals from a sitting to a
standing position.
AC 2.2 Describe the impact
of specific conditions on the
movement and positioning of an
individual
As you have learned, moving and positioning
individuals requires you to be knowledgeable
about the human body so as to ensure that all
moves are carried out safely and without the risk
of injury to yourself, individuals and/or others. It is
also important to take into account any conditions
individuals have as these may also affect how you
move and position them. Table 1.2 includes some
examples of specific conditions, but remember
each person is an individual and therefore how
their condition affects them when moving and
positioning will be unique to that person. This is
why it is important to always carry out preparatory
checks including reading an individual’s care plan
and moving and handling risk assessment. You will
learn more about how to do so effectively in AC 3.1.

13
Table 1.2 The impact of specific conditions when moving and positioning
➜
Specific condition Impact on the movement and positioning of an individual
Arthritis: causes pain and
inflammation in a joint.
There are two types:
• Osteoarthritis – the most
common type of arthritis
in the UK. It is a condition
that causes joints to
become painful and stiff.
• Rheumatoid arthritis – a
condition that causes
pain, swelling and
stiffness in the joints.
The symptoms usually
affect the hands, feet
and wrists.
• Pain may be caused when joints are moved therefore all moves must be carried
out carefully. It is important not to make any sudden or jerky movements or
to hold onto the affected area too tightly when moving and positioning them.
Sometimes, sheepskin protectors can be placed over the joint that’s painful, i.e.
the individual’s ankle or wrist, which acts as a cushion and protects it from being
harmed.
• Swelling and inflammation can result when joints are moved so moving and
handling equipment such as hoists can reduce the strain that is placed on the
joints during moving and positioning activities.
• The individual may experience stiffness in the joints and therefore it is important
when moving and positioning the individual that their joints are not moved
beyond the range where it is comfortable for the individual to ensure that pain
and distress are minimised.
Amputation: the loss of
a limb or part of a limb
through for example an
accident or infection
• Some individuals who have had a limb or part of a limb amputated may use a
prosthesis (i.e. an artificial limb). It is important to be aware of this so that you
know how to support an individual with a prosthesis, i.e. will this be fitted before
or after the move, will you be required to support the individual to do so?
• An individual’s muscle strength may be stronger on one side of their body than
the other where the amputation has occurred. It is important to be aware of this
because this may affect the individual’s balance when moving and positioning.
• An individual’s range of movement of their joints may be different; it may be more
restricted where the individual has had an amputation. Again, you will need to
take this into account when supporting the individual so that you provide them
with sufficient support to carry out the move safely and comfortably.
Cerebral palsy: a general
term used to cover several
neurological conditions
• An individual’s balance and coordination may be affected and these may become
worse when the individual is trying to carry out specific activities such as moving
and positioning. It is important to be aware of this and to allow sufficient time for
the individual to move and position at their own pace.
• An individual’s muscles may be affected such as by causing movements to be
slow, or involuntary spasms. Taking this into account will be important when
moving and positioning individuals in terms of knowing the type of support the
individual will require.
• An individual may find it difficult to move in terms of stiffness which may result in
their joints being rigid or their limbs not extending fully. Taking this into account
when moving and positioning the individual will minimise their pain and distress.
Dementia: a general term
used to cover conditions
that affect the memory and
the ability to carry out day-
to-day activities
• An individual with dementia may find that this condition leads to them having
difficulties with mobilising. This may make the individual more prone to falling or
losing their balance. It is important that you take this into account when providing
support to the individual.
• An individual with dementia may find that they experience memory loss.
Therefore, they may forget where they are moving or positioning to; you may find
that you will need to repeat this to them or show them where they are going so
that they cooperate with the move.
• An individual with dementia may find it difficult to understand what you are
communicating. It is important that when explaining the move or positioning to
them you do so using short and clear phrases and language they understand.

14
➜
Table 1.2 The impact of specific conditions when moving and positioning continued
Hearing loss: a partial or
total inability to hear
• An individual with hearing loss may wear a hearing aid. It is important
that you ensure that the individual is wearing their aid when moving and
positioning them and that it is working otherwise they may not be able to
communicate with you effectively.
• An individual with hearing loss may require you to stand in front of them when
explaining to them how you are going to support them to move or position.
• An individual with hearing loss may find it easier to interact with you in an
environment that is not busy or noisy. When moving and positioning them you
may find that there is too much background noise and you can minimise this
by for example turning the radio off or closing the open window.
Huntington’s disease: a
condition that causes the
death of brain cells and
prevents different parts
of the brain from working
properly
• An individual’s movement may be affected by this condition, which causes them
to have difficulties controlling their movements. An individual may find it difficult
to do what they want their body to do such as sit down or stand up.
• An individual’s behaviour may be affected by this condition. The individual may
become irritated and frustrated. It is important to allow the individual time when
moving and positioning and be patient as they may have to try several times to
move or reposition themselves.
• An individual’s memory may be affected. If an individual does experience memory
loss then you will need to check their understanding of how you are going to
support them.
Misuse of substances such
as alcohol, drugs
• An individual who has misused a substance may not be able to fully understand
you when you communicate with them. It is important you check their
understanding before supporting them so that you can ensure this is done safely
and that they are cooperating with the move.
• An individual who has misused a substance may become angry or aggressive.
It is important that you avoid placing yourself or others in an abusive situation.
Should this behaviour occur then you will not be able to continue with the moving
and positioning activity.
• An individual who has misused a substance may find it difficult to coordinate their
movements and may have difficulties maintaining their balance. Ensuring the
individual is supported will minimise the risk of them falling or injuring themselves
or others.
Multiple sclerosis: a
condition that affects your
brain and spinal cord
• An individual who has MS may experience muscle spasms, stiffness and
weakness. It is important you are aware of these to minimise any risks of falls
when an individual is moving and positioning.
• An individual who has MS may experience difficulty with balance and
coordination. It is important that you take your time when supporting an
individual when moving and positioning and that you are aware of these
symptoms that may make moves difficult.
• An individual with MS may experience pain when mobilising so it is important
to ensure that an individual is comfortable when moving and that you take into
account that it may be very painful for them to do so.

15
Muscular dystrophy: a
condition that leads to the
loss of muscle mass and
therefore weakness
• An individual with MD may have difficulty with their mobility such as walking and
standing or lose their ability to walk and stand and may use a mobility aid such
as a wheelchair. The equipment that the individual will require must therefore
be taken into account prior to supporting them to move and position, e.g. hoist,
sling, transfer board.
• An individual with MD may experience weakness in their leg muscles or their
muscles in their upper back making it more difficult for them to mobilise
independently and without support.
• An individual with MD may also experience pain when carrying out some
movements such as lowering themselves into a chair or lifting themselves out of
the bath. It is important to be aware of these symptoms so that you can minimise
the pain the individual experiences.
Parkinson’s disease: a
long-term degenerative
disorder of the central
nervous system
• An individual with Parkinson’s disease may experience tremors that can make
moving and positioning activities difficult due to the individual perhaps losing
their balance and falling.
• An individual with Parkinson’s disease may experience rigidity that may make
their movements very slow. Encouragement to continue and patience are
important when providing support to the individual as the individual may also be
feeling frustrated.
• An individual with Parkinson’s disease may experience fatigue and dizziness.
Both may lead to the individual having poor concentration and may lead to falls
while moving and positioning.
Stroke: a serious medical
condition that occurs when
the blood supply to part of
the brain is cut off
• An individual who has had a stroke may experience weakness in their muscles.
This may for example make one side of their body, arm or leg very weak. It is
important to take this into account when supporting an individual to move safely
from one position to another.
• An individual who has had a stroke may experience difficulties with their balance;
they may also feel dizzy. It is important therefore when supporting an individual
such as from a sitting to a standing position that the individual is not rushed and
is supported so that they do not get dizzy or feel unsteady.
• An individual who has had a stroke may experience tiredness and may get tired
quickly particularly if they are moving around for a long time. It is important to
check with the individual how they are feeling and if necessary to stop for a while
before continuing with the move.
Sight loss: a partial or total
inability to see
• An individual with sight loss may not feel confident when moving around. You will
need to ensure that you provide them with encouragement and support when
mobilising.
• An individual with sight loss may find moving from one position to another
confusing and unsettling. You can help them by orientating them with their
surroundings to ensure they know where the location of items are, i.e. their bed,
their chair, their door etc.
• An individual with sight loss may rely on interacting with you verbally; remember
they will not be able to pick up your non-verbal communication cues such
as your facial expressions and body language. You can help to enhance your
communication with them by explaining clearly how you are supporting them and
why, where they are moving from and to.
Table 1.2 The impact of specific conditions when moving and positioning continued

16
Knowledge: what do you know about anatomy and physiology in relation to moving and positioning
individuals?
Do you know what the functions are of the body’s skeleton?
Do you know how you can prevent bone fractures when moving and positioning individuals?
Do you know how an individual who has had a stroke can be supported to move and position safely?
Did you know that you have just shown your knowledge of why having an understanding of anatomy and
physiology is essential for safe moving and positioning?
Skills: how can you show that you can move and position individuals safely in line with their specific
conditions?
Do you know how to prevent injury to an individual with MS who has muscle spasms and stiffness when moving
and positioning them?
Do you know how to prevent injury to the joints of an individual who has arthritis when they move and position?
Do you know how to communicate with an individual with sight loss when moving and positioning them?
Did you know that you have just demonstrated some of the skills required to support individuals with specific
conditions when moving and positioning?
Behaviours: how can you show the personal qualities you have when moving and positioning individuals?
Do you know how to maintain a good level of understanding of anatomy and physiology when moving and
Do you know how to be patient when supporting individuals with specific conditions to move and position?
Do you know how to show your empathy towards an individual who may be in pain when moving and positioning?
Did you know that you have just demonstrated some of the essential behaviours required to support individuals
when moving and positioning in line with anatomy and physiology?
Research it
2.2 Rheumatoid arthritis
Research the complications that may arise
with rheumatoid arthritis. You will find
the following website useful: www.
nhs.uk/conditions/Rheumatoid-
arthritis/#complications-of-rheumatoid-
arthritis
Produce an information leaflet that describes
how this condition can impact on moving and
positioning an individual.
2.2 Impact of specific conditions on
the movement and positioning of an
individual
impact of specific conditions on the movement
and positioning of an individual.
Reflect on it
2.2 Individuals with specific
conditions
Reflect on two individuals who you work with
and who have different and specific conditions.
How do their conditions impact on how they
move and position themselves? Discuss with
a colleague the support they require when
moving and positioning and the reasons why.

17
LO3 Be able to minimise risk before moving and positioning
individuals
When I am using my walking rollator ensure that there are no trip hazards in my flat.
When I am using my wheelchair ensure that I am supported by two carers at all times
when moving and positioning. As I am likely to be in a lot of pain I will need more
time to move and position.
Care plan – my mobility requirements
Name:
Date of plan:
Specific requirements:
Moving and handling support:
Amy X
20/06/2018
I have cerebral palsy. I have good days and bad days. On good days I like to be
independent and use my walking rollator. On bad days I can have involuntary muscle
spasms and feel very stiff which means that it is painful when I move around and I
use my wheelchair.
Figure 1.4 Amy’s care plan
AC 3.1 Carry out preparatory
checks using a) the individual’s
care plan and b) the moving and
handling risk assessment
Before moving and positioning an individual it
is important that you are able to find and read
through their care plan as well as their moving
and handling risk assessment because these
documents will provide you with all the necessary
information you require to carry out the move
safely and in line with your employer’s agreed
ways of working. You will be observed carrying out
these preparatory checks for this AC.
The individual’s care plan will provide specific
information that is unique to the individual such
as in relation to their strengths, weaknesses, the
specific conditions they have and how they must
be taken into account, the support they require
such as for sitting or standing, any equipment
they use to move and position such as a hoist or
a walking frame. Figure 1.4 shows an example of
the type of information an individual’s care plan
may contain in relation to their mobility.
An individual’s care plan will be reviewed
regularly; at least every month or more often
if a change to an individual’s needs or support
is required. Not knowing about these changes
may result in you injuring the individual or
not following your employer’s agreed ways of
working. This is why it is important to check an
individual’s care plan every time you support them
with moving and positioning because an important
change may have occurred that you need to be
aware of. For example, perhaps the individual has
had a fall and has injured their arm or perhaps
they are using a new or different piece of moving
or handling equipment. Never assume that an
individual’s moving and positioning requirements
will always stay the same because they may not!
Reflect on it
3.1a Individual’s care plan
Reflect on an individual’s care plan that you
have referred to when supporting them to
move and position. What information does it
contain in relation to moving and positioning
the individual? When do you check it? Why?

18
The individual’s moving and handling risk
assessment must be checked together with the
individual’s care plan because it will provide
important information on how to move and
position the individual safely. Doing so beforehand
will ensure both the individual, you and any others
involved stay safe because moving and handling
risk assessments help to identify any hazards that
have the potential to cause injury or harm and the
actions that can be taken to prevent them from
doing so. It is important therefore to also read
through an individual’s moving and handling risk
assessment carefully so that you fully understand
what is required of you. If you do not understand
something or do not feel confident about
supporting the individual to move and position
then you must ask someone who does; this may
be your manager or if you work on your own your
employer or their representative. Figure 1.5 shows
an example of an individual’s moving and handling
risk assessment.
My moving and handling risk assessment
Name:
Date of assessment:
Review date:
Body build:
Body strength:
Communication:
Risk of falls:
My information
Moving and handling tasks
Tasks and methods to use: • To get in/out of bed – two carers needed
• To get in/out of wheelchair – two carers needed
• To get in/out of bath – two carers needed
• To sit/stand – two carers needed
What I can do for myself: • Position myself in bed
• Swing my wheelchair’s footplates round when I get in my wheelchair
• Operate the hoist to get in/out of the bath
• Position myself when sitting/standing
Support required: • Position my rollator/wheelchair close by
• Check for trip hazards when moving
• Place the sling around me when using the hoist
• Encourage me to move/position safely
Risk factors: • Trips/falls
• Small space to move in bathroom
• Pain and stiffness when moving
Signatures
Amy X
20/06/2018
20/07/2018
Average
I have spasms that cause stiffness and pain
I prefer to communicate verbally
Yes
Amy Jux
Carer’s name and signature: Liza McDonald
Individual’s name and signature:
Figure 1.5 Amy’s moving and handling risk assessment

19
Research it
3.1b Moving and handling risk
assessments
Carry out some research in the setting where
you work. Find two individuals’ moving and
handling risk assessments. How do they
compare? Is the information they contain the
same or different? Why? How do you use this
information when supporting these individuals
to move and position? Discuss your findings
with a colleague.
3.1a, 3.1b Carry out preparatory
checks using the individual’s care
plan and the moving and handling risk
assessment
You will need to arrange to be observed
carrying out preparatory checks using the
individual’s care plan and the moving and
handling risk assessment.
You could, for example, identify a moving and
positioning task that an individual requires
your support with. Before carrying this out
check the individual’s care plan and moving
and handling risk assessment. Ask someone
who knows you such as your assessor or
employer to observe you doing this.
AC 3.2 Identify any immediate risks
to the individual
Carrying out preparatory checks using the
individual’s care plan and moving and handling
risk assessment is one way of identifying any
risks to the individual, but remember there may
be other risks to the individual that may arise
and that have not been recorded because they
are unplanned such as for example the individual
or you not feeling unwell. Below is a useful
checklist for other factors that you can consider
before moving and positioning individuals that will
help with minimising any immediate risks to the
individual that may arise. For this AC you will be
observed identifying any immediate risks to the
individual before moving and positioning them.
Checklist for minimising immediate
risks when moving and positioning
individuals
The individual
● Has there been any changes to the individual’s
physical or emotional health that may affect
you moving and positioning them?
● Ask the individual to communicate the support
they require. If the individual’s understanding
has changed, report the changes before
moving and positioning them.
● Do you have any other concerns about the
individual’s well-being? If so, report your
concerns before moving and positioning them.
The task
● Have you been asked to carry out a task that
you do not feel competent to do? If so, don’t
carry out the task and report your concerns to
your manager or employer.
● Have you been asked to use a piece of
equipment you have not been trained to use?
If so, don’t carry out the task and report your
concerns to your manager or employer.
● Have you been asked to carry out a task that
does not follow the individual’s care plan? If
so, don’t carry out the task and report your
The environment
● Have you checked the space where you are going
to carry out the task? Is it too small for you move
around in it comfortably or too dark for you to
see? Or too noisy for you to communicate in?
If so, don’t carry out the task and report your
● Have you checked the environment for any
hazards? Have you removed these hazards so
they no longer pose a risk?
● Have you checked the environment for privacy?
Are you able to carry out the task in private?
You and others
● Have you checked who you will be working with
to support the individual? Do you know each
other’s responsibilities during the task?

20
● Do you and others you work with know how to
carry out the task safely?
● Do you know of any factors that may prevent
you or others from carrying out the task safely
such as stress, fatigue or not having sufficient
time? If so, report your concerns to your
manager or employer.
AC 3.3 Describe the action to take
in relation to identified risks
Once the risks to the individual have been
identified, measures need to be put in place
to reduce the harm that they could potentially
cause to the individual, you and others. For
example, it may be identified that for an
individual who is obese, care workers may be
at risk of injuring their backs or the individual
when supporting the individual to sit/stand.
These risks could be minimised by ensuring that
support is provided by three care workers, by
using a hoist and by encouraging the individual
to do as much for themselves as possible.
Reflect on it
3.2 Risks to individuals
Reflect on an occasion when a risk to an
individual was not identified prior to moving
and positioning them. What happened? How
did this impact on all those involved? What
could have been done differently?
3.2 Identify any immediate risks to
the individual
You must arrange to be observed during this
activity, identifying any immediate risks to the
individual.
You could identify an individual you support
to move and position in the setting where you
work. Discuss with the individual and your
assessor any immediate risks. You could ask
the individual’s representative or a colleague
to observe your discussion and provide you
with feedback. What did you learn? How could
you improve next time?
On other occasions it may not be possible to
minimise the risks to this extent. For example,
if you are supporting an individual who lives in
their own home and their bathroom is very small
there is nothing you can do to change the space
you are working in which may mean that it may
be difficult and awkward to move safely, i.e. you
may have to twist and bend your back awkwardly.
However, you could think about whether there
is any equipment that the individual can use
that may be more appropriate than you trying
to support them to move and position such as a
ceiling hoist. In this situation always follow your
employer’s agreed ways of working and do not
carry out a task that you do not feel competent
or trained to do; failure to do so may result in you
injuring yourself or harming the individual.
Similarly, you may have carried out all your
preparatory checks prior to moving an individual
and suddenly during the task the individual
collapses unexpectedly. In these circumstances,
you must call for help immediately and you must
not continue with the activity. You must also
record what happened afterwards, including the
actions you took; your employer will ask you to fill
out an incident form. It is important to complete
the incident form fully because it is a permanent
record of how you have supported the individual
with the task and will confirm that you have acted
in a safe and competent manner.
Reflect on it
3.3 Actions to take
Reflect on the small bathroom example above.
How else could you minimise the risk of you
twisting and bending when working in a small
space? What other actions could you take?
3.3 Actions to take in relation to
identified risks
Describe to your employer the actions to take
in relation to two identified risks when moving
and positioning individuals you support. Or you
could provide a written account describing this.

21
AC 3.4 Describe the action to take if
the individual’s wishes conflict with
their care plan
As you will have learned, checking and
following an individual’s care plan and moving
and handling risk assessment is essential for
ensuring the individual’s safety and for ensuring
that you are complying with your employer’s
agreed ways of working. But what happens if
it states in an individual’s care plan that the
individual must be hoisted when moving from
their bed to their chair and the individual refuses
to be hoisted and asks instead to be moved by
two staff? How would you deal with this conflict
that exists between what an individual’s care
plan states and the individual’s choice to not use
the hoist when being moved?
Let’s first think about the consequences of not
following an individual’s care plan. These could
include:
● putting yourself, the individual and others
involved in the move at risk in terms of your
safety, i.e. the individual may fall, you or your
colleague may injure your back
● not complying with your employer’s agreed
ways of working or moving and handling
policies and procedures, which may lead to
you being dismissed from your job.
Let’s now think about the consequences of not
respecting an individual’s wishes. These could
include:
● the individual not being treated as a unique
person
● the individual feeling that you are being
disrespectful because you are ignoring their
wishes
● the working relationship you have with
the individual being devalued because the
individual may feel you are undermining
them because you are not respecting their
wishes and human right to make their own
choices.
Reflect on it
3.4 Respecting an individual’s
wishes and choices
Reflect on how you respect an individual’s
wishes and choices when moving and
positioning them. What support do
you provide? Why? What would be the
consequences of not doing so? Why?
So, what action can you take if the individual’s
wishes conflict with their care plan? In the
first instance you should read through your
employer’s agreed ways of working, which will
guide you with taking the correct action in this
situation. You could also consider taking the
following action that may help you to manage
these types of conflicts that may arise effectively:
● Discuss the conflict with the individual, i.e. find
out what they disagree with in their care plan
and why. Perhaps an individual tells you that
they are scared when they are being hoisted.
If you know this, then you can provide them
with additional reassurance about their safety.
You could also perhaps spend time with them
practising using the hoist by involving them
as much as possible. In this way you will be
encouraging the individual to overcome their
fear of using the hoist.
● Discuss your responsibilities with the
individual, i.e. explain what your employer’s
agreed ways of working state and why it is
important for you to follow these. Perhaps
an individual who refuses to be supported by
carers when moving and positioning does not
understand the safety aspects involved when
being moved and positioned and your duty of
care to protect them from being harmed. If you
ensure the individual understands this, the
individual may become more cooperative and
decide that they do want to be supported.
● Discuss the consequences of an individual’s
wishes, i.e. explain the consequences to the
individual if their wishes conflict with their care
plan so that they can understand these and
make their own informed decisions.

22
● Record all discussions and actions you have
taken, i.e. record all relevant information
in the individual’s care plan to include for
example what you have discussed and
explained to the individual, the decisions the
individual made and the actions you have
taken as a result. The information you record
must be written clearly so that it can be
understood by others such as your colleagues
who may need to access it.
● Report the conflict, i.e. this may be to your
manager or the individual’s representative
if the individual is your employer. You must
include all relevant information. You could
also seek further advice and guidance
from your manager or the individual’s
representative if you are unable to resolve the
conflict or you think that your safety or that of
the individual or others you work with may be
compromised.
Remember, how you approach and manage the
conflict is also very important. Being sensitive,
empathetic and making time to listen and
understand the individual’s situation will show
that you genuinely care and therefore will more
than likely lead to a positive outcome.
6Cs
Care
Care when moving and positioning individuals
involves paying careful attention to how you
do this so that you can be sure that you are
making a positive difference to individuals’
lives. For example, this involves taking
into account the individual’s wishes and
considering how you can communicate with an
individual when their wishes conflict with their
care plan to ensure that you are respectful and
value them as a unique person. By involving an
individual as much as possible when moving
and positioning the individual not only will the
individual feel dignified and that they are in
control of their support but the individual will
also be able to develop their independence and
potential by for example learning new skills
and increasing their confidence.
Research it
3.4 Agreed ways of working and
individual wishes
Research your employer’s agreed ways
of working for moving and positioning
individuals. What do they say about the actions
to take if an individual’s wishes conflicts with
their care plan?
3.4 Describe the action to take if the
individual’s wishes conflict with their
care plan
actions to take if an individual’s wishes conflict
with their care plan. You could draw a flow
chart ensuring you describe the action to
take where you work if an individual’s wishes
conflict with their care plan.
AC 3.5 Prepare the environment
ensuring a) adequate space for the
move and b) potential hazards are
removed
You will be observed for this AC preparing the
environment by ensuring that there is adequate
space for the move you plan to carry out and that
any potential hazards are removed.
Adequate space
Being able to minimise the risk of injuries and
accidents involves having adequate space to carry
out the move. You will only know if the space is
adequate if you visually check this before you
support the individual to move and position.
For example, you could check the space that is
available:
● around the individual, i.e. if the individual uses
a wheelchair is there sufficient space to move
the wheelchair safely? If the individual wishes
to move from their chair to their bed, does the
individual have sufficient space to do so?

23
● for you, i.e. is there sufficient space for you
to stand by the individual and support them
to move without feeling cramped? Is there
sufficient space for you to bend and turn to
carry out the move safely?
● for your colleagues, i.e. is there sufficient
space for you and your colleague to carry out
the move safely? Is there sufficient space for
you and your colleagues to work together
comfortably?
● for the equipment used, i.e. if an individual
uses a walking frame, is there sufficient
space to place the walking frame in front of
the individual? If the individual uses a hoist,
is there sufficient space to operate the hoist
safely?
Preparing the environment ensuring that there is
adequate space for the move will mean that the
individual, you and your colleagues will be able to
move safely and comfortably.
Removal of potential hazards
Removing potential hazards before carrying out
a move is essential for minimising the risks of
the individual, you or others slipping or falling
over. Potential hazards can increase the risks of
accidents occurring and therefore must be removed
when identified. Figure 1.6 includes examples of
potential hazards you may come across.
Reflect on it
3.5a Adequate space for the move
Reflect on an occasion when you or someone
you know were in a very small space and
felt uncomfortable? How did not having
sufficient space affect how you were feeling?
Could you have changed the amount of space
available? If so, how? If not, why? Provide a
reflective account.
Potential
hazards
Slippery floors
that may
cause slips
Big furniture
that may prevent
free movement
Clutter that
may lead to
cramped spaces
Debris on the
floor that may
lead to the spread
of infections
Steps that
may cause trips
Poor lighting
and dark
areas that may
cause trips
and slips
Figure 1.6 Potential hazards in the environment
Remember that if, once you have completed your
visual checks, you decide that more space can
be created by moving furniture and/or that the
removal of furniture is required to carry out the
move safely, then ensure you have the individual’s
permission to do so. This includes agreeing
where to place them during the move as well as
always returning all furniture moved to its original
location. This will show the individual that you
respect them and their environment; after all it is
their home not yours!
Research it
3.5b Potential hazards
Research a moving and handling risk
assessment that has been completed with
an individual. Identify the potential hazards
that must be removed prior to the move. How
can you do this effectively whilst remaining
respectful to the individual and their
environment?

24
3.5 Preparing the environment
You will need to arrange for someone to observe
you preparing the environment ensuring that
there is adequate space for the move and that
potential hazards are removed.
You could, for example: for an individual that
you support with moving and positioning
prepare the environment ensuring that there
is adequate space and that potential hazards
are removed. Discuss the process you went
through with your assessor.
AC 3.6 Apply standard precautions
for infection control
Standard precautions refer to the ways of working
that adult care workers must follow when carrying
out a work task where there is a risk of infection.
You will be observed for this AC applying standard
precautions for infection control; additional
information about reducing the spread of infection
can be obtained from the mandatory unit, 210
Health, safety and well-being in care settings.
Moving and positioning individuals is a task that
carries a high risk of infection because it involves:
● you and others being in close bodily contact
with individuals; the risk for the spread
of infection is therefore high if you or the
individual is unwell or if you do not maintain a
good level of personal hygiene
● you being in direct contact with individuals’
bodily fluids, i.e. when supporting an individual
to move and position in and out of the bath
you may come into contact with their urine or
saliva, which can carry infection
● you being in direct contact with equipment
used during moving and positioning, i.e. when
supporting individuals to move and position
you may use a hoist, a sling, a walking frame
or a wheelchair that can carry infection if not
cleaned thoroughly before use.
Why standard precautions are
important
● Standard precautions create a protective
barrier between you and others to prevent the
spread of infections.
● They raise awareness of how to control the
spread of infection.
● They enable adult care workers to comply with
the law and their employer’s agreed ways of
working for infection control.
Applying standard precautions
Before moving and positioning individuals you
can apply standard precautions for infection
control by:
● Effective hand washing: it is important to wash
your hands thoroughly every time before you
move and position an individual and after you
come into contact with bodily fluids so that you
do not spread infection.
● Wearing protective clothing: it is important
to wear the protective clothing that your
employer has provided to you for carrying out
your day-to-day tasks because this acts as
a protective barrier between you and others
for the spread of infection. When moving and
positioning individuals you may be required to
wear a disposable apron over your clothing or
uniform as well as disposable gloves. Wearing
an apron and gloves means that you will be
protecting the individual from infection as
well as yourself: both these items prevent
the spread of infection as they do not allow
harmful bacteria that cause infection to
spread.
● Cleaning equipment: it is important that
all equipment you use when moving and
positioning individuals is clean before it is used
so that harmful bacteria that cause infections
are not spread to you and the individuals you
support. It is important therefore that you
read through the manufacturer’s instructions
and your employer’s agreed ways of working
for how to do this effectively for each piece
of equipment you use when moving and
● Maintaining good personal hygiene: it is important
that you maintain a good level of personal
hygiene. Not only will this be more pleasant for
the individuals you are supporting to move and

25
position, because you are going to be in close
contact with them, but you will also be playing
your part in reducing the spread of infections
where you work. For example, this involves
wearing clean clothes or uniform, ensuring your
hair is kept clean and your nails are kept short.
● Being aware: it is important that you know
about how infections can spread when moving
and positioning individuals, including your
responsibilities and your employer’s. For
example, you are responsible for ensuring that
when moving and positioning individuals you
do so safely and your employer is responsible
for providing you with protective clothing.
Research it
3.6 Hand washing technique
Research the hand washing technique that
you must use where you work before moving
and positioning individuals. Do you always
use this technique? Write down your findings,
especially the key points to remember.
Reflect on it
3.6 Consequences of not applying
standard precautions
Reflect on the consequences of not applying
standard precautions for infection control
when moving and positioning individuals
where you work.
3.6 Apply standard precautions for
infection control
Identify an individual that you are preparing
to support to move or position. Show your
assessor the standard infection control
precautions you apply. Ask your assessor for
feedback. Were these standard precautions
effective? Why?
Knowledge: do you know how to minimise risk before moving and positioning individuals?
Do you know what documents you can refer to before moving and positioning individuals and why these are important?
Do you know how to identify any immediate risks to the individual before the move?
Do you know what to do if an individual’s wishes conflict with their care plan?
Do you know what standard infection control precautions are and why they are important?
Did you know that you have just shown your knowledge of how to reduce the risks before moving and positioning
individuals?
Skills: how can you show the preparatory checks to carry out before moving and positioning individuals?
Do you know how you can prepare a safe environment for individuals before moving and positioning them?
Do you know what to check for when assessing whether there is adequate space to move an individual?
Do you know what action to check if you identify potential hazards in the environment before you move an individual?
Do you know how to apply standard precautions for infection control before moving and positioning an individual?
Did you know that you have just demonstrated some of the skills required to support safe moving and positioning
of individuals?
Behaviours: how can you show the personal qualities you have when you’re minimising the risks to individuals
before moving and positioning them?
Do you know how to empathise and genuinely care about an individual whose wishes conflict with their care plan?
Do you know how to actively listen when seeking advice from your employer or manager?
Do you know how to be thorough when reading your work setting’s infection control procedures when moving
and poisoning individuals?
Did you know that you have just demonstrated some of the essential behaviours required to minimise risk
effectively before moving and positioning individuals?

26
LO4 Be able to move and position an individual
AC 4.1 Confirm the individual’s
identity and obtain valid consent
Being able to move and position individuals
involves treating them in a caring and respectful
way. Before moving and positioning individuals
you must confirm who the individual is and then
obtain their consent to be moved and positioned;
doing so will mean that you are fulfilling your
duty of care to move and position them safely
and respecting their wishes. You will be observed
doing this for this AC.
Confirming the individual’s identity is essential
for ensuring that you will be providing the
individual with the type of support they require.
You can check the individual’s identity by
referencing their care plan and moving and
handling risk assessment. The individual’s care
plan can contain different pieces of information
to help you confirm the individual’s identity such
as the individual’s full name, date of birth, room
number if they live in a residential care setting
and/or a current photograph. You can also
check this information with the individual and/
or their representative if the individual is unable
to because of for example a condition such as
dementia.
Before moving and positioning an individual you
must also obtain their valid consent; in other
words you must obtain their permission to be
moved or positioned. Doing so means that you will
be respecting the individual’s human rights whilst
also working in an ethical way.
Reflect on it
4.1 Identity
Reflect on the different ways you use to check
an individual’s identity prior to an activity. Why
is it important to do so before you move or
position an individual?
For consent to be valid it must be:
● voluntary: the individual must be able to
give their permission freely without being
influenced such as by you or a family member.
In other words, the decision the individual
makes must be their own
● informed: the individual must receive all the
information that is required and relevant. For
example, when asking an individual whether
you can use the hoist to move them you can
explain to the individual what the move will
involve, how you are planning to do it, why you
will be using the hoist, the benefits and risks
involved, any other equipment that can be used
instead of the hoist, what will happen if they
don’t agree.
The individual must also then have the capacity
to make their own decision. This means that
they must be able to understand the information
you have provided, i.e. of the benefits and risks
involved and then be able to use this to decide
what they want to do. Remember that how you do
this will depend on the individual’s preferred form
of communication; for example, you may discuss
this with one individual but use photographs
or sign language with another individual. This
means that the individual will be making an
Key terms
Valid consent must be in line with the agreed
UK definition.
Ethical means working in a way that is moral,
such as obtaining an individual’s permission
prior to moving or positioning them.
Research it
4.1 Human Rights Act 1998
Research the Human Rights Act 1998. Why is
this law relevant to obtaining an individual’s
valid consent? Write down your findings.

27
informed decision. When an individual makes an
informed decision you must respect this. It is also
important that you record that you have obtained
the individual’s valid consent in their care plan.
If you are supporting an individual to move
or position who does not have the capacity to
consent (because for example the individual has a
condition such as dementia) then consent can be
given on behalf of the individual. A lasting power
of attorney (LPA) is a legal document that allows
individuals to nominate someone who they would
like to make decisions on their behalf such as a
family member, friend or professional.
If an individual does not have an LPA in place then
you and your colleagues or another professional
such as a doctor or nurse can provide the
individual with the support they require to move
or position providing it is in the individual’s best
interests to do so. To act in an individual’s best
interests when moving or positioning them, you
must consider the individual’s:
● wishes and beliefs, e.g. what are the
individual’s preferences? What is important to
them? What are their likes and dislikes?
● condition, e.g. how does the individual’s
condition affect them? How will moving or
positioning the individual benefit them? How
will this impact on their condition?
● capacity, e.g. is the individual’s capacity
permanent or temporary? Will they regain
their capacity? If so, can the decision be made
later when they have capacity?
● needs, e.g. how can you be supportive of the
individual and meet their needs? How can you
enable the individual to be in control of all
decisions?
● support network, e.g. how can you ensure you
take into account the views of others who know
the individual well, such as their family or
friends?
4.1 Confirm the individual’s identity
and obtain valid consent
Demonstrate that you have acted in an
individual’s best interests when moving
and positioning them. Think about how you
have confirmed the individual’s identity, the
methods you have used and the reasons why.
Have you obtained the individual’s permission?
Why?
AC 4.2 Communicate with the
individual in a manner which
a) provides relevant information,
b) addresses needs and concerns,
c) provides support and reassurance
and d) is respectful of personal
beliefs and preferences
You should be able to communicate with the
individual in a manner that:
● provides relevant information
● addresses needs and concerns
● provides support and reassurance
● is respectful of personal beliefs and
preferences.
Providing relevant information
Providing relevant information when
communicating with individuals involves providing
information that is clear and accurate; you can do
this by ensuring that you speak clearly and only
provide the information that is necessary. You can
check that information is accurate by clarifying
the information with the individual and others
who know the individual well, i.e. is it up to date?
Does it include all the necessary detail? Providing
relevant information also involves being able to
select the information that the individual needs
to know and that others may require to be able to
carry out their job roles effectively.
Communicating effectively with individuals when
supporting them with moving and positioning
involves providing them with all the information
Key term
Capacity means being able to understand and
weigh up the information provided to make
your own decision.

28
that they require. For example, this may include
explaining to the individual what the move is
going to involve, what support you are going
to provide and why. In this way, providing the
individual with relevant information will ensure
that they understand what is going to happen and
why; not doing so may make the individual feel
uncomfortable and may result in the individual
deciding not to participate when moving and
positioning.
Providing relevant information will also be
necessary when responding to individuals’
questions, concerns or suggestions. For example,
perhaps an individual wants to know why they
require support from two staff members to move
or perhaps the individual is concerned that they
may fall or perhaps the individual would like
to make changes to their moving and handling
guidance so that staff members can improve
the support they provide. You will find Unit 203
Communication in care settings and Unit 206
Handle information in care settings useful
sources of information.
Addressing needs and concerns
Addressing individuals’ varied needs and
concerns will be essential when communicating
with individuals when moving and positioning
them so that individuals feel that they are valued
and respected. How you communicate with an
individual will depend very much on their needs
and therefore you must not only get to know
the individual but also take into account their
individual and unique needs once you find out
what these are.
For example, an individual with a visual
impairment may prefer you to communicate
with them verbally or by using a specific form of
communication such as Braille when explaining
their risk assessment. An individual with
dementia may find a discussion about how you
are going to move them before the actual move
very confusing and so may prefer you to instead
explain this to them by using short clear phrases
as you are doing each part of the move.
Similarly, communicating effectively with
individuals involves being able to address the
concerns they have about moving and positioning
without making them feel embarrassed or
uncomfortable. For example, an individual may
be concerned about being dependent on others or
not being able to participate in a move or may be
afraid about using a new piece of equipment that
they hadn’t used before. You will need to provide
the individual with support and reassurance; you
will learn more about how to do this effectively in
the section that follows.
To fully address an individual’s needs and
concerns you must know what these are. This
is a good opportunity to review your previous
learning for LO3 around the preparatory checks
you must carry out using individuals’ care plans
and risk assessments in relation to moving and
positioning.
Providing support and reassurance
Providing support and reassurance when
moving and positioning individuals will enable
individuals to trust you and feel comfortable being
supported by you. For example, if an individual
feels embarrassed that they walk slowly; you can
support them by using encouraging words that
will not only reassure them but will also let them
know how well they are doing with their walking.
This in turn will make the individual believe in
their abilities and be more likely to continue to
mobilise independently. Without providing support
and reassurance, the individual may decide to not
mobilise or think that they are not able to; this
will lead to them becoming less independent and
more dependent on you and others.
Individuals may also need support and
reassurance for other reasons. For example,
changes may need to be made to an individual’s
care plan or risk assessment that they may find
difficult to understand and this may require you
to be explain the changes to them in a way that
they can understand. The individual may have
had a fall that may mean that they are fearful or
anxious about falling over again; your support and
encouragement will be needed. The individual’s
mobility may have declined or the individual’s pain
may have increased meaning that the individual
feels anxious about moving and positioning;
again the individual will require you to be both
supportive and reassuring.

29
Showing your support and reassurance can
be done both verbally and non-verbally. For
example, you may communicate with the
individual using a soft and supportive tone of
voice or by using positive body language to show
your genuine empathy towards the individual
such as by leaning towards the individual,
making regular eye contact or by smiling.
You will find it useful to review your previous
learning around using verbal and non-verbal
communication in Unit 203 Communication in
care settings.
Being respectful of personal beliefs
and preferences
Finally, communicating effectively with individuals
when moving and positioning them involves you
showing your respect of their personal beliefs
and preferences that may be different to yours
and other individuals’. For example, an individual
may feel safer if they are supported to move and
position with two carers or more comfortable and
relaxed if they can listen to music while being
moved or be given half an hour’s notice before
being moved. You can show your respect by
ensuring that individuals’ beliefs and preferences
are documented and taken into account when
moving and positioning, and by discussing this
with individuals so that you can ensure that you
fully understand what these are and how you can
take them into account.
Reflect on it
4.2c Support and reassurance
Reflect on an occasion when you were
provided with support and reassurance. How
did you feel? How would you have felt if you
didn’t have any support or reassurance?
Reflect on the impact providing support and
reassurance has on individuals when moving
and positioning them. What are the necessary
communication skills for providing support
and reassurance? On a scale of 1 to 5 with 5
being the most effective, how effective are you
at supporting and reassuring individuals when
moving and positioning?
6Cs
Communication
Communication is essential for moving and
positioning individuals safely and effectively.
Without good communication you will not
be able to involve individuals when they are
being moved and positioned. It will also not be
possible to build a caring and positive working
relationship with an individual if you do not
communicate effectively. Good communication
with individuals when moving and positioning
is essential for showing them that you respect
them and have taken into account their unique
needs and preferences. Good communication
is also essential if individuals are to feel cared
for and supported.
Research it
4.2d Personal beliefs and
preferences
Research the different personal beliefs and
preferences of two individuals you support
where you work in relation to moving and
positioning. Think about what these are and
how they differ. Think about how you adapt
your practices to meet these and the reasons
why. Write down your findings.
4.2 Communicate with individuals
Support an individual to move and position
by communicating with them in a way
that provides the individual with relevant
information, addresses their needs and
concerns, provides support and reassurance
and respects their personal beliefs and
preferences.
Ask your assessor to observe you and
provide you with feedback. How effective a
communicator were you?

30
AC 4.3 Position the individual in
accordance with their care plan
As you will have learned, moving and positioning
individuals requires a good knowledge of
individuals’ needs, preferences and support
requirements. Individuals’ care plans are good
sources of information because they can include
documented details of how individuals prefer
to be moved and positioned, the moving and
handling equipment they use and how they use
it as well as the conditions they have and how
these may affect how they are moved.
Positioning individuals by following their care
plans will therefore mean that you are working
in a person-centred way because you will be
respecting their rights and preferences and
meeting their needs. You will also ensure that
you are moving and positioning individuals
in ways that are most comfortable for them
and that do not cause them any unnecessary
distress and pain. You may find it useful to
review your previous learning in AC 2.2 of this
unit where you explored the impact that a
range of conditions can have when moving and
Following individuals’ care plans means that
you will also ensure that you are only using
techniques that have been agreed, so by following
individuals’ care plans you will also be working
in line with your employer’s agreed ways of
working.
Below are some top tips for positioning
individuals in accordance with their care plans:
● Ensure you know where to find individuals’ care
plans and make sure you read them through
carefully so you are aware of the information
they contain before you move and position
individuals.
● Remember that individuals’ care plans are
written alongside individuals’ risk assessments
and so make sure you read through both
documents together as both will contain useful
and relevant information in relation to moving
and positioning individuals safely.
● If there is any information that you have read
and do not understand then ask! This could be
your employer or a more senior colleague. Not
doing so may result in you carrying out unsafe
practices.
● If there is any information that has been
documented in an individual’s care plan and
you think may not be accurate or is out of
date then ask! Do not go ahead and follow the
individual’s care plan if you are unsure, clarify
the information it contains first before doing
so; this may be with the individual themselves,
your employer or a more senior colleague.
● If you notice any changes in the individuals
when positioning them in accordance with their
care plan such as discomfort or a deterioration
in their health then stop what you are doing
and seek help immediately. Depending on
the severity of the situation, this may involve
calling for the medical emergency services or
a more senior colleague.
● If you or others you are working with become
unwell when positioning individuals stop what
you are doing and seek help immediately as
continuing may result in you, others and/or the
individual getting injured.
● After you have positioned individuals safely
ensure that you document the support you
have provided to individuals with moving
and positioning, how your support has been
received including any difficulties you have had
and any advice or guidance you have sought.
Doing so will ensure that individuals’ care
plans remain up to date and contain accurate
information. You may find it useful to review
your learning in Unit 206 Handle information in
care settings.
Reflect on it
4.3, 5.1, 5.2 The care plan,
assistance and sources of information
Reflect on what actions you would take if you
were following an individual’s care plan and
they became distressed. What documents are
available to you where you work and would
guide you with what to do? Who could you seek
advice from? What would be the consequences
of continuing to position the individual?

31
4.3 Position the individual in
accordance with their care plan
Make arrangements to position an individual
in accordance with their care plan and
obtain a witness testimony from a colleague
who has observed you do this. Obtain
feedback after positioning the individual;
how effective were you in following the
individual’s care plan? Do you need to make
any improvements?
AC 4.4 Communicate effectively
with others involved in the
manoeuvre
Moving and positioning individuals will very
often involve working alongside others to ensure
that all moves are carried out safely and in
accordance with individuals’ care plans. This may
be a colleague, an individual’s family member or
another professional such as a physiotherapist
or nurse. For example, an individual who is
unsteady when walking may require a care
worker to stand either side of them when they
are walking so as to provide them with support
and prevent any falls. Similarly, an individual
who is unconscious will require two or more
care workers to support them to turn over in
bed safely and without causing any injury to the
individual or the care workers. Communication
with others involved is therefore very important
for moving and positioning individuals because it
ensures that:
● everyone works together and consistently as a
team
● moves are carried out safely and therefore
the risk of pain, discomfort and accidents are
minimised
● moves are carried out in line with legislation
and agreed ways of working
● the individual feels confident in your abilities
and those of others you work with
Key term
Others may include team members, other
colleagues, those who use or commission
their own health or social care services, family
members, carers and advocates.
Reflect on it
4.4 The manoeuvre
Reflect on an occasion when you and a
colleague supported an individual to move
and position. What did you do during the
manoeuvre? What did your colleague do? What
would have been the consequences of moving
the individual without your colleague’s help?
● the individual feels reassured that you and
others will be providing them with the support
they require.
When moving and positioning individuals you can
communicate effectively with others by:
● agreeing who will be leading the move so that
the move is smooth. This may involve specific
commands to move such as ‘ready, steady,
move’
● ensuring everyone understands who is doing
what in the manoeuvre. This includes the
individual, you and others involved so that the
move is comfortable and everyone is working
together consistently
● discussing and reviewing with everyone what
worked well, what didn’t, what improvements
could be made. This includes obtaining
feedback and observing individuals and others
you work with.
The reflective exemplar provides you with
an opportunity to explore in more detail the
importance of communicating effectively with
others involved in supporting individuals to move
and position.

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