Create a Culture of Safety at Your Home Care Agency

August 2, 2017

Safety and wellness are not just policies a home care agency lists in its business manual. They should be part of a culture of best practices that benefit both employees and patients. Ingraining the behaviors that create and perpetuate these virtues is an ongoing process, but one that will potentially assist in reducing Workers’ Compensation, health care and Liability claims.

While proper training is essential for home health care workers, much of employees’ safety relies on self-monitoring and personal compliance with protective measures and schooling. Still, the agency should take steps to improve and enforce compliance to avoid worker injury or illness, the spread of disease or infliction of harm on the patient or the worker.

Proper use of personal protective equipment, such as goggles, gloves and masks is essential, but compliance is difficult to monitor without onsite supervision—something many agencies are not able to provide. One possible method of monitoring is through supply use. A detailed log for checking out new and checking off used personal protective equipment on a daily or per-visit basis can alert supervisors to those workers using too few required or recommended supplies and red-flag those needing refresher training. For example, protective equipment is essential where biological hazards or unsanitary home-site conditions exist.

Other equipment and solutions are also needed in the latter circumstances. Where blood-borne pathogens or other biological hazards exist—either from the patient or from others in the home—all needles, bandages and medical equipment must be protected from exposure and kept sanitary (or sanitized for prevention before use). An assessment of the home-care site should precede any provision of care, and visiting workers should arrive prepared for known and suspected hygiene or sanitary problems. Items brought to the site might include hygienic pads, hand sanitizer and sanitary wipes for equipment. Disposable drinking cups for the administration of medicine and hazardous waste bags may also be recommended. In all cases, a detailed exposure-prevention plan should be written up and followed, and a log/checklist of procedures at the site should be filled out and returned to the health care agency.

Not only should visiting caregivers optimize hygiene for the patient; they should also protect themselves. This includes using shoe slipcovers, leaving personal items (such as purses, sweaters, etc.) in the locked car, and communicating with the patient or responsible person at the home about arrival times so pets can be put out or restrained before the worker enters. Agency employees or volunteers can emphasize the need for their undivided attention to the patient.

For agencies wishing to provide the best safety and wellness conditions for employees and independent contractors, OSHA recommends a series of considerations, including worker latex sensitivity, ergonomic hazards, dangerous or unhygienic conditions, potentially hostile environments, and motor vehicle accidents, whether in agency-owned or worker-owned autos.

The most common injuries to home healthcare workers are sprains, strains and other musculoskeletal problems related to lifting and moving patients, the National Institute for Occupational Safety and Health says. Training on proper lifting and moving methods as well as equipment that assists with such tasks is vital. Make sure that equipment travels with workers as needed. Needle sticks and other injuries from sharp objects are also common hazards. Emphasis on attentive use of such objects cannot be overdone.

Manager engagement with on-site workers is one of the best methods of developing a staff that abides by the best practices the home healthcare agency requires. Regular conversations that allow staff to “vent” or talk about site conditions and concerns give managers opportunities for suggestions, intervention or site reassessment as required. Checklists and logs establish a routine that creates (A) a permanent record of procedures and (B) a reference point for worker evaluations and counseling that is uniform across all sites and employees. These records may prove crucial should a liability claim from a patient or a Workers’ Compensation claim arise.

Part of a high-performing safety and wellness culture is quality insurance. Not only does that insurance indicate the agency is a responsible entity; it also gives managers a go-to reason for certain policies (“Our insurance requires this”) and a resource for loss-control and risk management measures. In fact, a home healthcare agency’s best safety and wellness partners are often its insurers and insurance agents.


Manchester Specialty provides total insurance solutions to the home health care providers. Our insurance products include General and Professional Liability, Workers’ Compensation, Non-Owned & Hired Auto, Directors & Officers Liability, Employment Practices Liability and other key coverages. We can help hospice agencies, palliative care providers and their insurance brokers navigate the coverage needs of a home health care business and find the best fit for insurance coverage. For more information about our insurance solutions, you or your local agent/broker may contact us at 855.972.9399.