People Moving and Handling: Protecting Skin, Dignity, and the Staff Who Care

When we talk about people moving and handling, the conversation can quickly become focused on equipment, techniques and compliance.

But every move involves two people: the person receiving care and the person providing it.

Done well, moving and handling can protect fragile skin, preserve dignity, encourage independence, and help someone feel safe. It can also protect a care worker’s back, shoulders, neck, and joints—not only during today’s shift, but throughout a long career and into retirement.

For employers, these outcomes matter too. Safer working practices can mean fewer injuries, less sickness absence, improved staff retention, and more consistent care.

People moving and handling should never be treated as an annual tick-box exercise. It is an essential part of compassionate, person-centred care and a sustainable care service.

Start with the person, not the maneuver.

Imagine being moved when you are in pain, frightened, unable to explain what you need or uncertain about what is going to happen next.

A task that feels routine to a member of staff may feel extremely personal to the individual being supported. They may be partially undressed, dependent on other people or worried about falling. They may also have experienced a previous move that was painful or distressing.

Person-centred moving and handling begins before anyone touches the person or reaches for a piece of equipment.

It involves:

• Explaining what is going to happen and why

• Gaining consent and checking understanding

• Asking about pain, skin sensitivity, fear and previous experiences

• Involving the person in decisions wherever possible

• Encouraging them to use the movement and independence they still have

• Protecting their privacy and dignity

• Following the agreed care plan while recognising that needs can change

• Communicating with the person throughout the move—not simply talking over them

The aim is not merely to transfer somebody from A to B. It is to help them move as safely, comfortably and independently as possible.

Moving and handling is also about skin integrity

Skin damage does not result only from prolonged pressure. Friction and shear can also contribute, particularly when someone is pulled or dragged across a bed, chair, or other surface.

Shear occurs when the skin and deeper tissues move in different directions. One familiar example is a person sliding down a bed when the backrest is raised. Their skin may remain against the bedding while their skeleton moves downwards, placing stress on the tissues beneath it.

This matters even more for someone with fragile skin, reduced mobility, poor circulation, reduced sensation, poor nutrition, or an existing pressure ulcer.

The NHS advises that changing position and moving regularly are important for relieving pressure and helping to prevent new pressure ulcers. NHS tissue-viability guidance also recommends reducing rubbing and shear, including the appropriate use of full-length slide sheets when repositioning someone.

Good moving and handling practice can support skin integrity by:

• Avoiding unnecessary dragging across surfaces

• Using the correct size and type of slide sheet

• Checking that slings, clothing and bedding are positioned correctly and are not creased

• Supporting limbs rather than pulling them

• Using profiling beds and other equipment appropriately

• Following an individual repositioning plan

• Checking the person’s skin and listening when they report pain or discomfort

• Reporting and escalating skin changes promptly

Equipment is only helpful when it is suitable for the individual, correctly maintained and used by people who understand it. A slide sheet, hoist or stand aid is not a substitute for assessment, communication or professional judgement.

Protecting the people who provide care

Care workers regularly perform physically demanding tasks in challenging circumstances. These can include restricted spaces, unpredictable movement, time pressure, fatigue and supporting people whose needs may change from one day to the next.

An injury does not always result from one dramatic incident. Musculoskeletal problems can develop gradually through repeated awkward postures, twisting, reaching, sustained loading or trying to manage a task without the correct equipment or assistance.

The latest Health and Safety Executive figures demonstrate the scale of work-related musculoskeletal disorders across Great Britain.

During 2024/25:

• 511,000 workers were suffering from a work-related musculoskeletal disorder

• Musculoskeletal disorders caused 7.1 million lost working days

• Each affected worker lost an average of 14 working days

These figures cover workers across all industries rather than care staff alone, but they demonstrate why preventing musculoskeletal injury deserves serious attention.

It’s not just your back

When people hear the words “manual handling injury”, they often immediately think about lower back pain. However, work-related musculoskeletal disorders can affect the whole body.

HSE estimates indicate that approximately:

• 43% affect the back

• 41% affect the upper limbs or neck

• 15% affect the lower limbs

This is why good practice must consider the complete physical demands of a task—not simply whether somebody remembered to bend their knees.

Your body needs to last longer than today’s shift

People working in care understandably focus on the immediate need: helping someone back into bed, responding to a fall or completing a repositioning task during a busy shift.

However, staff bodies absorb the effects of how those tasks are performed over months and years.

Repeatedly working in poor positions or attempting unsafe moves can affect someone’s ability to remain in a role they value. It can also influence their quality of life away from work and, eventually, into retirement.

Good practice is not simply about telling staff to “bend your knees and keep your back straight”. Human movement is far more complex than that.

Protecting staff means reducing unnecessary physical demands through assessment, preparation, suitable equipment, an appropriate environment and coordinated teamwork.

It also means creating a workplace culture in which employees feel able to pause and say:

• The person’s needs have changed

• This equipment is no longer suitable

• There is not enough space to complete this safely

• The moving and handling plan needs reviewing

• Another member of staff is required

• I do not feel able to complete this task safely

Employees should not have to choose between completing a task and protecting their own health.

The employer’s perspective: prevention makes business sense

When a member of staff develops a musculoskeletal problem, the consequences can extend far beyond one period of absence.

The organisation may face:

• Overtime or agency staffing costs

• Time spent arranging cover

• Increased pressure on the remaining team

• Reduced continuity for the people receiving care

• Rehabilitation or adjusted-duty requirements

• Recruitment and retraining costs if the employee cannot return

• A loss of experience and valuable knowledge

Experienced care workers often hold important knowledge about the people they support. Losing them because their bodies can no longer tolerate the work has a human and operational cost that is difficult to replace.

Investing in safer people moving and handling can support:

• A reduced risk of injury and sickness absence

• Improved employee confidence and competence

• Better staff retention and career longevity

• More appropriate use of moving and handling equipment

• Earlier reporting of changing needs and unsafe practices

• More dignified and consistent care

• Evidence that the organisation takes staff and service-user safety seriously

Training alone cannot control every risk. It should form part of a wider system that includes suitable risk assessments, individual moving and handling plans, well-maintained equipment, appropriate staffing, supervision and an open reporting culture.

What should good training include?

Effective people moving and handling training should connect practical techniques with the realities of providing care.

Staff need opportunities to practise with relevant equipment, solve realistic problems and understand how their decisions affect both the person receiving care and their own body.

Training should explore:

• Person-centred communication, consent and dignity

• Skin integrity, pressure, friction and shear

• Individual mobility and the importance of encouraging participation

• Dynamic and task-specific risk assessment

• Safer use of hoists, slings, slide sheets and stand aids

• Posture, repetition, physical load and cumulative musculoskeletal strain

• What to do when circumstances differ from the care plan

• When to stop, seek assistance or request reassessment

As an MSK physiotherapist and experienced trainer, I see people moving and handling from both perspectives: the quality of care experienced by the individual and the long-term physical demands placed on the worker.

The best outcome is not simply a completed transfer.

It is a person who feels listened to, respected and cared for, supported by a worker who can go home without unnecessary pain—and return tomorrow able to do their job safely.

People Moving and Handling Training in Hull, East Yorkshire and North East Lincolnshire

Hull Safety Training provides practical People Moving and Handling training for care and healthcare teams across Hull, East Yorkshire and North East Lincolnshire.

Led by an MSK physiotherapist, the training includes practical work with equipment such as hoists, stand aids and slide sheets. Sessions connect safer techniques with skin integrity, person-centred care and the long-term musculoskeletal health of employees.

To discuss People Moving and Handling training for your team, contact Hull Safety Training today.

Sources

Health and Safety Executive – Key figures for Great Britain 2024/25:https://www.hse.gov.uk/statistics/overview.htm

Health and Safety Executive – Working days lost in Great Britain:https://www.hse.gov.uk/statistics/dayslost.htm

NHS – Pressure ulcers:https://www.nhs.uk/conditions/pressure-sores/

NICE – Pressure ulcers: prevention and management:https://www.nice.org.uk/guidance/cg179

Please note: This article provides general information. Moving and handling decisions should be based on individual assessment, current care plans, suitable equipment and the policies and professional guidance relevant to the care setting.