5.1.18 Employee Support in Critical Incidents

1. Introduction

The County Council recognises that in your work you may meet people (either within the workplace or outside) who are potentially aggressive, violent towards staff or course actually bodily harm to themselves such as self harm/commit suicide in an Local Authority setting.

These guidelines are designed to help managers manage their team in a crisis in order to support employees who have been affected within the environment of a critical incident such as sudden death of a service user. These guidelines are not intended to provide guidance on clinical care or bereavement counselling.

When a critical incident occurs within your service area the manager must ensure that they follow all the necessary procedures outlined in LCC's reporting guidelines, e.g. Health and Safety, Violence at Work etc. ensuring that the situation is reported appropriately. We have to remember that the impact of such an incident have on an employee. Therefore it is imperative that you as a manager ensure all employees are supported throughout this incident.

Traumatic events can take time to get over and people vary in how long it can take to come to terms with something that has shocked them.

However, some people find they cannot seem to recover easily and experience symptoms of depression or grief long after the event - and sometimes the symptoms may not appear until months or even years after the initial trauma. Post traumatic stress disorder (PTSD).

Common symptoms of PTSD include reliving the event through flashbacks or nightmares; avoiding people, situations or circumstances linked or reminiscent of the event; experiencing hyper-arousal or hyper-vigilance, sleep disturbance and irritability or anger; feelings of emotional detachment; displaying other symptoms of depression; plus engaging in drug or alcohol misuse.

The County Council aims to provide a working environment that limits the potential for staff to experience incidents of a critical nature. It also provides support for employees who are subjected to serious incidents at work by:-

• Treating employees who have been subjected to a serious incident at work sensitively and compassionately;
• Providing assistance such as personal support and advice;
• Assessing and minimising the risk of serious incidents at work. You will be given details of the arrangements in your work area as part of your induction or ongoing training.

2. Providing Assistance to Employees who have been Subjected to a Critical Incident at Work

The County Council recognises the traumatic consequences of employees witnessing and being directly involved in critical incidents therefore is committed to providing full support to employees and managers.

Employees who are involved in or witness critical incidents at work should be able to seek advice, support and counselling in total confidence. Provisions for aftercare and counselling should be openly discussed, in order that employees know exactly what is available to them. The Employee Support and Counselling Service is available in all cases.

If an employee requests support or counselling, or there is obvious distress (including distress caused to other members of the victim's family or colleagues), then the Employee Support and Counselling Service should be contacted on the employee's behalf, but only with their agreement.

Dealing with a Serious Incident

• Summon assistance by telephone, shouting or as a last resort sound the nearest alarm, e.g. fire alarm etc;
• Staff need to use their own judgement depending on the incident - either move from the area where any objects are seen or suspected to be used, this should be a priority, provide first aid were necessary;
• Consideration must always be given to contact the Police/Ambulance/Fire service immediately or if not recording the reasons why not. Line managers/Senior Officer ultimately has this responsibility;
• All other staff should attempt to calm and isolate the situation from other service users;
• If the agitator insists on leaving before the Police arrive, the staff have no powers of restraint;
• Line manager shall complete a serious incident report and obtaining witness statements if possible. Remember violence to staff is reportable under Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) as well as reporting all serious incidents to health and safety;
• Ensure Senior Management is aware that a critical incident has occurred.

Aftercare for Employees

On the Day the Serious Incident Occurred

• Employees should receive first aid following a critical incident i.e whether it is for shock;
• The member of staff involved shall be relieved from duty in order to recuperate. The manager shall determine whether it is appropriate for the member of staff to be sent home by themselves;
• Each manager is expected to undertake a review of the incident prior to all employees leaving that shift, day of work, it is important to ensure that everybody is supported prior to leaving the premises;
• Ensure any review and appropriate paperwork is completed in writing;
• Employees may need immediate support for example out of hours, during the night etc. If this is the case then the following support has been outlined;
• Lincolnshire County Council currently contract into Mouchel, for Employee support and counselling which is available during office hours of which an answer machine is available. This is not 24 hour support, but if the employee/manager would like to be referred then the manager will need to follow the appropriate process;
• Employees should be advised to contact their own GP if required.

The Day After the Serious Incident

• The following day or as soon as possible the manager with senior support must conduct a debriefing review in order to discuss the incident and provide support for employees followed by one to one support meetings;
• Managers will continue to monitor employees for shock. Post traumatic stress disorder (PTSD) can occur days/weeks/months after a critical incident;
• Managers may be expected to contact HR Adviser, Mouchel and discuss group and one to one counselling sessions;
• Managers may be required to refer employees to Well Work as a means of support.

Line Manager shall Monitor Members of Staff for Shock

The Employee Support and Counselling Service can offer help in many areas. It may be that all you need is simple advice and a listening ear. You can contact the service by telephone, e-mail or post. An answerphone will take your message when there is no-one available to answer your call in person.

3. Legal Advice and Assistance

In some circumstances it may have been necessary to report the incident to the police. If you do have to attend a police station during working hours to give a written statement, provided the appropriate manager authorises that this absence is because of a work-related incident, you will be given time off with pay. You may be accompanied by your trade union representative or any other person of your choice. If that person is employed by the County Council, their absence will also be paid. The same arrangements will also apply if you are required to attend court.

As your employer the County Council is responsible for deciding whether or not to report an incident to the police. You also have the personal right to report a matter to the police.

Important Note: Failure to report an incident could result in loss of your rights to appropriate benefits. Similarly, failure to report an incident to the police could result in loss of your right to claim compensation from the Criminal Injuries Compensation Board.

4. Benefits and Compensation

Your manager will be able to give you detailed information about the benefits and compensation available if you are injured as a result of violence at work. Set out below is a brief outline:

You may be entitled to certain benefits under your conditions of service, such as superannuation provisions. These will vary according to your circumstances and conditions of service.

In addition, you may be able to make a claim under the Criminal Injuries Compensation Board, for payment of compensation if you have been physically or mentally injured as a result of a crime of violence.

In order to make a claim, you should have been a victim of a crime of violence, or injured in some other way covered by the scheme. In addition, unless there are good reasons, you should have:

• Reported the injury personally to the police, or to another acceptable authority, as soon as possible after the incident happened;
• Made an application within the statutory period.

5. How Line Managers can Support Employees by Measuring to Avoid or Minimise the Risk of Serious Incidents Occurring

Design of Premises

• Depending of residential setting assess the rooms service users are living and minimise the risk of self harm;
• Installing video cameras installing alarm buttons in high risk areas, telling employees about their use and ensuring adequate response.

Organisational Arrangements

• Ensuring that risks for and about service users own behaviour is properly assessed for risks, plans in place and actively monitored;
• Ensure employees advise managers of any observed risk taking behaviour by the service user;
• If employees are required to work late, arrangements should be made to enable them to drive to work and park safely or to provide transport keeping details of employees' whereabouts when they work away from base;
• The employee leaflet "Violence at Work - Staff Guidelines" (POEL18) can help with this arranging for employees to be accompanied where the risk is high and other measures are not practicable, e.g. when responding to intruder alarms after hours;
• Personal attack alarms for employees at risk. (Consider supplying these alarms to employees on request, even if the risk is assessed as low, as this will help to allay fears of attack).