Standard for Old Age.pdf

INTRODUCTION 

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

www.safeworksa.sa.gov.au

www.workcover.com

Disclaimer  The information produced by SafeWork SA and WorkCover Corporation of South Australia in this publication is correct at the time of printing and is provided as general information only. In utilising general information about workplace health and safety and injury m anagement, the specific issues relevant to your workplace should always be considered. This publication is not intended as a substitute for the requirements of the Workers Rehabilitation and Compensation Act, 1986 or the Occupational Health S afety and Welfare Act 1986.

Limitations of Liability To the best of our knowledge, the procedures described in this document reflect currently accepted practice, but cannot be considered absolute and universal recommendations. recommendations. All recommendations must be considered in view of the specific example and new information that has become available since the time of writing. The authors disclaim responsibility and assume no liability for any adverse affects resulting directly or indirectly from the suggested procedures, procedures, from any undetected errors, or from the reader’s misunderstanding of the text.

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INTRODUCTION 

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

www.safeworksa.sa.gov.au

www.workcover.com

Disclaimer  The information produced by SafeWork SA and WorkCover Corporation of South Australia in this publication is correct at the time of printing and is provided as general information only. In utilising general information about workplace health and safety and injury m anagement, the specific issues relevant to your workplace should always be considered. This publication is not intended as a substitute for the requirements of the Workers Rehabilitation and Compensation Act, 1986 or the Occupational Health S afety and Welfare Act 1986.

Limitations of Liability To the best of our knowledge, the procedures described in this document reflect currently accepted practice, but cannot be considered absolute and universal recommendations. recommendations. All recommendations must be considered in view of the specific example and new information that has become available since the time of writing. The authors disclaim responsibility and assume no liability for any adverse affects resulting directly or indirectly from the suggested procedures, procedures, from any undetected errors, or from the reader’s misunderstanding of the text.

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INTRODUCTION 

ACKNOWLEDGEMENTS: These guidelines have been prepared by the SAfer Aged Care Industry Working Party; in conjunction with the Health and Aged Care Sector. Acknowledgements are extended to:

Safer Aged Care Safe Design Steering Committee Brian Adams, SafeWork SA Sue Balde, SA Unions Richard Coker, University of South Australia Ingrid Ormay, SafeWork SA Theadora Papadopoulos, Karidis Corporation Limited CS Wong, SafeWork SA

Case Studies  Anā  Anānda Hope Valley Residential Care Eldercare Incorporated SA Southern Cross Care (SA) Incorporated

Additional acknowledgements to: Nic Doncaster, WorkCover Corporation Susan Ellis, Resthaven Incorporated Jim Klesyk, Helping Hand Aged Care Necia Michel, Walter Brooke & Associates Pty Ltd Valerie O’Keeffe, Workplace Services  Angela Sparrow, WorkCover WorkCover Corporation

David Stevens, David Stevens Consultancy Liz Bluff, The Australian National University WorkSafe, Victoria Queensland Health, Capital Works Branch

Design and produced by: SafeWork SA, www.safeworksa.sa.gov.au WorkCover Corporation of South Australia, www.workcover.com

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INTRODUCTION 

HOW TO USE THESE GUIDELINES: These guidelines are intended to provide general best practice information about safe design for the aged care industry. They are intended as a starting reference point for considering safe design as part of the development/redevelopment of a facility and/or a product. They are to be read in conjunction with the national (1) publication ‘Guidance on the Principles for Safe Design at Work’  . The needs of residents and service providers, site requirements, budgets and management will have implications for the overall design and safe design features of  a building project. The industry is encouraged to share best practice in a collaborative fashion in using these guidelines. This information is of a general nature and it is understood that affordability, sustainability and funding implications for  a site/product will have a bearing on the final design. However, an innovative and efficient design solution can be achieved by the proprietor/developer with a degree of flexibility. The guidelines are intended for those within the Aged Care Industry with responsibilities for planning, designing, operating, maintaining, altering, and d ecommissioning a facility; and its associated layout, plant and equipment, substances and work systems. This includes ‘persons with control’: owners, occupiers, directors of nursing, architects, interior designers, suppliers, installers, designers and manufacturers of plant and equipment and anyone who may be involved at any stage during the lifecycle of the facility and associated plant.

‘Guide to the Safe Design of  Aged Care Facilities’

‘Guidance on the Principles of Safe Design at Work’.

Refer to Principles of Universal Design

Refer to Considerations for Safe Design

Consider the Safe Design Process Steps: 1 – 8

Refer to Practical Examples: 1 – 24

Refer to Links for detailed information

Input into the design process

(1)

Australian Safety and Compensation Council, Guidance on the Principles of Safe Design at Work , Australian Government, Canberra, 2006

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INTRODUCTION 

TABLE OF CONTENTS Page  Acknowledgements

3

How to use these Guidelines

4

1

Introduction

7

1.1

Why Safe Design?

7

1.2

What is Safe Design?

7

1.3

Universal Design Principles

7

1.4

Considerations for Safe Design

8

1.5

Reasonably Practicable

9

Industry Case Study 1, Anānda Hope Valley, Hope Valley, South Australia, “Ceiling lift technology”

11

1.6

OHS Responsibilities for Design

12

1.7

Consultation

14

1.8

Global Directions

14

1.9

Ageing in Place and Emerging Issues

14

1.10

Design for Dementia

15

1.11

Design for Palliative Care

15

1.12

Overhead Lifters

16

1.13

Design for Disassembly

16

1.14

Culturally And Linguistically Diverse (C.A.L.D.)/ Aboriginal and Torres Strait Islanders

16

2

Practical Examples

18

2.0

Common requirements for all room functions

19

2.1

En suite/bathroom design

22

2.2

Bedroom design

23

2.3

Dining room design

24

2.4

Office areas design

25

2.5

Laundries design

26

2.6

Kitchen design

27

2.7

Storage room design

28

2.8

Common rooms design

29

2.9

Pharmacy/drug rooms design

30

2.10

Nurse’s stations design

31

2.11

Toilets design

32

2.12

Corridors design

33

2.13

Lounge rooms design

34

2.14

Spiritual area / Hall design

35

2.15

Hairdresser’s area design

36

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INTRODUCTION  2.16

Café / Internet café area design

37

2.17

Maintenance area design

38

2.18

Pan/sluice room design

39

2.19

Reception area design

40

2.20

Therapy area design

41

2.21

Dressing room (clinical) design

42

2.22

Doctor’s room design

43

2.23

Training room design

44

2.24

Outdoor areas design

45

3

The Principles and Process of Safe Design

46

3.1

Levels and areas of responsibility

46

3.2

The Safe Design Process Steps

46

3.3

Risk Management

51

Industry Case Study 2, Eldercare Incorporated SA, “Risk Management’

53

3.4

Development of aged care facilities: a seven step guide

54

3.5

Business efficiency

57

3.6

Sustainability

57

Industry Case Study 3, Southern Cross Care (SA) Incorporated, “Sustainability and Safe Work design”

58

Lifecycle stages of various product types

59

Appendices

60

 A

Definitions

61

B

Aged Care Industry - Generic Hazard Register

63

C

Pre-purchase criteria for equipment and products

63

D

Type, frequency, nature and cost of injuries and illness

63

References

64

 Australian Standards

64

3.7

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1. INTRODUCTION These guidelines have been developed in consultation with key industry stakeholders, including employer and employee representatives, to assist organisations within the Aged Care Industry in South Australia in the safe design of facilities and equipment. The guidelines aim to provide persons embarking on design projects with a clear set of guidelines that will enable a balanced outcome that will meet not only the requirements of compliance codes and regulations b ut will also meet the needs of the residents/clients. The guidelines endeavour to assist in the provision of a satisfactory standard of  comfort and care in a pleasant and safe environment. The guidelines consider the legislated Occupational Health Safety and Welfare requirements, and the roles and responsibilities of owners and designers in safe design. The guidelines have been developed to support other legislation, codes and standards that control the general aspects of product safety, such as the: Building Code of Australia, the Development Act, Trades Practices Act and the Electrical Products Act.

1.1 WHY SAFE DESIGN? Safe design eliminates any OHS hazards and minimises any potential OHS risk, by involving decision makers and end users when considering the life cycle of the designed-product.  A safe design approach will generate a design option that eliminates OHS hazards or minimises the risks to those (2) who make the product and to those who use it. Safe design may offer cost benefits and improved efficiencies throughout the lifecycle of the building and/or product. These guidelines are not intended to be prescriptive, and recognise that there will be cost limitations for the development, redevelopment, refurbishment and production of buildings and products. The initial cost, ongoing running costs, and other costs associated with the lifecycle of the building/product needs to be considered.

1.2 WHAT IS SAFE DESIGN? Safe design is a risk management approach to the design process that eliminates OHS hazards and minimises potential OHS risks, by involving decision makers when considering the life cycle of the designed product. Safe design can be applied through the life cycle of the designed-product whether in the: •

construction, use, maintenance or demolition of any building or structure

•

manufacture, supply, installation, use, maintenance or disposal of plant or equipment

•

manufacture, supply, use or disposal of chemicals

•

implementation or use of any system of work or process or any other physical attribute or system associated with either the workplace or the interface with people.

These guidelines align with the Australian Safety and Compensation Council: National OHS Strategy 2002-2012 ‘Eliminate the hazards at the design stage’ .

1.3 UNIVERSAL DESIGN PRINCIPLES The needs of older people vary significantly from person to person. The principles of Universal Design encourage the design of products and the environment for use by all people to the greatest extent possible, without the need for  adaptation or specialised design. The seven major principles of universal design indicate a product or feature should: •

•

provide equitable use – The design is useful and marketable to people with diverse abilities be flexible in use - The design accommodates a wide range of individual preferences and abilities

(2)

Australian Safety and Compensation Council, viewed 24 November 2006 www.ascc.gov.au/ascc/HealthSafety/SafeDesign/Understanding/Whatissafedesign.htm

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INTRODUCTION  •

•

•

•

•

be simple and intuitive to use - Use of the design is easy to understand, regardless of the user's experience, knowledge, language skills, or current concentration level  convey perceptible information - The design communicates necessary information effectively to the user, regardless of ambient conditions or the user's sensory abilities provide tolerance for error - The design minimizes hazards and the adverse consequences of accidental or  unintended actions require low physical effort - The design can be used efficiently and comfortably and with a minimum of fatigue provide sufficient size and space for approach and use of the feature -Sufficient size and space is provided for  approach, reach, manipulation, and use regardless of user's body size, posture, or mobility 

Note: a limitation to the principles of Universal Design is that the principles address only universally usable design, whereas the commercial practice of design involves a broader consideration than simply for usability. Designers must consider economic, engineering, cultural, gender, and environmental concerns as well as safety in their design processes. The Universal Design principles offer designers guidance to better integrate features that meet the needs of as many users as possible. All principles may not be relevant to all designs.

For further information refer to: Center for Universal Design (1997) Principles of universal design. www.design.ncsu.edu/cud/about_ud/udprinciples.htm Crews, D.E and Zavotka, S. Aging, Disability and Frailty: Implications for Universal Design (2006), Journal of  Physiological Anthropology, 25: 113-118, 2006

1.4 CONSIDERATIONS FOR SAFE DESIGN The principles of safe design are as follows:

1.4.1 There is an understanding of the health and safety requirements of the design •

•

•

•

•

Decision makers are aware of their responsibility for the safety of downstream users and beneficiaries. Decision makers understand their obligation under la w to design and supply a safe product by eliminating OHS hazards and controlling for residual OHS risk. Health and safety is considered with equal priority to other design requirements in an overall risk evaluation of the designed-product’s life cycle. Decision makers ensure that the most current knowledge of OHS principles, materials/technology and systems are applied in the design of the product. Education, training standards and protocols support the requirement for decision makers to have appropriate skills to identify and eliminate OHS hazards, and control OHS risks in the design phase.

1.4.2 There is systematic hazard identification and risk evaluation •

•

•

•

Decision makers identify OHS hazards and analyse the associated risks across the life cycle of the designedproduct. There is consultation during the concept and detailed design phases between all people involved with the designed product to make use of their knowledge and experience to identify and eliminate OHS hazards and minimise risk. (These people may include, but are not limited to, the commissioning agent, manufacturers, builder, users, employees, importers, suppliers, maintenance agencies, contractors, installers, distribution agencies and disposers). There is a systematic assessment of the probability and consequences of injury or illness arising from exposure to identified OHS hazards, which guides the selection and implementation of the most appropriate OHS risk controls for the designed-product. Decision making during the risk evaluation process is documented and made accessible to all parties.

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INTRODUCTION  •

 A residual risk register is established; recording any OHS hazards not eliminated in the design that impose significant risk, as well as the possible control strategies. Information from the risk register is passed onto those involved in the ‘downstream’ or subsequent life cycle stages.

1.4.3 Interaction occurs between people involved in the life cycle of the designed-product •

•

•

•

Decision makers are aware of the life cycle of the designed-product (including, but not limited to, its design, construction/manufacture, supply/installation, use, maintenance/servicing, decommissioning, and disposal). Decision makers consider the range of people who will use or otherwise interact with the designed-product. Consideration is given to the OHS hazards that might arise during the designed-product’s life cycle, including those due to environmental and human factors. Relevant residual risk information in the designed-product is communicated to those who will use or interact with the designed product throughout its life cycle.

Consideration is given to the potential disease and injury costs when assessing life cycle operating costs (including, but not limited to, environmental clean up, decommission/dismantling, redesign/retrofit).

1.4.4 Contractual arrangements and procurement systems operate to minimise purchased OHS risk •

•

•

Purchasing and contractual arrangements (e.g. specifications, supplier pre-qualification and tender  documentation) include a requirement to eliminate OHS hazards, minimise OHS risks, and provide residual OHS risk information. The design brief or draft specifications include an agreement to carry out a safe design approach. The agreement also includes production of a life cycle OHS risk evaluation and a residual risk register. The designed-product includes fail-to-safe strategies for possible failure or defect impacts.

1.4.5 A sustainable designed-product result •

•

•

The design is monitored as it evolves to identify new OHS hazards and manage each risk as it becomes evident. If alterations to the designed product are planned during its life, a systematic OHS risk evaluation is conducted in the planning and design stages to eliminate OHS hazards and minimise risk. Information relating to any new risks are fed back to the designer/manufacturer.

1.5 REASONABLY PRACTICABLE OHS legislation requires duty holders to do ‘what is reasonably practicable’ and recognises that this can occur only in situations over which the duty holder has control. Contractual arrangements between the owner of a proposed product and its designer may have influence over who has control in any situation. Deciding what is reasonably practicable may depend on the level of risk for any given situation, past experience of  those involved, what is widely known about the hazard, and the effectiveness and cost of its control strategies.

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INTRODUCTION 

INDUSTRY CASE STUDY 1 Anānda Hope Valley, Hope Valley, South Australia “Ceiling lift technology” The proprietors of Anānda Hope Valley residential aged care facility investigated the use of ceiling mounted electrical hoists in developing Stage 1 of their 71 b ed facility. They considered the devices, researched the issues involved in installing the devices into bedrooms and en suites, and conducted a cost analysis. They considered the benefits of  fixed systems verses the portable systems available. In a portable system, the motor can be detached from the tracking and used across a variety of rooms. In a fixed system, the motor is attached to the tracking and dedicated to a specific room. The design considered the various configurations of the tracking for over the bed, bed to chair, and bed to en suite. The devices and tracking are available in straight/curved sections, turntable junctions which allow for a change in direction; a transverse system allowing for two-way movement (up/down and across); fixed to the ceiling; suspended from the ceiling or recessed into the ceiling; various weight capacities up to 360kg.  Additional structural members in the ceiling were considered in the design to take the load. The main challenges involved the design and layout of the bedroom and en suite given the fixed position of the tracking. The aim was to make resident handling safer and more efficient, require minimal physical exertion, and reduce the requirements for storage space for mobile lifters. The hoists were also considered easy to use regardless of the floor  surface, as some textured floor surfaces make it difficult to manoeuvre mobile hoists. Staff required training in use of the devices. In making the decision to install the ceiling hoists, the organisation considered: •

compliance with Australian Standard AS ISO 10535-2003:Hoists for the transfer of disabled persons Requirements and test methods

•

checking with the building surveyor that fire safety requirements were not compromised

•

weight and noise of the motor 

•

comfort and dignity of the resident

•

aesthetics and compatibility with the home like environment

•

charging requirements.

The final design solution and safe work requirements put in place by the organisation are detailed in the photos and building plan below. The organisation has been pleased with the staff and resident response to using the ceiling lift technology and has incorporated provision for more ceiling hoists to be installed in stage two of their facility development. Refer to the obligations under the OHSW Regulations 1995 (S.A.) 1.3.2 and 1.3.3 to conduct ‘hazard identification and risk assessment’, and implement ‘control of risk’. This requirement encompasses the ‘life cycle’ impact to all persons associated with a facility; and the subsequent and ongoing requirement to create and maintain a risk register.

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INDUSTRY CASE STUDY 1 Anānda Hope Valley, Hope Valley, South Australia “Ceiling lift technology” Photos 1-3: illustrating ceiling mounted electrical hoists.

Photo 3

Photo 1 Photo 2

Plan 1: Illustrating design and layout of the bedroom and en suite and path of lifter track.

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INTRODUCTION 

1.6 OHS RESPONSIBILITIES FOR DESIGN Designers of a product that is associated with a workplace, whatever that product may be, have responsibilities under  OHS legislation to ensure their design is inherently safe throughout all stages of its life cycle. Refer to OHS&W Act 1986 (SA), Section 23A and 24, printed below. Owners of a product that is associated with a workplace, also have responsibilities to ensure that the product, (a building, building addition or extension, item of plant or equipment, substance or work process) is safe. These responsibilities of both the owner and designer are in addition to any responsibilities described under other  legislation such as the Development Act, Trade Practices Act or the Electrical Products Act. Designers may also have contractually enforceable obligations to the product’s prospective owner under their design commission and brief, which may guide the direction and extent of the designer’s work and may instruct the designer  in relation to some issues, such as acceptance/rejection of some design change proposals. Contractual issues may lead to concomitant responsibilities for product safety; both the designer and owner having responsibility to ensure the product is safe throughout its life cycle, but with the owner having some control over the extent and direction of the designer’s work. Contractual agreements between an owner and designer do not derogate from their legislated responsibilities under OHS legislation.

Occupational Health Safety and Welfare Act 1986 South Australia (Version 15.8.2005) Section 23A – Duties of designers and owners of buildings (1) A person who designs a building that is reasonably expected to comprise or include a workplace must-  (a) ensure so far as is reasonably practicable that the building is designed so that people who might work in, on or about the workplace are, in doing so, safe from injury and risks to health; and  (b) ensure that the buildi ng complies in all respects with prescribed requirements (if any) applicable to it. (2) The owner of a building that comprises or includes a workplace must-  (a) ensure so far as is reasonably practicable that the building, and any fixtures or fittings within the building  that are under the control of the owner, are in a condition that allows people who might work in, on or about  the workplace to be safe from injury and risks to health; and  (b) ensure that the buildi ng complies in all respects with prescribed requirements (if any) applicable to it. (3) In this section - building includes a part of a building.

Section 24 - Duties of manufacturers etc  (1) A person who designs, manufactures, imports or supplies any plant to which this subsection applies must-  (a) ensure so far as is reasonably practicable that the plant is designed and constructed so as to be safe(i) when properly used and maintained; and  (ii) when subjected to reasonably foreseeable forms of misuse; and  (b) ensure so far as is reasonably practicable that the plant is designed and constructed so that people who might use, clean or maintain the plant are, in doing so, safe from injury and risks to health; and  (c) take such steps to test or examine, or arrange for the testing or examination of, the plant as are reasonably necessary to ensure compliance with paragraphs (a) and (b); and  (d) ensure that the plant complies in all respects with prescribed requirements (if any) applicable to it; and  (e) ensure so far as is reasonably practicable that adequate information about any conditions necessary to ensure the safe installation, use and maintenance of the plant is supplied with the plant.

( 2) A person who erects, installs or modifies any plant to which this subsection

applies must ensure so far 

as is reasonably practicable that it will be safe-  GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES 0308

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INTRODUCTION  (a) when properly used and maintained; and  (b) when subjected to reasonably foreseeable forms of misuse. 2aa) Subsections (1) and (2) apply to— (a) any plant that is to be used, or reasonably expected to be used, at a workplace; and  (b) without limiting the operation of paragraph (a), any plant to which this Act extends by virtue of Schedule 2. (2a) Without derogating from the operation of subsections (1) and (2), where any structure is to be erected in the course of any work(a) the person who designs th e structure must ensure so far as is reasonably practicable that the structure is designed so that the persons who are required to erect it are, in doing so, safe from injury and risks to health; and  (b) any person who manufactures any materials to be used for the purposes of the structure must ensure so far as is reasonably practicable that the materials are manufactured so that the persons who are required to erect the structure are, in using, handling or otherwise dealing with the materials, safe from injury and risks to health; and  (c) any person who imports or supplies any materials to be used for the purposes of the structure must  ensure so far as is reasonably practicable that the materials are in such a state as to be safe to any person who must use, handle or otherwise deal with the materials; and  (d) the person undertaking the erection of the structure must ensure so far as is reasonably practicable that  the structure is safe during the course of its erection and subsequent use. (3) A person who manufactures, imports or supplies any substance for use at a workplace must-  (a) ensure so far as is reasonably practicable that the substance is in such a state as to be safe(i) when properly used, handled, processed, stored, transported or disposed of; and  (ii) when subjected to reasonably foreseeable forms of improper use, handling, processing, storage, transportation or disposal; and  (b) ensure so far as is reasonably practicable that the substance is in such a state that persons who might  use, handle, process, store, transport or dispose of the substance are, in doing so, safe from injury and risks to health; and  (c) take such steps to test or examine, or arrange for the testing or examination of, the substance as are reasonably necessary to ensure compliance with paragraphs (a) and (b); and  (d) ensure that the substance complies in all respects with prescribed requirements (if any) applicable to it; and  (e) ensure so far as is reasonably practicable that adequate information about any conditions necessary to ensure its safe use, handling, processing, storage, transportation or disposal is provided in connection with the supply of the substance. (4) In this section-  structure includes a part of a structure.

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1.7 CONSULTATION Consultation is an important aspect of safe design. Designing what is required and what will work, without creating additional hazards or unnecessary increased workloads, can be achieved by including all end users in the design of  products or buildings. Consultation involves the sharing of information and the exchange of views between people. In the workplace this is generally applied to the interaction between employers and employees. In the case of safe design, it involves the sharing of information between all persons involved in the development of the end product or building. Consultation ensures that everyone involved is made aware of hazards and OHS issues experienced by employees and residents and can take steps to eliminate them from any future d esigns of products or buildings. Consultation during planning of new work or work processes, and during identification, assessment and control of  risks, provides a practical and effective platform for agreement and commitment for the prevention of work related injury and disease.

1.8 GLOBAL DIRECTIONS Workplace safety and safe design is a key consideration globally. Health and aged care has been identified as a high risk industry for work place injuries. Research, policy and workplace interventions have been particularly progressive in countries such as Canada, United Kingdom, Netherlands, Sweden, Norway, Denmark, United States of America and Australia. In recent years, the global focus has been on eliminating or reducing hazards and injuries through promoting risk analysis of the work environment and practices, and implementing strategies to prevent injury. Strategies for the aged care industry include: the promotion of no lift policies, designing out potential risks in the development of new or  redevelopment of existing facilities, and consideration of the principles of universal design. Studies on use of new technologies to support a safer work environment have also been undertaken. These include a focus on portable patient ceiling lift devices and the use of wireless technology.

For further information refer to: The Construction Technologies Institute, unit of Rome 2006 – Health, Buildings, Typologies, Quality and Safety www.roma.itc.cnr.it/vers_inglese/home_ing.htm The Living Lab – Research to Facilitate Independent Living www.sfu.ca/livinglab Ontario Safety Association for Community and Healthcare www.osach.ca US Department of Labour – Occupational Safety and Health Administration www.osha.gov European Agency for Safety and Health at Work www.europe.osha.eu.int/info Health & Safety Executive www.hse.gov.uk

1.9 AGEING IN PLACE AND EMERGING ISSUES The capacity for design to enable older people to remain in their own homes and receive care, or receive a continuum of care in a retirement or residential facility without the need for continual relocation is an important design consideration. Design should be adaptable and take into account changes in people’s needs and levels of acuity, and the necessary involvement of others (carers, family members) in the designed space. GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES 0308

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INTRODUCTION  Design for ageing in place requires consideration of the most dependent levels of resident need. Residents with high degrees of physical dependency often require greater space to allow staff to assist residents in a safe working environment.

For further information and links refer to: Department of Health and Ageing www.health.gov.au/internet/wcms/publishing.nsf/content/ageing-publicat-ageplace.htm Design 4 Health National Manual Handling Campaign Industry Summary report (2005) www.safework.sa.gov.au - follow links to Industries > Community Services > Design 4 Health Valuing Older Workers: Preparing your business for an ageing w orkforce, Queensland Government Department of Industrial Relations 2005 www.dir.qld.gov.au/pdf/ir/olderworkers_booklet2006.pdf 

1.10 DESIGN FOR DEMENTIA Residents in a dementia specific unit or wing of a residential facility require expert and complex care in a specialised dementia program. The safe design of the building provides an opportunity to support behaviour management and provide appropriate stimulation and orientation for residents to function at their best. Designers need to consider issues that will i nfluence behaviour; and which design features will enhance the dementia program. Such issues include: •

•

•

•

•

•

Stimulation and control of visual, acoustic, and movement aspects, as they relate to behaviour management of  residents. Resident cues and interfaces which support behaviour management. The use of colour, form, finish, landmarks and multi-sensory design aspects should be considered. Enabling ‘planned’ wandering through design features, including the relationship between the internal and external space, continuous paths, lighting and attractions. Providing a secure environment with flexibility and freedom of movement through personal, building and perimeter  security Centralisation of daily activities around a core element of the facility (kitchen, lounge, dining room).  Access to controls, equipment, items and spaces leading to inappropriate use by dementia residents should be ‘designed out’ of such facilities. Issues of supervision, unauthorised access and potential for risk or harm to residents must be carefully evaluated.

For further information and links on dementia refer to: Alzheimer’s Australia www.alzheimers.org.au ‘Prevention and management of resistance to care report, Final report’, J. Grealy, C&G Education and Research Pty Ltd, WorkCover Grant, South Australia www.safework.sa.gov.au/contentPages/Industry/AgedCare/agedResources.htm

1.11 DESIGN FOR PALLIATIVE CARE The increasing levels of acuity within residential care facilities, Ageing in Place, and the desire for people to die in their ‘home’, makes palliative care an important consideration in the design of Aged Care environments. The avoidance of an institutional appearance and atmosphere is considered to be particularly important in relation to the need to take account of the complex emotions and perceptions of those in palliative care, as well as their family and friends. GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES 0308

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INTRODUCTION  The creation of a ‘domestic’ character may be assisted by: •

attention to the quality of light

•

exploiting views

•

use of colour 

•

selection of furniture and fi xtures.

The clarity of circulation is important through avoiding confusing or complicated circulation routes. The environment should offer privacy to palliative care residents and their families, as well as a quiet environment with a higher than normal level of sound containment and acoustic privacy. A hig her than normal level of ventilation should be provided to minimise odours. Sheltered outdoor spaces should be created in and around the area.

For further information and links on Palliative Care refer to: Palliative Care Australia www.pallcare.org.au

1.12 OVERHEAD LIFTERS  As ‘No Lift’ procedures become more widely implemented as a means of reducing risks to workers and accidents’ overhead tracking is becoming an important consideration in the design of facilities. It is available as a portable system - where the motor can be detached and used in a variety of rooms, or in a fixed position. Transfers using overhead tracking require minimal physical exertion, reduced transfer and storage space, and generally require only one carer. The system is primarily used in over the bed transfers, in the bathroom, and therapy/specialist settings. In terms of the design of a room - adequate ceiling supports are required, the room layout will need to consider the position of the tracking, and a mobile hoist is still required for b ack up. The complexity of the system will depend on the resident mix, no lift policy, other lifting equipment used and the overall design of the facility. In addition, the issues of comfort and dignity for residents, noise, aesthetics, costs and potential savings (storage, staff time) and ease of using need to be considered. Structural considerations, even for future planned installation of overhead lifters, is more economic when considered as part of the original design.

For further information and links for overhead lifters refer to:  Australian Standard AS ISO 10535-2002: Hoists for the transfer of disabled persons - Requirements and test methods www.standards.org.au – follow links to Australian Standards WorkSafe Victoria “Designing Workplaces for Safer Handling of Patients/Residents - Guidelines for the design of health and aged care facilities”, second edition 2002. www.workcover.vic.gov.au/publications

1.13 DESIGN FOR DISASSEMBLY Products should be chosen which facilitate disassembly for repair and subsequent recycling of materials. Built environments should consider issues affecting modification or demolition of structures; including recycling of  materials.

1.14 CULTURALLY AND LINGUISTICALLY DIVERSE POPULATIONS (C.A.L.D.) / ABORIGINAL AND TORRES STRAIT ISLANDERS The design process needs to consider the needs of all users; including people from Culturally and Linguistically Diverse Populations (C.A.L.D.), and Aboriginal and Torres Strait Islanders. A range of multicultural resources and information are available to designers, planners and service providers. It is recommended that information is sought on design considerations as they relate to safe design and the target group(s).

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INTRODUCTION 

For further information and links refer to: Multicultural SA www.multicultural.sa.gov.au Australian Department of Immigration and Multicultural Affairs www.immi.gov.au Aboriginal Health Council of South Australia www.ahcsa.org.au

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2. PRACTICAL EXAMPLES Environments (living and working) Within Aged Care environments we must consider both the needs of persons receiving the care/service and the service providers. A range of hazards can be identified within these environments and should be assessed, controls implemented and evaluated to ensure a safe and healthy environment for both the care receiver and the service provider. Some of the hazards that are commonly identified in Aged Care environments include: •

Inadequate space provision to allow for equipment to be moved in and out of an area to assist in manual handling or for persons to freely move when using their wheelchairs or walking frames.

•

Flooring that is slippery, uneven, or with differing textures makes moving of wheeled equipment difficult.

•

Poor or inadequate lighting of the tasks or activities being undertaken, or, failing to meet specific individual needs.

•

Radiated noise creating noisy built environments

•

Poor security arrangements

•

Lack of privacy or individual personal space needs

•

Poor work flows

•

Distances to storage areas for equipment required or inadequate amount of storage

•

•

•

Colour schemes that whilst they look aesthetically pleasing create confusion for residents when seeking specific rooms. Ramps placed throughout facilities, making moving around and moving trolleys etc difficult, and creating unnecessary muscular manoeuvring exertion. Poorly designed or inadequate ventilation. Simple designs for ventilation are often the most effective and can cost a great deal l ess than complex mechanised and electrical systems.

•

Long distances to toilets, lifts, common areas, and lounges.

•

Furniture purchased for use in areas is large and cumbersome, not adjustable.

There are common requirements for all room functions and environments which need to be considered in the design, and in conjunction with the specific requirements for each room. Examples are as follows:

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2.0 COMMON REQUIREMENTS FOR ALL ROOM FUNCTIONS

 Access •

Door opening - clear width requirements

•

Door swings - access and egress

•

Door furniture – specification requirements

•

Sliding doors – specification requirements

e-Links www.workcover.com WorkSafe Victoria, “Designing Workplaces for Safer  Handling of Patients/Residents” – www.workcover.vic.gov.au then publications “Transferring People Safely – A Practical Guide to Managing Risk” “Queensland RACF Design Guidelines” – www.health.qld.gov.au/cwamb/agedguide/ Building Code of Australia (BCA) – www.abcb.gov.au

Floor surfaces •

Specification of non-slip surfaces

•

Traversing between surfaces

www.hermanmiller.com – ergonomics

www.standards.org.au – for these and other relevant  Australian Standards  AS1428 - Design for access and mobility

Lighting / ventilation / noise •

•

•

•

•

•

•

•

 Access to windows Florescent filters, Lighting levels, Increase lighting and reduce the contrasts in lighted areas Reduce glare from windows, Reflected glare on monitors Colour contrasts between walls and floors Minimise discomfort from thermal conditions - operating temps  Air quality conditions - air movement, use of  filters Chemical storage  Acoustics and noise

 AS4299 - Adaptable Housing  AS1680 – Interior Lighting  AS1158 - Lighting for roads and public spaces  AS3661 - Slip Resistance of pedestrian surfaces  AS 1020 – The control of undesirable static electricity  AS3666 - Air handling & Water Systems of Buildings  AS 1668 - The use of ventilation and air conditioning in Buildings  AS1345 - Identification of the contents of pipes, conduits and ducts  AS2441 - Installation of Fire hose reels  AS 3000 - Electrical Installations  AS 3008 - Electrical Installations – Selection of Cables  AS 3009 - Electrical Installations- Emergency power  supplies in Hospitals  AS 1768 – Lightning protection  AS 2107 - Acoustics – Recommended design sound levels and reverberation times in building interiors  AS 3671 - Traffic noise intrusion in buildings  AS 4282 - Control of obtrusive effects of outdoor lighting

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2.0 Common Requirements for all Room Functions (Cont./)

Safety and Environmental systems •

•

•

•

•

Fire protection system - exits, doors, equipment, fire rating requirements for building and introduced materials, compartmentalisation, Electrical/network system - Light switches, plug outlets, cabling, lifts, Climate regulation system - heating, cooling, Infection control, water temperature/ flow rates, Water reticulation, pipe work and control of  backflow, Materials selection - low emissions, fire rating,

e-Links  AS 1670 - Fire detection, warning, control and intercom systems  AS 2118 – Automatic fire sprinkler systems  AS 2293 - Emergency escape lighting and access signs  AS 2419 – Fire hydrant installations  AS 2441 – Installation of fire hose reels  As 2444 - Portable fire extinguishers and fire blankets  AS 3745 - Emergency control organization and procedures for buildings  AS 2500 - Guide to the safe use of electricity in patient care

Legislative requirements  Acts, Regulations and Guidelines

HB 260 - Hospital acquired infections – Engineering down the risk  AS 1470 - Health and safety at work

Equipment •

•

•

•

•

•

•

Purchasing procedures - health and safety assessment and approval Consultation – key stakeholders (i.e. residents, direct care staff)

 AS/NZS 2208 - Safety glazing materials in buildings  AS 4485 - Security for health care facilities  AS 3811 - Hard-wired patient alarm systems  AS 1657 - Fixed platforms, walkways, stairways, and ladders

Information - sufficient information about the proposed design/product Compatibility - with the design of the building and work practices

www.safework.sa.gov.au then Legislation

Space requirement - footprint/floor area covered by the new equipment

www.workcover.vic.gov.au/vwa/home.nsf/pages/so_ag ed – pre-purchase guidelines

 Access requirements - storage space, floor  surfaces compatible with the design of the equipment

www.dirp.qld.gov.au/pdf/whs/plant_code2005.pdf  Plant Code of Practice

Staff movement - constraints, anchorages, supports, manoeuvrability

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2.0 Common Requirements for all Room Functions (Cont./) Infection control considerations •

•

•

•

•

•

•

Clinical waste - treated appropriately, contained and transported carefully. Arrangements for collection impact on design and the location, size and infrastructure of the aged care facility. Waste disposal facilities - clear access to waste disposal facilities, including sluices, section for  storage of clean items should be carefully defined and protected from vapours, splashing or aerosols during procedures, hand washing, equipment washing, ultrasonic cleaning and reprocessing. Clinical hand basins - in all areas which resident treatment may occur with hot and cold water, non touch taps, supplies of liquid hand wash, and disposable paper towels. Taps should have anti splash devices. Impervious surfaces - areas for managing resident blood and body waste should have smooth impervious seamless surfaces without crevices

e-Links  ANCAHRD Guidelines for blood and body fluid exposures www.health.gov.au/internet/wcms/publishing.nsf  /content/icg-guidelines-index.htm www.safework.sa.gov.au

www.standards.org.au  AS 4031 and amendment 1 and AS/NZ 4261 and amendment 1  AS 1668.2 and Supplement 1 or State/Territory guidelines. - ventilation  AS SET 3500, AS/NZS 3666 and Standards  Australia Handbook HB32, AS/NZS 3896 cooling towers and water systems  AS/NZS 4187, AS/NZS 4815 - work flow

Work areas - adequate lighting, good ventilation and suitable receptacles for the disposal of waste, easy access to equipment and safe storage for  equipment not in use. Adequate bench space, at least one stainless steel sink or trough deep enough to accommodate instruments and other  equipment requiring cleaning (double sinks are preferred), space for ultrasonic cleaners Cooling towers and water systems - meet  Australian Standards Workflow - from clean to contaminated areas

The following practical examples provide a guide to the safe design of a specific room function:

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2.1 EN SUITE/BATHROOM DESIGN Function: provision of bathroom facilities for residents. Plan: sourced from  Anānda, Hope Valley, Hope Valley, South  Australia

Workflow and Layout •

Clear space on both sides of the toilet

•

Toilet ideally located opposite door 

•

Manoeuvrability for carers, person and equipment

Sanitary ware

e-Links WorkSafe Victoria, “Designing Workplaces for  Safer Handling of Patients/Residents” – www.workcover.vic.gov.au then publications “Design Guidelines for Queensland Residential  Aged Care Facilities” www.health.qld.gov.au/cwamb/agedguide/

•

Shower floor gradient

•

Shower alcove size requirements

•

Lip to shower area

www.standards.org.au

•

Specification of basins

 AS 1428.1 - Design for access and mobility

Specification of grab bars in the bath/shower 

 AS 3500 - Plumbing and Drainage

•

•

•

Support arms on both sides of the toilet and/or grab bars Ease of use of taps

 AS 3661 - Slip Resistance of pedestrian surfaces  AS 3666 - Air handling & Water Systems of  Buildings  AS 1668 - Interior Lighting

Considerations of use •

•

•

Carers - assisting with transfers and personal care

www.safework.sa.gov.au

 Ageing in place - provision for increasing dependencies Equipment – type, dimensions, storage and access

Potential hazards / risks Slippery/wet floors; space restrictions; inadequate ventilation; personal emergency - door locked; visual problems re: lighting/patterns/contrast

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2.2 BEDROOM DESIGN Function: provision of bed, personal affects/furniture.

Workflow and layout •

•

•

Required clear space on both sides, and end of the bed Storage of wheelchairs/walking frames, television/entertainment equipment/computer   Access to the en-suite bathroom

Furniture / equipment

e-Links WorkSafe Victoria, “Designing Workplaces for  Safer Handling of Patients/Residents” – www.workcover.vic.gov.au then publications “Design Guidelines for Queensland Residential  Aged Care Facilities” www.health.qld.gov.au/cwamb/agedguide/ Building Code of Australia (BCA) www.abcb.gov.au www.standards.org.au

beds (variable widths) and wardrobes (built in/free standing)

 AS1428.1 - Design for access and mobility

•

side tables and chairs - ergonomic requirements

 AS4299 - Adaptable Housing

•

display cabinets, built in furniture

•

lifting machine at foot end of bed

 AS3661 - Slip Resistance of pedestrian surfaces

•

medical equipment (eg. Nebuliser)

 AS1680 - Interior Lighting

•

 AS3000 - Electrical Installations

Considerations of use •

•

•

•

Carers - assisting with transfers and personal care  Ageing in place - provision for increasing dependencies

 AS 2500 - Guide to the safe use of electricity in patient care

www.safework.sa.gov.au

Change of use - rooms may be used for other  purposes Equipment - a variety of equipment may be used

Potential hazards / risks Space restrictions; tripping points; non-electric beds; manual handling; uneven flo ors; sharp edges on furniture; poor  levels of lighting/external glare; protruding b ed controls; clutter, lack of adequate storage

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2.3 DINING ROOM DESIGN Function: serving of meals and various other activities of a social nature.

Workflow and layout •

•

Space for the temporary storage of mobility equipment Proximity of furniture and space between dining tables to allow for easy transfer and manoeuvrability of residents

•

Wheelchair and walking frame access

•

Food service requirements

•

•

Consideration of numbers of persons with regard to access & egress

e-Links WorkSafe Victoria, “Designing Workplaces for Safer Handling of Patients/Residents” – www.workcover.vic.gov.au then publications “Design Guidelines for Queensland Residential Aged Care Facilities” www.health.qld.gov.au/cwamb/agedguide/ Building Code of Australia (BCA) – www.abcb.gov.au

 Access to alfresco dining www.standards.org.au  AS1428.1

Furniture / equipment •

tables and chairs - ergonomic requirements

•

display cabinets, built in furniture

•

servery/ buffet/mobile trolleys

 AS 4688 – Furniture – Fixed height chairs

www.safework.sa.gov.au

Considerations of use •

•

Carers - assisting with transfers and personal care Change of use - rooms may be used for other  purposes

Potential hazards / risks •

Space restrictions; tripping points, uneven floors; sharp edges on furniture; poor levels of lighting/external glare; clutter, lack of adequate storage

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2.4 OFFICE AREAS DESIGN Function: administrative tasks, storage of records.

Workstation design and layout Horizontal surface and storage space needs for type of work

e-Links

•

Equipment requirements/data points/ adjustability

•

Privacy requirements

www.safework.sa.gov.au – Safeguard No. GS 43, GS 31, GS 66/2

•

Display space / personalization

•

Enclosed meeting spaces

•

www.workcover.com

Building Code of Australia (BCA) – www.abcb.gov.au www.standards.org.au - for these and other relevant Australian Standards

Furniture / equipment

 AS 3590 – Screen based workstations

Desks and chairs - Ergonomic requirements  AS 4438 - Height adjustable swivel chairs Filing cabinets, display cabinets, tables, built in furniture  AS 1680 – Interior lighting Separate room for photocopier   As 3080 - Telecommunications installations HB 59 – Ergonomics

Considerations of use •

•

Change of use - rooms may be used for other  purposes

www.safework.sa.gov.au

Equipment - a variety of equipment may be used

Potential hazards / risks Space restrictions; inadequate ventilation; ergonomic hazards i.e. static postures; repetitive movements; trip hazards such as file drawers and electrical cables; security; lighting; inadequate space; limited storage; photocopiers; ventilation.

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PRACTICAL EXAMPLES

2.5 LAUNDRIES DESIGN Function: washing and drying/folding of residents clothes.

Workflow and layout requirements •

Demarcation of dirty linen from clean linen

•

Ease of use of taps

•

Sinks dimensions & positioning

•

Cupboards

•

Folding area, ironing facility

e-Links “Queensland RACF Design Guidelines” – www.health.qld.gov.au/cwamb/agedguide/

www.standards.org.au  AS 4146 - Laundry Practice  AS 1428.1 - Design for access and mobility

Washing machines and Dryers •

•

Specification to meet load requirements for  number of residents Height access for loading/unloading washing

 AS 3500 - Plumbing and Drainage  AS 3661 - Slip Resistance of pedestrian surfaces  AS 3666 - Air handling & Water Systems of  Buildings  AS 1668 - The use of ventilation and air  conditioning in Buildings

Chemicals •

•

 AS1680 - Interior Lighting

Direct feed system to reduce handling, contamination, Secure storage of chemicals

www.safework.sa.gov.au

Considerations of use •

•

Use by residents (with mobility aids) Equipment - a variety of equipment may be used

Potential hazards / risks Biological / infectious hazards; chemicals; temperatures; slippery/wet floors; space restrictions; Inadequate ventilation; build up of lint & noxious gasses in washing machine filter 

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PRACTICAL EXAMPLES

2.6 KITCHEN DESIGN Function: food preparation, serving, cold/dry storage of food supplies.

Workflow and layout requirements •

Commercial Kitchen design guidelines

•

Cooking/ reheating

•

Serving

•

Clean / dirty dishes flow

•

Dry and cold stores

•

Deliveries

e-Links www.safework.sa.gov.au

“Queensland RACF Design Guidelines” – www.health.qld.gov.au/cwamb/agedguide/

www.standards.org.au  AS 1428.1 - Design for access and mobility

Furniture and Equipment •

Commercial kitchen equipment

 AS 3500 - Plumbing and Drainage  AS 3661 - Slip Resistance of pedestrian surfaces  AS 3666 - Air handling & Water Systems of  Buildings

•

Fridge/ freezers

 AS 1668 - The use of ventilation and air conditioning in Buildings

•

Shelving/ height for access

 AS1680 - Interior Lighting

Cold storage

“Safe Design of Commercial Kitchens”

Considerations of use •

Equipment - a variety of equipment may be used

www.safework.sa.gov.au/contentPages/Industry/Ho spitality/Resources/hospResSafeDesignKitchens.ht m

Potential hazards / risks Temperatures; chemicals; cold heat stress; electrical; machine guarding absent; latex allergy; non-ionizing radiation; sharp objects; steam; thermal burns; slippery/wet floors; space restrictions; inadequate ventilation; light pooling

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2.7 STORAGE ROOM DESIGN Function: storage of records, paper supplies, general supplies

Workflow and Layout •

•

•

 Ascertain total storage requirements

www.safework.sa.gov.au

Type of goods and equipment to be stored Minimum access requirements between shelving

Shelving •

Load requirements

•

Reaching Height/ steps

Considerations of use •

e-Links

Storage- a variety of equipment and items may be stored including records, paper supplies, general supplies

“Queensland RACF Design Guidelines” – www.health.qld.gov.au/cwamb/agedguide/

www.standards.org.au  AS 1428.1 – Design for access and mobility  AS 1470 – Health and safety at work – principles and practices  AS 1940 – The storage and handling of  flammable and combustible liquids

www.safework.sa.gov.au

Potential hazards / risks Space restrictions; poorly maintained step/ladders; inadequate ventilation; unstable shelving / height of shelving and stored items; cluttered

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2.8 COMMON ROOMS DESIGN Function: multi-purpose room for activities, relaxation

Workflow and layout •

•

•

•

•

 Allowance for Lounge chairs/ recliners and tables sufficient for number of residents Separation of activities – passive/ active

e-Links WorkSafe Victoria, “Designing Workplaces for Safer Handling of Patients/Residents” – www.workcover.vic.gov.au then publications

Television visual comfort and screen size/positioning Ease of movement

“Queensland RACF Design Guidelines” – www.health.qld.gov.au/cwamb/agedguide/

 Access and storage for wheelchairs and walking frames

Furniture & equipment

Building Code of Australia (BCA) – www.abcb.gov.au

•

Lounge chairs/ recliners and tables

•

Display cupboards/ sideboards

www.standards.org.au

•

Storage cupboards

 AS1428.1

 Audio visual

 AS 4688 – Furniture – Fixed height chairs

•

Considerations of use •

•

•

www.safework.sa.gov.au

Carers - assisting with transfers and personal care Change of use - rooms may be used for other  purposes Equipment - a variety of equipment may be used

Potential hazards / risks Slippery/wet floors; space restrictions; inadequate ventilation; sharp edges; tripping; light pooling; visual problems re: patterns/contrast

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PRACTICAL EXAMPLES

2.9 PHARMACY/DRUG ROOMS DESIGN Function: preparation/ management of medications, storage

Workflow and layout •

•

•

 Ascertain total storage requirements Type of goods and equipment to be stored – high risk/ low risk Minimum access widths between storage areas

Dispensing

e-Links www.safework.sa.gov.au

“Queensland RACF Design Guidelines” – www.health.qld.gov.au/cwamb/agedguide/

www.standards.org.au

•

Storage cupboards / shelves

 AS 1428.1 – Design for access and mobility

•

Secure storage for drugs/ medicines

•

Preparation areas

 AS 1470 – Health and safety at work – principles and practices  AS 1940 – The storage and handling of  flammable and combustible liquids

Considerations of use •

Storage- a variety of medication and supplies

•

Preparation - medications

 AS/NZS 3816 – Management of clinical and related wastes

www.safework.sa.gov.au

Potential hazards / risks •

Slippery/wet floors; heavy and poorly maintained drug trolleys; latex allergy; chemicals; hazardous drugs; sharps i.e. needles; space restrictions; inadequate ventilation

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2.10 NURSE’S STATIONS DESIGN Function: visual monitoring, administration tasks, records storage

Workflow and layout •

•

e-Links

Visual access to facility areas

www.workcover.vic.gov.au then publications

 Access to records/ information/ computer 

www.safework.sa.gov.au – Safeguard No. GS 43, GS 31, GS 66/2

•

Ergonomics for furniture

•

Storage requirements

Building Code of Australia (BCA) – www.abcb.gov.au

www.standards.org.au

Furniture and equipment •

Storage cupboards

•

Benches/ desk

•

Computer 

•

Medication trolley/ cupboard

 AS 4438 – Height adjustable swivel chairs  AS 1680 – Interior Lighting  AS 3590 – Screen based workstations  AS 3080 – Telecommunications installations HB 59 – Ergonomics

Considerations of use •

 A variety of equipment may be used

•

 Administration

•

 AS/NZS 3816 – Management of clinical and related wastes

www.safework.sa.gov.au

Nurses, carers, visiting practitioners

Potential hazards / risks •

Tripping; sharp edges; space restrictions; light pooling; privacy restrictions; work bench restrictions; noise; security

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2.11 TOILETS DESIGN Function: independent or assisted ablutions.

The functional area for a wheelchair bound patient/resident who requires assistance in a side transfer.

Workflow and Layout •

•

•

Toilet ideally located opposite door  Minimum access space around the toilet for  manoeuvrability for carers, person and equipment Wheelchair and walking frame storage/ access to basin

The functional area for a patient/resident who can stand on both legs. This transfer requires the option of two staff  assisting by standing either side. The wheelchair is placed as shown in the diagram. This is also sufficient space for a patient to transfer with the help of a swivel board/turntable.

e-Links WorkSafe Victoria, “Designing Workplaces for  Safer Handling of Patients/Residents” – www.workcover.vic.gov.au then publications “Queensland RACF Design Guidelines” – www.health.qld.gov.au/cwamb/agedguide/

www.standards.org.au

Sanitary ware/ equipment •

Minimum Specifications and access space apply

•

Support arms on both sides of the toilet

•

Ease of use of taps

 AS 1428.1 – Design for access and mobility  AS 3500 – Plumbing and Drainage  AS 3661 – Slip Resistance of pedestrian surfaces  AS 3666 – Air handling & Water Systems of  Buildings  AS 1668 – Interior Lighting

Considerations of use •

•

Carers/ family - assisting with transfers and personal care

www.safework.sa.gov.au

Equipment - a variety of equipment may be used

Potential hazards / risks •

Slippery/wet floors; space restrictions; inadequate ventilation; personal emergency - door locked; light pooling; visual problems re: patterns/contrast

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2.12 CORRIDORS DESIGN Function: access to a variety of functions and spaces, flow pathways for people and equipment.

‘Clear width’ refers to the unencumbered space between the handrails.

The amount of clear width required in aged care facilities.

Layout

e-Links

Impact resistance

www.safework.sa.gov.au

Minimum widths apply to trafficable areas Lines of sight Reduce obstruction – ease of access and egress

Furniture •

Hall table & chairs in alcoves in some circumstances

“Queensland RACF Design Guidelines” – www.health.qld.gov.au/cwamb/agedguide/

www.standards.org.au  AS 1428.1 – Design for access and mobility

•

Handrails

 AS 1470 – Health and safety at work – principles and practices

•

Fire safety equipment

 AS – 2441 – Installation of fire hose reels  AS 2444 – Portable fire extinguishers and fire blankets

Considerations of use •

•

Clear access for beds/ equipment manoeuvrability Residents, carers, visitors

Potential hazards / risks •

Slippery/wet floors; space restrictions; inadequate ventilation; sharp edges; tripping; light pooling; visual problems re: patterns/contrast

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2.13 LOUNGE ROOMS DESIGN Function: relaxation, watching television/DVD/video, games.

Workflow and layout •

 Allowance for Lounge chairs/ recliners and tables sufficient for number of residents

•

Separation of activities – passive/ active

•

Television visual comfort and screen size/positioning

•

Ease of movement

•

 Access and storage for wheelchairs and walking frames

Furniture & equipment •

Lounge chairs/ recliners and tables

•

Display cupboards/ sideboards

•

Storage cupboards

•

 Audio visual

e-Links WorkSafe Victoria, “Designing Workplaces for  Safer Handling of Patients/Residents” – www.workcover.vic.gov.au then publications “Queensland RACF Design Guidelines” – www.health.qld.gov.au/cwamb/agedguide/

Building Code of Australia (BCA) – www.abcb.gov.au www.standards.org.au  AS1428.1 – Design for access and mobility  AS 4688 – Furniture – Fixed height chairs  AS/NZS 2107 – Acoustics – Recommended design sound levels and reverberation times in building interiors

Considerations of use •

•

•

Carers - assisting with transfers and personal care

www.safework.sa.gov.au

Change of use - rooms may be used for other  purposes Equipment - a variety of equipment may be used

Potential hazards / risks •

Slippery/wet floors; space restrictions; inadequate ventilation; sharp edges; tripping; light pooling; visual problems re: patterns/contrast

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2.14 SPIRITUAL AREA/HALL DESIGN Function: spiritual fellowship, quiet contemplation,

Workflow and layout •

•

•

•

Maximum numbers of users at any one time  Access for wheelchairs and walking frames Visual comfort and lectern height/positioning Consideration of numbers of persons with regard to access & egress

•

Impact resistance

•

Minimum widths apply to trafficable areas

•

Lines of si ht

e-Links WorkSafe Victoria, “Designing Workplaces for  Safer Handling of Patients/Residents” – www.workcover.vic.gov.au then publications “Queensland RACF Design Guidelines” – www.health.qld.gov.au/cwamb/agedguide/ Building Code of Australia (BCA) – www.abcb.gov.au

www.standards.org.au  AS1428.1 – Design for access and mobility

Furniture •

Lectern

 AS 4688 – Furniture – Fixed height chairs

•

Religious items

•

Chairs

 AS/NZS 2107 – Acoustics – Recommended design sound levels and reverberation times in building interiors

•

Tables

 AS 1428.1 – Design for access and mobility

•

Handrails

•

Fire safety equipment

 AS 1470 – Health and safety at work – principles and practices  AS – 2441 – Installation of fire hose reels

Considerations of use •

•

•

•

Carers - assisting with transfers Change of use - room may be used for other  purposes

 AS 2444 – Portable fire extinguishers and fire blankets

www.safework.sa.gov.au

Equipment - a variety of equipment may be used Clear access for resident wheelchairs / equipment manoeuvrability

•

General public, visitors

•

Recessed storage for equipment and supplies

Potential hazards / risks •

Space restrictions; inadequate ventilation; sharp edges; tripping; light pooling; visual problems re: patterns/contrast; blocked or locked egress routes; double door problems with travel paths; loose safety rails; splintered safety rails; slipping hazards from spills/wet floors; broken or torn flooring GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

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PRACTICAL EXAMPLES

2.15 HAIRDRESSER’S AREA DESIGN Function: grooming of residents hair. May incorporate beauty treatment in some circumstances and be used for other purposes.

Workflow and layout •

•

•

Separation of activities – washing/ drying/ beauty treatments Storage requirements/ Separation of storage for  hair products  Access and storage for wheelchairs and walking frames

Basins and Furniture •

Minimum Specifications for basins & wash area layout

e-Links WorkSafe Victoria, “Designing Workplaces for  Safer Handling of Patients/Residents” – www.workcover.vic.gov.au then publications

“Queensland RACF Design Guidelines” – www.health.qld.gov.au/cwamb/agedguide/

Building Code of Australia (BCA) – www.abcb.gov.au www.standards.org.au

•

Manoeuvrability and positioning of chairs

 AS1428.1 - Design for access and mobility

•

Ease of use of taps/ handheld shower outlets

 AS 4688 – Furniture – Fixed height chairs

•

Storage cupboards

 AS 3500 - Plumbing and Drainage

Considerations of use •

Carers - assisting with transfers and personal care

•

Equipment - a variety of equipment may be used

www.safework.sa.gov.au

Potential hazards / risks Slippery/wet floors; space restrictions; inadequate ventilation; personal emergency - door locked; light pooling; visual problems re: patterns/contrast.

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PRACTICAL EXAMPLES

2.16 CAFE/INTERNET CAFE AREA DESIGN Function: meeting place for visitors, residents and staff to enjoy leisure time, eat/drink and use computers. Photo sourced from Anānda, Hope Valley, Hope Valley, South Australia

Layout •

•

•

•

Ease of movement around tables & chairs Separation of activities (i.e. café versus internet cubicles) Minimum access/ traffic flow pattern for sales counter   Access and storage for wheelchairs and walking frames

•

Bins/ rubbish removal

•

Commercial kitchen design requirements

e-Links WorkSafe Victoria, “Designing Workplaces for  Safer Handling of Patients/Residents” – www.workcover.vic.gov.au then publications

“Queensland RACF Design Guidelines” www.health.qld.gov.au/cwamb/agedguide/

Building Code of Australia (BCA) www.abcb.gov.au

www.standards.org.au

Furniture •

Tables & chairs

•

Serving counter 

•

Computer visual comfort and screen size/positioning

Considerations of use •

•

•

 AS1428.1  AS 4688 – Furniture – Fixed height chairs  AS 4438 - Height adjustable swivel chairs

www.safework.sa.gov.au

Carers - assisting with transfers and personal care Change of use - rooms may be used for other  purposes Equipment - a variety of equipment may be used

Potential hazards / risks Slippery/wet floors; inadequate ventilation; sharp edges; tripping; light pooling; visual problems re: patterns/contrast; ergonomic hazards from poorly laid out computer areas; lack of space for wheelchairs to access computers; overcrowding; slips from spills.

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PRACTICAL EXAMPLES

2.17 MAINTENANCE AREA DESIGN Function: workshop activities, storage of supplies, tools, plant and electrical equipment, chemicals.

Workflow and layout

e-Links

Workshop workflow requirements

www.safework.sa.gov.au

Storage requirements for portable & fixed equipment Minimum access widths and working area around machinery & equipment

“Queensland RACF Design Guidelines” www.health.qld.gov.au/cwamb/agedguide/

Furniture

www.standards.org.au

Work bench - heights/ adjustability/ manoeuvrability

 AS 1428.1 - Design for access and mobility

•

Desk & chair/ notice board

 AS 1470 - Health and safety at work – principles and practices

•

Shelving height and accessibility

•

Garden equipment/ machinery

•

 AS 1940 - The storage and handling of  flammable and combustible liquids

Considerations of use •

Garage/ store of excess equipment & supplies

•

Equipment - a variety of equipment may be used

Potential hazards / risks •

Slippery/wet floors; space restrictions; inadequate ventilation; light pooling

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PRACTICAL EXAMPLES

2.18 PAN/SLUICE ROOM DESIGN Function: disposal of blood and body waste, cleaning of equipment.

Workflow and layout •

•

•

Storage requirements  Access widths and working area around wash area Height of washing areas and washing hose hook-up

e-Links “Queensland RACF Design Guidelines” www.health.qld.gov.au/cwamb/agedguide/

www.standards.org.au  AS 2437 - Flusher/sanitizer for bed pans and urine bottles

Basins and equipment

 AS 1428.1 - Design for access and mobility

Minimum Specifications and access space apply

 AS 3500 - Plumbing and Drainage

Equipment for managing human waste

 AS 3661 - Slip Resistance of pedestrian surfaces

Ease of use of taps

 AS 3666 - Air handling & Water Systems of  Buildings

Considerations of use •

•

Nurses/ carers/ cleaners Equipment - a variety of equip ment may be used

 AS 1668 - The use of ventilation and air  conditioning in Buildings  AS 1680 - Interior Lighting HB 260

www.safework.sa.gov.au

Potential hazards / risks •

Slippery/wet floors; space restrictions; inadequate ventilation; biological and infectious waste; chemicals; latex allergy; slips from spills; ventilation

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PRACTICAL EXAMPLES

2.19 RECEPTION AREA DESIGN Function: phone reception, receiving visitors/members of the general public/contractors.

Workflow and layout •

Exit and Entry traffic flow through main doors

•

Reception counter positioned to avoid congestion

•

Delineated waiting areas separate from traffic flow/reception

•

Wheelchair and walking frame access/ storage

•

Displays of information

e-Links www.safework.sa.gov.au - Safeguard No. GS 43, GS 31, GS 66/2

Building Code of Australia (BCA) www.abcb.gov.au

www.standards.org.au - for these and other  relevant Australian Standards

Furniture •

Reception counter functionality and ergonomics

•

Waiting chairs and tables ergonomics

 AS 3590 – Screen based workstations  AS 4438 - Height adjustable swivel chairs  AS 1680 – Interior lighting  As 3080 - Telecommunications installations HB 59 – Ergonomics

Considerations of use •

Public access/ visitors/ contractors

•

Carers/ family - assisting residents

•

Equipment - a variety of equipment may be used

www.safework.sa.gov.au

Potential hazards / risks •

Tripping / sharp edges/ space restrictions/ light pooling/ visual problems re: patterns/contrast; security; ergonomic hazards form poor workstation design

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PRACTICAL EXAMPLES

2.20 THERAPY AREA DESIGN Function: provision of physiotherapy, occupational therapy, group therapy activities, treatment rooms/cubicles/screened areas.

Workflow and Layout •

Required number of therapy suites/ cubicle

•

Multi purpose therapy floor area as per service needs

•

•

•

•

Waiting areas to suit wheelchair and walking frame access and storage Space around massage tables/ lifting equipment Hydro therapy - issues regarding pool safety/ traffic flow Storage requirements for therapy equipment

Furniture/Equipment

e-Links WorkSafe Victoria, “Designing Workplaces for  Safer Handling of Patients/Residents” – www.workcover.vic.gov.au then publications

“Queensland RACF Design Guidelines” www.health.qld.gov.au/cwamb/agedguide/

Building Code of Australia (BCA) www.abcb.gov.au www.standards.org.au

•

Provisions for lifting equipment/ ceiling mounting

 AS1428.1

•

Therapy beds – access for patient and staff 

 AS 4688 – Furniture – Fixed height chairs

•

Gym equipment/ basins/ sinks

 AS 4438 - Height adjustable swivel chairs

•

Storage cupboards/ privacy screens

 AS 2500 - Guide to the safe use of electricity in patient care

Considerations of use •

•

•

 Aids & Carers - assisting with transfers

www.safework.sa.gov.au

Change of use - rooms may be used for other  purposes Equipment - a variety of equipment may be used

Potential hazards / risks Slippery/wet floors; space restrictions; inadequate ventilation; light pooling; visual problems re: patterns/contrast

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PRACTICAL EXAMPLES

2.21 DRESSING ROOM (CLINICAL) DESIGN Function:, storage of dressings, equipment, treatment preparation.

Workflow and layout •

•

•

Positioning of cupboards and bench/ sink to assist workflow

e-Links “Queensland RACF Design Guidelines” www.health.qld.gov.au/cwamb/agedguide/

Sufficient trolley turning space Storage requirements specific to items and equipment

Furniture / equipment •

Built in cupboards/ benches/storage

•

Mobile dressing trolley

•

Bench top fridge for medications/ dressings

•

Basin/ sink

www.standards.org.au  AS 1428.1 - Design for access and mobility  AS 1470 - Health and safety at work – principles and practices  AS 1940 - The storage and handling of  flammable and combustible liquids  AS 1680 – Interior lighting  AS/NZS 3816 - Management of clinical and related wastes

Considerations of use Nurses/ carers

www.safework.sa.gov.au

Equipment – type, dimensions, storage and access

Potential hazards / risks •

Tripping; sharp edges; space restrictions; space restrictions; privacy; temperatures; latex allergy

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PRACTICAL EXAMPLES

2.22 DOCTOR’S ROOM DESIGN Function: visiting general practitioners for consulting with residents. The room may be used by allied health practitioners depending on the facility infrastructure and site requirements.

Workflow and layout •

•

 Access and storage for wheelchairs and walking frames

e-Links “Queensland RACF Design Guidelines” www.health.qld.gov.au/cwamb/agedguide/

Location of Patient bed/ desk for ease of  consultation www.standards.org.au

•

Separation of storage requirements (i.e. medical supplies)

Furniture / equipment •

Desk/chairs and computer 

•

Patient bed/ lifting equipment/ steps

•

Storage of medical supplies

•

Storage units/ built ins for paperwork/ reference material

 AS 1428.1 - Design for access and mobility  AS 1470 - Health and safety at work – principles and practices  AS 1940 - The storage and handling of  flammable and combustible liquids  AS/NZS 3816 - Management of clinical and related wastes  AS 2500 - Guide to the safe use of electricity in patient care

Basins •

Specification of basins

•

Ease of use of taps

www.safework.sa.gov.au

Considerations of use •

Use by multiple practitioners/ nurses

•

Equipment - a variety of equipment may be used

Potential hazards / risks •

Tripping; space restrictions; inadequate ventilation; light pooling

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PRACTICAL EXAMPLES

2.23 TRAINING ROOM DESIGN Function: in-service education, staff and management meetings, education resources. The training room may be used for other purposes such as an interview room and staff  room depending on the facility infrastructure and site requirements.

Workflow and layout •

•

•

 Access and circulation around tables and chairs Consideration of location of fixed audio visual equipment for presentations Consideration of numbers of persons with regard to access & egress

Furniture / equipment •

 Audio visual equipment

e-Links WorkSafe Victoria, “Designing Workplaces for  Safer Handling of Patients/Residents” – www.workcover.vic.gov.au then publications

“Queensland RACF Design Guidelines” www.health.qld.gov.au/cwamb/agedguide/

Building Code of Australia (BCA) www.abcb.gov.au

•

Tables & chairs – ergonomics

•

Storage/ display cupboards

www.standards.org.au

•

Side board

 AS1428.1

•

Portable whiteboard/ screen

 AS 4688 – Furniture – Fixed height chairs

Considerations of use •

Multiple use as a meeting/ board room

•

Staff & visitors

www.safework.sa.gov.au

Potential hazards / risks •

Tripping; space restrictions; inadequate ventilation; visual problems re: patterns/contrast; lighting

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PRACTICAL EXAMPLES

2.24 OUTDOOR AREAS DESIGN The design of the site plan incorporating the facility buildings in relation to the outside areas is important regarding the access to the building, lighting, ventilation, the creation of separate areas for residents, secure gardens, and management/maintenance. The types of vegetation, pathways, access points and screening/shelter are also important to consider in the overall plan.

Flow and layout •

•

•

•

•

e-Link

Variety of accessible and inaccessible landscape areas

“Queensland RACF Design Guidelines” www.health.qld.gov.au/cwamb/agedguide/

Consideration of therapeutic and sensory plantings/ raised garden beds

www.standards.org.au

Screening and shelter/ activity areas Minimum access widths for paths around buildings, passing spots, materials Way finding

 AS 1428.1 - Design for access and mobility  AS 1470 - Health and safety at work – principles and practices  AS 1657 - Fixed platforms, walkways, stairways, and ladders  AS1158 - Lighting for roads and public spaces

Furniture and fixtures •

•

•

Perimeter fencing - security and design Water features - safety features and management Outdoor chairs and tables - heights and ergonomics

•

Garden ornaments & lighting

•

Garden equipment

 AS3661 - Slip Resistance of pedestrian surfaces  AS1345 - Identification of the contents of pipes, conduits and ducts  AS2441 - Installation of Fire hose reels  AS 1768 – Lightning protection  AS 3671 - Traffic noise intrusion in buildings  AS 4282 - Control of obtrusive effects of  outdoor lighting

Considerations of use •

Equipment - a variety of equipment may be used

http://www.safework.sa.gov.au/ Crime Prevention Through Environmental Design www.penrithcity.nsw.gov.au/index.asp?id=860

Potential hazards / risks •

Slippery/wet paths; space restrictions; inadequate shelter; inadequate light; poorly secured; uneven surfaces

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PRINCIPLES OF SAFE DESIGN 

3. THE PRINCIPLES AND PROCESS OF SAFE DESIGN 3.1 LEVELS AND AREAS OF RESPONSIBILITY The principles of safe design were considered in section 1.3 above and, therefore will not be covered in detail here.  As an explanation of applying the principles of safe design in a process for the industry to utilise, the principles of safe design can be summarised as: •

•

•

•

Owners and designer’s levels of responsibility are equivalent to those of any employer under the OHS legislation and are based on their responsibility to take reasonable steps to eliminate hazards and minimise risks, to the extent to which each party h as control.  Applying risk management and continuous improvement processes to eliminate hazards to health and safety, or if  elimination is not possible, minimising risks from those hazards over the full life cycle of the designed-product. This includes consideration of the risks to workers, residents, volunteers and the public during manufacture / construction, installation, use, maintenance and decommissioning / demolition. Consulting with those affected by their product throughout its life cycle when identifying hazards and developing control strategies over the product’s life cycle. This is best achieved by involving representatives (through their  knowledge and experience) of each life cycle phase during the risk management and design review studies as early as practicable in the development of the project. Provide information and instruction about any risks associated with the product that could not be eliminated through the development of a risk register and feedback process, or its equivalent document that can be developed for an individual life cycle phase.

3.2 THE SAFE DESIGN PROCESS STEPS (Refer to Fig. 1 Page 49) The safe design process is a collaborative risk management process implemented at the design stage of a product. Such processes can only be effective if the parties to the design, development and ownership of a product adopt the safe design process as a responsibility and documented procedure in their everyday business strategy. Safe design processes are an investment in a product’s effectiveness, supporting other risk, value or asset management systems used to develop effective and efficacious products. The safe design process, which must be initiated at the product concept design stage to be effective, requires the allocation of responsibilities as well as time and financial resources. It is a process that can inform and educate all stages of a product, including the designer and owner, and lead to better and more innovative design solutions over  time.  An essential outcome of the safe design process is the production of a residual risk register to record any risk that could not be eli minated. On completion of the safe design process the residual risk register becomes part of the product owner’s documentation. The owner must then address residual risk at each life cycle stage by informing those involved about the risk and requiring those with control at each phase to implement risk mitigation strategies. Steps in the process are:

3.2.1. The product owner initiates the safe design process through the procurement process  A product owner engages, or arranges the engagement of the designer. It is clear, therefore, that the owner must take responsibility for initiating the overall safe design process by specifying it in the designer’s engagement brief. The designer’s brief should specify that the designer: •

•

•

Lead the safe design hazard identification, assessment and control process in consultation with the owner and representatives of the life cycle stages of the proposed product. Undertake redesign of the product, as a result of the risk assessment process, to eliminate, or if elimination is not practicable, minimise risks to health and safety arising from the product. Develop a residual risk register for the product owner to use to mitigate risks over the product’s life cycle.

Specifying responsibilities for the safe design process as part of procurement ensures that the process will occur. The owner should then use the residual risk register to bring identified risks to the attention of those in control at later  life cycle stages. There are various ways of doing this: by including an explanation of residual risks in contract GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES 0308

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PRINCIPLES OF SAFE DESIGN  specifications and then requiring proposals for mitigation strategies with tenders during later life cycle stages; or by ensuring work procedures developed in a workplace address known risks.

3.2.2. Identify and assemble a risk management team The designer team leader identifies and engages a risk management team in consultation with the owner. •

The team must represent knowledge about risks from each stage of the product’s life cycle and its context to be effective.

3.2.3. Set out the context for the review The context for examining design safety will depend upon the type of product, how a product may be used, the industry in which it is involved and skill levels of its users. The context of any product must address health and safety risks across the life cycle, and could also include a range of issues affecting the business, e.g. sustainability, future business requirements and long-term business objectives that may also have an impact on health and safety. Guidance on examining the context for risk management is outlined in AS/NZS 4360: Risk Management.

3.2.4. Collate information about risks associated with all stages of the product’s life cycle. The design team leader guides the risk management team to collate information about relevant issues based on each member’s involvement and should include: •

design industry publications and research,

•

previous injury or risk experience information from each industry sector involved,

•

research reports and industry publications that may address similar products or issues, and

•

OHS Authorities’ or other safety association reports.

3.2.5. Review the design to identify health and safety risks and redesign options to eliminate or minimise the identified risks The design team leader guides the risk management team at the design review stage to: •

identify hazards at each life cycle stage

•

assess risks from the hazards, and

•

identify options for redesign to eliminate or, if elimination is not possible, minimise the risks.

Designers must consult with the owner to gain their agreement with some design change aspects, and for the owner  to understand any implications of not approving recommended changes.

Example: No. 1  A high noise risk is identified in the drive operation of a proposed product: The owner specified the drive in the original documentation.  A designer recommends a quiet, but much higher cost redesign option that eliminates the noise risk. The owner, having been apprised of the risk, and its design solutions, exercises their contractual right, as the owner, to reject the redesign option, include the original drive in the process and accept responsibility for mitigating  the risk. The owner intends to install other, minimum cost control devices onsite, and so instructs the designer use the originally specified drive system. The designer is obliged to comply with their contractual obligation to the owner and design the product as specified. The designer can comply with their duty of care for safe design by registering the risk information for the owner to develop mitigation strategies at a later life cycle stage. This demonstrates and records the designer’s reasonably   practicable efforts to comply with risk minimisation by keeping written records of all negotiations or instructions concerning the decision.

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PRINCIPLES OF SAFE DESIGN 

3.2.6. Establish a residual risk register and record details of risks not eliminated The designer documents any risks not eliminated, their location, exposure circumstances and any suggested ‘downstream’ risk control strategy. The risk register becomes part of the owner’s project documentation, providing risk information to those involved at later stages of the product’s life cycle.

3.2.7. Use the residual risk register to inform life cycle stages of risk applicable to each life cycle stage The owner must ensure that residual risk information including any suggested mitigation strategies on is passed on to those in control, and to those involved at each life cycle stage of the product to ensure that risks are understood and mitigation strategies implemented. Including risk information in contract specifications, and requiring mitigation strategies to be outlined in t ender  documents can effectively achieve this. Example No.2 Residual risks that might be present during the construction phase of a building should be highlighted in the construction contract documentation, or  safety issues associated with the maintenance of an item o f plant can be highlighted in contract documents when engaging a maintenance contractor. Prospective building or maintenance contractors should then be required to submit proposed risk control strategies from their safety plans or work procedures with their tender documentation. Specific materials, processes or equipment necessary as part of a safety solution identified in the design review should be included, in general terms, in the specifications and/or drawings.

3.2.8. Review the process and product to update the register and inform the designer. Review the safe design process and the product at the post development and post implementation phases. The aim of this step is to record any new risks or risks not identified in the safe design process. Any new risks identified must be assessed and control strategies implemented. Update the risk register and in form the designer of any additional risks discovered or introduced and any additional options for hazard elimination or minimisation that might have been available.

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PRINCIPLES OF SAFE DESIGN 

Fig. 1 Risk Management in the overall context of product delivery Product owner initiates a project, engages a designer and specifies their  involvement in safe design through the engagement brief.

Designer and Owner initiate the safe design process, using design change where possible to eliminate or minimise risks to health and safety. The process must involve representatives of the owner, designer, manufacturer / constructor, user/ occupier, maintenance and disposal functions.

Designer develops the residual risk register to inform and guide the owner and those involved in life cycle stages through procurement processes and management systems.

Concept design phase

Detail design phase

Manufacture / Construct Supply / Fit out / Installation Use / Occupy Maintain Refurbish / Repair  Dispose / Demolish

Post delivery / construction & post run in / occupancy review. Owner to provide feedback to the designer, life cycle stages, and to update risk register.

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PRINCIPLES OF SAFE DESIGN 

Fig. 2 The Safe Design Process Process 1.

The product owner initiates owner initiates safe design through the procurement process Include responsibilities in designer’s engagement brief  •

2.

The design team leader identifies leader identifies and assembles the risk management team The team should represent each life cycle stage of the product.  A qualified Risk Manager could could act for the owner  • •

3. The owner and risk management team must agree the context for the review The context could include a range of business and/or environmental issues.

    E     S     A     H     P     N     G     I     S     E     D     T     C     U     D     O     R     P

4. The risk management team collates information about risks associated with all stages of the product’s life cycle.

5. The designer leads designer leads the risk management team to review the design, identifying health and safety hazards, assessing the risks and identifying redesign options to eliminate or minimise the identified risks. Ref Fig. 3 for Risk Assessments. Ref Fig. 4 for Risk Control. • •

6.

The designer establishes designer establishes a residual risk register and records details of risks not eliminated. The register becomes part of the of the owner’s product documentation. •

7.     S     E     S     A     H     P     E     L     C     Y     C     E     F     I     L     T     C     U     D     O     R     P

The product owner must owner must use the residual risk register to inform those involved at each life cycle stages of risks applicable to them. •

Use service specifications and tender documents to provide risk information and request mitigation strategies from prospective tenderers.

8.

As part of the product review process the owner should: owner should: review the product’s performance and risks, And, And, if necessary: update the residual risk register, inform those involved with manufacture, installation, use and maintenance about any change, and inform the designer of any issue for possible future redesign •

• •

•

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PRINCIPLES OF SAFE DESIGN 

3.3 THE RISK ASSESSMENT PROCESS (Ref: AS/NZS 4360 Risk Management) The following steps, adapted from AS/NZS 4360: Risk Management provides one method for assessing the risk of  hazards identified by the risk management team. The level of risk estimated for each hazard is not an absolute indicator; there is no definitive ‘right or wrong’ answer to risk assessment. The result is a measure of the view of the participants and serves to indicate two things, (a) a priority for treatment of the risk and (b) an indication of the effort that should be committed to eliminating the hazard.

•

The process described below is suitable for general physical hazards, however for assessment of the health effects of chemical, noise, heat, pressure hazards, other risk assessment processes that take into account dose and dose response effects may be more suitable. (e.g. Enhealth’s ‘Environmental Health Risk Assessment Guidelines, available at www.health.gov.au/pubhlth/strateg/env www.health.gov.au/pubhlth/strateg/envhlth/risk/) hlth/risk/)

•

Establish the context for  Risk Assessment

Hazards Identified by Risk Management Team

Fig. 3 Risk Assessment Phase 1. Estimate the Consequence:

2. Estimate the Exposure:

If an incident occurred, would the result be:

1. How many people exposed? 2. How often are people exposed to the hazard? 3. What is the duration of each exposure? Is the likelihood of an incident occurring considered to be:

Catastrophic, Major, Moderate, Minor, or  Insignificant ?

Almost certain, Likely, Possible, Unlikely, Rare? 3.

Use the matrix below to determine the Risk Level from the exposure and consequence information above: Is the level of risk: Extreme, High, Moderate or L or  Low? LIKELIHOOD

   e    c    n    e    u    q    e    s    n    o     C

Almost certain

Likely

Moderate

Unlikely

Rare

Catastrophic

E

E

E

E

H

Major

E

E

E

H

H

Moderate

E

H

H

M

M

Minor

H

H

M

L

L

Insignificant

H

M

L

L

L

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PRINCIPLES OF SAFE DESIGN 

Fig. 4 Risk Control

4. Use the estimated risk level from Fig. 3.

(above) as a guide to risk treatment effort:

5. Identify redesign options and redesign the situation .

6. Can the hazard be ELIMINATED by

redesign?

(a). Yes – Hazard ELIMINATED. 7 (a).

7. (b) No – Risk only MINIMISED

•

•

Document the solution for  future reference Register the residual risk for  mitigation by the product owner  during the products life cycle.

The level of risk determines the input effort to eliminate a hazard. E.g. more time and costs costs to eliminate an extreme risk level are justifiable, whereas an insignificant risk level might require only a warning label process instruction or monitoring note to a user. Risk may be minimised by minimising minimising exposure. Total exposure to a risk includes a number of components:

Risk = No. of people exposed X duration of each exposure X frequency of exposure X concentration (of some risks). •

Reducing any one or combination of the components may reduce the risk exposure.

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INDUSTRY CASE STUDY 2 Eldercare Incorporated SA “Risk Management” Eldercare Inc SA adopted the following approach to risk management across nine sites, as part of a continuous improvement and Occupational Health & Safety initiative: •

each site identified hazards and associated risks

•

all staff were involved across care, lifestyle and environmental service positions

•

risks were prioritized as either high, medium or low

•

a hazard register was established

•

a hazard status log was established for each site

•

controls were put in place for each risk

•

3 monthly review commenced to ensure controls are working

•

developed additional safe work practices at each site, which are now being amalgamated into a generic set.

Issues identified from previous building projects led to: •

•

•

•

•

Design of air handling systems in new kitchens to avoid moisture build up on the floors and possible risk of  slips/falls Fall arrest system for working at heights (eg cleaning windows and gutters) Development of checklist to identify any Occupational Health and Safety risks that may occur during the planning, implementation and commissioning stages of any new/renovating projects. To assist with the control of these phases Action Plans are developed prior to commencement of, and if required, during, each phase. Development of register to identify any OHS hazards/ risks at existing sites to eliminate at the design stage for any new buildings/ upgrades. Development of a Working Party for development/redevelopments involving Architects, Project Managers, Executive Directors, OHS Coordinator and staff from all areas to discuss OHS related issues commencing from the planning stage to implementation

Eldercare engaged a risk management consultant to assist the organisation in the process. Refer to the obligations under the OHSW Regulations 1995 (S.A.) 1.3.2 and 1.3.3 to conduct ‘hazard identification and risk assessment’, and implement ‘control of risk’. This requirement encompasses the ‘life cycle’ impact to all persons associated with a facility; and the subsequent and ongoing requirement to create and maintain a risk register.

Photo 4 Roof anchor bolt

Photo 5 Anchor bolt used for attaching a harness to clean external windows. Thanks to Roofsafe-T-systems Pty Ltd

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3.4 DEVELOPMENT /REFURBISHMENT OF AGED CARE FACILITIES: A SEVEN STEP GUIDE TO SAFE DESIGN When embarking on a building, product development program we often look to what is to be done and overlook the review of what is currently being done. As part of the development program organisations should look at what policies and procedures they currently have in place to ensure that safe and health of employees and persons in their care. Will these suit the needs of the new facility or are you going to be introducing poor practice into a new site? How can the changes to the building or introduction of a ne w product improve the practices for health and safety and have these been reflected in the policies and procedures. What training for staff will be required to ensure that they are aware of the changes to practice or policy? The success of any project or facility is reliant on foresight, good planning and attention to detail. Failing to plan is planning to fail. The following steps are a guide to help achieve the desired outcome. No one step stands alone but all are reliant on each other and will be found to overlap in some instances: Step 1: Concept Step 2: Outline Brief, organisation Step 3: Feasibility, research Step 4: Identification, Detailed brief  Step 5: Design, documentation Step 6: Construction Step 7: Commissioning

Step 1: Concept The first step in any endeavour is the idea, the vision of what will be. This requires an individual or group of individuals with foresight and commitment to put the procedures into place to bring the vision into existence. Communicate to members of your organisation the intent to build, refurbish or design. Invite interested persons to participate in the project. Identify what it is you want to achieve and why. Break the project into smaller components and establish focus groups. Utilise the skills, knowledge, experience and expertise of employees who are the users of  the end product, or building. Have these groups identify all the key considerations for the project? Invite external specialists or experts to sit on the focus groups or to provide input into outcomes from these groups. Liaise with other  organisations that have or are going through similar projects. Share difficulties together to achieve acceptable outcomes. Develop a framework for the vision.

Step 2: Outline brief, organisation •

The broad picture of what the aims of the facility or product will be.

•

Where the facility or product will be located or used.

•

When the expected commencement and completion of the project will be.

Collating all the information, identified needs, ‘wish lists’ and vision outcomes that have been gathered through the consultative process with all end users and f ocus groups.  At this stage consultants should be engaged. Architects are able to draw up sketch plans and colour perspectives utilising their information gathered and input from across the organisation and other persons involved in Step one.

Step 3: Feasibility, research It is at this stage where quantity surveyors need to be engaged to initially assess the feasibility of the original idea. Can the conceptual idea work or is it too expensive? It is at this point where budgets and costs need to be put together and take into consideration the usage and running costs.

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Research should be undertaken for a market analysis of: •

Current demographics

•

Projected populations

•

Demographic trends

•

User needs

•

Private and public sector involvement or competition

•

Operating personnel

•

Suitable sites

•

Potential user groups

•

Future trends and needs

•

Operation of similar facilities

Only when all information is available and research complete should the owner decide whether to proceed with the project, or not. The sole intention should not be to cut costs; it is important to accommodate future needs and avoid creating unsafe or substandard environments, which may lead to additional costs in the long term. It is good business sense and more cost effective to accept the costs early in the design stage rather than to make expensive changes later.

Step 4: Identification, detailed brief  Identify the market groups the facility is aimed at. Look at the future needs – changes within the Aged Care Industry and the impact of Ageing in Place. Identify the size and number of rooms and usage specific rooms or areas. Consult with the persons that will be using the areas. Consider space requirements for equipment that needs to be used within the rooms and furniture that residents may wish to have within their rooms. More detailed specification of building and operating requirements Develop a list of desirable features to include and avoid. This is where the work done by the focus groups in identifying safe operating needs and requirements can be utilised. Refine details as required through further discussions with consultants and the focus groups or end users.

Step 5: Design, Documentation Formal architectural plans and specifications Working drawings Engineering details Final consultations with: •

representatives of user and wider community groups

•

government bodies

•

interior designers

•

suppliers.

Detailed description of functional specifications in order for the facility to fulfil goals of the project such as: •

size and internal relationships

•

special requirements, temperature, lighting, usage adaptability

•

other special needs

Positive design changes may be required to meet changing needs of the community thus updated forecasting is required to meet these design changes.

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Step 6: Construction Determine suitable form of contract Engage Project manager to monitor project Go to tender and engage builder and or subcontractors experiences with type and size of facility Commence site works Have a detailed progress schedule of works and expected completion and update it monthly Order specialised commodities, furnishings, fit outs early Plan cash flow to avoid interest charges in line with expected work schedule and completion dates.

Step 7: Commissioning •

Set a realistic opening date after consulting with builder and architect and then allow a buffer of three weeks.

•

Develop a budget sufficient to launch the facility

•

Selection and hiring of personnel should have been completed during construction thus allowing for manager, key staff and maintenance supervisor to be on site before completion

•

Furniture, equipment etc should be ready for delivery

•

Ensure suppliers provide detailed operating manual on commissioning of equipment

•

Finalise selection and training of staff 

•

•

 Address defects and rectify any problem areas Make sure facility does what it is intended to do.

These seven steps are a basic starting point to guide one from the start through to the completion of any facility. They are not meant to be conclusive and allow for room and scope for the addition of specific requirements depending on the type of facility and its use. Once commissioning has taken place ongoing maintenance operational checks must be put into practice as well as adequate training. It is important that consultation occurs throughout all stages and steps of the development of the program and that post implementation an evaluation and monitoring program is established. Modification may be required with time as the needs of the community change. Further consultation with experts in various fields may this be required. Feedback from users, the general community and personnel is also important in order to keep the facility running efficiently. Most importantly we must not lose sight of the reasons for building the facility, the needs it must meet and the quality of care it must provide.

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3.5 BUSINESS EFFICIENCY Safe design processes are virtually identical to other risk management processes such as value management and asset management in that risks in various areas of a business are recognised and mitigated. In their analysis of  (3) costs of owning and using buildings , Evans et al identified that, in the overall life cycle costs of buildings, significant business operating cost reductions can be achieved through greater investment in the design and construction process, resulting in greater business efficiency. Example No. 3 (from Evans et al) For a commercial building) the whole of life cost ratios were found to be: Design and construction costs

1

Maintenance and building operating costs

5 

Business operating costs

200 

During the life of a building, usage, technology and operational aspects change. Complex pressures and problems arise when attempting to improve the productivity within a given building.  A design review, in one factory, to examine factors such as noise, temperature fluctuation, lighting and glare, layout and control of the layout by the occupants, resulted productivity improvements of up to 1 7%. Construction costs for a building are significant and an outcome of the safe design review can be construction cost reductions. Modularisation, standardisation and prefabrication, not only improve health a nd safety performance in construction by reducing exposure to falls and musculo-skeletal injury, but may also speed up construction, minimising construction time and costs. Loose fit design of plant and equipment in a building can reduce operating costs through simplified maintenance and provide a more flexible re-use of the structure in future.

3.6 SUSTAINABILITY  A major worldwide trend is sustainability. Managing resources and business activity to minimise global impacts of  energy usage, greenhouse effects and materials usage through re-use are becoming standard societal demands. (4) Ethical investment is a new cornerstone of business development and sustainability is an economic issue . Safe design supports sustainability. Many of the safe design solutions in use improve sustainable developments: •

•

•

minimising the use of volatile organic compounds not only improves the general health of workers but also supports greenhouse initiatives, using prefabricated building modules not only reduces construction workers’ exposure to falls from heights and musculoskeletal injury, but also reduces materials waste in manufacture and promotes recycling of building components through deconstruction instead of demolition maximising the use of natural lighting and natural ventilation has health and safety benefits for workers through an improved work environment as well as minimising energy consumption and greenhouse effects.

(3)

Evans R. et al The Long Term Costs of owning and using Buildings. The Royal Academy of Engineering, London November 1998. Viewed 24 November 2006 www.raeng.org.uk/news/publications/list/default.htm?TypeID=2 (4)

Property council of Australia. Sustainable Development Guide: A roadmap for the Commercial Property Industry. Property Council of Australia 2001

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INDUSTRY CASE STUDY 3 Southern Cross Care (SA) Incorporated “Sustainability and Safe Work design” Southern Cross Care (SCC) provides residential care to older people across South Australia. SCC investigated the use of solar panels as part of a residential facility development at Goolwa in the Fleurieu Peninsula. The benefits of  solar panels would provide a backup system to mainline electricity supply, as power blackouts have been a common occurrence in the region. The installation of solar panels would also align with the organisations newly developed environmental policy on the use of sustainable energy systems.  As part of the design planning process, the issue of cleaning the solar panels and appropriate safety considerations was raised as part of ongoing maintenance for the roof mounted solar panels.  Anchor bolts were specified by the Architect/Builder to be mounted on the roof, together with the use of harnesses for  maintenance staff and training in their use. Consideration was also given to accessing the roof from internal and external areas. The final design solution and safe work requirements put in place by the organisation are detailed in the pictures/diagrams for mounting the solar panels and anchor bolts. Refer to the obligations under the OHSW Regulations 1995 (S.A.) 1.3.2 and 1.3.3 to conduct ‘hazard identification and risk assessment’, and implement ‘control of risk’. This requirement encompasses the ‘life cycle’ impact to all persons associated with a facility; and the subsequent and ongoing requirement to create and maintain a risk register.

Onkaparinga Lodge Hostel Liddell Drive, Huntfield Heights. Facility is two storeys with a flat steel roof. Recognised during the construction planning that it would be necessary to access the roof for maintenance of the air-conditioners and for window cleaning and other maintenance tasks.  A pull down ladder was designed and installed – and anchor bolts fitted for use of fall arrestor lines. Further  safeguards included the installation of walkways over the roof steels sheets. Refer to Photos 6 -10

Photo 6

Photo 9

Photo 7

Photo 8

Photo 10

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3.7 LIFE CYCLE STAGES OF VARIOUS PRODUCT TYPES

Table 1: Life cycle stages of various product types Phase Design/development

Manufacture

Import/supply   s   e   s   a    h    P   e    l   c   y    C   e    f    i    L

Set up

Use

Maintenance

Further use

End of use

Description Planning Concept Research & development General design Detailed design  Approval Technical specifications Manufacture Construction  Assembly Testing & evaluation Packaging Labelling Storage Packaging Labelling Marketing Distribution Sale Hire or lease Transport Installation Erection Commissioning Occupation Operation Consumption Cleaning Maintenance Servicing  Adjustment Inspection Repair  Modification Refurbishment Renovation/extension Recycling Resale (direct, auction, dealer) Decommissioning Dismantling

(5)

Plant

Building

Substance

System

√ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

√ √ √ √ √ √ √

√ √ √

√ √

√

√ √ √

√ √

√ √ √

√ √ √ √ √ √ √ √ √

√ √ √

√ √ √ √

√ √

√ √ √ √ √ √ √

√ √

√ √

√ √ √ √ √ √ √

√ √

√

√

√

√ √

√

(5)

Modified, based on: Bluff L, Occupational Health and Safety in the Design and Manufacture of Plant  , unpublished draft of PhD research - 2002

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 APPENDICES and REFERENCES

APPENDICES

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APPENDIX A TABLE 1: GLOSSARY OF OHS AND DESIGN RELATED TERMS

Decision maker 

 Any party with influence over the specifications of the designed-product (including, but not limited to the designer, the client or commissioning agent, the financier, the manufacturer, supplier, purchaser, installer, user, insurer, importer, erector, maintainer and regulator, and employees of these agents).

Design

The process of bringing together innovation, aesthetics, and functionality to plan and create a product, process or system to meet the artistic, industrial or performance requirement of an individual or group. The design process involves a series of  activities where an idea is conceived, shaped, developed, produced and then acted upon to produce a designed product. It also includes any subsequent alteration of a designed product (redesign or retrofit). The stages of the design process include: •

•

Design process

•

•

the concept design phase which considers preliminary design options determining the best preliminary design by assessing design options against product specifications research and development, feasibility and risk management (including OHS risks). the detailed design phase which develops the selected design to its final state. This includes research and development, feasibility studies, concept and detail design, technical and functional specifications, plans and dra wings, operational systems, construct/manufacture options and detailed quantities, cost and risk analysis (including analysis of OHS risks).

Designed-product

The item to be designed, including a built environment, structure, an item of plant or  equipment, chemical, work system or process; or any other physical attribute or  system associated with either the work or its interface with people.

Hazard

 A source or situation with a potential for harm in terms of human injury or ill health, damage to property, environment or a combination of these.

Hazard identification

The process of identifying potential causes of injury or illness. Different methods may be used to identify h azards including observation; consultation with workers, clients or other users; trial of models or prototypes; review of technical standards and other  information sources; monitoring and measurement.

Hierarchy of controls

 A list of control measures, in priority order, which should be used to eliminate OHS hazards or minimise exposure to OHS risks. Application of the hierarchy of control considers, as the first priority, whether a risk can be eliminated. Where this is not practicable, the second priority is to consider substitution. If substitution is not practicable, the third priority is to use engineering controls. Lower order controls are then considered, eg, administrative procedures and, lastly the use of personal protective clothing or equipment. This hierarchy is applied, until a control measure or  combination of control measures are identified to eliminate the OHS hazard or  minimise the OHS risk.

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 APPENDICES and REFERENCES Cont./ Table 1: Glossary of OHS and design related terms

Life cycle

 All phases in the life of a product. Specific phases depend on the type of product but may include design, development, manufacture, construction, assembly, import, supply, distribution, sale, hire, lease, storage, transport, i nstallation, erection, commissioning, use or operation, consumption, maintenance, servicing, cleaning, adjustment, inspection, repair, modification, refurbishment, renovation, recycling, resale, decommissioning, dismantling, demolition, discontinuance or disposal.

OHS risk

Risk, in relation to any hazard, means the probability and consequences of injury, illness or damage arising from exposure to the hazard(s).

Plant

Plant includes any machinery, equipment (including scaffolding), appliance, implement or tool and any component or fitting thereof or accessory thereto.

Risk

The chance of something happening that will have an impact upon o bjectives, measured in terms of probability and consequences (see OHS risk above).

Risk assessment

The process of analysing the probability and consequences of injury or illness arising from exposure to identified hazards.

Risk evaluation

 An appraisal of the degree of undesirability of the various risks after they have been quantified, with consideration to the various factors and tradeoffs influencing risk acceptability.

Residual risk

Risk that remains after the application of controls, and other risk reducing methods or techniques.

Safe design

Safe design is a design process that eliminates hazards, or minimises potential risk to health and safety by involving decision makers and considering OHS risks throughout the life cycle of the designed-product. A safe design approach will generate a design option that eliminates OHS hazards or minimises the risks to those that make the product, and those that use it.

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 APPENDICES and REFERENCES

APPENDIX B  Aged Care Industry Generic Hazards Register  www.safeworksa.sa.gov.au Industry > SAfer Industries > Aged Care > Resources

APPENDIX C Pre purchase criteria for equipment and products www.workcover.vic.gov.au/vwa/home.nsf/pages/so_aged > pre-purchase guidelines

APPENDIX D Type, frequency, nature, and cost of injuries and illness in Aged Care www.safeworksa.sa.gov.au Industry > SAfer Industries > Aged Care > Resources

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REFERENCES  Australian Standards relating to Safe Design for Aged Care Facilities Australian Standard

Topic

 AS 1428

Design for access and mobility

 AS 4299

Adaptable Housing

 AS 3661

Slip Resistance of pedestrian surfaces

 AS 1668

The use of ventilation and air conditioning in Buildings

 AS 1680

Interior Lighting

 AS 1158

Lighting for roads and public spaces

 AS 4282

Control of obtrusive effects of outdoor lighting

 AS 3666

Air handling & Water Systems of Buildings

 AS 3500

Plumbing and Drainage

 AS 1345

Identification of the contents of pipes, conduits and ducts

 AS 2441

Installation of Fire hose reels

 AS 4146

Laundry Practice

 AS 3000

Electrical Installations

 AS 3008

Electrical Installations – Selection of Cables

 AS 3009

Electrical Installations- Emergency power supplies in Hospitals

 AS 3010

Electrical Installations - Generating

 AS 3013

Electrical Installations – Classification of the fire and mechanical performance of wiring system elements

 AS 3080

Telecommunications installations

 AS 1768

Lightning protection

 AS 1020

The control of undesirable static electricity

 AS 4688

Furniture – Fixed height chairs

 AS 4438

Height adjustable swivel chairs

 AS 3590

Screen based workstations

 AS/NZS 2107

Acoustics – Recommended design sound levels and reverberation times in building interiors

 AS/NZS 3816

Management of clinical and related wastes

HB 260

Hospital acquired infections – Engineering down the risk

 AS 2293

Emergency escape lighting and access signs

 AS 3811

Hard-wired patient alarm systems

 AS 1670

Fire detection, warning, control and intercom systems

 AS 2118

Automatic fire sprinkler systems

 AS 2419

Fire hydrant installations

 AS 2441

Installation of fire hose reels

 AS 2444

Portable fire extinguishers and fire blankets

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