Introduction
For a worker faced with the prospect of visiting a service user in their own home who smokes when they don’t smoke themselves, can be unpleasant as well as harmful to their health. All over the UK, carers, district nurses, CPN’s, GP’s and other health and social care professionals face the challenge of passive smoking. The difficulty is, that for the service user, it is their home, however for the worker that place becomes a place of work, in that they are employed to provide a service in a service user’s own home. In residential care homes, residents are generally escorted to a designated smoking area, out of the building, and not permitted to smoke in their rooms.
Workers smoking
From a legal viewpoint since the Health Act 2006 which came into place 1st July 2007 (Scotland was in 26 March 2006 & Wales 2 April 2007). Health and Social Care workers are not allowed to smoke at work other than in a designated smoking area or off site. Neither are they allowed to smoke in company vehicles or in the home of a service user (even if the service user is a smoker).
NB: QCS have an article on “NO Smoking in the Workplace” which focusses more on workers smoking at https://www.qcs.co.uk/smoking-workplace-3/
How does passive smoking affect me?
“Passive smoking” is where one person (not smoking) is subject to the smoke from a person who is smoking. As well as being unpleasant, Smoke Free England has identified the following effects of passive smoking:
- Asthma
- A reduced lung function
- Heart disease
- SIDS (Sudden Infant Death Syndrome)
- Lung Cancers etc.
More information can be found from http://www.smokefreeengland.co.uk
Can I stop residents smoking in residential care?
Whilst I would like to say YES, the answer is dependent on the policy and risk assessment in place by the care home provider. If a resident wishes to smoke in their room or own home that is their choice, however, most of the care homes I have audited escort residents to a designated smoking shelter and do not allow lighters or matches in their bedrooms as this is part of their risk management plan.
How do I protect workers!
In residential care homes, some have a complete no smoking policy so residents have to go outside to smoke, (usually escorted smoke breaks), whilst others will have designated bedrooms in which they can smoke. Whilst educating residents not to smoke or reduce smoking is a way forward, those who have other consideration i.e.: mental ill-health, or of a nervous disposition, may find this helps them to relax, and as such, will not be high on their agenda. To protect the worker from passive smoking you could do some of the following:
- Designated bedrooms for smoking residents (who wish to smoke in their rooms)
- Ensure smoking rooms are at the top of the building and ideally separated by a corridor fire door
- Home care managers to monitor how much time workers attend to residents who are smokers
- It is suggested that where smoking is permitted in an assigned residential bedroom that crib 9 fire retardant material is used on furniture and fittings to reduce fire risk.
In both residential care and home care you could protect workers through the following:
- Ensure rooms have plenty of ventilation if possible
- Encourage residents to not smoke whilst you are visiting them and ideally 30 minutes before the visit (phone to let them know your 30 minutes away if possible)
- Whilst using staff who are smokers to attend to service -users who are smokers might be a way forward, the ideal option is to encourage the reduction of smoking in service-users
Educating service-users to reduce smoking
Trying to stop service users from smoking when some staff themselves struggle with this issue can be an uphill struggle. The NHS, Smoke Free England to name a few have advice and support services to help both staff and residents to reduce their smoking levels. I have already outlined the effects of smoking on both the smokers and passive smokers (those who inhale other people’s smoke).
What about Electronic Cigarettes?
Currently, there is no law against using e-cigarettes though the fire dangers are well known. It is up to the health and social care provider to include this in their smoking policy though again, most do not allow them on the premises to be used either by staff or residents.
What does the law say?
Under “The Health Act 2006” Section 3 regarding residential settings and home care, the act cites the following:
(2) Descriptions of premises which may be specified under subsection (1) include, in particular, any premises where a person has his home, or is living whether permanently or temporarily (including hotels, care homes, and prisons and other places where a person may be detained).
This is known as an exemption under the Smoke-free (Premises and Enforcement) Regulations 2006 which does not allow smoking in public places or public transport.
