Manual Handling Risk Assessment TILE for Single-Handed Hoisting

Single-handed hoisting can be safe and efficient when a manual handling risk assessment TILE (task, individual, load, environment) framework is applied consistently, documented clearly, and supported by suitable hoist equipment and training. This guide offers guidance that adapts TILE to hoisting decisions in aged care and home care.

Understanding TILE in Hoisting

The TILE framework helps assess manual handling risks in single-handed hoisting by breaking the task into four key areas: Task, Individual, Load, and Environment.

• Task: Define the goal of the transfer (bed-to-chair, toileting, repositioning). Consider how often it’s done, how far the move is, and how complex it might be. Note any time pressures that could lead to unsafe shortcuts.
• Individual: Assess both the carer and the client.
  
  • For the carer: Competency, fatigue, and confidence.
    
  • For the client: Cognition, behaviour, muscle tone or spasticity, pain, and any medical contraindications.
• Load: In hoisting, the “load” refers to the client being hoisted and considers their capabilities and limitations, behaviours, ability to follow instructions, balance and other aspects of cognition and mobility.
• Environment: Room layout and conditions determine whether a single-carer hoist transfer is practical. Check space dimensions, turning radius, clutter, lighting, floor surfaces, gradients, thresholds, doorway widths, and ceiling track routes.

When Single-Handed Hoisting Is and Isn’t Appropriate

Single-handed hoisting is appropriate when all safety conditions are met.
It can be used when the client’s presentation is predictable, the sling and hoist are correctly matched, there’s enough space for movement, and the carer is trained and confident, including in emergency procedures.

Escalate to a two-carer transfer or another method if any of the following apply:

• The client shows acute instability or fluctuating cognition or behaviour
• New or unmanaged pain is present
• The equipment is incompatible or poorly fitted
• Space or turning radius is limited
• Flooring or gradients increase risk
• No trained staff are available

Gantry Hoist vs Ceiling Hoist: Making the Right Choice

This comparison helps guide the selection and trial of hoist solutions in aged care and home care settings.

To explore more options, review hoist solutions for aged care or compare ceiling hoists for disabled person needs.

TILE Hoisting Checklist: Step-by-Step

Standardise hoisting assessments and records across shifts. Use each step as a required check; document outcomes and any escalation.

• Define the Task
  • State transfer goal (bed → chair, toileting, reposition).
  • Note frequency, distance, and any time constraints or urgency.
• Screen the Carer: Assess carer competency and fatigue.
• Confirm Plan for Client: Assess stability, cognition/behaviour, pain, medical contraindications.
• Survey the Environment
  • Measure room size and turning radius (aim for 1.5–2.0 m as a guideline).
  • Check clutter, floor condition, thresholds, doorway widths, and lighting.
  • For ceiling systems: confirm track route and clearances.
• Select Equipment
  • Choose your hoist - floor/gantry/ceiling based on task, environment and frequency.
  • Select spreader bar style, hoist accessories, and battery/charging plan.
  • Specify sling type and size, head/back support needs, and attachment method (loop vs clip).
  • Check Safe Working Load (SWL), labels, and compatibility with the hoist.
• Pre-Transfer Checks
  • Inspect hoist and sling for damage. Verify emergency lowering, handset, charger, and brakes per manufacturer instructions.
  • Confirm battery charge and service tags are up to date.
• Sling Application
  • Confirm the sling fits and is the right size. Keep line of sight to attachment points.
  • Avoid twists, straps under bony prominences, or sling fouling. Preserve client dignity and skin integrity.
• Controlled Lift
  • Perform a tension test (lift a few centimetres). Observe client response.
  • Communicate clearly with the client. Avoid lateral forces, sudden jerks, or rapid movements.
• Landing & Posture
  • Align the landing surface before lowering. Adjust bed / chair height to minimise awkward postures.
  • Clear obstacles from the landing zone.
• Post-Transfer Review
  • Record outcome, hazards, deviations, and any near misses.
  • Update the plan, equipment, or training if conditions or risk change.

Training, Servicing, and Governance

Competency and Supervision

• Maintain a local competence register covering hoisting and single-handed practice.
  
• Include initial assessments, sign-offs, and scheduled refresher training.
  
• Provide supervised shifts when introducing new equipment models or when staff work in unfamiliar environments.

Servicing Cadence

• Follow both manufacturer instructions and local policy for hoist servicing, sling inspections, and battery checks.
  
• Display a clear tag or maintain a digital record showing the last service date, next due date, and emergency-lowering test results.

Incident Learning

• Record and review near misses, incidents, and staff or client feedback.
  
• Use findings to update room layouts, sling selection, and staffing protocols.
  
• Revise the TILE checklist and any site-specific prompts to reflect new learning or equipment changes.

Contact Enable Lifecare to plan an evidence-based rollout and arrange equipment trials tailored to your site.