Unsafe Lifting Practices to Avoid in Health and Social Care Guide

Unsafe lifting threatens both staff and those receiving care. Injuries from poor manual handling can reduce quality of life, prolong recovery, and create legal or disciplinary issues for organisations. This guide explains the lifting practices that should always be avoided in health and social care settings.

The Drag Lift

The drag lift is a highly unsafe and outdated manual handling technique. It involves pulling or dragging a person up, usually in bed, by their shoulders, arms, or clothing. Staff sometimes use this method to move someone up the bed without mechanical aids or slide sheets, especially when time or resources are limited.

This lift is now strictly banned in all health and social care settings in the UK.

Why the Drag Lift is Unsafe

Dragging places excessive force on both the person being moved and the staff member.

For the person receiving care:

• High risk of skin damage, such as friction burns, bruising, and tearing, especially in those with fragile skin
• Increased likelihood of pressure sores developing or worsening
• Discomfort or distress during and after the move
• Increased risk of injury to upper limbs, shoulders, and neck

For staff performing the lift:

• Severe strain on the lower back, shoulders, and wrists
• Twisting or awkward stretching when trying to move someone without help
• High risk of sudden, unexpected movement which can cause immediate injury

How the Drag Lift is Performed (for Reference Only – Not To Be Used)

Typically, the drag lift involves two carers standing on either side of the bed. They place their hands under the person’s armpits or use the person’s clothing or a draw sheet that is not a slide sheet. Both carers then pull or drag the person upwards towards the head of the bed.

This is unsafe for all the reasons listed above. Current guidance strictly forbids this practice. Slide sheets, hoists, or other approved aids must be used.

Never use the drag lift in any care setting.

The Australian Lift

The Australian lift is another manual handling practice that must be avoided. This technique involves two carers lifting a person from a surface such as a bed or floor by reaching underneath them—one under the shoulders, the other under the thighs or knees. This can also involve sliding hands under the person’s body or “linking” arms behind the back and knee.

Why the Australian Lift is Unsafe

This lift bypasses the safer use of aids and puts pressure directly on vulnerable parts of the body. Risks include:

• Pressure and potential injury to the person’s lower back, spine, and shoulders
• Causing the person physical pain or distress as their body weight is not evenly supported
• Restricting breathing if done incorrectly as the chest may be compressed
• Disturbing medical devices, such as catheters or IV lines
• Traumatic for people with injuries, recent surgery, osteoporosis, or poor mobility

For staff, the risks are also considerable:

• Awkward body positions, often involving stooping or overreaching
• Sudden or uneven weight distribution leading to strains and pulled muscles

How the Australian Lift is Performed (for Reference Only – Not To Be Used)

The move is usually carried out by two carers standing at either side of the person who is lying down. One carer supports the person’s shoulders and neck, while the other supports under the knees or thighs. On a joint signal, the person is lifted or shifted up or sideways.

This practice is not appropriate for today’s standards of care and must be avoided at all times. Slide sheets, transfer boards, or hoists are the correct methods for such moves.

The Orthodox Lift

The orthodox lift is a manual handling technique where two carers stand on either side of the person and use their joined hands, supported beneath the person’s back and thighs, to directly lift them. This method might also be called the “classic two-person lift.”

Why the Orthodox Lift is Unsafe

This approach puts both the person being moved and the staff at high risk.

Risks to the person:

• Lack of even weight distribution, causing pressure to the back, hips, and thighs
• Receiving little or no support for the head or upper body if not done perfectly
• Increased danger of falls if the carers’ grip slips or they tire
• Aggravation of pre-existing injuries or medical conditions

Risks to staff:

• Heavy or awkward loads that cannot be well controlled
• High risk of back injuries, strained muscles, and joint damage
• Poor posture due to the need to bend and reach around the person

How the Orthodox Lift is Performed (for Reference Only – Not To Be Used)

Two carers stand on either side of the person, usually at shoulder and knee level. Each carer positions one arm behind the person’s back and the other under the thighs. Their hands burrow beneath the person and then meet, palm-to-palm. On a signal, both carers lift the person into the desired position.

This method is unsafe and does not meet modern health and social care standards. Approved equipment and team-moving techniques should always be used instead.

Summary of Unsafe Lifting Methods

• Drag Lift: Pulling a person up in bed or on a surface, often by armpits or clothing
• Australian Lift: Two-person manual lift, supporting under neck/shoulders and knees/thighs
• Orthodox Lift: Two-person manual lift using linked arms or hands beneath the person’s back and thighs

All these techniques are no longer accepted in UK health and social care. Safer, person-centred options such as slide sheets, hoists, and team-based approaches must replace them. Using banned techniques is dangerous and could result in injury and disciplinary action. Always follow your workplace’s manual handling policy and keep people’s safety and dignity at the front of all care tasks.

The Risks of Unsafe Lifting

Back injuries make up a large portion of work-related health complaints among health and social care workers. Poor lifting techniques lead to:

• Strains and sprains, mainly affecting the back, shoulders, and neck
• Slips, trips, and falls
• Dropping or shifting the person being moved, which may result in secondary injuries or trauma
• Chronic pain for staff, which could end careers and harm lives

Even a single wrong movement has the potential to cause lasting harm.

Moving People Without Risk Assessment

Never lift or move a person without first completing a risk assessment. Skipping this step means you do not know what support, equipment, or help might be needed. You must always consider:

• Mobility or weight of the person
• Medical history and current condition
• The environment, including space and hazards
• The available equipment, if any
• Your own training and physical ability

Risk assessments help highlight dangers such as falls, bruising, or pressure sores. If you skip this process, you could put everyone involved at risk.

Manual Lifting: Lifting a Person By Yourself

You must avoid lifting a person on your own without mechanical aids or support from other team members. Manual lifting of adults or children is the most common way staff suffer injuries. Situations to avoid include:

• Picking up a person from the ground or chair without help
• Trying to prevent a fall by grabbing or supporting someone solely through your own strength
• Lifting someone into bed or a wheelchair using only your hands and arms

Manual lifting often leads to sudden, uneven weight loads. This increases the chance of twisted backs, muscle pulls, and other injuries.

Incorrect Use of Hoists or Aids

Hoists, standing aids, slide sheets, and transfer boards help move people safely. Unsafe practices related to these aids include:

• Operating a hoist without completing checks on straps, batteries, and slings
• Ignoring weight limits or using incompatible accessories
• Not explaining the moving process to the person being lifted, leading to confusion or panic
• Rushing the procedure and leaving someone unsupervised in lifting equipment
• Using equipment for a purpose it was not designed for

Only trained staff should handle lifting aids. Improper use leads to preventable accidents where people can fall, get trapped, or suffer discomfort.

Twisting and Overreaching

Never twist your back or stretch excessively while lifting. Twisting or overreaching increases pressure between the vertebrae, which can cause slipped discs or strained muscles. Common mistakes include:

• Turning your upper body while holding a person or piece of equipment
• Reaching across a bed to drag or push someone towards you
• Working in awkward positions, such as bending over a low bed or stooping in a confined space

Best practice involves keeping feet shoulder-width apart, facing the direction you need to move, and using your legs—not your back—to support weight shifts.

Dragging or Pulling People

Dragging places huge strain on both staff and service users. It causes friction burns, bruising, and muscle injuries. Common unsafe actions to avoid:

• Pulling someone across a bed, car seat, or wheelchair without a slide sheet or board
• Yanking arms or legs in an attempt to encourage movement
• Supporting someone by their underarms, which puts strain on shoulder joints and nerves

Dragging can also damage skin, leading to pressure sores or tears, especially in older adults or those with fragile skin.

Handling People Under the Arms

Never move someone by holding under their arms. This is uncomfortable and unsafe. The axilla (area under the arm) contains nerves, blood vessels, and muscles that do not tolerate pressure well. Unsafe effects include:

• Nerve damage, which may cause pain, numbness, or weakness
• Dislocated or sprained shoulders
• Cutting off circulation, which brings a risk of fainting or tissue injury

Always use approved techniques and, where needed, aids to reduce pressure on the body.

Rushed Lifting and Lack of Communication

Taking shortcuts when lifting is unsafe. Staff who fail to communicate face higher risks of error and panic. Particular unsafe actions:

• Not informing the person being moved about what is happening
• Failing to plan with colleagues before carrying out a lift
• Moving too quickly, which raises the risk of slips, drops, and bumps

Communication puts people at ease and allows everyone to anticipate each step—reducing anxiety and accidents.

Moving Too Heavy or Too Large Loads

Health and social care staff are sometimes tempted to “just do it quickly” if time is short. Attempting to lift someone who is too heavy or large without help or mechanical aid is a common source of injury. Signs that the load is unsafe include:

• Needing to strain or “heave” to get the person or object moving
• Losing grip or balance partway through the movement
• Feeling pain or discomfort during or after the lift

If you are unsure, stop and find help.

Ignoring Individual Needs and Preferences

People receiving care often have their own preferences or requirements. Not considering these can increase anxiety and expose them to harm. Unsafe practices include:

• Failing to adjust aids for height or fit
• Ignoring a person’s request for a different position or more time
• Handling someone without checking that their medical needs allow for it (such as recent surgery, fractures, or skin conditions)

Always consider the person behind the task. Their comfort and safety must come first.

Unsafe Lifting Environment

The environment plays a huge role in safe moving and handling. You should always avoid:

• Wet, slippery, or cluttered floors
• Working in rooms that are too small for safe lifting techniques
• Lifting across raised thresholds, such as doorways or uneven flooring
• Attempting lifts near obstacles like medical equipment, cables, or sharp corners

Fix or remove hazards before starting. If you cannot fix them, do not proceed.

Poor Posture and Body Mechanics

Your posture determines your safety. Unsafe posture includes:

• Bending at the waist instead of the knees
• Hunching your shoulders or craning your neck
• Unbalanced feet, such as standing with feet together or on tiptoe

Always keep your back straight, bend your knees, and hold your feet apart for stability. Standing close to the person or object you are lifting gives better control.

Inadequate Training

Lack of training is a key source of unsafe practice. People who have not attended manual handling courses may make mistakes such as:

• Using outdated or banned techniques
• Not adjusting to new equipment or procedures
• Failing to recognise their own limits

Ongoing training keeps everyone up to date and confident. Staff must never be asked to carry out lifts or moves if they have not been shown how to do it safely.

Working Alone During Complex Lifts

Certain lifts, such as moving an unconscious person or supporting someone with severe mobility issues, require more than one staff member. Unsafe solo actions include:

• Trying to reposition or transfer a person single-handedly when two or more should be present
• Calling out for help only once the lift has already become unsafe

Complex lifts should always be performed as a team, with clear roles and communication.

Ignoring Policy and Procedure

Trust policies, care home procedures, and training set out the safest way to lift or move people. Ignoring these rules opens the door to unsafe acts such as:

• Using equipment for jobs it is not intended for
• Skipping safety checks
• Working outside the guidelines for staff-to-patient ratios or equipment maintenance

Keep up to date with local protocols—this protects everyone.

Unsafe Shortcuts to Avoid

Shortcuts are tempting, but always dangerous. Examples include:

• Grabbing items to stand on instead of getting a step ladder or asking for help
• Using broken aids or worn-out slings
• “Improvising” support from belts, towels, or non-standard items

Shortcuts trade immediate convenience for the lasting risk of injury.

Best Practice: What To Do Instead

• Always assess the person’s needs and the environment first
• Use mechanical aids and equipment whenever required and available
• Call for help with complicated or uncertain lifts
• Keep communication open between all people involved
• Follow up-to-date policies and procedures closely
• Attend regular refresher training

Safe moving and handling protect staff from injuries and people in care from harm. By avoiding unsafe lifting, you build a workplace where everyone is safe and confident.