Working alone in healthcare and social assistance

How to reduce and manage risks associated with working alone or in isolation.

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Overview

How this helps your business

An employee can be considered to be working alone or in isolation even if other people are close by, whether for a short amount of time or even weeks on end.

People who work alone or in isolation face different levels of risk compared to other employees. These employees may be unable to access immediate assistance from team members, other people or emergency services due to the location, time and type of work they are doing. Employees may also be unable to receive assistance with difficult tasks, identifying hazards or be able to notice the visible signs of fatigue. This puts employees at an increased risk of injury.

Not only are these employees potentially at an increased risk of physical harm, but working alone or in isolation can have a negative effect on their mental health. Employees who do not feel safe at work are at an increased risk of developing work-related stress, and workplace isolation is a contributing factor.

Key stats and facts


Employees who feel isolated at work experience lower job satisfaction, commitment to the organisation and are more likely to leave. Lack of management action is a major contributor to isolation in the workplace.

Comcare, 2013, Comcare's Guide to Remote or Isolated Work

Step 1

Learn more on this topic

It is important to understand the mental and physical risks associated with working alone or in isolation, and note that the delivery of home and community based care can provide challenges in identifying and managing the risks to workers.

An employee can be considered to be working alone or in isolation even if other people are close by, whether for a short amount of time or even weeks on end. Therefore staff working in larger institutions and cities can also still be working alone or in isolation.

Not only is the risk of occupational violence and aggression higher in roles experiencing isolation, but employees may be unable to get immediate assistance from emergency services or other team members. In addition, concerns about employee safety and welfare, threats and attacks from clients/patients and their friends and family members are linked to poor employee mental health and wellbeing.

CRANAplus, the peak professional body for the remote and isolated health workforce of Australia has developed safety and security guidelines for remote and isolated health. Click on the link below and download the 'Safety and Security Guidelines for Remote and Isolated Health' guideline.

The guidelines can be adapted for health services where the place of work is away from a centre or a base, and cover the following principles:

  • Always accompanied (not alone)
  • Preparation for remote practice
  • Staff resilience and fatigue management
  • Workforce stability
  • Communicating and connectivity
  • Prevention and de-escalation
  • Hazard identification and risk management.

The Working Safe in Rural and Remote Australia website has some case studies on cross sector and community approaches to safety for front line rural workers.

Step 2

Consult your staff

It is important that you speak to your employees and find out if they are experiencing isolation in their day to day activities. There are many ways you can raise and discuss the topic, and begin to support your employees. Some prompts to start the conversation could include asking your staff:

  • How do you know when you are at risk when you are working alone? What do you consider the physical and mental health risks involved with working alone are?
  • What things can the organisation do to improve your physical and mental safety?
  • What support networks are in place (in addition to physical safety)?
  • Who do you call when you need to reflect or debrief regarding your work or when you need assistance?
  • How would the workplace support you if you feel unsafe?

Step 3

Assess the risk

There are a number of risks to your employees if they work alone or in isolation. Exposure to violence and poor access to emergency assistance are the two main hazards.

When completing your risk assessment, remember to consider the physical and mental health risks (psychosocial) associated with the work, and ensure that working alone or in isolation is considered.

Fill out the risk assessment checklist in WorkSafe Victoria's 'Working alone information sheet' to find the risks in your workplace.

To assist you with completing your risk assessment, have a chat to your health and safety representatives (HSRs), affected employees and/or relevant employee association to make sure you are aware of any potential risks.

Step 4

Manage the risk

In general, when looking at what your workplace can put in place to address these risks, remember that your aim is to remove the risk completely. If this is not possible, then your aim is to reduce the risk as much as you can.

Read pages 1 and 2 of the Working alone information sheet from WorkSafe Victoria for ways to eliminate or reduce the risk in your workplace.

Further strategies could include:

  • Complete screening safety check before the first visit to a client's home (use the referral and assessment checklist).
  • Allow extra time for first visit to a client's home.
  • Have an office based option if assessment is deemed not safe or a buddy is not available.
  • Use communication devices.
  • Use tracking devices.
  • Use a mobile phone app for checking in.
  • Use code messaging.
  • Use corporate vehicles so all safety equipment is in place.
  • In group homes, have a safe room.
  • Respect your staffs 'gut feel'.
  • Use journey management applications, a type of technology to track and monitor employees who work alone or in isolation.
  • Manage client carer ratios in relation to working alone.
  • Provide training in de-escalation.
  • Provide structured supervision programs.
  • Allocate workers / clients suitably, including referring clients to other workers who are more suitable to the clients needs and requirements.
  • Determine safety thresholds to make clear to your workers what is the exit point if the risks of working alone or in isolation become too high.

Page 15 in WorkSafe Victoria's Working Safely in Visiting Health Services has further information on how to manage the risks of working alone in isolated or rural areas, and is relevant for a range of services beyond health.

When referring clients to other services, it's important to identify and document any potential occupational violence risk. Complete the Referral and Assessment Checklist below to help you with this.

Step 5

Draft or review your policy

Your employees must be able to have their say in what the policy will be. It could be a stand-alone workplace working alone, remotely or in isolation policy, or you can include information on working alone, remotely or in isolation as part of your general occupational health and safety policy. What's important is that everyone knows where to find it.

Use the below template to draft or review your own working alone, remotely or in isolation policy.

Step 6

Share and review

Use your regular meetings to discuss the risks of working alone or in isolation, and the ways in which the workplace has agreed to remove or reduce these risks. Encourage your employees to ask questions. Share the information widely so that all employees have access: you could display them on your notice boards, share them via email or any other ways your workplace communicates with employees. Set a review date to make sure your policy remains up to date and relevant.

Once you’ve shared information it is important that your workplace maintains data such as near misses, incidents or fatalities related to working alone or in isolation.

Evaluate the willingness of your employees to speak up / seek help after a workplace incident, traumatic event or fatality that occurred whilst working alone or in isolation.

By regularly reviewing and monitoring your risks, you are ensuring your workplace is working towards creating a physical and mentally healthy workplace.

Naomi's story

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