A variable work environment
Home care can include personal care, support for independence, and health or social services, depending on the specific service. Homes have different layouts, equipment, and conditions. This variability necessitates understanding the service location and relating it to the assigned tasks, rather than relying on a generic professional category assessment.
It should also be distinguished from direct employment in the family home. Service providers are subject to the corresponding preventive framework. The first final provision of Royal Decree 893/2024, which amended the Regulation of Prevention Services for home care, was annulled by a 2025 court ruling; it should not be cited as a current obligation.
Evaluate before assigning and when the situation changes
Planning requires information about access, space, lighting, equipment, tasks, and available support. It must identify which tasks can be performed by one person alone and which require additional organization. Knowing the address allows for planning resources and timelines, respecting the privacy of the residents and managing the necessary access for the assessment.
Conditions can change rapidly: a person receiving care may lose mobility, a bed may be replaced, or an obstacle may appear in the bathroom. There must be a system in place to communicate these changes and review the service. The lack of direct control over the home does not justify shifting the responsibility to the caregiver to improvise an unsafe solution.
Mobilization and physical load
Mobilizing people depends on the available support, the task at hand, the space, and the resources. Aids must be selected and actually usable at home. Equipment that doesn’t fit next to the bed or isn’t available during the visit doesn’t reduce exposure, even if it’s listed as a service resource.
The INSST’s 2026 summary identifies the importance of combining training, assistive devices, and organizational changes to address musculoskeletal disorders. Sustained postures and exertion, not just lifting, should be reviewed. Lower back pain and other problems require medical assessment and, where appropriate, job adjustments.
Exposures and material conditions
Depending on the activity, there may be contact with fluids, sharp objects, cleaning products, or poorly ventilated environments. Precautions must be appropriate for the task and the routes of exposure. It is necessary to plan where the material is stored, how waste is managed, and what to do in case of accidental exposure.
Access points, flooring, cables, pets, and thermal conditions can also pose risks. The assessment must translate into concrete agreements and measures before the service is provided. It is insufficient to simply hand out protective equipment if basic conditions for its safe use or removal are lacking, or to ask for the continuation of an activity that has substantially changed.
Working alone and violence
External violence can originate from individuals receiving care, family members, or other situations in the environment. Criteria for assessment, communication, support, and withdrawal in the event of danger must be in place. Communication training can be helpful, but it does not replace resources, procedures, and organizational decisions that prevent foreseeable exposures.
Working alone requires a system for contact and incident response. It’s essential to know who to notify and what happens if a visit cannot be completed safely. Procedures should not depend on the worker enduring threats to avoid missing a deadline. The analysis should focus on observed behaviors and conditions, avoiding stereotypes about individuals or neighborhoods.
Times, travel, and emotional demands
The schedule should take into account the actual duration of care, preparation, travel, and recovery. Accumulated delays can increase effort, create rushing, and make it difficult to follow procedures. Road safety is part of this planning when traveling between homes, with attention paid to routes and weather conditions.
Emotional demands require professional support, clear roles, and open communication channels. It’s crucial to prevent expectations unrelated to the service from expanding tasks without proper evaluation or resources. Involving those conducting home visits helps identify problems that might be missed by administrative staff.
Practical example
In a simulated service, a user’s functional status changes, and she ceases to cooperate in a transfer that she could previously perform with limited support. The staff member communicates the change. The coordinator does not simply remind the user of the learned technique; she reviews the task, the space, and the need for assistance or intervention with more resources.
The service is adapted, and it is verified that the materials can be used in the home. The duration of the visit is also reviewed to prevent the new arrangement from creating a rush in subsequent homes. This example shows that safety, care conditions, and planning must be considered together.
Monitoring and preventive coordination
The company must maintain up-to-date information, designate those responsible for implementing measures, and have a system in place to verify their effectiveness. Incidents, access difficulties, and tasks suspended due to unsafe conditions provide valuable preventive information. Reporting these issues should elicit a response and not automatically penalize those who report the problem.
The review must include prevention, service coordination, and staff, with the participation of those relevant at the facility. The health data of users and staff require protection. Effective prevention allows us to know which tasks are authorized, with what resources and support, and what changes require reconsideration before proceeding.
