Last reviewed 3 March 2020
Employees are particularly at risk of violence in environments where services are offered to the public. Mike Sopp advises on how to assess the risk of violence and its common triggers, as well as how to prevent and mitigate violence, by tracing the service user’s journey.
Risks to employees of violence
Latest official statistics on violence at work for 2017/18 indicate that 374,000 adults of working age in employment experienced violence at work, including threats and physical assault.
Among the 46% of incidents where the offender was known, they were most likely to be clients, or a member of the public known through work.
With service provision in such areas increasingly becoming “open plan”, the challenge for employers is to protect employees from violence at the same time as providing an efficient, accessible service to the public.
Public access and violence
Many organisations in the UK provide services to the public that mean clients/service users need to visit the provider’s premises in person, either on an ad hoc basis or as a planned attendance.
Typical examples in the public sector include NHS Accident & Emergency or out-patient departments, local authority “one-stop-shops”, GP surgeries and job centres.
In the private sector, examples include high street bank counters, pharmacies and opticians as well as services that may be delivered for the public sector as an out-sourced function.
A high proportion of the services provided via public access areas are often utilised by those who are more vulnerable in society and/or who may have underlying characteristics that make violence and aggression towards employees more likely.
This includes mental health issues or confusion arising from disease, intoxication through drugs and alcohol, being frightened or distressed and so on. Service users may also be angry or frustrated due to prior poor service experiences, or being constantly referred elsewhere.
Clearly in some environments such as an NHS setting there is no choice but to have environments where the public and employees must be in direct contact.
Service providers are increasingly designing public access areas where the service users and providers have no clear area demarcation, ie there are no high counters with security glazing. Rather the way forward for many is to have employees “floor-walking”.
How to risk assess the user’s “journey”
Health and Safety Executive guidance requires employers to determine if they “have a problem” with violence and aggression and, if so, to assess the risks associated with violence and aggression.
Although this sounds relatively straightforward, it can be challenging as the employer needs to predict what causes a service user to become aggressive (and ultimately violent) and then determine what risk control measures are necessary to prevent, reduce or mitigate the risk.
One method is to undertake the risk assessment by looking at the service user’s “journey” when utilising the service. This will entail breaking down the journey into stages and identifying at each stage the potential triggers for violence and aggression.
A typical journey may be broken down as pre-arrival, arrival/reception, assessment of requirements, service, outcome and leave. In between in each there is also likely to be some waiting time that must also be considered.
For each stage, the risk assessment should consider the potential triggers for violence. The following are some suggestions but local knowledge may identify additional triggers.
Pre-arrival: inability to use online services, premises hard to find or badly signposted, unsure of opening hours, previous poor experience, preconception that service will be busy.
Arrival/reception: lack of information, initial staff member response, perceived service inefficiency, unsure what to do or where to go.
Assessment of requirements and service: lack of staff understanding/knowledge of procedures, intense emotion, perceived inefficiency, inconsistent approach by different staff, staff response to user, dehumanising environment.
Outcome: desired outcome not achieved, intense emotion, inconsistent outcomes, perceived staff inefficiency and injustice, lack of next steps.
Departure: clash with other service users, clash with staff, inability to exit premises.
Waiting: lack of progression, perceived long waiting time, inhospitable environment, clash with other/incompatible service users.
Obviously it isn’t easy to identify those more likely to get triggered and become violent, particularly in open access environments.
However, Health and Safety Executive guidance states that employers should “where appropriate, identify potentially violent people in advance so that the risks from them can be minimised”. This is most likely to be through previous incidents involving known service users.
Preventing and mitigating the risks of violence
Having identified the potential triggers on the service user’s journey, the employer can then determine whether the current risk control measures are meeting the “as low as reasonably practicable” criteria or whether more risk control measures need to be applied.
In basic terms, risk control measures should aim to prevent or reduce the potential for violence but also to mitigate the impact of any violence and aggression.
Risk control measures can be based around the principles of safe place, safe systems and safe person.
Again, referring back to the service user journey, examples of (non-security) risk control measures to prevent or reduce trigger activation may include the following.
Pre-arrival: enable services to be accessed online to reduce footfall and waiting times, ensure premises’ location and opening times are well signposted along with what services can be utilised on-site, where possible prebook meetings with known service users to ensure additional risk control measures can be put in place.
Arrival: ensure services are well signposted and appropriate information provided on what to do on arrival, provide self-service counters, ensure employees are client focused and trained in customer services as well as knowledge/experience of service/s being provided, offer self-service systems where appropriate.
Assessment of requirements and service: ensure employees are fully conversant with processes and procedures, provide employees with information on known persons with previous history for violence, reduce cash transactions, increase staffing during known heavy footfall periods.
Outcome: ensure staff can “dynamically risk assess” outcomes that may activate violence and put in place additional risk control measures.
Departure: design the premises to allow easy egress from waiting rooms and main floor areas, etc.
Waiting: design a waiting area that separates incompatible groups, provide information on progress of visit, keep clean/well-maintained area, make seating comfortable, ensure low noise levels and good lighting, provide the option of refreshments and welfare facilities.
There are also a number of more traditional security risk control measures that can be used to minimise triggers but also to mitigate outcomes if a violent incident occurs.
The design of public areas matters. The use of wide desks, for example, or raised floors in reception/meeting rooms can enable employees to move away from an undesirable situation to a place of safety.
Other simple design measures include reducing moveable objects to a minimum (less choice of weapons)
Closed-circuit television may act as a deterrent as well as provide evidence where incidents occur.
CCTV that is continually subject to monitoring can also be used to react to potential and actual incidents but is a measure that is both expensive and reliant on good operator vigilance and training.
Other simple measures include ensuring access control to staff-only areas and providing panic alarms (either fixed installation or personal or combination of both). With panic alarms, an appropriate response procedure must also be developed for when an actuation occurs.
Safe systems will include ensuring employees are able to “double up” when necessary for dealing with persons who are known to be aggressive or show signs of becoming so. Training staff in conflict resolution is also another key risk control measure that may be adopted.
A manned security function is another consideration that may act as a deterrent but can also react to situations that may occur. Again, this can be a costly option but would give assurance that there are staff members qualified in conflict resolution and even restraint techniques if required.
Managing the risks associated with violence in premises with public access can be challenging for the employer who must ensure risks to employees from service users are reduced to as low as reasonably practicable.
By looking at the risks in an assessment from the perspective of service users and their “journey”, the employer may get a better understanding of the triggers that can lead to violence and aggression, allowing them to develop the necessary control measures to prevent, reduce or mitigate incidents.
When looking at risk control measures, these should not just focus on security measures but also how the service is being provided. This will impact on the users experience and can have a significant impact on preventing and reducing the triggers for aggression.