Moving and Positioning People in Care: Why the Small Things Matter Most
Written by Stephanie Austin — Owner & Lead Trainer, Prima Cura Training
Last reviewed: April 2026 | Next review: April 2027
Moving and positioning people is one of the most physically demanding and technically precise tasks in care. It happens across every shift, in care homes, domiciliary settings, supported living, and NHS facilities alike. And because it’s so routine, it’s also the area where small things quietly drift.
Not through carelessness. Not through not caring. Usually, through a combination of busy shifts, understaffing, and simply not having been taught the right way in the first place.
That last point matters more than the sector likes to acknowledge.
You’re only as good as the information you’re given
A few years ago, I was running a moving and positioning training session when a care worker came to me afterwards, visibly upset. She’d just realised that a technique she’d been using since she started her first job in care was a condemned practice. The drag lift. Her in-house trainer at her previous organisation had taught it to her as standard. She genuinely didn’t know it was wrong. She was mortified.
I said to her what I say to anyone in that situation: you’re only as good as the information you’re given.
The drag lift was formally condemned decades ago. It places severe strain on the shoulders, neck and spine of the person being moved, and causes significant musculoskeletal risk to the carer. No reputable training programme teaches it. But poor or outdated in-house training still exists in pockets of the sector, and the care workers on the receiving end of it have no reason to question what they’ve been taught.
This is why the quality of training matters. Not just whether a certificate exists, but what was actually taught.
The gold standard: HOP7
The Handling of People, 7th edition, known as HOP7, is the recognised gold standard for moving and positioning practice in the UK. Published by BackCare in 2023, it’s the reference that underpins quality trainer programmes across the country and is endorsed by organisations including the HSE, the Royal College of Nursing, the Chartered Society of Physiotherapy, and the College of Occupational Therapists.
Every edition reflects changes in legislation, case law, equipment developments, and technique. If the moving and positioning training your staff receive isn’t grounded in HOP7, it’s worth asking what it is grounded in.
What the law requires
Employers in care have clear obligations. The Manual Handling Operations Regulations 1992 require employers to avoid hazardous manual handling wherever reasonably practicable, and where it can’t be avoided, to assess the risk and reduce it as far as possible. In care settings, the load is a person. That changes the nature of the task entirely.
The Health and Safety at Work etc. Act 1974 places a broader duty on employers to protect the health, safety and welfare of their staff. And the Lifting Operations and Lifting Equipment Regulations 1998 (LOLER) apply directly to hoisting equipment used in care, including overhead hoists, mobile hoists, stand aids, Sara Steadys, and Rotundas. Under LOLER, all lifting equipment must be thoroughly examined at least every six months by a competent person, with records kept. Slings must be inspected before every use. A hoist that hasn’t been examined isn’t just non-compliant; it’s a risk to the person in it and the staff operating it.
The HSE’s guidance on moving and handling in health and social care brings this together in a care-specific context and is worth bookmarking for any care manager responsible for moving and positioning policy.
The small things that make the biggest difference
Good technique isn’t just about avoiding serious injury. It’s about the experience of the person being moved in every single interaction.
Take how a care worker supports a person’s arm during repositioning. Grabbing an individual’s wrist to move their arm is something I see regularly. It’s quick, it works mechanically, but it can be painful, it can feel undignified, and for someone with fragile skin or joint problems, it can cause real harm. Supporting the limb properly, with the whole hand placed beneath it, takes no longer. It just needs to have been taught correctly and practised until it’s the default.
When rolling an individual in bed, I use a mantra with care workers in training: paws not claws. What I mean is this. When you’re repositioning someone, your hands need to be flat and open, spread across the body to distribute contact. If your fingers curl even slightly, your nails are making contact with the person’s skin. They may not say anything. But they feel it every time.
Slide sheets are another example. Fitting a slide sheet to someone who is already lying on their side is a task I see done badly more often than well. The most common version involves the care worker folding the sheet and pushing it underneath the person with their fingers, jabbing repeatedly into the individual’s back until the sheet is in position. It’s uncomfortable at best. For someone with pressure injuries, pain conditions, or sensory sensitivities, it can be genuinely distressing.
The correct technique avoids all of that. The sheet is prepared and positioned properly before the person is moved onto it. Nobody has fingers jabbed into their back. The difference isn’t about time or effort. It’s about knowing how.
Why does this keep happening?
None of the above reflects badly on care workers as people. The sector is full of people who genuinely care about the individuals they support. What it reflects is the gap between good training and the reality of what some staff are actually taught.
Technique drifts over time, too, particularly when refresher training isn’t regular, when staffing pressures push shortcuts, or when a care worker has been shown an easier-looking way by a more experienced colleague who picked up their own habits somewhere along the line.
Good moving and positioning practice needs reinforcing. Not as a tick-box exercise, but as a genuine quality check on what is actually happening in practice.
For care managers
Individual moving and positioning care plans need to reflect the actual person, reviewed whenever their condition or needs change. A generic risk assessment applied to every resident isn’t a risk assessment; it’s an unfilled template. The Manual Handling Operations Regulations 1992 are explicit that assessments must be suitable and sufficient for the specific task and individual.
Equipment needs to be maintained, inspected, and fit for purpose. LOLER isn’t a bureaucratic formality; it exists because hoisting equipment that fails puts lives at risk.
And training needs to be delivered by someone working to current best practice standards, including HOP7, not just someone who holds an old certificate.
For care workers
If something doesn’t feel right in how you’re working, it’s worth saying so. If a technique feels awkward or if you’re not confident with a particular piece of equipment, ask. There is no version of this work where guessing is safer than asking.
And if you’ve ever been taught something that later turned out to be wrong, that isn’t on you. Training quality varies. The responsibility for giving staff accurate, current, safe practice guidance sits with the employer and the trainer, not the person on the receiving end of it.
We deliver moving and positioning training across care settings in Greater Manchester and beyond, working to HOP7 standards. If you’d like to talk through what your team needs, get in touch.
This article is for general guidance only and reflects current UK legislation and best practice at the time of writing. It does not replace formal training or your organisation’s moving and handling policies. Always follow your employer’s procedures, individual risk assessments, and care plans when supporting people with moving and positioning.
