Case Study Collaboration between Jolly Back and Trent Vale Nursery and Infant School

Musculoskeletal Health and Wellbeing Collaboration between Jolly Back and Trent Vale Infant School, Nottingham July 2017-to date

Introduction

Jolly Back, created by Physiotherapist Lorna Taylor, has customer service, purpose and passion at heart – to improve the working lives of those who teach and care for children, whilst positively supporting children’s learning.

This is achieved through providing award-winning practical, ergonomically designed products which safely equip educators to most effectively carry out their work, together with up-to-date, reliable knowledge to support employees and employers deliver the best outcomes for children in their care. This is further supported by knowing the legal H&S requirements of employers towards their staff and volunteers are being fulfilled.

Jolly Back’s original product, the Jolly Back Chair, won the Education Resources Award Best New Primary Product in its first year of production with judges saying: “A resource that judges felt addressed the physical needs of the teacher in the classroom, as well as improving the learning environment. This ingenious and cost-effective solution to the needs of teachers working with young children at small desks is ergonomically designed and adjustable to work at low table heights. The judges said that it was good for teachers and learning assistants to feel valued and their needs addressed.” Sharon Cufflin on behalf on the judging panel for the Education Resources Awards.

Trent Vale Infant School, located in Nottingham has 150 pupils on role, within 3 year groups There are 7.5FTE teachers and 8FTE Teaching Assistants. In addition a 52 place nursery, successfully runs along on site. Staff turnover is low, school leadership is progressive and values based.

Trent Vale Infant School is in collaboration with Beeston Rylands Junior School, part of which is “to develop a continuum of education from 3-11 years; an education that encourages every child to reach their potential both academically and socially while at the same time enjoying their learning”.

“Our School Motto which underpins all of this work is ‘Helping each other towards excellence in all that we do’. As a school our priorities during 2017-18 includes:

• A relentless focus on improving the quality and consistency of teaching.
• Monitoring and evaluating the delivery and impact of interventions/provision”.

These priorities helped shaped the basis of the collaboration with Jolly Back.

Background to Collaborative Case Study

As a paediatric physiotherapist working within special schools, clinically Lorna has valuable insight into the needs of the educator, the child and the learning environment. Every
feature of the Jolly Back chair and associated products are designed to practically improve teacher’s health and associated wellbeing.

As an occupational health physiotherapist, professionally Lorna understands the benefits of investing in staff and how beneficial outcomes for staff and children can be achieved with an open culture, genuine leadership, respect and as a team.

This is a view shared by Pauline Cole, representing ACPOHE – the Association of Chartered Physiotherapists in Occupational Health and Ergonomics.

“Investing in the health and well-being of staff at work is repeatedly showing a return on investment. Not only are staff able to work more comfortably at work but reduced absence and improvements in performance can also be achieved, so it’s really a ‘win-win’ situation, benefitting both employees and employers. These benefits are already being realised on a regular basis in some industries, but it appears to be less well established in the education sector which means employees and employers in this area are currently missing out”.
Evidence globally, both quantitative and qualitative consistently shows “quality of teaching is the single most important driver of pupil attainment and a range of other positive outcomes.

Maximising the quality of teaching through the effective deployment and development of teachers and teaching assistants will therefore be at the top of any school’s priorities” (Education Endowment Foundation, 2018).

The Work Foundation and Teacher Support Network carried “Healthy teachers, higher marks? Establishing a link between teacher health & wellbeing and student outcomes”, 2014 which also confirmed “the health of employees is a major factor for organisational productivity, with evidence suggesting that when health and wellbeing is improved, organisational savings will be reported through increased productivity and reduced absenteeism”. Although further research is required within education, findings did describe “a positive association with teacher wellbeing and pupil performance”.

Education is a profession which “relies almost in its entirety upon personal relationships to drive our “end product” and it is those personal relationships in our schools, between our staff and between teachers and SLT that ultimately drive our wellbeing”. Dr Maria O’Neill, Healthy Toolkit Founder. This is particularly important during child development in the formative early and primary years.

However, low-level working with young children is hazardous for adults and associated with an increased risk of Musculoskeletal Disorders or MSDs. The Health and Safety Executive (HSE) define MSDs as “any injury, damage or disorder of the joints or other tissues in the upper/lower limbs or the back”. Areas which create a risk include (HSE):

• Bending and twisting repeating an action too frequently
• Uncomfortable working position
• Repetitive and heavy lifting
• Not receiving and acting upon request of symptoms quickly enough
• Psychosocial factors (e.g. high job demands, time pressure and lack of control)

There are several pieces of legislation relating to MSDs, which attach responsibilities to both employers and employees. The Health and Safety at Work Act 1974 is the main legal
responsibility for employers to protect the health, safety and welfare of their employees and other people who might be affected by what they do (eg. reading and parent volunteers).
The main premise of H&S legislation is that “all workers have a right to work in places where risks to their health and safety are properly controlled. Health and safety is about stopping you getting hurt at work or ill through work. Your employer is responsible for health and safety, but you must help” Health and Safety Law Poster “What you need to know”, HSE.
Other pertinent H&S regulations, particularly relevant to dealing with MSDs in the education workplace are: Management of Health and Safety at Work Regulations 1999, Manual Handling Operations Regulations 1992, Health and Safety Display Screen Regulations 1992, Workplace (Health, Safety & Welfare) Regulations 1992 and Seating at Work Regulations 1997

Despite the growth of stress related illness, MSDs remain the single biggest cause of absence from work (Musculoskeletal health in the Workplace: A Toolkit for Employers, Public Health England & Business in the Community, 2017).

Research in 2014 with a sample of 802 early years and primary teaching professionals, showed 82% respondents experienced MSDs once a week or more. 70% had received treatment to ease symptoms (either NHS, private or both), 99.5% thought work-related MSDs in the education profession were under reported – 77% feel because it is “accepted as part of the job”, over half “because they are unaware of reporting symptoms in place” and alarmingly, over a third (37%) because of “fear of jeopardising career”. Back pain (88%) was the most reported discomfort, followed by neck and shoulders (73%) and then knee pain (56%). 38% had been off work because of their work-related pain.

Top 5 work activities which caused most discomfort:

• Bending over low tables (91%),
• Sitting on children’s chairs (85%)
• Kneeling at low tables/on the floor (71%)
• Moving equipment (68%) and
• Admin/preparation activities at children’s desks (62%).

It’s not surprising to learn that these were the top 5 discomfort-causing activities as they involve exactly the HSE risk factors for MSDs described above.
Staff are and will continue to experience work-related MSDs unless initiatives are taken to reduce these risks.

It’s now recognised, there are clear links between MSDs, mental illness and work loss (e.g pain, reduced mobility, limitation of activities, fatigue = loss of confidence, fear of pain, fear of future long-term impact, further anxiety and avoidance behaviours).

Stress often manifests itself as MSD (physiological changes occur in the body – increased heart rate, tightening of muscles, increased blood pressure). At the same time, behaviour is likely to change – (individuals may not think about posture or take breaks = increased risk of injury, feeling despondent).

Employees with MSDs are at a higher risk of stress, anxiety and depression.

Depression is 4 times more likely for those in persistent pain (Musculoskeletal health in the workplace: a toolkit for employers, PHE 2017)

Psychological distress, depression and anxiety increase the activation of the body’s pain system.

A person with depression is likely to take longer to recover from back pain and requires more time off work. Chronic pain also takes longer to treat. Employers need to look at reducing MSDs together with supporting improved mental health and wellbeing. Prevention is Key, especially when considering the impact teachers have on children’s learning.

In today’s education climate where there are significant workload challenges with retention and recruitment difficulties putting further emotional and physical pressure on existing staff, often compounded by budget constraints and further staff turnover, it’s plain to see how a vicious circle can be perpetuated – all of which will have a negative impact on children’s learning and outcomes.

There has been a 30% drop in teacher applications this year (TES 2018), with the lowest teacher entry rate in 5years. Teachers are continuing to leave faster than ever, especially after 3 years and there are a soaring number of school vacancies. Primaries with atleast one vacancy went up from 6.9% in 2015 to 8.9% last year (DfE School Workforce Census 2016).
In 2015-16, 54% of teachers had at least one sick day, with the average number of sick days 7.5 days. 2.16 million teaching days were lost due to sickness absence (Schools Week, 2017).

“In a climate where recruitment is tough and academic expectations continue to rise, governors and leaders realise that they need to move funding away from ‘sticking-plaster’ interventions and into sustained support and development for their most expensive assets, the teachers and other staff who work with students every day.” David Weston CEO Teacher Development Trust (Education Business 2016)

The DfE are now looking at issues to address teacher workload with Ofsted asking a new question this year to ensure leaders and managers take workload into account. This will create a wider picture of evidence to ensure “everything is being done to ensure that the school has motivated, respected and effective teaching staff to deliver a high-quality education for all pupils” (Tackling Workload together – a new question for staff at the point of inspection, educationinsepctorblog.gov.uk 2017).
Sean Harford, Ofsted National Director of Education believes “If we work together, we can turn a corner and improve the lives of teachers and in turn the pupils they teach.”

Method

Trent Vale first purchased a Jolly Back chair in July 2017 on the recommendation of a Local Authority Occupational Health Advisor supporting a member of staff with back and knee pain back to work. The Jolly Back chair successfully enabled the member of staff to return to work.

Once in school, another staff member with back pain, asked to try it and found it eased her pain and made working at low tables much easier and comfortable. Another Jolly Back chair was purchased in October 2017,

Janet Humpherson, SBM realised that other members of staff had back ache and were not a young workforce. Having experienced back pain herself, she felt every member of staff who wished to have a Jolly Back chair to support and help them at work should be able to have one.

After getting in touch with Lorna at Jolly Back, a visit was set up. Lorna visited Trent Vale in January to deliver a staff training (with model spine) so that staff could understand the physical hazards of working with young children and why and how their bodies maybe strained.

The BackChat training DVD resource which offers additional CPD was trialled and a “Back Health Handy Hints” poster was put up in the staff room as a helpful reminder. A recording system to tackle future hazards and joint/muscle discomfort was set up as a book in the office.

The new Jolly Back Musculoskeletal Self-Audit and Action Plan was carried out to identify any current work activities and difficulties staff were facing. This will continue to be used independently in future, to help prevent MSDs and injury developing in staff and volunteers (current and future members).

PosturePad Adult cushions were trialled to assist staff with floor sitting (indoors and out) and with kneeling. PosturePad Junior cushions were trialled to assist improved posture and concentration in pupils sitting on the floor and on their chairs. The products were trialled for 3 weeks.

Results

School Business Manager, Janet Humpherson

“No-one has been off with back or knee pain since investing in Jolly Back chairs. We have a supportive culture at Trent Vale but I can definitely say morale has increased even further since our collaboration. The chairs are a very reasonable cost as they’re stopping staff going off sick. Supply cover costs me £200 a day for a teacher. We try not to use TAs to cover as then the cost is on childcare and learning (e.g guided reading, 1 on 1) which will affect performance and education of our children.

When we needed an office chair for a member of staff with back pain, it cost £360 so I think the Jolly Back chair is good value.

Although we didn’t have a high turnover of staff or those off with back pain frequently before, I know now that our valued teachers are healthier and have an improved quality of life. That’s really good to know.

I’d not really thought about musculoskeletal pain prior to the study, staff used to say they were fine in the holidays but when they got back to school they had back and knee pain within a few days and we didn’t really think or pinpoint the cause. It’s only when people sit down and think about it, now we are much more aware and open about it. We have a
reporting system in place via a book in the office for early reporting, so any future issues are addressed quickly.

An unforeseen positive impact on learning has been that one member of staff with a chronic, progressive joint condition was previously quite stressed with the children as she was in pain and understandably that makes it harder to be patient. Since having her Jolly Back chair, her behaviour management has improved no end and children and parents/carers are happier.”

Testimonials from staff on the Jolly Back chair

“I’m sitting upright at the same height as the children, but not tucking feet under so my ankles feel better too. Knees not as stiff”
“I did use a stool before but that put pressure on my back and my feet were swollen at the end of the day. The Jolly Back chair lets me move around the classroom in comfort and my feet don’t get swollen”.
“Back rest can be positioned in the correct place for your height. The wheels help you move and it’s lightweight too.”
“I can ask my children to bring me my chair and don’t risk hitting them on the head as it doesn’t need lifting”.
“I’ve no pain when sitting, much easier to move after sitting, amazing”.
“I’ve got to work financially until claiming my pension at 67. I was struggling before. The support of the back of the chair has helped me and it’s not difficult to move around.”
“I have a chronic joint condition, it gives me best posture whilst sitting which in turn takes pressure of my joints. I noticed a remarkable difference with my joints after using my chair within a few days”.
Take pressure of my joints when standing up/sitting down.
“I like the general comfort. If I’m comfortable, my work with children is easier. Children can even get my chair for me!”
“I am less tired and go home with more energy at the end of the day. It’s made a difference at home too”.
“I’ve been a teacher for 29 years and have never heard of or used anything so useful, makes the job so much easier”.
The PosturePad children’s cushion “improved children’s posture and attention span”.
The PosturePad Adult cushion “made sitting on the carpet and kneeling more comfortable, for me it could it would be even better if a bit firmer”.

Conclusion

Jolly Back and Trent Vale have worked in an innovative and personalised way to help generate operational excellence and efficiency and will continue to do so.
Trial and introduction of Jolly Back products and advice has improved both the physical and emotional health and wellbeing of teachers and teaching assistants. As a school, that’s a valuable & proactive intervention. Trent Vale also meet their legal H&S requirements with regards to reducing musculoskeletal injury as far as is reasonably practical for staff and volunteers.

In addition, the Trent Vale leadership team are genuinely motivated to care for their staff, supporting them to be the best they can be, as such, they attract high calibre staff and retain them well.

Staff morale and energy levels have improved leading to more effective behaviour management within the school learning environment and further positive contributions have been shown benefiting the whole school community. Staff are “genuinely willing to go the extra mile”. Workload is effectively managed within the supportive team.
Staff sickness absence from back and knee pain has been eliminated, meaning financial savings on supply and associated costs.

“Fundamentally this collaboration has helped improve the quality and consistency of our teaching and we are very pleased with the positive impact it’s had on the everyday work and life of our teachers. In addition, the Jolly Back collaboration has contributed towards our school vision and priorities for 2017-18”, Jackie Moss, Executive Headteacher, Trent Vale Infant and Nursery School.