Supporting Participants with Mobility
The core module — assisted transfers, wheelchairs on ramps and kerbs, personal care in home bathrooms, vehicles, following the manual handling plan, and balancing participant choice with your own safety.
Last reviewed September 2026 · Part of Manual Handling Training for Disability Support Workers
Key learning points
- Follow a participant's manual handling plan and OT or physio instructions for every mobility support
- Describe the key steps in common assisted transfers — bed to wheelchair, wheelchair to toilet or shower commode, and wheelchair to vehicle
- Push a manual wheelchair safely on ramps, kerbs, slopes and uneven ground
- Balance participant choice and control and dignity of risk with your duty to refuse an unsafe technique
- Recognise and respond to unpredictability, including behaviours of concern and changes in a participant's condition
- Manage the added risks of working alone in a home, in the community and in vehicles
The plan comes first
Every participant who needs physical help to move should have a manual handling plan — sometimes called a mobility plan or transfer plan — written by an occupational therapist or physiotherapist and kept with their support plan. It specifies the method for each transfer, the equipment, the sling type, size and loop settings, the number of workers, and what the participant does for themselves. If there is no plan, or the plan is clearly out of date, ask your coordinator before you provide the support; your provider must arrange an assessment. The plan also describes the participant as they usually are, and mobility can change within hours — after a seizure, a medication change, a poor night, a chest infection or a period of high tone. If the participant is not moving the way the plan expects, do not push on with yesterday's method: keep them safe where they are, reassess, and follow your provider's procedure for reporting a change so the plan can be reviewed.
Before any transfer, check
- What can the participant do today? Are they tired, in pain, unwell, or recovering from a seizure?
- Has anything changed — medication, a fall, new spasms, a weight change, a new wheelchair?
- How is their mood, and do they understand and agree to what is about to happen?
- Is the equipment in the plan present, charged, and rated for them?
- Brakes on, footplates away, bed at working height, floor dry, path clear?
- Does the plan require two workers, and is the second worker actually here?
Choice, control and dignity of risk
Participants direct their own supports. Choice and control, and the dignity of risk — the right to make choices that carry some risk — are central to the NDIS and to good support work. A participant can choose to go out in the rain, to sit on the couch they like, or to try walking further than usual. What they cannot do is direct you to perform a technique that is unsafe for them or for you, or that contradicts their plan. Those are two different kinds of risk, and you need to be clear about which one is in front of you.
You can say no to a technique without saying no to the person
Try something like: I am not able to lift you that way, because it is not in your plan and it could hurt one of us. What I can do is use the transfer board, and if you want the method changed I will ask your coordinator to get the OT to look at it. Then follow through on the referral. Refusing an unsafe technique and escalating is part of respecting the participant, not a failure of it.
Common assisted transfers — what the plan usually covers
- Bed to wheelchair, hoist
- Bed at working height, correct sling fitted as the plan describes, wheelchair positioned and braked, loops attached and checked before the lift, participant lifted only as high as needed, lowered well back into the seat
- Bed to wheelchair, sitting transfer
- Participant sits on the edge of the bed with feet flat, wheelchair at 30–45 degrees with the near armrest removed and brakes on, transfer board bridged under the thigh, participant leads the slide in small movements while you steady
- Wheelchair to toilet or shower commode
- Often the tightest space in the home. Footplates away, clothing managed before the move, stand-aid hoist or transfer board as planned, never a lift under the arms, and a second worker if the plan says so
- Wheelchair to car seat
- Park level, seat slid back and reclined slightly, transfer board or swivel seat as planned, participant leads, you steady from the door opening rather than leaning across the seat
- Wheelchair into a van
- Participant stays in the wheelchair, up the ramp or on the vehicle hoist, secured with a four-point tie-down and an occupant restraint, headrest positioned
- Floor to chair after a fall
- Never a manual lift. Falls procedure, check for injury, hoist or emergency services as the plan directs
Wheelchairs on ramps, kerbs and rough ground
- Check tyres, brakes, anti-tip bars and the pelvic strap or lap belt before you leave the house
- Ramps: go up forwards using your body weight; go down backwards if the ramp is steep, so the participant stays tilted into the chair
- Kerbs going up: use the tipping lever to lift the front castors onto the kerb, then roll the rear wheels up; kerbs going down: turn and lower the rear wheels first
- Grass, gravel and sand: choose another route where you can; if you must cross, tip slightly onto the rear wheels and go slowly
- Never travel across a slope sideways, and never leave a chair on a slope without the brakes on and your hands on it
- Power wheelchairs are driven by the participant; you do not push or lift them unless the plan says how
- Crowds, escalators and revolving doors: use the lift, wait for space, and do not rush
Personal care in a domestic bathroom
Home bathrooms are small, wet and full of fixed heights. Where the plan allows, wheel the shower commode over the toilet and into the shower so the participant transfers once rather than three times. Use a shower stool for yourself, bring towels and clothes within reach before you start, and use long-handled sponges or reach aids rather than bending under the commode. If the door does not clear the commode or the shower has a step, report it — that is a modification or equipment issue for the OT, not something to solve with your back.
Walking assistance
- Use the walking aid and the level of assistance in the plan — a transfer belt is for steadying, not for holding a person up
- Walk slightly behind and to the side, on the side the physio has nominated
- Plan rest points, and check footwear and the floor surface before you set off
- If the participant starts to fall, do not try to hold them up; guide them down as safely as you can, protect their head, then call for help
Unpredictability, behaviours of concern and restraint
For some participants a transfer, a shower or a seatbelt is a known trigger, and their behaviour support plan will tell you how to approach it. If a participant becomes distressed, hits out or resists during a manual task, stop and make everyone safe. Manual handling is never restraint: you do not hold, drag or pin a participant to finish a task. Physically restraining a person is a regulated restrictive practice, and outside an authorised behaviour support plan it must not happen. Give the participant time and space, use the strategies in their plan, and reschedule the task or call for support.
Working alone, in the community and in vehicles
- Check in and out under your provider's lone-worker procedure, keep your phone charged and on you, and know the address and the on-call number before anything goes wrong
- Never do a task the plan lists as two-worker on your own, however routine it feels
- If the participant falls, do not lift them — make them comfortable and warm, check for injury, and call for help or an ambulance as the plan directs
- Keep the hoist on charge between shifts and leave the equipment ready for the next worker
- Park on level ground with room to open the door fully or deploy the ramp, and check the vehicle hoist or ramp before you use it
- Wheelchair tie-downs and occupant restraints must be the rated system for that vehicle and fitted every trip; a wheelchair's own lap belt is not an occupant restraint
- Folded manual wheelchairs and walkers go in the boot only if the plan says how; if a chair is too heavy, the answer is a different vehicle, not a bigger lift
- Never leave a participant on a vehicle hoist platform unattended, and build breaks into long drives — vibration and sustained posture are manual task risk factors too
- Trust your judgement: if the home, the route or the task does not feel safe, stop and call
Practical scenario
Scenario: Jordan and the rain
Jordan usually transfers from his wheelchair into your car using a transfer board, one worker. Today the car park slopes, it is pouring, and Jordan says just lift me in, we are getting soaked.
How do you respond?
Reveal the explanation
Do not lift him. A manual lift into a car is not in his plan and puts both of you at risk of a sudden-force injury on a wet, sloping surface. Acknowledge the frustration, move the car to level ground under cover if there is any, dry the board and seat, and do the planned transfer. If a safe transfer is still not possible, wait it out or call your coordinator for another option. Jordan gets to choose whether to go out in the rain; he does not get to choose how much load your spine takes.
Practical scenario
Scenario: 6 am at the SIL house
Leo has cerebral palsy and transfers by ceiling hoist with two workers, as his plan requires. Your co-worker calls in sick at 5:45 am. Leo needs to be up, showered and on the bus for his day program by 8 am, and he is already asking to get up.
What should you do?
Reveal the explanation
Do not attempt the hoist transfer alone. Phone the on-call coordinator immediately for a replacement worker. Explain the situation to Leo honestly, keep him comfortable — reposition him in bed with the slide sheet if that is a one-worker task in his plan — and let the day program know he may be late. Record the staffing shortfall as an incident so the roster is fixed, not just this morning but for next time.
Knowledge check
These questions are for your own learning. They are not part of the final assessment.
1. A participant asks you to lift them into the car manually because the transfer board in their plan is slow. What should you do?
Choice and control cover the participant's own life, not how much risk your body takes. Refuse the unsafe technique, provide the planned support and escalate the request properly.
2. You are taking a manual wheelchair down a steep ramp. The safest approach is to:
Going down backwards keeps the participant tipped safely back into the seat and lets you control the descent with your body weight.
3. A participant's plan requires two workers for a ceiling hoist transfer. Your co-worker calls in sick. You should:
Two-worker tasks stay two-worker tasks. Untrained helpers are not a substitute. Escalate the staffing problem and report it so it is fixed.
4. A participant falls in a shopping centre. They seem uninjured but cannot get up, and you are working alone. What should you do?
Never manually lift a participant from the floor, and never recruit an untrained bystander to do it with you. Falls are managed by procedure, assessment and equipment.
5. A participant becomes distressed and pushes you away during a transfer. What should you do?
Manual handling is never restraint. Holding or pinning a participant to complete a task is a restrictive practice and must not happen outside an authorised plan.