Please note if you are a provider registered with the Care Quality Commission (CQC), and with premises located in England, they are the relevant regulatory body for patient safety matters. You can find guidance on the Care Quality Commission website.
The risks from using bed rails
Bed rails, also known as side rails or cot sides, are widely used to reduce the risk of falls. Although not suitable for everyone, they can be very effective when used with the right bed, in the right way, for the right person.
However, accident data shows that bed rails sometimes don't prevent falls and can introduce other risks.
Poorly fitting bed rails have caused deaths where a person's neck, chest or limbs become trapped in gaps between the bed rails or between the bed rail and the bed, headboard, or mattress.
Other risks are:
- rolling over the top of the rail
- climbing over the rail
- climbing over the footboard
- violently shaking and dislodging rails
- violent contact with bedrail parts
Bed rails are 'medical devices', which fall under the authority of the Medicines and Healthcare Products Regulatory Agency (MHRA).
MHRA enforces the Medical Devices Regulations and the General Product Safety Regulations to ensure medical devices are acceptably safe.
There is MHRA guidance about bed rails management and safe use on GOV.UK.
Should bedrails always be provided in care homes?
Many factors need to be considered, including the rights and freedoms of individuals. Fatalities have occurred where people using care services have become trapped in bedrails or fallen from beds.
Even where people are vulnerable to injury, because of falling from their bed, bedrails may not always be a suitable option. You will need to assess the risk of falling, and, whether bedrails are suitable. Where provided, bedrails must be properly fitted and maintained.
How to manage the risks
When bed rails are used during the course of a work activity, such as in a care home or hospital, the employer or self-employed person providing them must ensure they are safe.
Risks identified during inspection include:
- trapping between poorly fitting mattresses and bedrails
- rolling over the top of the bedrails when overlay mattresses reduce their effective height
- trapping between the bedrail and mattress, headboard or other parts because of poor bedrail positioning
Bed rails need careful management. Users should ensure:
- they are only provided when they are the right solution to prevent falls
- a risk assessment is carried out by a competent person, taking into account the bed occupant, the bed, mattresses, bed rails and all associated equipment
- the rail is suitable for the bed and mattress
- the mattress fits snugly between the rails
- the rail is correctly fitted, secure, regularly inspected and maintained
- gaps that could cause entrapment of neck, head and chest are eliminated
- staff are trained in the risks and safe use of the rails
When assessing risk and ensuring correct fitting, HSE advises users to take into account the dimensions in British Standard BS EN 60601-2-52:2010 on requirements for basic safety and essential performance of medical beds.
Manufacturers and suppliers of bedrails also have a duty to ensure equipment is safe for use and you should refer to their instructions.