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MHRA Bed Rail Risk Assessment

  • What are the safe product alternatives to bed rails and how to choose appropriately?

    Bed rails are specialist equipment commonly used in care homes to prevent vulnerable people falling out of bed. However the use of bed rails doesn’t come without risks, as if they’re not used safely the consequences for the people you support can include fracture or asphyxiation.

    Safe bed rail usage is monitored by CQC as part of the safe use of equipment under Regulation 12,and they have the authority to prosecute if there are any breaches to the safety aspect in the use of bed rails. A provider was successfully prosecuted for a serious by CQC following an accident with the wrong use of bed rails by ordering them to pay a fine of more than £150k, and the provider was rated “Inadequate”.

    Here, our MD Jo Bonser, shares her learnings from attending the MHRA course ‘Are your residents sleeping safely?’ including what are the safe alternative products which can be used instead of bed rails.

    What are the risks associated with the use of bed rails?

    • Entrapment - when a person is caught, trapped or entangled in the spaces in or about a bed rail, mattress or hospital/profiling bed frame and can result in serious injury or death.
    • Falling – when a person tries to ‘escape’ and climbs over bed rails and falls
    • Injury – entrapment in bed rails can cause skin bruising, cuts and scrapes as well as fractures, strangling and asphyxiation.
    • Agitated behaviour – people can feel frightened and isolated by being ‘caged’ or ‘hemmed in’ by bed rails which are being used as a restraint.
    • Rolling out of bed – when the height of the mattress is level with the bed rails there is a risk of rolling out of bed.
    • Restriction of freedom of movement – can prevent people who are able from getting out of bed to perform routine activities such as going to the bathroom
    • Who are the people most at risk with bed rails?
    • People living with dementia, delirium, conditions of involuntary and uncontrolled muscle movement, physical limitations and frailty are those who are most at risk from bed rails.


    Understanding the needs of the resident and finding the best solution with them is the correct intervention when using the bed rails

    Bed rails can be very useful for individuals who can benefit from them, however before bed rails are used, there should be a full bed rail risk assessment carried out as per MHRA (Medicines and Healthcare Regulatory Agency) guidelines


    Before choosing a bed rail alternative, you must first establish what the purpose of using it is for

    • Preventing a person from falling out of bed
    • Preventing them from slipping from the bed when sitting
    • Helping to get in and out of bed
    • To pull themselves into a better position when in the bed

    You may get one, or a combination of the following items to help you with your loved one's needs


    Here's a range of practical alternatives to bed rails which are easily obtained and can also be used in combination with one another to make a safer bed environment, and negate most risks


    If a person is falling out of bed when they are sleeping, a low or floor bed can really help, as it can be lowered to as little at 67cm from floor level, so that if they roll off the mattress, the bed reduces the impact and allows the user to roll safely to the floor or a fall mat. Low beds are designed for use without the need for side rails and can be raised for getting into and out of bed and for any caregiving which is done on the bed.



    Are designed to be used in conjunction with low-level beds, and placed on the floor on both sides of the bed to ensure that residents don't injure themselves if they fall out of the bed with no bed rails. They are manufactured from high-density foam. NB, these mats are not suitable for people on end-of-life care or who do not move in bed.




    Side wedges are designed to be placed on a mattress to raise up the sides in relation to the centre of the bed, so a person sleeping can't fall out of the bed. They are large wedge shaped pieces of high-density foam with breathable and wipeable covers together which come complete with a breathable connecting sheet that connects underneath the bed by durable straps to hold the wedges in place. Handy tip: Using 2 pairs together will cover the full length of the bed for added security and peace of mind.


    Bed leaving sensor alarms, pressure mats with alarms, motion sensors and pagers, call buttons and pagers plug directly into the nursing system and alert you as soon as someone tries to get out of bed. They are becoming increasingly popular in the falls prevention sector and are also available as a wireless option with a pager.




    You can view our fit for purpose range of product solutions in our "Safe alternatives to bed rails" section here. Lets get started

    If you would like any further help or advice on choosing safe alternative product options to bed rails, then please don’t hesitate to get in touch on 01773 713713 or email us at [email protected] or chat to us on our new live chat function.


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