Insufficient Appreciation for the Dangers of Bed Rails
Tuesday, 11th October 2011
Two recent cases have highlighted the risks presented when training has been insufficient or where the risk assessment process has not been properly adhered to. In both cases the organisations involved admitted breaching Section 3(1) of the Health and safety at Work etc Act, 1974.
A leading provider of palliative care has been fined £65,000 following the death by suffocation of a 40-year-old woman who suffered from Huntingdon’s disease. Ms Charlotte Young died when she became trapped between her mattress and a bed rail. A specialist cushioning system had been installed as Ms Young was prone to involuntary movements but Preston Crown Court was told that staff’s failure to use the equipment correctly had put the deceased at risk. The bed rail was not the correct fit for the bed and when Ms Young knocked it out of place she became trapped between rail and mattress.
HSE Inspector David Shorrock, speaking after the hearing, said, ‘The home was oblivious to the risks associated with this kind of equipment [and therefore] they had no proper risk assessment in place. The maintenance of the equipment was also poor and staff were not trained to spot any problems which could have arisen in Mrs Young’s case.’
In addition to the fine the organisation responsible was ordered to pay £35,000 towards costs in addition to the fine. In light of Mrs Young’s death, the organisation declared that it had amended policies and introduced new training for staff.
In the second incident Ms Elizabeth Roberts – 89 – suffocated when she became trapped between her mattress and the bed rail at the nursing home where she was a resident in Llangollen. Ms Roberts had survived a similar incident only three weeks before but insufficient action had been taken to address the problem. In this case, the HSE investigation found that bed rails had been introduced as a result of Ms Roberts’ regular falls from her bed but staff had not been given sufficient training and, particularly, the potential risks of bed rails had not been highlighted. The HSE concluded that had a suitable and sufficient risk assessment been in place it should have revealed the unsuitability of bed rails to address Ms Roberts’ needs.
The owners of the North Wales home admitted liability and a breach of Regulation 3(1) of the Management of Health and Safety at Work Regulations, 1999 in addition to the breach of HASAW, 1974. They were fined £70,000 and ordered to pay costs of £21,818.56.
HSE Inspector Sarah Baldwin-Jones said, ‘This is a terrible incident and one that could have been easily avoided. It is essential that home owners and care staff consider whether bed rails are the most appropriate method of preventing a patient falling from bed. There are many alternative options, such as low-profile beds, which should be considered.
‘Free guidance on the safe use of bed rails has been widely available for a number of years. This home could have taken simple steps provided in the guidance to train care staff and implement a safe system of routine inspection and maintenance.’
If you are concerned about the use of bed rails visit www.hse.gov.uk/healthservices/bedrails/ which provides useful advice. Also remember for to consult with the manufacturer if you have any queries concerning the use of bed rails or indeed any equipment used by your staff.