Can anyone in the Health Care Industry help me. A colleague's mother is receiving long term care in a nursing home, due to her medical condition she is prone to falling. She is in a single room and gets out of bed in the middle of the night, which is when the majority of the falls occur, there are no bed rails oin place, although a matress has been placed on the floor to help soften a fall. The latest fall has resulted in an arm fractured in 2 places. Should this have been reported to anyone? RIDDOR, local authority etc? Thaks in anvance for your help, being from a manufacturing environment I have no idea how care industry works

Carol, can I take it that she was taken to hospital for treatment? I can't see that any risk assessment would advocate the placing of matresses to soften any damage in a fall as being suitable and sufficient (if one has been carried out) or even in a patient care plan. The assessment should really identify the need to prevent falls occuring in the first place by adequate controls. I would advise you friend to challenge the care home as I believe they are falling short in their level of care to his mother.

Carol B Any person not at work who is injured and taken to hospital is a category under RIDDOR that requires immediate reporting by the quickest practical means, which is usually by phone. Reporting arrangements are readily available at www.hse.gov.uk Nursing Homes are a workplace and therefore are subject to the HASAW 74. Roly

Hi Carol, Usual 'rules' of RIDDOR apply, If the injury was caused by the Care Home's acts or ommissions it would be RIDDOR. If its caused by the frailty of the person it's not. In Scotland we have (what used to be called Care Commission) who certain types of injuries are reported to no matter the cause. As people are free to leave their beds and as some climb over bedrails it can be practice that these aren't used. There are specialised mats for floors at sides of beds so anyone with a mobility problem falling out of bed falls onto which when walked over don't bounce as much as a mattress. There are alarms which can go under the mat to alert carers of movement over them. These mats won't prevent all injuries though as some frail poeple will still have fractures. The Care Home won't be permitted to restrain the person in bed so unfortunately this type of injury happens. It might be that the Care Home needs to check in on this person more regularly but this is unlikely to stop them trying to get out of bed in between visits. It's an upsetting time for the family and the carers when this happens and if the Care Home is a reputable one they will have taken all the measures that they can. The alternative is a hospital where there is nurse in the same room/ward but even then some 'patients' climb bed rails/get out of bed and have falls. I'ts all down to independance and control of their own lifes. Lilian

Health and Safety in Care Homes - which superseded HS(G)104 may be an interesting read too Amanda

Thanks for you quick and helpful replies. A care plan was in place some months ago, my colleague is now going to check that it has been updated in line with the changes in her condition. I will also pass on copies of the recommended guidance

Carol, This is not reportable under RIDDOR unless there is something amiss with supervision levels or the individual care plan i.e. the fall was due to the service users health/medical condition. In care homes bed rails are used as a last resort and should be subject to individual risk assessment, problems including climbing over, strangulation in the gaps and loss of dignity/independance. Inevitably there always needs to be a balance between the positive risk benefits of allowing the service user to remain independant, mobile and doing as much for themselves as they can against the risk of injury when working out suitable control measures for their care plan.

With the limited information available I suggest that it is probably reportable under RIDDOR (person not at work and taken directly to hospital) and you don't have anything to lose by doing so. Simply report to the Incident Contact Centre via the HSE website and they will pass it to the relevant authority for you (in this case the LAEHO).