Care home bed and bed rail register, with QR tags
What a care home's register of beds and bed rails should record, following MHRA guidance: traceable rail assemblies, matched pairs, compatibility with the bed and mattress, the checks at fitting and at maintenance, withdrawing worn rails, and QR tags that survive cleaning.
By Hovermarks team
Quick answer. Register every bed and every bed rail assembly with its own ID. MHRA guidance says rails should be traceable by the manufacturer's serial number, a Unique Device Identification number or an in-house numbering label, so they can be inspected regularly and found quickly if a fault or recall comes up, and that records should be kept of their inspections, repairs and maintenance. Record which bed each rail is fitted to, whether it is an integral or third-party rail, and the mattress in use. Check the fit at fitting and after each period of use, put rails in your planned maintenance, and withdraw worn or damaged rails rather than storing them for later.
Bed rails are one of the few pieces of care home equipment that can cause harm by working exactly as designed on the wrong bed. MHRA's guidance, Bed rails: management and safe use (last updated 30 August 2023), is written for care home managers and staff among others, and much of it is about knowing which rail is on which bed, with which mattress, and in what condition. That is a register.
HSE's page on the safe use of bed rails makes the same point from the employer's side: where rails are provided in work activity, such as in a care home, the provider must make sure they are safe, and they should be correctly fitted, secure, regularly inspected and maintained.
This post covers the equipment record. The decision to use bed rails at all, and the risk assessment for the person in the bed, belong in the person's care records.
What the law and guidance cover
MHRA's guidance lists the legislation that applies, including the Health and Safety at Work etc. Act 1974, the Management of Health and Safety at Work Regulations 1999, regulation 12 (safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and the Medical Devices Regulations 2002 for the products themselves.
For beds, HSE's information sheet HSIS4 lists profiling beds and trolleys as not lifting equipment, so they do not need a LOLER thorough examination, but the requirement under PUWER to maintain the equipment adequately still applies. PUWER regulation 5 requires work equipment to be maintained in an efficient state, in efficient working order and in good repair.
What to record for each bed
| Field | Example |
|---|---|
| Unique ID | BED-023 |
| Type | Electric profiling bed, low bed, bariatric bed |
| Make, model and serial number | From the bed's label |
| Safe working load | As marked by the manufacturer |
| Site and location | Oak Wing, room 23 |
| Mattress in use | Type and size (foam, hybrid, active), with its own ID if you track mattresses |
| Rails fitted | The IDs of the rail assemblies on this bed |
| Service and maintenance | Last date, next date, by whom |
| Status | In service, out of service, retired |
Record the room, not the resident. The equipment register is about the bed, and a label or scan page that names the person in it shares personal data nobody needs to see.
What to record for each rail assembly
MHRA's guidance on traceability is the reason this table exists. Give each rail assembly an ID that is never reused, and record:
| Field | Why it matters |
|---|---|
| Unique ID (in-house label, serial or UDI) | MHRA says assemblies should be traceable by one of these |
| Integral or third-party | MHRA says integral rails, designed for a specific bed, have been involved in far fewer adverse incidents, and third-party rails need particularly careful selection |
| Make, model and serial number | So a recall or safety notice can be matched to units |
| Bed it is fitted to | Compatibility is between this rail, this bed and this mattress |
| Matched pair | MHRA advises storing unused rails in matched pairs |
| Date fitted | And who fitted it |
| Last check and next check | On the interval your local policy sets |
| Status | In service, withdrawn, destroyed |
Compatibility: rail, bed and mattress together
MHRA's guidance repeatedly asks for the bed, mattress and rails to be compatible in combination, and with the needs of the person in the bed. Among the points it makes:
- mattress length, width and height should be checked against the bed manufacturer's limits, because the wrong size can create gaps;
- overlay, hybrid and active mattresses can reduce the effective height of the rail and compress at the edge, creating gaps, so the worst case should be assessed;
- a rail designed for a divan should not be used on a wooden or metal bedstead.
MHRA's list of things to avoid includes gaps of more than 60 mm between the end of the rail and the headboard, and more than 120 mm in any accessible opening between the rail and the mattress platform. For children and adults with atypical anatomy it recommends a maximum of 60 mm between rail bars. The guidance also says the dimensions in the device standards are mainly for manufacturers and should not be the sole basis for judging an installation.
A register helps here in a plain way: when a mattress is changed or a rail is moved to another bed, the record changes, and the change is the prompt to check the combination again.
The checks
MHRA's guidance does not set a fixed interval. It says the frequency should be set by local policy and the manufacturer's instructions, that bed rails should be included in planned preventative maintenance, and that fitting and positioning should be checked initially and after each period of use.
At fitting, MHRA lists checks including that:
- the rails fit the bed and staff know how to fit them;
- mounting clamps are the right way round and in good condition;
- there is no inappropriate gap between the lower bar and the top of the mattress, or between the rail and the mattress, headboard or footboard;
- the rail is secure and cannot move away from the bed or mattress;
- the mattress dimensions and height do not reduce the rail's effectiveness.
At maintenance inspection, MHRA's checklist includes the current instructions for use being followed; rust; sound welded joints; cracked paint or coating; flaking chrome; missing locking handles, clamps, pads or other components; loose fixings; free movement in joints suggesting wear; stripped threads on frame clamps; bent or distorted parts; damaged plastic; and intact labelling.
Each of those makes a question on a phone checklist, with a photo for anything that fails.
Withdrawn rails
MHRA says bed rails found to be unsuitable or in poor condition should be withdrawn from use and appropriately destroyed, and notes that it has received incident reports of bed rails being brought back into use after being kept or stored. A withdrawn rail sitting in a store cupboard is the one that gets refitted. In the register:
- Mark the rail out of service the same day, with what was found.
- Label it on the rail so it is not refitted from the store.
- When it is destroyed, mark it retired with the date. Its ID is never reused.
MHRA strongly encourages reporting suspected adverse incidents with medical devices; in England, healthcare professionals and members of the public report through the Yellow Card scheme.
Tagging beds and rails
- On the bed, put the label on the frame at the foot end, away from moving parts, the controls and the manufacturer's label.
- On each rail assembly, put the label on a part that does not move or clamp, and never over the manufacturer's labelling, which MHRA lists as something to check is intact.
- Choose a label that survives your cleaning chemicals. Beds and rails are cleaned often; a paper label will not last.
Setting this up in Hovermarks
Hovermarks is an asset register with inspections built in:
- One asset per bed and per rail assembly, each with its own QR label, printed in bulk on A4 sheets or rolls.
- Rails as child assets of the bed they are fitted to, so the bed's record shows its rails. Move a rail to another bed and its history moves with it.
- Custom fields for your categories: integral or third-party, mattress type, matched pair.
- Serial number, manufacturer, model and documents on each record, including the instructions for use.
- A schedule per item on the interval your policy sets, with a checklist built from MHRA's lists above and reminders before checks fall due. A failed answer raises a defect against that rail.
- Find every unit of a model. Search the register, or ask in plain English, when a field safety notice names a model.
- Out of service and Retired statuses. Anyone who scans a label without signing in sees only the item's name, site and status, and can report a fault from it.
Hovermarks does not hold the resident's risk assessment and is not a substitute for it. The asset management page sets out what each record holds.
Sources
Checked on 2 November 2026.
- MHRA, Bed rails: management and safe use (last updated 30 August 2023), GOV.UK
- HSE, Safe use of bed rails (page updated 29 June 2026)
- HSE, How the Lifting Operations and Lifting Equipment Regulations apply to health and social care (HSIS4 rev1)
- PUWER 1998, regulation 5 (maintenance), legislation.gov.uk
Related reading
Contains public sector information licensed under the Open Government Licence v3.0. Quotations from legislation and HSE guidance are Crown copyright. Hovermarks is not endorsed by HSE or any other public body.