How often should bed rails be checked?

When to check

Source: MHRA, Bed rails: management and safe use, sections 1, 3, 4, 6 and 7. The routine interval is for your local policy to set, using the conditions of use and the manufacturer’s instructions for use.

What to check at fitting

MHRA’s questions for the start of the fitting process:

• Can the rails be fitted to this bed correctly, following the manufacturer’s instructions?
• Do staff understand how to fit them properly?
• Are mounting clamps, if present, used the right way round and in good condition?
• Is there a gap between the lower bar and the top of the mattress, or does the mattress edge compress easily?
• Is there a gap between the rail and the side of the mattress, the headboard or the footboard that could trap the person’s head or body?
• Is the rail secure and robust, or could it move away from the side of the bed and mattress in use?
• Do the mattress dimensions and height reduce the rail’s effectiveness for this person? Are extra-height rails needed?

Among the things MHRA says to avoid: gaps of over 60 mm between the end of the rail and the headboard, which could be enough to cause neck entrapment; gaps over 120 mm from any accessible opening between the rail and the mattress platform; filling gaps with blankets, bedding or pillows; rails designed for a divan used on a wooden or metal bedstead; and using one rail of a pair against a wall unless the manufacturer allows it. The mattress length, width and height should be within the limits the bed manufacturer specifies.

What to check at maintenance

Follow the manufacturer’s instructions for use first. MHRA’s typical aspects to check during planned maintenance are:

• the most up-to-date version of the instructions for use is being followed;
• rust, which can affect how easily telescopic tubes adjust;
• welded joints are sound, with no signs of cracking or failure;
• cracked paint or coating, which can point to deeper structural failure;
• flaking or peeling chrome plating, which can cause cuts;
• missing locking handles, fixing clamps, clamp pads and other components;
• loose fixings, which affect the rigidity of the assembly;
• free movement in joints, which can point to loose, worn or incompatible parts;
• stripped threads on bed frame clamps;
• bent or distorted components, and damaged plastic components;
• intact labelling.

To inspect properly, MHRA says it may be necessary to remove duvets, blankets, sheets and valances.

Bed rail check form

One form per rail assembly, built from MHRA’s fitting and maintenance lists above. Print it, or download it as Word to edit for your own rails and policy. It records the check, not the person’s risk assessment, which stays separate.

Records and traceability

MHRA says bed rail assemblies should be traceable, for example by the manufacturer’s serial number, the Unique Device Identification number when available, or an in-house numbering label, so every device can be regularly inspected and found if there is a safety issue such as a recall. Records should be kept of inspections, repairs and maintenance completed on bed rails. Rails found unsuitable or in poor condition should be withdrawn from use and appropriately destroyed, and rails not in use should be stored in matched pairs where they will not get damaged. Our post on a care home bed and bed rail register sets out what to record for each bed and each rail.

What about the bed?

A profiling bed is not lifting equipment. HSE’s HSIS4 says height adjustment alone does not bring equipment under LOLER and lists profiling beds as needing no thorough examination, but the PUWER requirement to maintain the equipment adequately still applies where it is used at work. PUWER regulation 5 requires work equipment to be “maintained in an efficient state, in efficient working order and in good repair”, and sets no interval. Hoists and slings are different: they need a LOLER thorough examination at least every 6 months, covered in LOLER for hoists and slings in care homes.

How Hovermarks handles this

In Hovermarks each bed and each rail assembly can have its own record and QR label, on a schedule at the interval your policy sets, with an email on the day a check is due and another once it is overdue. A built-in profile bed template checks the rails’ fitting, gaps and compatibility with the mattress, and a failed answer on it opens a defect against that item. For medical equipment you can turn on a dated SERVICED label that shows the next due date. The care homes solution page has the detail.

Frequently asked questions

How often should bed rails be checked?

MHRA does not set a fixed interval. Its guidance, Bed rails: management and safe use, says the frequency of inspection should be addressed by local policy, specific to the conditions of use and the recommendations in the manufacturer's instructions for use. It also says bed rails should be in a planned preventative maintenance scheme, and that fitting and positioning should be checked initially and after each period of use.

Is there a legal requirement to inspect bed rails every 6 months?

Not that MHRA states. The 6-month thorough examination in LOLER regulation 9 applies to lifting equipment for lifting people and lifting accessories, such as hoists and slings. HSE's HSIS4 lists profiling beds as not lifting equipment, so no LOLER thorough examination is needed for the bed, though PUWER's duty to keep work equipment maintained still applies. For the rails, MHRA leaves the interval to local policy and the manufacturer's instructions.

What should a bed rail check cover?

MHRA's list for planned maintenance covers: the current instructions for use being followed, rust, welded joints, cracked paint or coating, flaking chrome, missing locking handles, clamps, pads or other parts, loose fixings, free movement in joints, stripped threads on frame clamps, bent or distorted parts, damaged plastic and intact labelling. At fitting, it adds the fit to the bed, clamps, gaps against the mattress, headboard and footboard, how secure the rail is, and the mattress height.

What gaps does MHRA say to avoid?

Among other things, gaps of over 60 mm between the end of the bed rail and the headboard, which could be enough to cause neck entrapment, and gaps over 120 mm from any accessible opening between the bed rail and the mattress platform. MHRA also says not to fill gaps with blankets, bedding or pillows.

Do I need to keep records of bed rail checks?

MHRA says records should be kept of inspections, repairs and maintenance completed on bed rails, and that rail assemblies should be traceable, for example by the manufacturer's serial number, the Unique Device Identification number when available, or an in-house numbering label, so every device is regularly inspected and can be found if there is a recall.

What should happen to a bed rail that fails a check?

MHRA says defective devices should be withdrawn and replaced, if appropriate, quickly, and that bed rails found to be unsuitable or in poor condition should be withdrawn from use and appropriately destroyed. It has had reports of rails being brought back into use after being kept or stored.

Related: bed and bed rail register, LOLER for hoists and slings, CQC Regulation 15 records, equipment responsibilities in supported living, Hovermarks for care homes and supported living.