Slips and trips
Slips and trips are the most common accidents that can occur and make up for one third of all accidents. Slips can result in broken bones. Most slips occur on wet or contaminated floors. Many health and social care providers make use of smooth vinyl on their floors which can lead to an increased risk of slip accidents. However, approaches should be done to integrate best practice in this area to prevent slips and trips. A simple risk assessment carried out by employers will help mitigate against risk. Attention should be given to what could cause harm and control measures should be in place. For example, simply cleaning up spillages immediately and using signs to make aware the floor is unsafe to walk on are all quick and easy steps. There are many simple ways to prevent slips by employees and service users in health care settings. Entrance matting can be used near entrances so any liquids are not brought into the building. Leaks from machinery should be fixed. Trailing cables and any trip hazards should be out sight. The correct cleaning fluid should be used for the floor type. The floor should not have loose, damaged or worn floor tiles. These should be replaced immediately. Lighting in walkways and in slopes and steps should be adequate. Falls from windows can also occur where residents are in a confused mental state. Windows should be fitted so they are too small for individuals to fall through, and sills are not accessible to sit on.
Scalding and burning
Burns can occur to vulnerable individuals in care home settings. Those with a reduced mental capacity, a sensory impairment or those who cannot react appropriately are at risk. Sometimes hot water storage temperatures are kept high to fill the hot water demand, for the efficient running of the boiler and controlling the risk from Legionella bacteria. Apart from running water accidents there may be risk of burns from hot pipes and radiators. Where there is a risk of burns from radiators, the surface should not exceed 43°C. A risk assessment should be carried out to identify risks to vulnerable individuals. This should be part of completing the individual’s care risk assessment. It should be considered whether the service user is likely to run a bath or shower when unattended. This is a particular issue with someone whose mental capacity is impaired. A person’s lack of mobility may mean they are unable to respond safely to hot surfaces and running water. Precautions should be taken where a person’s sensitivity to heat is impaired, for example, lack of feeling in legs. Service users must be able to call for assistance via a lever or by pressing a button. Hot water should be engineered (via thermostatic mixing valves) so that it never reaches above 44°C in vulnerable patient settings. Showers should be fitted so they can never be at a temperature to cause scalding. Radiators and pipework should have low temperature heat emitters or be placed out of reach.
Bed rails are used to prevent falls, however sometimes they can cause other risks. If bed rails are poorly fitted they may cause a person’s neck, check or limbs to become trapped in them. Trapping can occur between the bedrail and mattress, headboard or other parts because of poor bed rail positioning. A risk assessment should be carried out by a competent person taking into account the vulnerability of the occupant, the bed, the mattress and all associated equipment. The mattress must fit snugly between the rails, and, gaps that could cause entrapment should be eliminated.
There are many other factors that can be a risk to vulnerable patients in care and social care settings. All staff should be well trained in risk assessment and know how to prevent accidents. Laws that are applicable are the Health and Safety at Work etc Act 1974 (HSWA), the Management of Health and Safety at Work Regulations (MHSWR), and Provision and Use of Work Equipment Regulations 1998 (PUWER).