Bed Rails: Management & Safe Use. Guideline Update - Medaco (2025)

Is your care team up to date with managing and using bed rails safely?

If you are a care operator who uses bed rails, you must adhere to the bed rail regulations set out by the Medicines & Healthcare products Regulatory Agency (MHRA) to ensure you are managing and using bed rails safely.

CQC will monitor care facilities for adherence to this under Regulation 12 for the safe use of equipment and has the authority to prosecute if there are breaches to this whilst using bed rails.

What has been updated in the Bed Rail Guidance?

The MHRA official guidance shares best practices in the provision, use, maintenance and fitting of bed rails.

The Guidance on managing and using bed rails safely was first published in March 2020 and has been updated since. The most recent update was in August 2023 and below lists the updates made:

• The need for risk assessments to be updated regularly. The frequency of reviewing the risk assessment will vary depending on the patient and their circumstances and should be recorded as part of the risk assessment but will likely be more frequent for children.

• The entrapment risks that trolleys with side rails share with medical beds.

• Additional risks relating to bariatric beds and lateral turning devices.

• The differences between bed rails and bed grab handles and the risks if they are used incorrectly.

• Involving the patient and/or their family or carers in the decision to use bed rails.

• Ensuring that the most up-to-date version of the instructions for use are being used and are provided to the bed occupant and/or their family and carers.

What has been updated in the Bed Rail Guidance?

The MHRA official guidance shares best practices in the provision, use, maintenance and fitting of bed rails.

The Guidance on managing and using bed rails safely was first published in March 2020 and has been updated since. The most recent update was in August 2023 and below lists the updates made:

• The need for risk assessments to be updated regularly. The frequency of reviewing the risk assessment will vary depending on the patient and their circumstances and should be recorded as part of the risk assessment but will likely be more frequent for children.

• The entrapment risks that trolleys with side rails share with medical beds.

• Additional risks relating to bariatric beds and lateral turning devices.

• The differences between bed rails and bed grab handles and the risks if they are used incorrectly.

• Involving the patient and/or their family or carers in the decision to use bed rails.

• Ensuring that the most up-to-date version of the instructions for use are being used and are provided to the bed occupant and/or their family and carers.

What are the risks of using bed rails in care facilities?

Care facilities use a wide range of profiling beds, some come with integrated bed rails whilst others are purchased separately and retrospectively fitted. As bed rails are designed to protect the service user from falling and not to limit their freedom of movement, many have spaces and gaps. It is these gaps that can cause many of the risks associated with bed rails including:

1. Entrapment between the gap of the top and bottom bed rail

1. Entrapment between with bottom of the rail and the mattress

1. Entrapment between the of the bed rail and the head/foot board

1. Entrapment in the gap between the side of the mattress and the rail

1. Falling out of bed if the mattress is too high in relation to the top of the bed rail

Because of these risks of serious injury or even death, the MHRA have set out dimensional requirements (BS EN 60601-2-52:2010+A1:2015) which must be complied to. These can be found in Appendix 2 and 3 of the guidance.

Guidance

It is important to note that compliance to some of these standards are the responsibility of the manufacturer and requires the use of specific measurement tools, rather than basic distance measurements alone. However, many of the dimensions are the responsibility of the care provider and staff as they could vary with each service user depending on the mattress used for instance.

As part of the service and maintenance of profiling bed, your service provider should use a bed rail ruler guide to ensure the bed rails comply to the regulations. However, this is just a snapshot at the time the bed is being serviced. To ensure compliance and reduce the risk of injury in between service visits, staff must understand how to carry out a risk assessment for the safe use of bed rails, as well as the correct provision of bed rails.

A handy ruler guide can be used to ensure your bed rails meet the dimensional requirements.

Contact Medaco if you would like one of these ruler guides for your care facility.

Maintenance of Bed Rails

As a service and maintenance provider, we must highlight some of the key takeaways from section 7 of the guidance.

• MHRA adverse incident investigations have confirmed that some incidents with bed rails have been caused by inadequate maintenance.

• Bed rails should be included in planned preventative maintenance schemes.

• Bed rails should be maintained in accordance with the manufacturer’s recommendations in the instructions for use.

• Records should be kept of inspections, repairs and maintenance completed on bed rails.

• Bed rails found to be unsuitable or in poor condition should be withdrawn from use and appropriately destroyed.

• When not in use, bed rails should be stored in matched pairs in a suitable area where they will not get damaged.

If you don’t have your profiling beds under and service and maintenance schedule, read more about why you should get your profiling beds serviced in this article:

Conclusion:

Now you are aware of the regulations around the management and safe use of bed rails, make sure all your staff are updated on the routine duties they should be carrying out. It is also worth speaking to your service and maintenance provider to ensure they are doing the necessary checks during their annual inspections to keep you compliant and your service users safe.

If you have any questions or would like further advice on profiling bed, bed rails or other care equipment, get in touch with our team here at Medaco, we’d be happy to help.

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