Mattress Check Audit - Care Homes

Evidence to check

• • Current SOP or policy covering foam mattresses, dynamic mattresses, overlays, covers and pumps
• • Process includes selection, inspection frequency, cleaning, decontamination, quarantine, repair and disposal
• • Staff can explain what makes a mattress unsafe or unsuitable
• • Observed practice matches the written procedure

Evidence to check

• • Named IPC lead, facilities lead, clinical lead or manager responsible for mattress oversight
• • Responsibilities are clearly documented
• • Responsible person reviews mattress checks, faults and replacement actions
• • Deputy or cover arrangements are in place during absence

Evidence to check

• • Inventory includes unique ID or asset tag, location, mattress type, size, supplier and purchase date
• • Dynamic systems, pumps, overlays and spare mattresses are included
• • Inventory matches mattresses physically present in the home
• • Removed, replaced or quarantined mattresses are updated promptly

Evidence to check

• • Planned preventive maintenance schedule includes inspection, servicing, testing and replacement review
• • Dynamic mattress systems and pumps are included
• • Planned preventative maintenance tasks are completed within expected timescales
• • Overdue maintenance is escalated and risk assessed

Evidence to check

• • Inspection schedule states when checks are required
• • Checks include admission, discharge, room moves, contamination, infection risk, after damage and routine checks
• • Higher-risk residents or high-use mattresses receive appropriate increased checks
• • Staff know when additional checks are needed outside the routine schedule

Evidence to check

• • Inspection records are completed at the required frequency
• • Records include mattress ID, location, condition, action and staff signature or electronic equivalent
• • Gaps or missed inspections are followed up
• • Records are stored in a way that supports audit and inspection

Evidence to check

• • Mattress fits bedframe without unsafe gaps, overhang or instability
• • Mattress size is appropriate for bed extensions or bariatric frames where used
• • Entrapment or gap risks are considered
• • Incorrectly fitting mattresses are removed or replaced promptly

Evidence to check

• • Manufacturer guidance is available or referenced
• • Mattress compatibility is checked when bedrails, extensions or profiling beds are used
• • Bedrail height and entrapment risks are assessed with the actual mattress in use
• • Incompatible combinations are escalated and changed

Evidence to check

• • Mattress and bedframe weight limits are available
• • Resident weight and equipment suitability are reviewed where relevant
• • Bariatric equipment is provided where required
• • Staff know not to use mattresses outside manufacturer weight limits

Evidence to check

• • Pressure ulcer risk assessment is completed on admission
• • Risk assessment is reviewed after illness, reduced mobility, weight loss, falls, hospital admission or skin changes
• • Mattress type matches assessed risk and clinical judgement
• • Staff can explain which residents require pressure-relieving mattresses and why

Evidence to check

• • Records show high-risk residents receive suitable pressure-relieving support without avoidable delay
• • Equipment requests and delivery dates are recorded
• • Interim risk controls are used if equipment is delayed
• • Clinical escalation occurs where pressure risk cannot be safely managed

Evidence to check

• • Care plan states mattress type and pressure care equipment in use
• • Dynamic mattress settings are recorded where required
• • Staff know how to check settings and alarms
• • Care plan is updated when mattress type or settings change

Evidence to check

• • Change records include reason for escalation or downgrade
• • Decision is linked to pressure risk, skin condition, comfort or clinical advice
• • Responsible person is identified
• • Resident response and effectiveness are reviewed after change

Evidence to check

• • Training includes signs of damage, bottoming out, loss of support, contamination and incompatibility
• • Staff can explain when to remove a mattress from use
• • Concerns raised by staff are logged and acted on
• • Training is refreshed after incidents, audit findings or new equipment

Evidence to check

• • Bottoming-out check process is defined
• • Checks are recorded where required
• • Residents at higher pressure risk are prioritised
• • Mattresses that fail bottoming-out checks are removed or replaced

Evidence to check

• • Inspection records include cover and surface condition
• • Physical checks confirm no visible damage
• • Damaged mattresses are removed from use immediately
• • Repeated damage themes are reviewed

Evidence to check

• • Inspection includes seams, welded joints, zips and edges
• • Fluid ingress risk is considered, not only visible surface damage
• • Compromised seams or zips trigger removal from use
• • Staff understand why fluid ingress creates infection control risk

Evidence to check

• • Cover checks include waterproofing, coating, pinholes and wear
• • Torch or appropriate inspection method is used where part of local procedure
• • Worn or compromised covers are replaced or mattress removed
• • Cover integrity checks are recorded

Evidence to check

• • Cover model matches mattress type where manufacturer-specific covers are required
• • No improvised covers, plastic sheets or unsuitable protectors are used
• • Replacement covers are approved for the mattress
• • Compatibility is checked after repair or replacement

Evidence to check

• • Handles are checked for damage or tearing
• • Staff understand handles are not for lifting residents
• • Moving and handling practice does not place stress on covers or handles
• • Damaged handles are recorded and reviewed for replacement

Evidence to check

• • Inspection includes smell, staining, dampness and underside checks
• • Mattresses with suspected fluid ingress are quarantined immediately
• • Resident infection risk and skin risk are considered
• • Contaminated mattresses are not returned to use unless safe decontamination is confirmed

Evidence to check

• • Procedure states when inner core checks are required
• • Core checks are completed after contamination, odour, cover damage or failed inspection
• • Contaminated or deteriorated cores are removed from use
• • Staff use appropriate PPE and IPC precautions when checking cores

Evidence to check

• • Inspection includes checking for foreign objects and sharp risks
• • Needle or sharps concerns are escalated according to sharps policy
• • Damaged zips or sharp components are repaired or removed from use
• • Residents and staff are protected from injury

Evidence to check

• • Inspection includes support and comfort condition
• • Sagging, lumps or flattening are recorded
• • Resident comfort and pressure risk are reviewed
• • Mattresses with poor support are replaced promptly

Evidence to check

• • Observation of sampled mattresses and covers
• • Cleaning records match mattress condition
• • Body fluid contamination is managed immediately
• • Poor cleanliness triggers cleaning review and staff feedback

Evidence to check

• • Approved cleaning products are listed in the SOP or manufacturer guidance
• • COSHH information and dilution instructions are available
• • Staff understand contact times and compatibility
• • Inappropriate products that damage covers are not used

Evidence to check

• • Manufacturer cleaning guidance is available for each mattress type
• • Cleaning practice matches guidance
• • Steam, bleach or high-strength products are only used where approved
• • Damage caused by incorrect cleaning is reviewed and prevented

Evidence to check

• • Training records for domestic, care, infection prevention and facilities staff as relevant
• • Staff can demonstrate or explain correct cleaning steps
• • Pump, hoses and control units are included in cleaning procedures
• • Competency is checked through observation or audit

Evidence to check

• • Records show prompt cleaning after urine, faeces, vomit, blood or wound fluid contamination
• • Staff use PPE and approved products
• • Mattress is checked for cover breach or fluid ingress
• • Contamination incidents are escalated where cleaning may not be sufficient

Evidence to check

• • Quarantine process is documented
• • Unsafe mattresses are labelled and physically separated
• • Mattresses are not returned to use without inspection and sign-off
• • Disposal or replacement is arranged promptly

Evidence to check

• • Infection prevention guidance covers mattresses used during infection risk or isolation
• • Enhanced cleaning is completed where required
• • Mattress condition is checked after infection precautions end
• • Staff understand additional precautions for infectious body fluids or outbreaks

Evidence to check

• • Mattresses are transported clean and protected
• • Protective bags or covers are used where required
• • Clean and dirty routes or handling processes are understood
• • Hand hygiene and PPE are used appropriately during transport

Evidence to check

• • Stored mattresses are clean, dry, off the floor and protected from damage
• • Mattresses are not stored in dirty utility areas
• • Mattresses are not bent, compressed or stacked in a way that damages them
• • Stored mattresses are inspected before reuse

Evidence to check

• • Storage area is clean, dry and ventilated
• • No evidence of damp, mould, pests or contamination
• • Mattresses are not exposed to heat or direct sunlight that may damage covers
• • Overcrowding or abrasion risks are addressed

Evidence to check

• • Clean and soiled mattresses are stored separately
• • Quarantined items are labelled clearly
• • Staff understand separation process
• • No unlabelled mattress is returned to use without inspection

Evidence to check

• • Post-move checks are completed after room moves, storage transfer or delivery
• • Covers, seams, zips and pumps are checked after relocation
• • Damage during transfer is recorded and investigated
• • Staff use safe handling methods to reduce damage

Evidence to check

• • Replacement criteria include cover breach, fluid ingress, persistent odour, staining, damaged seams, loss of support or failed testing
• • Staff know when a mattress cannot be repaired or reused
• • Replacement decisions are documented
• • Residents are not left on unsuitable mattresses while awaiting replacement

Evidence to check

• • Damaged mattresses are physically removed from resident use
• • Labels clearly state do not use or quarantine
• • Fault is recorded and escalated
• • Staff know where unsafe mattresses should be placed

Evidence to check

• • Repair and replacement process is documented
• • Approved suppliers and contact details are available
• • Lead times are understood and planned for
• • Contingency stock or alternative arrangements are available for urgent pressure care needs

Evidence to check

• • Dynamic systems are checked when set up and during routine care
• • Pump is running and connected correctly
• • Mattress cells inflate and cycle as expected
• • Faults or alarms are escalated immediately

Evidence to check

• • Pump settings match resident weight or clinical guidance
• • Alarm function is tested as required
• • Pump casing, controls and display are intact
• • Staff know what each alarm means and how to escalate

Evidence to check

• • Hoses and connectors are inspected regularly
• • No kinks, disconnections, leaks or damaged valves are present
• • CPR valve is correctly closed during normal use
• • Faults are recorded and repaired promptly

Evidence to check

• • Filter maintenance schedule is in place where applicable
• • Cleaning or replacement records are completed
• • Manufacturer guidance is followed
• • Poor filter maintenance or pump faults are escalated

Evidence to check

• • PAT or electrical safety records include pumps where applicable
• • Testing dates are current
• • Damaged plugs, leads or units are removed from use
• • Electrical safety concerns are escalated promptly

Evidence to check

• • Cables are routed safely around beds and walkways
• • No trailing leads create trip hazards
• • Cables are not trapped in bed mechanisms
• • Residents, staff and visitors can move safely around the bed

Evidence to check

• • Use of overlay or topper is clinically justified and recorded
• • Compatibility with mattress, bedframe, bedrails and fire safety is checked
• • Overlay does not increase entrapment or falls risk
• • Effectiveness is reviewed after use

Evidence to check

• • Staff understand which products can reduce pressure-relieving effectiveness
• • Continence products are used according to care plan and clinical guidance
• • Heat, moisture and skin damage risks are monitored
• • Unnecessary layering is challenged and reduced

Evidence to check

• • Resident comfort and temperature are reviewed
• • Care plans address overheating, sweating or discomfort
• • Bedding and room temperature are adjusted where needed
• • Skin checks are increased where heat or moisture risk is identified

Evidence to check

• • New or worsening pressure damage triggers mattress reassessment
• • Skin integrity records are reviewed with equipment suitability
• • Mattress changes are made where current support is ineffective
• • Clinical advice is sought when pressure damage develops despite equipment

Evidence to check

• • Pressure damage investigation considers mattress type and condition
• • Repositioning, continence, nutrition and care practice are reviewed alongside equipment
• • Faulty or unsuitable mattress use is escalated
• • Learning leads to changes in mattress checks, training or procurement

Evidence to check

• • Safeguarding threshold is considered for serious, unexplained or avoidable pressure damage
• • Rationale is recorded where safeguarding referral is or is not made
• • Immediate protective actions are taken
• • Care plans and practice are reviewed after safeguarding concerns

Evidence to check

• • Staff are observed making beds and repositioning residents safely
• • Sharp objects, excessive friction and dragging are avoided
• • Staff understand how bed making can damage covers or reduce pressure relief
• • Poor practice is corrected through supervision or retraining

Evidence to check

• • Scissors, razors, needles and other sharp items are stored safely
• • Sharps bins are available where clinical sharps are used
• • Mattress puncture risks are considered in rooms with clinical equipment
• • Damage linked to sharp items is investigated

Evidence to check

• • Labels are present and readable on sampled mattresses
• • Manufacturer and model can be matched to inventory
• • Cleaning and fire safety information is available
• • Unidentified mattresses are risk assessed and replaced where assurance is not possible

Evidence to check

• • Fire compliance information is retained or available from supplier
• • Mattresses and covers have not been cut, altered or repaired unsafely
• • Procurement checks include fire safety suitability
• • Damaged or modified mattresses are removed from use

Evidence to check

• • Procurement records or rationale reflect resident needs and clinical risks
• • Bariatric, dementia, pressure care, infection control and durability needs are considered
• • Purchases are made through approved suppliers
• • New mattresses are added to the inventory and maintenance schedule

Evidence to check

• • Mattress audit schedule is in place
• • Audits include condition, cleanliness, compatibility, records, storage and dynamic systems
• • Actions include owners and deadlines
• • Follow-up confirms unsafe mattresses were removed or replaced

Evidence to check

• • Managers review mattress audit findings and incident themes
• • Recurring damage or cleaning failures are investigated for root cause
• • Replacement delays are escalated where resident safety is affected
• • Actions are included in governance or quality improvement plans

Evidence to check

• • Incidents such as pressure damage, infection risk, falls from bed, entrapment risk or equipment failure are reviewed
• • Learning is shared through handovers, team meetings, supervision or training
• • Policies, checks or procurement are updated following learning
• • Follow-up audits confirm learning has changed practice

Evidence to check

• • Audit includes resident comfort, skin integrity and pressure care outcomes
• • Mattress condition is checked physically, not only through paperwork
• • Audit findings are compared with wound, infection prevention, falls and tissue viability data
• • Actions lead to measurable improvement in safety, comfort and infection control