Commissioning care homes: common safeguarding challenges

Common safeguarding issues – Pressure sores

Many people who are frail and have restricted mobility are at risk of developing sores on the points of their body which receive the most pressure. These are known as pressure sores and are sometimes called bed sores or ulcers. Pressure sores start with skin discoloration but, if left untreated, they can become very deep and infected; in the worst cases they can be life threatening. With management and care, pressure sores can be avoided in most cases.

Pressure sores are not always due to neglect and each individual case should be considered, taking into account the person's medical condition, prognosis, any skin conditions and their own views on their care and treatment. These things, rather than the grading of the pressure sore, should determine whether a safeguarding referral is appropriate. Other signs of neglect, such as poor personal hygiene and living environment, poor nutrition and hydration may help to influence this decision.

Prevention checklist


The Waterlow score for grading pressure sores

Waterlow - Other free resources

Royal College of Nursing clinical practice guideline for pressure ulcers

Alzheimer's Society pressure sore information