Don't slip up on new flooring regulations

Slips and trips are a massive issue for the health services. More than a third of major injuries in this sector are caused by slips and trips, and 95% of those accidents result in broken bones. The cost of treating these, not to mention litigation claims for slips and trips incurred in a healthcare environment, is huge. And that’s before you consider slip and trip injuries to staff in the sector.

Because of this, there have been recommendations in place to help prevent slips and trips in this sector for many years. The Department of Health’s Performance requirements for building elements used in healthcare facilities (HBN-00-10) supersedes HTM61 in England and places even more responsibility on specifiers, project teams and anyone who commissions building and maintenance works to choose the right floor to reduce the risk of slips and trips. This means that flooring contractors making recommendations to end users need to work within this legislation. Even in the case of a refurbishment, a risk assessment must be carried out and the flooring specified as if it were a new project taking current and possible flooring usage into account.

Flooring requirements

The regulations set out legal requirements and standards to ensure efficient healthcare through quality and fit for purpose NHS estates. Key requirements for flooring include:

• Floors in hospital streets and corridors must be capable of withstanding loads from heavy wheeled and intense pedestrian traffic
• Carpet should be avoided in clinical areas and only considered in non-clinical areas once a risk-assessment has been carried out and a clearly defined preventative maintenance and cleaning programme is in place
• Floors in operating theatres should be able to withstand the movement of heavy mobile equipment and frequent spillages, cleaning and disinfection
• Entrance floors should be slip-resistant in all weather conditions
• All flooring, including slip-resistant, should be capable of being cleaned to agreed hygiene standards and surfaces must prevent pedestrians from slipping both in areas deemed as dry and those that can become wet or contaminated
• Design should focus on enhancing patient safety, thereby contributing both to a reduction in accidents involving patients and to costs incurred by ensuing hospital stays

Healthcare providers need to provide evidence that they are adhering to these performance requirements, which also include more stringent measures of slip resistance, including monitoring performance once installed. The guidance states that "there should be evidence that healthcare providers are monitoring slip resistance levels at regular intervals throughout the service life of a floor in order to identify any changes.” 

Installed floors do not always behave in the same manner as new with regard to slip performance, which is one of the main reasons for bringing in this extra level of testing. Some floors quickly lose their initial slip resistance. A number of factors can influence the slip resistance – such as incorrect cleaning regimes or contamination – but most worrying, some slip resistant flooring just isn’t built to perform over time.

The Pendulum Test

In the UK, the slip resistance rating of a floor covering will typically be quoted either as an R value or a Pendulum value. Sometimes the manufacturer will supply both. There are, however, considerable differences between the two values, so it is important to understand how each rating has been arrived at, and what it means for slip resistance of the product throughout its lifetime.

The R value, used in Europe and the UK, indicates the performance of a floor covering in the ramp test (DIN 51130). It is based on angle measurements taken on a ramp, as shown in Figure 1, until a slip occurs. R values range from R9, where the angle is 6° to 10°, through to R13 where the angle is greater than 35°.

The Pendulum Test - recommended by the HSE for the assessment of slip resistance of flooring in the UK - is entirely different to the ramp test. The Pendulum Test measures the co-efficient of friction (COF) between the heel of your shoe and the floor covering. It does this by swinging a dummy heel over a set length of flooring in a controlled manner. This provides a slip resistance value (SRV), also referred to as a Pendulum Test Value. An SRV of 36 or above represents a low slip risk. 

The Pendulum Test is a key method of testing slip resistance of a floor in situ and is being recommended in the healthcare sector. Reputable manufacturers of safety flooring will be happy to provide results of performance over time for their products. Failure to take this into account when choosing or recommending flooring to end users could cause you to fall foul of the legislation.