How to prevent pressure sores: Top tips for care teams

Pressure sores affect approximately 700,000 people in the UK each year, and a 2019 estimate put the cost of pressure sore treatment to the NHS at more than £1.4 million a day. 

These injuries occur when an area of skin and the tissues below it are damaged when placed under pressure for long periods of time – so of course, people who have limited mobility and/or spend a lot of time in bed are most at risk of pressure sores. These sores or ulcers can range in severity from a patch of discoloured skin to a deep open wound. They most commonly affect areas of the body where the bone is close to the skin, e.g. heels, lower back (sacrum, coccyx), hips, ankles, and shoulders. 

The good news: with the right procedures and equipment in place, many pressure sores are preventable.

Effective prevention begins with systematic risk assessment. Regular skin assessments should be conducted at least weekly, and high-risk individuals should be monitored more frequently. Look for changes in the skin’s colour or texture, any swelling or areas that are hotter or cooler than the surrounding skin, and any areas that are causing pain. Bear in mind that incontinence and pressure sores commonly occur together, so make sure you have incontinence care strategies in place. 

Standardised assessment tools like the Waterlow or Braden scales provide consistent, objective measurements to support clinical decision-making and demonstrate due diligence to regulators and care home inspectors.

Finally, documentation is crucial – not only for continuity of care between shifts, but also for demonstrating compliance with NICE guidelines and CQC standards. 

The key to pressure sore prevention remains regular repositioning. Recommendations of how often someone should be repositioned vary according to risk level – it could be every two, four or six hours, or more frequently. 

However, repositioning is more than simply moving someone – it requires proper technique to avoid shearing forces and ensure pressure is genuinely relieved from vulnerable areas. So, staff training on safe positioning techniques is essential, and training should cover:

• Anatomical pressure points
• Appropriate positioning aids
• When to use specialist equipment 

It’s important to remember that repositioning schedules must be realistic and achievable with your staffing levels: a pragmatic schedule everyone can commit to is much better than an overly ambitious schedule that isn’t consistently adhered to.

Ensure you have high-quality pressure-relieving equipment, such as alternating mattresses and cushions, which use advanced materials and technology to distribute weight effectively while maintaining comfort. 

Consider your equipment strategy holistically – specialist mattresses and beds work best as part of a comprehensive programme of care that also includes positioning aids and skin care products. Barrier creams and moisturisers maintain skin integrity, while heel protectors and positioning wedges target specific vulnerable areas. 

Learn more: Pressure care equipment

Poor nutrition significantly increases pressure sore risk, as it compromises the body’s ability to heal and affects skin health. Two of the main ways you can support pressure sore prevention are to ensure residents eat enough protein and stay hydrated.

Monitor residents who are losing weight, eating poorly, or showing signs of dehydration. Consider nutritional supplements for at-risk individuals, but remember these should complement, not replace, a varied and appealing diet. Working closely with other medical specialists, such as dietitians, can help optimise your nutrition and hydration strategies.

Read more: Nutrition for care home residents

Successful pressure sore prevention requires a systematic approach rather than an ad-hoc one. Develop clear, written procedures that specify assessment frequencies, repositioning schedules, equipment usage guidelines, and escalation procedures. These procedures should be regularly reviewed and updated based on current evidence and your care home’s experiences.

Staff training is crucial, so ensure all care staff understand what to do – and why they’re doing it.  Regular refresher training will help to maintain high standards, while involving staff in the development of your processes will help identify any practical implementation challenges.

Integration with your existing care planning systems ensures prevention measures become routine rather than additional tasks. When pressure sore prevention is embedded into daily care routines, compliance improves and residents receive consistent, high-quality care. 

Working to prevent pressure sores benefits both residents and staff, and is also smart business practice. Pressure sores can affect your CQC rating, with poor skin care outcomes often leading to 'Requires Improvement' or 'Inadequate' evaluations.

There are operational benefits too: care homes and healthcare settings with robust prevention strategies report reduced staff time spent on complex wound care, fewer emergency GP visits, and decreased hospital admissions. This translates to better resource allocation, improved staff morale, and ultimately, enhanced resident well-being and satisfaction. 

Preventing pressure sores requires a holistic approach that combines: 

• Regular assessment
• Appropriate positioning
• High-quality equipment 
• Good nutrition 
• Systematic procedures that are clearly documented

While initial investment in training and equipment requires commitment, the returns – in terms of resident wellbeing, staff morale and operational benefits – are significant. Review your current prevention processes regularly and ensure they reflect current best practice. And if you need help with sourcing care supplies or upgrading your equipment, get in touch with our friendly team.