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Standards › ASF Health Standards v10 › Module 3D · Environment and Accessibility

Module 3D · Environment and Accessibility

8 criteria · ASF Health Standards v10 · Draft for review

Each criterion below shows what the surveyor checks, the evidence to show, and what counts as met, partly met or not met.

Colour key: Red = Essential, required in every setting. Green = Recommended. Amber = Standard.

3D.1 Handrails Are Fitted Where Patients Walk

Standard

Sturdy, continuous handrails are fitted on both sides of corridors, stairs and ramps where patients walk, so that a patient can hold on for the whole route.

Questions the surveyor asks

  1. Are handrails fitted on both sides of corridors, stairs and ramps where patients walk? One-sided handrails leave a patient without support on the other side.
  2. Are the handrails continuous, without gaps where a patient would need to let go? A gap at a door or landing is where a fall happens.
  3. Are handrails checked for firmness and security on a defined schedule? A loose handrail gives false support and is worse than none.

Why it matters. A patient who is unsteady and walks along a corridor can fall where there is nothing to hold. Continuous handrails on both sides let them hold on for the whole route.

Evidence to show. Route survey with photographs of the handrails and the quarterly firmness check record.

Good

Failure

Partly met when

How to implement

What the surveyor does

E-learning. Environment and Shared Spaces

3D.2 Toilets and Washrooms Have Correct Grab Bars

Standard

Grab bars in toilets and washrooms are placed for toilet transfer, both horizontal and vertical where the design allows, and are fixed so that they do not turn in their fittings.

Questions the surveyor asks

  1. Are grab bars fitted beside the toilet and in the shower or bathing area, in positions that support sitting down and standing up? A bar in the wrong place gives support only to someone who does not need it.
  2. Are bars horizontal where they support a transfer, and do they hold firm when tested? A bar that rotates or pulls out of the wall does not prevent a fall.
  3. Where space allows, are fold-down bars fitted beside the toilet, so that a patient can use one on either side? Fixed wall bars on one side only leave the other side unsupported.

Why it matters. Toilet transfers are one of the most common moments of falls in care. Grab bars in the right place and fixed firmly give the patient something to hold.

Evidence to show. Photographs of the grab bars at each toilet and the quarterly firmness test record.

Good

Failure

Partly met when

How to implement

What the surveyor does

E-learning. Environment and Shared Spaces

3D.3 An Accessible Toilet Is Available Where Patients Need One

Standard

At least one toilet in the facility is accessible to a patient who uses a wheelchair, with enough clear floor space for a transfer and bars placed for that transfer, to recognised international design guidance for health facilities.

Questions the surveyor asks

  1. Is at least one toilet accessible to a wheelchair user, with clear floor space for a transfer, designed to recognised international guidance for health facilities, and is the basis of the design recorded? Local custom alone does not establish accessibility.
  2. Is the accessible toilet clearly signed and placed on the route patients take from the main entrance? An accessible toilet that patients cannot find is not available to them.
  3. Is the accessible toilet kept free of storage, so that it can be used at any time? A toilet used as a store room is closed to the patient who needs it.

Why it matters. A patient who uses a wheelchair cannot use a toilet that is too small to turn in or has no bars to transfer with. At least one accessible toilet is needed for those patients to use the facility at all.

Evidence to show. Floor plan showing the accessible toilet with dimensions, photographs and the weekly check record.

Good

Failure

Partly met when

How to implement

What the surveyor does

E-learning. Environment and Shared Spaces

3D.4 Toilet and Washroom Doors Allow Rescue

Non-negotiable

Toilet and washroom doors open outward, or can be released from outside in an emergency, so that a patient who has fallen or is unable to open the door can be reached and removed promptly.

Questions the surveyor asks

  1. Do toilet and washroom doors open outward, or can they be released from outside without a key? A door that opens inward and is locked from inside can trap a patient who falls against it.
  2. Is the emergency release tested on a defined schedule, and does it work? A release that has not been tested may fail when it is needed.
  3. Are staff trained to use the release, and is the release location known to all staff? A release that only one person knows how to use delays rescue.

Why it matters. A patient who falls behind a toilet door that opens inward may not be found in time. A door that opens outward, or that can be released from outside, lets staff reach the patient in an emergency.

Evidence to show. Door survey (type and opening direction for each toilet) and the monthly release check record.

Good

Failure

Partly met when

How to implement

What the surveyor does

E-learning. Emergency Preparedness and Fire Safety

3D.5 Lighting Supports Safe Movement

Standard

Corridors, stairs, toilets, washrooms and patient rooms are lit at a level that allows safe movement at all hours, with night lighting or motion-activated lighting where patients walk at night.

Questions the surveyor asks

  1. Are corridors, stairs and washrooms lit to a level that allows safe movement at night? Patients often get up at night, when light is low and staff presence may be thinnest.
  2. Is night lighting provided where patients walk between bed and toilet? Lighting that only works when the main lights are on does not serve the patient at night.
  3. Are lights checked on a schedule, and are failed lights replaced promptly? A corridor that is dark because a bulb has failed for weeks is a known hazard.

Why it matters. Patients get up at night and move in poor light. A dark corridor or toilet is where a fall is most likely. Adequate light, and night lighting, make the route safe at all hours.

Evidence to show. Light level survey on the routes and the monthly light check record.

Good

Failure

Partly met when

How to implement

What the surveyor does

E-learning. Environment and Shared Spaces

3D.6 Beds and Chairs Are Set to Reduce Fall Risk

Standard

Patient beds are set to a low height when the patient is in them, brakes are locked, and the call system and personal items are within reach, so that a patient can get in and out safely.

Questions the surveyor asks

  1. Are patient beds kept at a low height when the patient is in bed, and raised only for care and transfer? A bed raised for convenience of care is a risk when the patient gets up alone.
  2. Are bed and chair brakes locked when the patient is in them, and is this checked? A bed that moves when a patient sits on its edge is a common cause of falls.
  3. Are the call button, water, glasses and personal items within reach from the bed and the chair? Items out of reach lead patients to stretch, climb or stand unsupported.

Why it matters. A high bed is a common cause of falls when a patient climbs out. A low bed, with brakes on and the call bell in reach, keeps the patient safer in bed and on the way out.

Evidence to show. Bed check procedure (current) and the shift check record for the last 30 days.

Good

Failure

Partly met when

How to implement

What the surveyor does

E-learning. Slip, Trip and Fall Prevention

3D.7 Walking Aids and Mobility Equipment Are Available and Checked

Standard

Walking aids, wheelchairs and other mobility equipment are available in the sizes needed, are in working order, and are checked on a defined schedule, so that a patient's own aid or a facility aid is safe to use.

Questions the surveyor asks

  1. Are walking aids and wheelchairs available in the sizes and types the patients need? An aid that is too tall or too short for the patient is an additional fall risk.
  2. Are walking aids and wheelchairs checked on a defined schedule, with the check recorded? A worn wheel or loose clamp is a fall waiting to happen.
  3. Are defective aids removed from use immediately, and is their repair or replacement tracked? A defective aid left in use is worse than none.

Why it matters. A patient who needs a walking frame or a wheelchair but finds none, or finds one that is broken, is put at risk. Having the right aids, in the right sizes, and checking them on a schedule keeps them ready.

Evidence to show. Mobility equipment register with the check schedule and the monthly check record.

Good

Failure

Partly met when

How to implement

What the surveyor does

E-learning. Slip, Trip and Fall Prevention

3D.8 Routes Are Clear of Clutter and Trip Hazards

Standard

Routes that patients walk are kept clear of equipment, cables, boxes, mats and other objects that could cause a trip, and any hazard that cannot be removed is marked and managed.

Questions the surveyor asks

  1. Are patient routes kept clear of equipment, cables, trolleys, boxes and loose mats? A trolley left in a corridor for an hour is a trip hazard for every patient who passes.
  2. Are cables and leads routed so they do not cross walkways? A cable across a walkway is a trip hazard that patients cannot see.
  3. Where a trip hazard cannot be removed, is it marked and managed until it is removed? A hazard that is known and unmarked is not managed.

Why it matters. A cable, a box or a mat on the floor is among the commonest causes of falls in a ward. Clear routes, with any hazard that cannot be removed marked, keep patients moving safely.

Evidence to show. Route walk record (weekly) with the hazards found and fixed.

Good

Failure

Partly met when

How to implement

What the surveyor does

E-learning. Slip, Trip and Fall Prevention