Risk of falling from windows

Serious injuries and fatalities have occurred when people have fallen from or through windows in health and social care premises.

There are three broad categories of falls. These are:

• accidental – these are a minority, but occur where people unintentionally fall through or from windows. This can happen where people are able to sit on and fall from sills, or where windows are positioned such that people could easily fall through them.
• falls arising out of a confused mental state – a significant number of reports refer to the mental state of individuals. In particular, senility, dementia, reduced mental capacity, mental disorder and the effect of drink and drugs (both prescribed and illegal) can all cause anxiety and confusion. In these cases, people have often tried to escape or used a window, believing it to be an exit.
• deliberate self-harm or suicide –a recognised risk for people with certain health conditions, particularly those with a history of self-harm or mental disorder.

Risks from glazing

Health and social care providers must assess risks at their premises. Where assessment identifies the risk of falling against or through glazing, adequate precautions must be taken. These may include provision of suitable safety film, replacement with safety glass or provision of barriers.  Glass doors and patio windows should also be fitted (in accordance with building regulations and British Standards) with toughened or safety glass or covered with a protective safety film.

Falls from windows and balconies

Where assessment identifies that people using care services are at risk from falling from windows or balconies at a height likely to cause harm (eg above ground floor level), suitable precautions must be taken. Windows that are large enough to allow people to fall out should be restrained sufficiently to prevent such falls. The opening should be restricted to 100 mm or less. Window restrictors should only be able to be disengaged using a special tool or key (see NHS guidance in Health Technical Memorandum No 55). Access may need to be restricted to balconies that are not designed to prevent people who are at risk from climbing over.

Further information

• NHS Estates Health Technical Memorandum No 55 Windows (1998) (available electronically from the NHS Space for Health information portal)
• Falls from windows or balconies in health and social care (HSIS5) - this HSE information sheet provides advice on controlling risks to people who use health and social care services associated with falls from windows or balconies.