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Repositioning & Pressure Care Chart

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  • Record the date and exact clock time of every repositioning episode: vagueness such as "morning" does not satisfy Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which requires accurate and complete records. For adults assessed as at risk, intervals must not exceed 6 hours; for those assessed as high risk, intervals must not exceed 4 hours (NICE CG179, recommendations 1.2.5 and 1.2.8).
  • Record the specific position used at each episode, using standard descriptors: supine (lying on back), left lateral (30-degree tilt preferred over full 90-degree), right lateral (30-degree tilt), prone (if clinically appropriate and tolerated), or seated upright/reclined in chair. The 30-degree tilt is the evidence-based lateral position because it avoids direct loading over the greater trochanter.
  • Record the skin condition at every turn using the NWCSP/NICE four-category classification: intact skin (no change), blanching erythema (Category 0, returns to normal colour within seconds of finger pressure), non-blanching erythema (Category 1, skin intact but redness persists under pressure), open wound (Category 2 or above). Any non-blanching erythema must be escalated immediately to the nurse or GP and noted on the chart.
  • Record which pressure areas were inspected at each episode: as a minimum, sacrum/coccyx, heels, hips/trochanters, elbows, and any area in contact with medical devices such as oxygen masks or splints. NICE CG179 section 1.1 directs that skin inspection should focus on bony prominences and areas under devices.
  • Record the equipment in use at the time of the episode: standard mattress, pressure-redistributing foam mattress, dynamic air mattress (and pump setting if adjustable), heel-offloading device or boot, or specialist seating cushion. If equipment was not available or declined by the resident, state this explicitly and document the reason.
  • Record whether the person was able to assist with the reposition (independently mobile, partially assisted, fully assisted by one carer, fully assisted by two carers and hoist). NICE QS89 Quality Statement 6 requires that people who cannot reposition themselves are actively helped; failure to record this help is treated by CQC as evidence it did not occur.
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Repositioning & Pressure Care Chart

A repositioning and pressure care chart is the contemporaneous record that proves each at-risk resident or service user was turned or repositioned at the correct frequency, in the right positions, with skin checked at every episode. Without it, a Category 2 or above pressure ulcer becomes legally presumed avoidable under NICE CG179, exposing the provider to CQC enforcement under Regulation 12 (safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and potentially to safeguarding investigation by the local authority.

12 checksPDF + printReviewed August 2026
Built on published UK guidance Show sources

Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 9 (person-centred care), Regulation 12 (safe care and treatment), Regulation 17 (good governance); NICE Clinical Guideline CG179 (Pressure ulcers: prevention and management, 2014), recommendations 1.1 (skin assessment) and 1.2.5 and 1.2.8 (repositioning frequency); NICE Quality Standard QS89 (2015), Quality Statements 5 and 6 (advice on and help with repositioning); NHS and Social Care Records Management Code of Practice 2021 (Appendix 1 retention schedule); National Wound Care Strategy Programme Pressure Ulcer Clinical Recommendations 2023; Data Protection Act 2018 (UK GDPR), Article 5(1)(e) (storage limitation)

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What’s on it

12 things to check.

Everything that matters, nothing that does not. Here is the full list, exactly as it appears on the template.

  • 1Record the date and exact clock time of every repositioning episode: vagueness such as "morning" does not satisfy Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which requires accurate and complete records. For adults assessed as at risk, intervals must not exceed 6 hours; for those assessed as high risk, intervals must not exceed 4 hours (NICE CG179, recommendations 1.2.5 and 1.2.8).
  • 2Record the specific position used at each episode, using standard descriptors: supine (lying on back), left lateral (30-degree tilt preferred over full 90-degree), right lateral (30-degree tilt), prone (if clinically appropriate and tolerated), or seated upright/reclined in chair. The 30-degree tilt is the evidence-based lateral position because it avoids direct loading over the greater trochanter.
  • 3Record the skin condition at every turn using the NWCSP/NICE four-category classification: intact skin (no change), blanching erythema (Category 0, returns to normal colour within seconds of finger pressure), non-blanching erythema (Category 1, skin intact but redness persists under pressure), open wound (Category 2 or above). Any non-blanching erythema must be escalated immediately to the nurse or GP and noted on the chart.
  • 4Record which pressure areas were inspected at each episode: as a minimum, sacrum/coccyx, heels, hips/trochanters, elbows, and any area in contact with medical devices such as oxygen masks or splints. NICE CG179 section 1.1 directs that skin inspection should focus on bony prominences and areas under devices.
  • 5Record the equipment in use at the time of the episode: standard mattress, pressure-redistributing foam mattress, dynamic air mattress (and pump setting if adjustable), heel-offloading device or boot, or specialist seating cushion. If equipment was not available or declined by the resident, state this explicitly and document the reason.
  • 6Record whether the person was able to assist with the reposition (independently mobile, partially assisted, fully assisted by one carer, fully assisted by two carers and hoist). NICE QS89 Quality Statement 6 requires that people who cannot reposition themselves are actively helped; failure to record this help is treated by CQC as evidence it did not occur.
  • 7Record any refusal by the resident or service user to be repositioned, including the reason given and what alternative comfort measure was offered. A refusal must be countersigned by the nurse in charge or senior on duty to demonstrate that clinical oversight was applied. This protects the provider from a finding of neglect if a pressure ulcer develops.
  • 8Record the full name and designation of every carer carrying out or supervising the reposition, together with their legible signature or unique digital identifier. Initials alone are not sufficient under Regulation 17. In domiciliary care, the visiting carer's employee number or digital login serves this purpose.
  • 9Record any communication to the district nurse, tissue viability nurse, GP, or on-call clinician triggered by a skin change. Note the time of contact, name of the clinician contacted, and the advice or instructions given. A Category 1 finding that is not escalated within the same shift is a patient safety incident under Regulation 12.
  • 10Record a brief nutritional note at each shift review (typically every 12 hours), confirming whether the person has eaten and drunk adequately. Malnutrition and dehydration are independent risk factors for pressure ulcer development and NICE CG179 section 1.1 links nutrition monitoring directly to skin-integrity care.
  • 11At each weekly review by a registered nurse, record the current validated risk score (Waterlow, Braden, or Norton scale) and whether the repositioning frequency or equipment has been updated in response. The chart entry should cross-reference the care plan review date so CQC inspectors can trace the decision pathway.
  • 12Record the chart reference number and the dates of the period it covers on the front of every printed sheet. Completed charts must be retained for a minimum of 8 years from the last date of care for an adult, in line with the NHS and Social Care Records Management Code of Practice 2021 (Appendix 1, Social Care retention schedule) and the UK GDPR principle of storage limitation under the Data Protection Act 2018.

Good to know

Under NICE CG179 (published April 2014 and confirmed at 2018 surveillance), a pressure ulcer is considered avoidable if the provider cannot demonstrate that the risk was assessed, that a repositioning plan was in place and followed at the frequencies the guidance specifies, and that skin was inspected at each episode. A missing or incomplete repositioning chart is therefore not a paperwork failure: it is evidence of avoidable harm under Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which carries CQC prosecution powers without the need to prove intent.

Source: Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 9 (person-centred care), Regulation 12 (safe care and treatment), Regulation 17 (good governance); NICE Clinical Guideline CG179 (Pressure ulcers: prevention and management, 2014), recommendations 1.1 (skin assessment) and 1.2.5 and 1.2.8 (repositioning frequency); NICE Quality Standard QS89 (2015), Quality Statements 5 and 6 (advice on and help with repositioning); NHS and Social Care Records Management Code of Practice 2021 (Appendix 1 retention schedule); National Wound Care Strategy Programme Pressure Ulcer Clinical Recommendations 2023; Data Protection Act 2018 (UK GDPR), Article 5(1)(e) (storage limitation)

Good to know

Questions, answered

What is the Repositioning & Pressure Care Chart?

A repositioning and pressure care chart is the contemporaneous record that proves each at-risk resident or service user was turned or repositioned at the correct frequency, in the right positions, with skin checked at every episode. Without it, a Category 2 or above pressure ulcer becomes legally presumed avoidable under NICE CG179, exposing the provider to CQC enforcement under Regulation 12 (safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and potentially to safeguarding investigation by the local authority.

Why does it matter?

Under NICE CG179 (published April 2014 and confirmed at 2018 surveillance), a pressure ulcer is considered avoidable if the provider cannot demonstrate that the risk was assessed, that a repositioning plan was in place and followed at the frequencies the guidance specifies, and that skin was inspected at each episode. A missing or incomplete repositioning chart is therefore not a paperwork failure: it is evidence of avoidable harm under Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which carries CQC prosecution powers without the need to prove intent.

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The PDF downloads the moment you check out, prints sharp in black and white, and opens on any phone. It is reviewed for August 2026 and you get any future update free when the official guidance changes.

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