Recurring concern
Failure to reliably reposition patients at required intervals
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Request correctionFirst reported 20 Aug 2013•Latest report 26 Nov 2025
What this concern includes
Includes failures in arrangements for assessing, scheduling, performing, recording, monitoring and assuring required repositioning or turning of patients at specified intervals, including repositioning for pressure-damage prevention, respiratory care or other clinically identified needs.
Not included
- Excludes general pressure-ulcer prevention or treatment failures where no patient-repositioning deficiency is identified.
- Excludes generic care staffing, training, documentation or audit failures unless they directly impair required patient repositioning or its assurance.
- Excludes failures concerning mobility, moving and handling or patient positioning where repositioning at clinically required intervals is not the unsafe condition.
- Excludes failures to act on pressure damage or respiratory deterioration after required repositioning has been reliably provided.
- Reports
- 14
- Individual concerns
- 14
- Date range
- 2013–2025
- Stated actions
- 22
Distinct published reports
A report can raise multiple concerns
First to latest report issue date
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
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Concerns raised1
Lack of turning charts for pressure-sore care
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
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Action
Maintain individual resident folders containing daily care records, including repositioning charts.
Stated by The Grange Care Centre Cheltenham -
Action
Require the responsible nurse to sign off each chart before evening handover and record additional notes.
Stated by The Grange Care Centre Cheltenham
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Concerns raised1
Falsification of pressure sore repositioning records
This report raised 15 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
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Action
Share investigation learning with New Park House and recommend improvements to recording practices.
Stated by Stoke-on-Trent City Council
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
The investigation found no evidence that the pressure-sore management plan was inadequately followed or that records had been falsified.
Stated by Stoke-on-Trent City Council
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Concerns raised1
Incomplete and poor repositioning records
This report raised 24 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
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Action
Monitor documentation more closely and provide nurses with real-time feedback.
Stated by University Hospitals Sussex NHS Foundation Trust -
Action
Review and condense Acute Medical Unit documentation into multidisciplinary paperwork that directs care and reduces duplication.
Stated by University Hospitals Sussex NHS Foundation Trust
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Concerns raised1
Failure to turn patients at the required frequency
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
Data last updated 7 September 2026