Slip Resistance in NHS Properties - Compliance with HTM6-1

(Download full HTM61 document here)

Introduction

HTM61 provides slip resistance specification and design guidance for floorings used in NHS properties. The document does not stipulate a specific slip resistance measurement, instead it refers to the requirements of the Health & Safety Executive, namely, their 2004 document “The assessment of pedestrian slip risk: the HSE approach”.

This document, in line with general HSE guidance and UK law, requires floors to present a “low risk of slip” when measured with the TRL Pendulum test machine in accordance with BS 7976.

Grip Potential regularly conduct slip tests for a range of NHS and privately owned healthcare properties including hospitals, care homes for the elderly or disabled, doctors surgeries and dentists. Read more about our services.

Defining “Low Risk of Slip”

Generally, a floor that measures at least 36 PTV (Pendulum Test Value) in wet conditions when tested in accordance with BS 7976 is considered to be a low risk of slip. It is considered good practice to increase this lower limit to 40 PTV to account for small variations in floor performance and slight changes in level.

A more precise approach is given with further HSE and UK Slip Resistance Group (UKSRG) guidance. The minimum safe PTV should be adjusted to account for gradients, vulnerable pedestrians, various environmental factors, specific surface usage and contaminants of differing viscosity to water.

Grip Potential follow all guidance from the HSE and UKSRG on slip risk assessment, allowing us to produce a definitive measure of slip risk. Our holistic approach ensures that all factors affecting slip risk are duly considered. A comprehensive report detailing test methods, compliance with HSE guidelines, results and advice is issued within 5 working days of a site assessment. Request a sample report.

Obtaining Slip Resistance Values

Slip resistance data supplied by manufacturers is a good guide to specifying an appropriate flooring product. The buyer should be aware that there are several methods for assessing slip resistance, of varying relevance, besides the TRL Pendulum. Further information on common slip test methods can be found here.

Production variations can mean significant changes in slip resistance between an 'end use' product and its associated 'ex-factory' technical data. The installation process can also have a serious effect on a product's slip resistance, especially so with resin products. On site slip testing is recommended in order to effectively document compliance with slip resistance guidance, providing an accurate 'end use' measurement of slip resistance.

Many test methods can be used to provide a slip resistance value for a flooring product. Some are more accurate than others. Grip Potential use the BS 7976 TRL Pendulum as it is the preferred method of both the HSE and UKSRG. This method accurately models the interaction between sole and floor in both dry and contaminated conditions and is backed up with an extensive history. More information on slip test methods.

Slip Resistance During Use

Most flooring products suffer reduced slip resistance as they wear. This effect can be much greater than imagined: research has shown some products to lose a third of their slip resistance after just three months in end use.

Section 3.83 of HTM61 recommends that the slip resistance levels of floors be monitored at regular intervals throughout their service lives. This will account for gradual contamination as well as for wear.

Grip Potential always recommend periodic testing, adjusted for individual applications, to ensure ongoing documented compliance. Dependent on many factors, including floor type, usage and current slip resistance, test intervals can range from quarterly to biennially. Documented slip resistance values for a floor that has changed significantly since testing are of little use.

Ex-factory slip resistance values should not be expected to last long term in end use. Periodic slip testing ensures a continuous documented slip risk assessment, early warning of any drop in slip resistance, fewer slips and a strong defence against any slip and fall claims.

Flooring Applications Requiring Documented Slip Resistance Values

HTM61 requires that all category 4 floors should be slip resistant. In addition, and in line with legal obligations and HSE requirements, HTM61 also states:

"In situations where spillage is likely, special attention should be paid to floor surface slip resistance"

and:

“Surfaces in areas which may become wet (or simply periodically damp after cleaning) should ideally satisfy the performance requirements of the Health & Safety Executive’s (2004) ‘The assessment of pedestrian slip risk: the HSE approach’."

Floors classified as 'category 4' include:

Hospitals generally bring together many factors contributing to a slip and fall injury. Smooth, easy to clean floors which are regularly mopped, staff rushing or pushing/pulling heavy loads and a high proportion of elderly or infirm 'high risk' users. Slip resistance of flooring materials must be a priority in this environment to avoid unnecessary injury.

An Overview of Slip Resistance in HTM61

Find below a brief summary of the parts of HTM61 dealing specifically with the issue of slip resistance. (Download full HTM61 document here)

Physical Performance Characteristics, Hard Finishes, Section 2.4

Smooth hard floor finishes typically offer a very low slip resistance. Despite this, their aesthetically pleasing qualities mean they are usually placed in main entrances, experiencing both high traffic levels and a risk of water ingress. The slips caused by this poor planning could easily be avoided with better doorway management and intelligent flooring choices.

The definition of “Slip Resistant”, directing the reader to the Health & Safety
Executive’s 2004 document ‘The assessment of pedestrian slip risk: the HSE approach’.

“Note: Surfaces in areas which may become wet (or simply periodically damp after cleaning) should ideally satisfy the performance requirements of the Health & Safety Executive’s (2004) ‘The assessment of pedestrian slip risk: the HSE approach’. The Workplace (Health, Safety and Welfare) Regulations 1992 have several requirements for floors. There is also an important duty in these Regulations to the standard of “reasonable practicability” to keep floors free from substances that could cause slipping. See also the Health & Safety Executive’s information sheet ‘Slips and trips in the health services’.”

Showers

Generally featuring the slippery combination of water and soap showers can poses a serious slip risk if they are not given due consideration. Resin floors are becoming more popular but care should be taken to ensure that the anti-slip particulate is effective enough to provide a 'low risk of slip'.

3.53

Describes construction to allow easy access for wheelchairs with a warning that gradients will affect the slip resistance requirements of the floor. The UK Slip Resistance Group advises that the PTV value of a sloped floor needs to be increased by approximately 100 x Tan α(the slope angle) compared to a level surface.

It should also be remembered that the person assisting another person in a wheelchair will have increased friction requirements themselves.

Grip Potential can recommend appropriate PTV values for such floors.

3.54

“The material should be slip-resistant (see Health & Safety Executive (2004))”

Please see the information at the beginning of this page for guidance on what this means, or contact Grip Potential for further clarification.

Central Kitchens

Its no surprise that a large proportion of slips occur in a kitchen environment. Kitchens bring together a busy distracting workplace with a high likelihood of contamination and the possibility of serious injury. Intelligent management of slip risk is essential to protect staff from harm and employers from the significant costs associated with a slip injury.

3.56

“The essential performance requirements of the material are the need to combat the slipperiness caused by water and grease lying on the surface, and the need to maintain the high level of hygiene required in food preparation areas.”

Slip resistant floors, especially ones capable of handling viscous contaminants such as grease, often require adoption of different cleaning techniques. Slip resistance and hygiene should not be mutually exclusive properties.

Advice on appropriate cleaning methods for a particular flooring product should be available from the flooring supplier.

3.57

“Selection of an appropriate finish should be made in consultation with environmental health officers (EHOs) and reference to the Health & Safety Executive’s (2004) ‘The assessment of pedestrian slip risk’.”

Please see the information at the beginning of this page for guidance on the HSE’s requirements for pedestrian slip risk, or contact Grip Potential for further clarification.

Entrances

High traffic volumes and the risk of water ingress mean a high proportion of slips occur in reception/lobby areas. An effectively managed entrance and intelligently specified floor surface can all but eliminate the risk of a slip.

3.59

Describes the design of entrances to buildings incorporating an external (with canopy), intermediate and inner zone to prevent dirt, grit and liquids being trafficked onto interior floors. Such steps to minimize contamination of floors near external doorways are important in preventing slips. The minimum “depth” of each zone is also described by a diagram.

The quality and quantity of entrance matting and exterior canopies are one aspect covered by Grip Potential’s slip risk assessments. Foot-borne water contamination can extend up to 50 paces into a building without adequate matting.

3.60

Describes the physical characteristics of the external zone flooring: “slip-resistant hard surface.”

The area immediately outside an external door is often forgotten when considering slip resistance. This can be detrimental because the surface is extremely likely to become contaminated. Such contamination, and reduced likelihood of regular cleaning compared with interior floors requires that they should exhibit excellent slip resistance.

3.63

“Matting is one control that can be used to reduce the risk of slips at entrances by removing wet contamination from pedestrian footwear. It will work best when used in conjunction with other controls including effective or enclosed canopies and heating, in particular under floor heating and ventilation. If considered early enough in the design process, the location and orientation of entrances may also help to control the risk by reducing the ingress of wind-driven rain and snow.”

These factors, taken together, form an excellent approach to entrance management and are highly recommended as part of an overall strategy to reduce slip incidents. All these factors form part of Grip Potential’s slip risk assessment.

3.65

“The pendulum test can be used to determine the slip resistance of mats. The property may be directional, and this should be tested by the operator.”

As with nearly all slip measurements, the TRL Pendulum is recommended by the HSE, the UK Slip Resistance Group and Grip Potential as the most accurate and suitable method of assessing slip risk when used in accordance with BS7976.

Many surfaces have directional slip resistance properties and for this reason a Pendulum test is conducted in three separate directions, in both dry and contaminated conditions.

3.66

“Surface micro roughness measurements cannot be made on the matting materials themselves but may provide additional useful information on metal, plastic, rubber or other inserts”

Surface roughness measurements can provide additional information in addition to a Pendulum test. They can provide a rough guide of likely slip resistance on areas physically too small to accommodate the Pendulum tester, but should be treated with some trepidation when considered alone. For advice on such matters please contact Grip Potential.

3.67

Describes the difficulty of prescribing how many footfalls of entrance matting are required to provide effective decontamination. Variables such as the specific dewatering properties of the particular matting, it’s age/wear, the type and volume of traffic, heating, wind, and the presence or absence of an exterior canopy. As a very rough indication, fewer than five footfalls worth of matting is never likely to be sufficient.

“If wet footprints are visible beyond the matting, it is being compromised, and further controls will have to be considered."

Additional, temporary matting should be used in such circumstances (taking care not to cause a trip hazard) until a more permanent solution can be effected. The additional matting may only be required during particularly heavy rain and can be stored away at other times. This of course requires monitoring the permanent matting during bad weather to ensure the temporary matting is positioned before the permanent matting is compromised.

3.68

“Matting should extend to, and include, the threshold. There should be no strips of unprotected floor between threshold and matting.”

This obvious problem is surprisingly common, particularly with matting sunk into an existing floor. It’s not uncommon to find a row of slick ceramic tiles between the slip-resistant exterior surface and the entrance matting and this creates a real slip hazard.

“It should be cleaned and maintained appropriately and regularly. If wet cleaning techniques are used, the mats should have sufficient time to dry before use.”

Good advice on an often-neglected subject. Proper cleaning will extend the effective working life of matting; cleaning instructions should be available from the matting supplier.

3.69

“If supplementary matting is needed, it should be butted up to the fixed matting with no gaps”

This presents a similar issue to that in the first part of section 3.68. The backing of the matting should also be appropriate to hold it securely in place and prevent it from being gradually shifted across the floor by foot traffic.

3.70

“The way in which pedestrians use the entrance should determine how and where the matting should be positioned. The position and dimensions should prevent short-cut routes across the matting.”

If short-cuts are available people will take them. Good planning at the design phase should eliminate much of this problem.

3.71

“Matting is functional, and designers should avoid using it to make aesthetic design statements.”

Entrance matting can form an integral part of a floor design and does not have to be ugly, but its primary purpose should always be borne in mind and not be compromised for the sake of aesthetics.

Slip Resistance

A floor producing a 'Pendulum Test Value of 36 or more when tested to BS 7976-2 is classified as a 'low risk of slip'. A surface with a PTV of 36 or greater provides pedestrians with a safe walking surface unlikely to cause slips. This is in accordance with HSE and UKSRG guidelines.

3.77

Direction to the Health & Safety Executive’s (2004) ‘The assessment of pedestrian slip risk’ for the classification of floor surface slip resistance.

3.78

States that “Traditional smooth surfaces (such as thermoplastics or smooth natural stone) are unlikely to provide satisfactory levels of slip resistance in wet conditions.”

Whilst often true and a good guide, this is not always the case. The roughness required to provide adequate slip resistance in water-wet condition is quite small, on the order of 20 microns peak-to-valley height. Treatments are also available for some ceramic and stone products that provide excellent slip resistance despite a very smooth surface. Grip potential can offer advice on such treatments.

3.79

“Research has suggested that the surface micro roughness contributes more to the slip resistant properties of the floor than the presence of visible patterning or texturing on the surface of either hard or soft flooring.”

As with section 3.78, this is broadly correct. Exceptions exist where a floor experiences highly viscous contamination. Again, Grip Potential can offer advice on such matters.

3.80

A reminder of the requirement to leave floor surfaces dry after cleaning and that only a very thin film of water is necessary to cause a slip. A simple alternative to specialist cleaning processes or to restricting access to a floor until it dries naturally by evaporation is to specify a floor that is not slippery when wet.

3.81

Advice on cleaning methods and the importance of using the correct type and concentration of cleaning solution. Grip Potential frequently find contamination by excess cleaning product on floors that are not meeting their expected slip resistance performance.

3.82

A recommendation that reliable slip resistance data is supplied by flooring manufacturers and suppliers during the specification process.

Also that: “Specifiers should be aware of potential differences in the slip-resistant properties of ex-factory flooring materials and the effect of installation processes and applied finishes on them.”

Grip Potential can offer advice on these matters as well as verifying manufacturer/supplier test data, or supplying test values where none exist in the product technical specification. We can conduct in-house sample testing on products and on-site testing of the installed floor.

3.83

A recommendation that floors, once installed, should have their slip resistance levels monitored at regular intervals throughout their service lives. The slip resistance of floors does often change over time for a number of reasons and this is an integral part of the service offered by Grip Potential. It is an important step in demonstrating due diligence and on-going compliance with legislation.

Risk Assessment

It is important to consider all factors affecting slip risk. Cleaning regimes, expected users, footwear, contamination, environmental factors, wear and slip resistance all contribute to the risk of a floor surface causing a slip. Reducing slip risk. The HSE's Slips Potential Model.

3.84

The factors listed under this section on conducting risk assessments for new or existing floors incorporate the basic aspects of the HSE’s “Slips Potential Model”. Grip Potential’s slip risk assessments are modeled closely on the Slips Potential Model and include all factors mentioned by HTM61.

3.85

“The choice of flooring for wet or contaminated areas needs careful consideration. A slip-resistant floor, with appropriate cleaning regime, may be an effective control in some areas, such as kitchens or shower rooms. The choice of flooring will be influenced by the likely source of contamination. However, it is important to establish with suppliers that slip-resistant flooring can be cleaned to appropriate hygiene standards. In certain areas, such as operating theatres, where hygiene is paramount, this is especially important.”

The type of contaminant does indeed affect the choice of flooring product: the more viscous a contaminant, the greater slip resistance (PTV score) the floor will require in order to provide a safe walking surface. Grip Potential can offer advice on the slip resistance properties a floor will require to deal with particular contaminants.

Cleaning is an important factor both for hygiene, aesthetics and to maintain slip resistance. A different cleaning technique is likely to be required on a rough, slip-resistant floor compared to a smooth one. The product supplier should provide appropriate cleaning guidance for their specific product.

“Other options to control slip risk such as spillage procedures, more frequent cleaning and slip resistant footwear should also be considered.”

Such techniques are often employed to risk-manage a floor which fails to provide a low risk of slip in contaminated conditions, but are good practice for any floor. Legal precedent suggests that, depending on circumstances, such measures may not be sufficient to meet the requirements of the Workplace (Health Safety and Welfare) Regulations 1992.

3.86

“The flooring is just one – albeit important – element in the slip potential model, and in areas where contamination occurs only occasionally, it may be more appropriate to control the risk through enhanced cleaning regimes.”

In Relation to the comments above regarding section 3.85, it is important to recognize the limits of what risk can be adequately managed. The case of Ellis Vs. Bristol City Council established that a slip risk occurring through contamination just once per year demanded the floor should provide a low risk of slip when contaminated.

3.87

This section gives warning regarding the usage of non-slip resistant floors adjacent to slip resistant ones. This is a frequent problem often high-lighted by Grip Potential’s risk assessments. Contamination can be spread considerable distances by foot traffic or wheels and pedestrians stepping from a slip resistant surface to one offering insufficient grip are likely to be caught off guard and a slip incident becomes more likely.

Conclusion

Generally NHS properties play host to a number of factors significantly and unavoidably increasing slip risk. Regular cleaning, high risk users and the transportation of heavy objects around the property all contribute to an increased risk of slip and fall injury. HTM61 sets out intelligent management techniques to reduce the risk of slips in NHS properties. Effective management of contamination sources and a properly specified anti-slip floor go a long way to reducing slip risk.

Grip Potential stand ready to provide comprehensive measurement of slip resistance and slip risk to the HSE methods recommended by HTM61. Our wide experience, competitive pricing and excellent service aim to provide a documented measure of slip risk quickly and easily. Please don't hesitate to contact a member of our team to discuss your requirements, wherever you are in the UK or Ireland.

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Further information

Pendulum testing to BS 7976 - Grip Potential's risk assessment service - Surface roughness - Slip testing methods - HSE slips site - Grip Potential Ltd

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0845 163 0 163

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info@grip-potential.com

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