Ask Sheila England

Sheila will try to answer as many of your English Social Care questions as possible, giving priority to frequently asked questions and questions regarding current events and trends.

10th February 2016

Removal of cord bell from resident

Hi Sheila,
My name is Julian, and I am a Deputy Manager into a nursing home with people with dementia.
Can you please tell me step by step the procedure to remove a cord bell from a person, what kind of risk assessment needs to be done? Do I need to call a specialist to do a mental evaluation for that person?
I will give you an example to understand the situation beter, in my opinion a lady who is resident in our house is ringing the bell all the time and when she is asked why she rang the bell she doesn't remember to do that, I think she doesn't understand the reason of ringing the bell.
Kind regards,
Julian Davida

Dear Julian,

This is an extremely difficult question and is not a decision you should take alone.

I expect most of us have faced this difficult decision over the years and probably will have come to different decisions.

First of all you need to try to establish why she is ringing the bell so often.

She may be ringing the bell because she is frightened or anxious. Have you done all you can to comfort her?

She may be frightened of being alone.

Is the ringing of the bell disturbing other service users especially at night?

I think it is important to say that in principle the removal of the call bell should never happen.

You have a Registered Manager and that is the first person to discuss your concerns with.

If the Registered Manager thinks there are times when the bell should be removed then that should then be a part of a multi-disciplinary decision involving the GP, the family, the staff in your home, the Local Authority if they have placed the service user and any advocate that she has.

The most important thing to remember is that she will need to be checked regularly and the removal should only be for a short time.

I have heard instances over the years where the call bell has been removed and no one has checked on the service user for several hours and an accident has happened with serious consequences.

I have always believed although not always proved to be right that it should be possible to interest the person in something else if there is no reason why the bell is being rung continually. Presumably she is alone when she is ringing the bell all the time so where possible let her sit with other people.

Finally if you were to make a decision to remove the call bell for any length of time I believe that a DoLS authorisation should be in place.

Best wishes.


*All information is correct at the time of publishing.

What would you like to ask Sheila?

Sheila Scott OBE from National Care Association (NCA). Care is Sheila’s life; she possesses a strong command of the issues facing the care sector informed by her long career as a nursing professional, the owner and manager of a care business and as a leader in the care sector.

Sheila will try to answer as many of your questions as possible, giving priority to frequently asked questions and questions regarding current events and trends.

Please note that Sheila can not offer answers to matters requiring legal advice. If your matter concerns a specific service provider, please contact the CQC.

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