RIDDOR in Care Homes: What to Report, When and How

RIDDOR, the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013, applies to every workplace, and that includes residential care, nursing homes and domiciliary care. The principle is simple, but the specific triggers are frequently misunderstood, and getting them wrong is a common finding at CQC inspections. This guide explains what RIDDOR is, who has to report, exactly what must be reported and when, how falls by residents fit in, and how CareStream helps care homes, nursing homes, home care agencies and other care services stay ready all year round.

What is RIDDOR, in simple terms?

RIDDOR is a UK health and safety law. It places a legal duty on employers, the self-employed, and people in control of work premises to report certain serious work-related incidents to the Health and Safety Executive (HSE). It is not optional. Failing to report something that should have been reported is a criminal offence.

The purpose is not paperwork for its own sake. By collecting reports, the HSE can spot patterns, investigate serious failures and help prevent the same thing from happening elsewhere. In a care setting, the duty can cover incidents involving both staff and the people you support, but only in specific circumstances, which is exactly where the confusion tends to start.

The clue is in the name. RIDDOR covers three broad things: injuries (including deaths), diseases, and dangerous occurrences.

Who is responsible for RIDDOR reporting?

The legal duty falls on the "responsible person." In a care service, this is almost always the employer or the registered manager, not the injured individual and not the member of staff who witnessed the incident. For incidents involving residents or visitors arising from work on the premises, the responsible person is the person in control of those premises at the time. In practice, for a care home or a domiciliary agency, that means the manager needs a clear process so nothing slips through.

What must be reported to the HSE?

There are several distinct triggers. An incident only needs reporting if it falls into one of these categories.

Deaths

The death of any person, whether a worker or a resident, must be reported if it resulted from a work-related accident. This duty also extends in time: if a worker dies within one year as a result of a reportable work-related injury, it must be reported even if the original incident was reported at the time.

Specified injuries to workers (Regulation 4)

The following injuries to staff are reportable when they result from a work-related accident:

• Fractures, other than to fingers, thumbs or toes
• Amputations
• Any injury likely to cause permanent loss of sight or a reduction in sight
• Any crush injury to the head or torso, causing damage to the brain or internal organs
• Serious burns, including scalding, covering more than 10% of the body, or causing significant damage to the eyes, respiratory system or other vital organs
• Any scalping requiring hospital treatment
• Any loss of consciousness caused by a head injury or asphyxia
• Any injury from working in an enclosed space leading to hypothermia or heat-induced illness, or requiring resuscitation or admittance to hospital for more than 24 hours

It is worth knowing that a closed fracture sometimes only shows up on an X-ray a day or two later. In that case, the duty to report begins when the diagnosis is made, not on the day of the accident.

Over 7-day incapacitation (the 7-day rule)

If a worker is unable to carry out their normal range of duties for more than seven consecutive days, not counting the day of the accident, this must be reported to the HSE. You have up to 15 days from the date of the accident to do so. The longer window exists because you often will not know whether the seven-day threshold has been crossed until a week has passed.

The 3-day rule: record, but do not report

This is a common point of confusion. Injuries that keep a worker off their normal duties for more than three consecutive days must be recorded, for example, in an accident book, but they do not need to be reported to the HSE unless the incapacitation reaches seven days. So the three-day threshold is about recording, and the seven-day threshold is about reporting. Mixing these up is one of the most frequent RIDDOR errors.

Injuries to residents and other non-workers (Regulation 5)

This is the part care providers most often get wrong. For a resident, visitor or any other person who is not at work, an injury is reportable only if both of the following are true. First, the accident arose out of or in connection with work, for example, it was caused by the condition of the premises, faulty equipment, or the way care was organised and delivered. Second, the person is taken directly from the scene of the accident to the hospital for treatment of that injury. A specified injury to a non-worker that happens on hospital premises is also reportable.

Two things catch people out. Being taken to the hospital purely as a precaution, or only for examination or diagnostic tests such as X-rays, does not count as treatment. And an incident that flows from a person's own medical condition or frailty, rather than from a work related cause, is generally not reportable under RIDDOR at all.

Occupational diseases (Regulation 7) and dangerous occurrences (Regulation 8)

Certain work-related diseases must be reported once a doctor diagnoses them, for example, occupational dermatitis or certain infections caught through work. Dangerous occurrences are specified as near-miss events with the potential to cause serious harm, and these must be reported even when no one is actually injured.

Falls by residents: the care-specific picture

Falls are where care homes feel the most uncertainty, and rightly so. A resident fall is reportable under RIDDOR only when it meets the non-worker test above: the fall arose out of or in connection with work, and the resident was taken directly to a hospital for treatment. A fall caused by a wet floor that should have been signed, a broken hoist, or unsafe premises is far more likely to be work-related and therefore potentially reportable. A fall that reflects a resident's mobility, balance or underlying health, with no work related cause, generally is not.

Because the judgment is genuinely difficult, HSE and CQC guidance should be read together for any specific case. Your falls policy should reference RIDDOR directly and set out, step by step, how staff assess each fall against the criteria. If it does not, that is a gap worth closing before your next inspection.

RIDDOR is not the same as a CQC notification

It is easy to confuse the two, so it is worth being clear. RIDDOR reports go to the HSE under the Health and Safety law. Separately, as a registered provider, you also have statutory duties to notify the CQC about certain events, such as deaths and serious injuries of people using your service. These are different obligations to different bodies, and one does not replace the other. A single incident can require both a RIDDOR report to the HSE and a notification to the CQC, so your incident process should prompt your team to consider each.

Reporting timeframes and how to report

• Deaths, specified injuries and dangerous occurrences: notify the HSE without delay. Many of these can be reported online, and a dedicated telephone line exists for fatal and specified injuries. The formal report should be submitted within 10 days.
• Over 7-day injuries to workers: report within 15 days of the accident.
• Occupational diseases: Report as soon as you receive the diagnosis in writing.

Reports are made through the HSE RIDDOR online reporting service, or by phone for the most serious cases. Always download and keep a copy of every report. RIDDOR records must be kept for at least three years, and the CQC may ask to see them.

What happens at a CQC inspection

CQC inspectors may ask to see your RIDDOR reports and cross-reference them against your own incident log. Incidents that should have gone to the HSE but did not are a clear warning sign, and they can count against you under Regulation 12, which covers safe care and treatment, and Regulation 17, which covers good governance. The inspector is not only checking that you reported the right things. They are checking whether your systems reliably catch reportable events in the first place, and whether your staff understand what to do.

How CareStream helps your team get RIDDOR ready

The hardest part of RIDDOR compliance is not the law itself. It is making sure that, at the moment an incident happens, the person on shift knows whether it is reportable, what to do, and where your policy says to do it. CareStream is built for exactly that.

CareStream is a platform for UK care providers that turns your own library of policies and procedures into an always available, intelligent assistant. Each provider's content, staff and data are kept fully separate, and group operators can run several homes under a single account. Instead of staff hunting through binders, shared drives or out-of-date handbooks, the answer is one question away, by web chat or by email, and every answer is traceable back to your own source document.

Explain RIDDOR in plain English, in your staff's own language. Care teams in the UK are wonderfully diverse, and not everyone is comfortable reading dense legal English under pressure. A staff member can ask, in their own language, whether a particular fall needs reporting, and CareStream finds the relevant part of your falls and incident policy and answers in that same language, while still pointing to the source. The right procedure is only useful if the person on shift actually understands it.

CQC staff questions let managers build and send a bank of inspection-style questions, such as "What is the difference between the three-day and seven-day rule?" or "Who is the responsible person for RIDDOR reporting here?" You can track who has answered and how well, so you know where your team is confident and where they need a refresher before an inspector ever arrives.

Training lets you create and assign learning modules drawn from your own RIDDOR, falls, and incident policies, auto-generate questions and answers, lock approved versions, and watch a live compliance grid showing exactly who has completed what, with post-incident and return to work sends built in.

New staff onboarding brings this together into structured flows for each role, so a new starter works through your incident reporting procedures from day one, giving you a clear, auditable record that they were properly inducted.

Audits provide templated, repeatable checks you can run against your incident and reporting practice, capturing evidence and surfacing gaps early rather than at inspection.

The CQC Report and gap analysis pull all of this together. By looking at the questions staff actually ask, including the ones your policy library could not answer, the regulations your policies do and do not cover, training compliance and audit results, CareStream produces a coverage score and a readiness picture mapped to the CQC framework. The result is that your service is not just storing a RIDDOR policy. It is continuously demonstrating that the policy is understood, trained, followed and evidenced.

This works just as well for nursing homes, home care and domiciliary agencies, supported living, learning disability and autism services, hospices and other settings as it does for residential care homes. Wherever staff need to make the right reporting call quickly, the same approach applies.

Common questions about RIDDOR

Is RIDDOR a law?

Yes. RIDDOR 2013 is a legal requirement made under the Health and Safety at Work etc. Act 1974. It came into force on 1 October 2013, replacing the earlier 1995 regulations. Failing to report a reportable incident is a criminal offence.

What is the RIDDOR 3-day rule?

The three-day rule relates to recording, not reporting. An injury that keeps a worker off their normal duties for more than three consecutive days must be recorded, but it does not have to be reported to the HSE unless it reaches the seven-day threshold.

What is the 7-day rule for RIDDOR?

If a worker cannot perform their normal duties for more than seven consecutive days after a work-related accident, not counting the day of the accident, the incident is reportable to the HSE within 15 days of the accident.

Is a broken finger a RIDDOR?

Not as a specified injury. Fractures to fingers, thumbs and toes are specifically excluded from the specified injury list. However, if a broken finger keeps a worker off their normal duties for more than seven consecutive days, it becomes reportable under the separate over-7-day rule.

Who is responsible for RIDDOR reporting?

The "responsible person," which in a care service is almost always the employer or registered manager, or the person in control of the premises. It is never the injured person or the witness.

What is Regulation 4 of RIDDOR?

Regulation 4 covers non-fatal injuries to workers, including both the specified injuries and the over-7-day incapacitation trigger. Regulation 5 deals with injuries to non-workers such as residents and visitors, and Regulation 6 deals with work-related deaths.

What is an example of a RIDDOR reportable incident in a care home?

A care worker fractures their wrist while using a faulty hoist and cannot work for two weeks. A resident is taken directly to the hospital for treatment after a fall caused by an unmarked wet floor. A member of staff is diagnosed with occupational dermatitis linked to cleaning products. Each of these would typically be reportable, while a fall caused purely by a resident's frailty, with no work-related cause, would usually not be.

The bottom line

RIDDOR is not complicated once your team is clear on three things: who reports, what counts, and by when. The services that stay compliant are the ones where every member of staff can get a reliable answer the moment an incident happens, and where the systems reliably catch reportable events. CareStream is built to make that the everyday reality, and to turn it into evidence that is ready whenever the CQC asks.

This article is for general guidance and is based on HSE guidance on RIDDOR 2013. It is not legal advice. For any specific incident, read the current HSE and CQC guidance together, and check the latest position on the HSE and CQC websites.