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DC49-Prevention of Falls and Injury Policy

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Registration Number: {{org_field_registration_no}}

Prevention of Falls and Injury Policy

1. Purpose

At {{org_field_name}}, we are committed to ensuring the safety and well-being of our service users by minimising the risk of falls and injuries in their homes. Falls can have a significant impact on a person’s health, confidence, and independence, and we recognise the importance of proactive prevention to enhance quality of life.

This policy serves to:

At {{org_field_name}}, we believe that every service user has the right to feel safe in their own home, and through this policy, we aim to proactively reduce risks while promoting confidence, mobility, and overall well-being.

2. Scope

This policy applies to all service users supported by {{org_field_name}} who may be at risk of falls due to:

This policy also applies to all staff members, including:

What This Policy Covers

This policy outlines:

3. Legal and Regulatory Framework

At {{org_field_name}}, we are committed to upholding the highest standards of safety, quality, and compliance in our fall prevention strategies. Our approach aligns with national regulations and legislation that govern safe care delivery and ensure that all service users receive dignified, person-centred support that minimises risks while promoting well-being.

This policy is structured in accordance with the following legal and regulatory frameworks:

Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

The Care Act 2014

Manual Handling Operations Regulations 1992

The Equality Act 2010

By following these legal and regulatory standards, {{org_field_name}} ensures that fall prevention is not only a priority but a fundamental part of delivering high-quality, person-centred domiciliary care.

This policy is underpinned by the Health and Social Care Act 2008 and the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, including, but not limited to, the following fundamental standards: Regulation 9 (Person-centred care), Regulation 10 (Dignity and respect), Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment), Regulation 13 (Safeguarding service users from abuse and improper treatment), Regulation 15 (Premises and equipment), Regulation 16 (Receiving and acting on complaints), Regulation 17 (Good governance), Regulation 18 (Staffing), Regulation 19 (Fit and proper persons: employed) and Regulation 20 (Duty of candour). These regulations set the minimum standards that must be met to ensure that fall prevention and response are safe, person-centred and effectively governed.

{{org_field_name}} also complies with the Care Quality Commission (Registration) Regulations 2009, in particular Regulation 18 (Notification of other incidents), which requires the registered provider to notify CQC of specified serious injuries and other incidents, including serious harm arising from falls, and to do so without delay.

NICE Falls Guidance

{{org_field_name}} recognises and has regard to relevant National Institute for Health and Care Excellence (NICE) guidance on falls, including NICE guideline NG249 “Falls: assessment and prevention in older people and in people 50 and over at higher risk” and NICE Quality Standard QS86 “Falls”, both updated in April 2025. This policy and related procedures are implemented in a way that reflects current evidence-based recommendations on identifying people at risk of falls, carrying out comprehensive multifactorial risk assessments and delivering personalised, multifactorial interventions (for example, strength and balance exercises, medication review and home hazard assessment) for people living at home.

4. Principles

At {{org_field_name}}, we believe that fall prevention is about more than just avoiding accidents—it’s about enhancing confidence, independence, and quality of life for our service users. Our approach is guided by the following core principles:

4.1 Safety First

4.2 Person-Centred Approach

4.3 Promoting Independence

4.4 Dignity and Respect

4.5 Training and Awareness

5. Identifying and Assessing Risks

We take a proactive approach to identifying and assessing risks associated with falls. Our aim is to detect potential hazards early, enabling us to implement effective preventative measures and support service users in maintaining safe mobility in their homes.

Initial Risk Assessments

Before beginning care with {{org_field_name}}, every service user undergoes a detailed falls risk assessment as part of their initial care needs assessment and care planning process. This assessment is person-centred and multifactorial and, where appropriate, follows the principles set out in current NICE guidance on falls in older people and people at higher risk of falls. It considers medical conditions, mobility, previous falls, medications (including polypharmacy and medicines known to increase falls risk), vision, footwear, continence, cognition and mood, as well as environmental hazards in and around the home. Findings are clearly documented and used to develop an individualised fall prevention plan.

During the initial assessment, we consider:

Following this assessment, a personalised fall prevention plan is developed to address identified risks and support the service user in maintaining a safe living environment.

Ongoing Risk Monitoring

Falls risk is not static—it can change over time due to age-related decline, health conditions, or new medications. At {{org_field_name}}, we conduct regular risk reviews to ensure our support remains responsive to our service users’ evolving needs.

Our approach includes:

If any significant changes are identified, we update the service user’s care plan immediately, ensuring that our fall prevention measures remain effective, relevant, and person-centred.

Environmental Risk Assessments

At {{org_field_name}}, we recognise that many falls occur due to preventable environmental hazards within the home. As part of our safety-first approach, we conduct environmental risk assessments to ensure service users’ homes are as safe as possible.

Key areas of focus include:

These assessments are reviewed and updated regularly to ensure that service users’ homes remain as safe and fall-proof as possible.

Safeguarding considerations

{{org_field_name}} recognises that some falls – particularly repeated, unexplained or poorly explained falls, or falls associated with neglect, reckless care practices or deliberate harm – may indicate abuse or neglect. In such circumstances, staff must follow the organisation’s Safeguarding Adults Policy without delay, including raising a safeguarding concern with the local authority in line with section 42 of the Care Act 2014 and informing the Registered Manager. Fall prevention measures must never be used in a way that is abusive, discriminatory or overly restrictive, and all practice must comply with Regulation 13 (Safeguarding service users from abuse and improper treatment).

6. Preventative Measures

We  believe that preventing falls is more than just reducing risk—it’s about promoting confidence and independence. Our preventative measures are personalised to each service user, ensuring that they can continue to live safely and comfortably at home.

Personalised Fall Prevention Plans

We understand that every service user has unique mobility needs, which is why our approach to fall prevention is fully tailored.

Each service user’s fall prevention plan includes:

By taking a holistic and individualised approach, we empower service users to move with confidence while reducing their risk of injury.

Home Safety Modifications

At {{org_field_name}}, we work closely with service users and their families to implement small changes that make a big difference in fall prevention.

Some of the key home safety modifications we recommend include:

Even simple adjustments like moving furniture to create safer walking paths can significantly reduce fall risks while maintaining a comfortable and familiar home environment.

Medication Review

Some medications can cause dizziness, drowsiness, or impaired balance, increasing the risk of falls. At {{org_field_name}}, we take a collaborative approach to medication management by working alongside GPs, pharmacists, and healthcare professionals to ensure:

If a medication is identified as a fall risk factor, we work with the relevant healthcare professionals to explore safer alternatives while ensuring that the service user’s health conditions remain well-managed.

Exercise and Strengthening

Falls often result from reduced strength, balance, and coordination. We encourage service users to participate in simple, low-impact exercises that help maintain:

Where appropriate, we:

Even small amounts of daily activity can have a significant impact on maintaining strength and reducing fall risks.

Footwear and Clothing

At {{org_field_name}}, we understand that inappropriate footwear or clothing can increase fall risks. We guide service users on safe choices, such as:

Simple adjustments in daily dressing habits can make a big difference in reducing the likelihood of trips and falls.

7. Responding to Falls

At {{org_field_name}}, we understand that a fall can be a distressing experience for both the service user and their loved ones. Our priority is to ensure a prompt, safe, and compassionate response that minimises harm and provides the necessary support to aid recovery.

Our falls response protocol ensures that:

Immediate Response

When a fall occurs, our first priority is to ensure the safety and well-being of the service user. All staff at {{org_field_name}} are trained to respond to falls with calmness, confidence, and professionalism.

Step 1: Check for Injuries and Assess the Situation

Step 2: Emergency Response (Calling 999 or 112)

Step 3: Supporting the Service User to Regain Balance Safely

By acting swiftly and following correct procedures, we ensure that service users receive appropriate care while reducing the risk of further harm.

Post-Fall Assessment

Once the immediate situation has been addressed, it is critical to investigate the cause of the fall to prevent future incidents. At {{org_field_name}}, we follow a structured approach to post-fall assessment and care planning.

Reporting the Incident

Where to report:

1) Verbally to the Registered Manager or Safeguarding Lead

2) Inform the Registered Manager by email: {{org_field_registered_manager_email}}

3) Call the office and inform the Registered Manager or Safeguarding Lead: {{org_field_phone_no}}

4) Out of hours phone number: {{org_field_out_of_hours}}

Identifying Causes and Risk Factors

After each fall, we conduct a thorough review to identify contributing factors. This includes assessing:

Our goal is to understand why the fall happened and take preventative steps to reduce the risk of it occurring again.

Reviewing Mobility Aids, Medication, and Home Environment

Following a fall, we reassess:

By making these adjustments promptly, we help service users regain confidence and reduce future risks.

Family and GP Communication

At {{org_field_name}}, we believe that open communication is key to ensuring the best possible care following a fall.

Informing Family Members and Healthcare Professionals

Seeking Medical Review for Recurrent Falls

By coordinating care and keeping families informed, we ensure that service users receive the best possible follow-up care and prevention strategies.

Statutory notifications to CQC

Certain falls that result in serious injury, or that meet the definition of a notifiable safety incident, must be reported to the Care Quality Commission (CQC) under the Care Quality Commission (Registration) Regulations 2009, Regulation 18 (Notification of other incidents). The Registered Manager is responsible for ensuring that CQC is notified without delay where a fall results in (for example) a fracture, head injury requiring hospital assessment or treatment, or any other serious injury or incident that meets the CQC notification criteria for domiciliary care providers. All such notifications must be recorded, reference numbers kept on the service user’s file, and learning from the incident incorporated into service and governance reviews.

Duty of candour following a notifiable safety incident

Where a fall constitutes a “notifiable safety incident” under Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, {{org_field_name}} will comply fully with the statutory duty of candour. This means we will:

The Registered Manager is accountable for ensuring that duty of candour requirements are met for all applicable falls-related incidents and that staff understand their responsibilities.

8. Staff Training and Responsibilities

At {{org_field_name}}, we recognise that preventing falls starts with knowledgeable, well-trained staff. Our commitment to continuous learning and accountability ensures that every team member is equipped with the skills and confidence to prevent, manage, and respond to falls effectively.

Training in Falls Prevention

To maintain the highest safety standards, all {{org_field_name}} staff—whether permanent, agency, or voluntary—must complete specialist training in fall prevention. This ensures that we can proactively minimise risks while promoting safe mobility and independence for our service users.

Completion of this training, and timely refresher training, is mandatory and forms part of our compliance with Regulations 12, 13, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Learning disability and autism training

{{org_field_name}} complies with the statutory requirement for learning disability and autism training introduced under section 20(5ZA) and section 21A of the Health and Social Care Act 2008. All staff, including managers and care workers, must complete learning disability and autism training that is appropriate to their role and responsibilities, following the nationally recognised Oliver McGowan code of practice. This training includes understanding how learning disability and autism may affect communication, mobility, sensory needs, risk of falls and the way in which people experience distress or anxiety. Staff must apply this learning when planning and delivering fall prevention and post-fall support, including making reasonable adjustments to care and the environment.

Mandatory Training Covers:

Risk assessment techniques – Identifying service users at risk of falls and assessing environmental hazards.
Safe moving and handling procedures – Ensuring staff can assist service users without causing harm to themselves or others.
Recognising fall hazards – Identifying trip risks, medication side effects, and early signs of reduced mobility.
 Emergency response protocols – Understanding what to do if a service user falls, including first aid, calling for help, and proper documentation.

All staff must complete falls prevention training during induction and attend refresher sessions annually to stay updated on best practices, policy changes, and new safety techniques.

Specialist training may also be provided for staff supporting service users with complex mobility needs (e.g., those requiring hoists, wheelchair transfers, or advanced physiotherapy support).

Accountability and Monitoring

At {{org_field_name}}, we believe that fall prevention is a shared responsibility. Every member of our team—from frontline care staff to management—plays a crucial role in maintaining safe, high-quality support.

Care Staff Responsibilities:

Monitor changes in mobility, balance, and confidence levels in service users.
Report any concerns about increased fall risks (e.g., dizziness, unsteadiness, medication side effects).
Ensure all fall prevention measures in the care plan are followed correctly.
Encourage safe practices, such as appropriate footwear, mobility aid use, and good hydration.

Manager Responsibilities:

Ensure risk assessments are regularly reviewed and updated.
Oversee training compliance, ensuring all staff are up to date with falls prevention protocols.
Conduct audits and policy reviews to ensure all fall prevention strategies align with CQC regulations and best practices.
Support staff in escalating serious concerns about fall risks, environmental hazards, or recurring incidents.

By fostering a culture of accountability, {{org_field_name}} ensures that every team member contributes to a safer, fall-free environment for our service users.

9. Consent and Record Keeping

At {{org_field_name}}, we understand that fall prevention measures must always respect service users’ rights, choices, and dignity. We prioritise informed consent, accurate documentation, and proactive care plan reviews to ensure that all actions taken align with best interests and legal requirements.

Informed Consent

At {{org_field_name}}, we believe that service users should remain in control of their care—we work with them, not just for them, to make their homes safer while preserving their autonomy and independence.

Documentation

Maintaining clear, accurate, and up-to-date records is essential for effective falls prevention and regulatory compliance.

Records We Maintain:

Risk assessments – A full evaluation of individual fall risks completed during initial care planning and reviewed regularly.
Falls prevention interventions – Details of measures put in place to prevent falls, including home modifications, physiotherapy, and medication reviews.
Incident reports – If a fall occurs, a detailed report is completed outlining:

At {{org_field_name}}, we treat documentation as more than just a compliance requirement—it’s an essential tool that helps us deliver safer, more responsive care.

For all falls that result in serious harm, or that meet CQC’s criteria for statutory notification and/or a notifiable safety incident, records must clearly show: whether CQC was notified (including date and reference), whether the local authority and other agencies were informed, and how the statutory duty of candour was fulfilled (including copies of letters, apology and follow-up actions). These records support our compliance with the Care Quality Commission (Registration) Regulations 2009, Regulation 18, and Regulation 20 (Duty of candour) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Reviewing and Updating Care Plans

Falls risk is not static—it can increase or decrease over time based on:

To ensure that fall prevention measures remain effective and relevant, care plans must be:
Reviewed at least every six months, or sooner if significant changes occur.
Updated immediately after a fall, with revised interventions to prevent reoccurrence.
Communicated clearly to staff, family members, and healthcare professionals.

By maintaining dynamic, up-to-date care plans, {{org_field_name}} ensures that service users receive the right support at the right time, reducing fall risks while promoting safety and independence.

10. Complaints and Feedback

Concerns, complaints or compliments relating to falls prevention, the response to a fall, or perceived unsafe practice are welcomed as opportunities to learn and improve. All complaints are managed in line with our “Receiving and Acting on Complaints Policy” and Regulation 16 (Receiving and acting on complaints). Themes and learning from complaints about falls are reviewed through our governance processes and are used to update risk assessments, staff training, supervision and this policy, in line with Regulation 17 (Good governance).

For more details about raising complaints please see “Receiving and Acting on Complaints Policy”

11. Policy Review and Continuous Improvement

This policy will be reviewed at least annually, and sooner if there are significant changes in legislation, CQC regulations, national guidance (including NICE falls guidance), or learning from incidents, audits, complaints or safeguarding enquiries. As part of our Regulation 17 (Good governance) responsibilities, {{org_field_name}} will monitor and analyse falls-related data (including frequency, severity, locations, times and contributory factors), audit compliance with this policy and associated procedures, and ensure that actions and learning are recorded, implemented and reviewed. Key findings and improvement actions will be shared with staff, service users and, where appropriate, families or representatives.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.

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