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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Falls Prevention and Management Policy

1. Purpose

The purpose of this policy is to establish clear guidelines for the prevention, management, and reporting of falls within {{org_field_name}}. Our goal is to minimise the risk of falls for service users while promoting their independence and safety. This policy ensures compliance with the Health and Social Care Standards, Care Inspectorate guidance, and best practices for falls prevention.

2. Scope

This policy applies to all staff, volunteers, contractors, and service users within {{org_field_name}}. It covers falls prevention, risk assessment, incident management, and post-fall care, ensuring service users receive safe and effective support.

3. Related Policies

This policy should be read alongside the following policies:

• Health and Safety Policy
• Infection Prevention and Control Policy
• Risk Assessment Policy
• Personal Plans Policy
• Staff Training and Development Policy​​.

4. Falls Prevention Strategy

Falls prevention is a core part of {{org_field_name}}’s approach to delivering safe and person-centred care. Our strategy includes risk identification, staff training, environmental safety checks, and service user education.

4.1 Risk Identification and Assessment

• Initial Assessment: Upon commencing care, each service user undergoes a comprehensive falls risk assessment as part of their personal plan. This assessment includes medical history, medication review, mobility, vision, balance, and environmental factors​.
• Ongoing Monitoring: Falls risk is reviewed regularly, including at six-monthly care plan reviews, following significant health changes, and after any fall.
• Falls Risk Categorisation: Service users are categorised as low, moderate, or high risk based on their assessment. High-risk users receive enhanced monitoring and interventions.

Staff Responsibilities:

• Identify signs of increased falls risk, such as unsteady gait, dizziness, or recent falls.
• Record all observations in the service user’s personal plan and report concerns to the Care Manager.

4.2 Personalised Falls Prevention Plans

Each service user at risk of falling will have a personalised falls prevention plan, incorporated into their personal care plan. This plan includes:

• Mobility Support: Appropriate mobility aids (e.g., walking frames, grab rails) and guidance on their safe use.
• Exercise Programmes: Strength and balance exercises, such as the Otago Exercise Programme, to improve stability.
• Medication Review: Collaboration with healthcare professionals to review medications that may affect balance.
• Footwear and Clothing: Advice on safe, well-fitting shoes and clothing that reduces tripping risk.
• Vision and Hearing Checks: Encouragement for regular eye and hearing tests to reduce sensory impairments contributing to falls.

4.3 Environmental Safety Measures

{{org_field_name}} ensures that service users’ homes are safe and free from fall hazards:

• Home Environment Assessment: A room-by-room falls risk assessment is conducted, identifying hazards such as loose rugs, poor lighting, cluttered walkways, and slippery floors.
• Adaptations and Equipment: Recommendations for grab rails, non-slip mats, stairlifts, and adequate lighting are documented and communicated to service users and families.
• Regular Checks: Staff are responsible for ongoing checks of service users’ living environments and reporting hazards to the Care Manager.

4.4 Education and Awareness

Falls prevention education is crucial for staff, service users, and families. {{org_field_name}} promotes awareness through:

• Staff Training: All care staff complete falls prevention training during induction and annually thereafter. This includes safe moving and handling techniques, fall risk identification, and emergency response.
• Service User Education: Service users and their families receive leaflets and verbal advice on preventing falls at home, including lifestyle changes and home adaptations.
• Promoting Independence: While preventing falls, staff also encourage safe mobility and independence, ensuring service users remain active and engaged​.

5. Falls Management Procedure

When a fall occurs, {{org_field_name}} follows a clear, step-by-step protocol to ensure the service user’s safety and prevent further harm.

5.1 Immediate Response

• Assess the Situation: Staff assess the service user’s condition without moving them initially. If the fall is unwitnessed, staff treat it as a potential injury situation.
• Check for Injury: If the service user is conscious, staff look for signs of injury, including bruising, bleeding, or deformities.
• Call for Help: In case of suspected serious injury (e.g., head injury, fracture), staff call emergency services immediately and inform the Care Manager.
• Comfort and Support: Staff provide reassurance and ensure the service user remains warm and calm until help arrives.

5.2 Safe Lifting and Moving

If the service user is uninjured and able to stand:

• Staff follow moving and handling protocols, using appropriate aids if available.
• Two-person assistance is provided when needed, and mechanical lifting devices are used if appropriate.

If the service user is unable to stand or has sustained an injury:

• Staff do not attempt to lift the individual and await professional assistance.

5.3 Post-Fall Assessment and Follow-Up

Following any fall, a thorough post-fall assessment is conducted:

• Observation: Service users are monitored for 24 hours post-fall for delayed symptoms, including dizziness, confusion, or pain.
• Health Review: If necessary, the GP or district nurse is contacted for further assessment.
• Update Personal Plan: The falls risk assessment and personal plan are updated to reflect any changes in risk status and required interventions.

6. Incident Reporting and Documentation

All falls, regardless of severity, must be reported and documented promptly:

• Incident Report: Staff complete a Falls Incident Report, detailing the circumstances, observations, actions taken, and outcomes.
• Care Manager Notification: The Care Manager must be informed immediately after any fall.
• RIDDOR Reporting (HSE): A fall involving a person using the service is only reportable to the Health and Safety Executive (HSE) where the accident arises out of, or in connection with, work (for example, because of the way care/support was delivered, unsafe work equipment used by staff, or a work activity created or contributed to the risk) and the outcome meets RIDDOR reporting criteria. The Care Manager/Registered Manager will determine whether the incident is RIDDOR-reportable and, where required, submit the report via the HSE reporting system and retain confirmation of submission.

Incident reports are reviewed by the Care Manager to identify trends and implement preventative measures​​.

6.1 Care Inspectorate Notifications

Where an incident meets Care Inspectorate notification criteria, the Registered Manager (or delegated on-call manager) must submit the relevant notification within 24 hours using Care Inspectorate eForms. Depending on the circumstances, this will be submitted as an Incident, Accident, Injury to service user, or Protection concern about a person using the service notification. If full information is not available within 24 hours, an initial notification will be submitted and an update provided as soon as further information becomes available.

6.2 Protection Concerns (Safeguarding) – escalation and notification

Where a fall, repeated falls, or environmental concerns indicate potential neglect, harm, or abuse (including self-neglect), staff must immediately report this to the Care Manager/Registered Manager. Where a protection referral is made to the lead agency, the service will notify the Care Inspectorate using the eForms “Protection concern about a person using the service” notification within 24 hours, and will provide an update to the Care Inspectorate within one month of the incident/referral.

7. Multidisciplinary Collaboration

Falls prevention and management require collaboration with healthcare professionals:

• GP and Pharmacist: To review medications contributing to falls risk.
• Physiotherapist and Occupational Therapist: For mobility assessments and home adaptation recommendations.
• District Nurse: To support post-fall wound care and health monitoring.

Referrals to external agencies are made promptly to ensure service users receive appropriate support.

8. Monitoring and Quality Assurance

{{org_field_name}} ensures continuous improvement in falls prevention through robust monitoring and quality assurance processes:

1. Falls Data Analysis: All falls incidents are recorded and analysed monthly to identify patterns, such as frequent falls in specific environments or times of day.
2. Care Plan Reviews: Following a fall, the service user’s personal care plan and falls risk assessment are reviewed and updated within 24 hours.
3. Audits: Regular audits of falls prevention measures, including home environment checks and adherence to risk reduction strategies.
4. Staff Competency Checks: Spot checks and competency assessments are conducted to ensure staff follow safe practices.

9. Communication and Reporting

Effective communication ensures that falls prevention and management are integrated into daily care:

• Service Users and Families: Informed immediately after any fall and involved in decision-making regarding follow-up care.
• Internal Communication: Staff are updated on any changes to falls prevention strategies during handovers and team meetings.
• External Reporting / Statutory Notifications: The Registered Manager (or delegated on-call manager) will decide whether a statutory notification is required and, where required, will submit the appropriate Care Inspectorate eForms notification within 24 hours. This includes serious adverse events occurring while a person is receiving care and support from the service, including incidents resulting in injury requiring medical advice or attention. Notifications will include details of the event, action taken to ensure safety, medical advice sought, and who has been informed (for example, family, placing local authority, HSCP and, where applicable, HSE/RIDDOR).

Duty of Candour

{{org_field_name}} will follow the Duty of Candour Procedure (Scotland) where an unintended or unexpected incident occurs in the course of providing care that results in (or could result in) death or harm, in line with the Health (Tobacco, Nicotine etc. and Care) (Scotland) Act 2016 and the Duty of Candour Procedure (Scotland) Regulations 2018. This includes informing the person (and/or their representative) in a timely manner, offering to meet, providing an apology, explaining what is known at the time, recording the steps taken, and identifying learning and improvement actions.

10. Policy Review

This policy will be reviewed annually or earlier if there are changes in legislation, best practices, or organisational requirements. Updates will be communicated to all staff, and training will be provided as necessary.

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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}}
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