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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Prevention of Falls and Injury Policy

1. Purpose

At {{org_field_name}}, we are committed to ensuring the safety, well-being, dignity and independence of people we support by reducing the risk of avoidable falls and fall-related injury during the delivery of regulated activity and support in people’s own homes, tenancies and community settings. In supported living, people have the right to make choices and take positive risks. This policy therefore balances safety with independence, choice, mental capacity, consent and least restrictive practice.

This policy serves to:

• Prevent falls and injuries by implementing effective risk management strategies tailored to each service user’s needs.
• Ensure compliance with CQC regulations, the Health and Social Care Act 2008, and best practices in falls prevention, reinforcing our commitment to delivering safe and high-quality supported living services.

This policy supports compliance with the CQC fundamental standards, particularly Regulation 9, person-centred care; Regulation 10, dignity and respect; Regulation 11, need for consent; Regulation 12, safe care and treatment; Regulation 13, safeguarding; Regulation 15, premises and equipment where these are within the provider’s control; Regulation 17, good governance; Regulation 18, staffing; Regulation 19, fit and proper persons employed; Regulation 20, duty of candour; and the Care Quality Commission Registration Regulations 2009, including statutory notifications where a fall results in serious injury, death, abuse concerns or another notifiable incident.

• Promote independence and dignity by supporting service users to maintain safe mobility in their own homes while empowering them to engage in daily activities confidently.
• Equip our staff with the necessary knowledge and tools to assess risks, implement preventative measures, and respond effectively if a fall occurs.
• Enhance communication with service users, families, and healthcare professionals, ensuring a collaborative approach to fall prevention.

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 people supported by {{org_field_name}} where falls risk may be present, including people aged 65 or over and people aged 50 to 64 with one or more factors that may increase their risk of falling, such as a long-term condition, learning disability, dementia, Parkinson’s disease, diabetes, stroke, frailty, reduced mobility, sensory impairment, medication side effects, previous falls, poor balance or environmental hazards.

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

• Age-related mobility issues (e.g., frailty, reduced strength, or balance difficulties).
• Medical conditions that impact stability, coordination, or cognitive awareness (e.g., Parkinson’s disease, dementia, stroke recovery, arthritis).
• Medication side effects that increase the risk of dizziness, drowsiness, or low blood pressure.
• Environmental hazards within the home, such as loose carpets, poor lighting, cluttered walkways, or unsafe furniture arrangements.

Supported Living Responsibilities and Boundaries

In supported living, {{org_field_name}} recognises that people usually live in their own homes under their own tenancy or occupancy agreement. Staff must respect the person’s home, choices, privacy and independence. Where environmental risks are identified, staff must discuss these with the person and, where appropriate, their representative, landlord, housing provider, occupational therapist, local authority or other relevant professional.

{{org_field_name}} is responsible for assessing and managing falls risks connected with the regulated activity and support it provides. Where risks relate to the wider property, building maintenance, fixtures, fittings or adaptations outside the provider’s direct control, staff must escalate concerns promptly to the responsible person or organisation and record the action taken. Where an unresolved environmental risk presents immediate or significant risk of harm, this must be escalated to the Registered Manager and, where appropriate, safeguarding, the local authority, health professionals or emergency services.

This policy also applies to all staff members, including:

• Care workers, managers, agency staff, and volunteers who provide direct support to service users at home.
• Supervisory and management teams responsible for overseeing fall prevention strategies and ensuring that risk assessments are properly conducted.
• Training coordinators who equip staff with the skills and knowledge to effectively prevent, identify, and respond to falls.

What This Policy Covers

This policy outlines:

• Comprehensive fall prevention strategies that take a person-centred approach to maintaining safety while preserving independence.
• Risk assessment procedures to identify hazards, monitor changes in mobility, and implement home modifications where necessary.
• Staff training and development to ensure all team members have the competence and confidence to support service users effectively.
• Incident response procedures, ensuring that in the event of a fall, the appropriate actions are taken to minimise harm and support recovery.

3. Legal and Regulatory Framework

{{org_field_name}} will comply with all legislation, regulations and statutory guidance relevant to falls prevention, safe care and supported living in England. This policy must be read alongside the organisation’s policies on risk assessment, safeguarding, mental capacity, medicines, moving and handling, health and safety, incident reporting, complaints, duty of candour, CQC notifications and record keeping.

3.1 Health and Social Care Act 2008

The Health and Social Care Act 2008 establishes the Care Quality Commission and the system of registration and regulation for providers carrying on regulated activities in England. The Act requires regulated providers to comply with registration requirements and regulations made under the Act. CQC’s main objective is to protect and promote the health, safety and welfare of people who use health and social care services.

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

This policy supports compliance with the following regulations:

• Regulation 9 – Person-centred care: falls prevention must be based on the person’s needs, preferences, goals, lifestyle, communication needs and choices.
• Regulation 10 – Dignity and respect: falls prevention must not be delivered in a way that unnecessarily restricts, humiliates or disempowers the person.
• Regulation 11 – Need for consent: staff must seek valid consent before assessments, interventions, referrals, equipment use or environmental changes. Where the person may lack capacity, the Mental Capacity Act 2005 must be followed.
• Regulation 12 – Safe care and treatment: the provider must assess risks to people’s health and safety, do all that is reasonably practicable to mitigate risks, ensure staff are competent, ensure equipment used by the service is safe, and ensure medicines are managed safely. CQC states that the purpose of Regulation 12 is to prevent unsafe care and avoidable harm.
• Regulation 13 – Safeguarding service users from abuse and improper treatment: repeated falls, unexplained injuries, unsafe environments, neglect of mobility needs, failure to use agreed equipment, or failure to seek medical help may indicate safeguarding concerns and must be escalated.
• Regulation 14 – Meeting nutritional and hydration needs: dehydration, poor nutrition, weight loss, alcohol use or poor dietary intake may increase weakness, dizziness and falls risk.
• Regulation 15 – Premises and equipment: where equipment or premises are within the provider’s control, they must be safe, suitable, properly maintained and used correctly. In supported living, where the provider does not control the premises, concerns must still be identified, recorded and escalated to the appropriate landlord, housing provider, occupational therapist, local authority or other responsible person.
• Regulation 16 – Receiving and acting on complaints: concerns about falls prevention, mobility support, equipment, staff response or environmental safety must be managed through the complaints process where appropriate.
• Regulation 17 – Good governance: the provider must operate effective systems to assess, monitor and improve the quality and safety of the service. Falls, near misses, injuries, themes, audits, actions and learning must be recorded, analysed and used to improve practice. CQC expects governance systems to be reviewed, based on Regulations 4 to 20A where possible, and to enable providers to identify where safety is compromised and respond without delay.
• Regulation 18 – Staffing: enough suitably qualified, competent, skilled and experienced staff must be deployed. Staff must receive training, supervision, appraisal and support necessary for their role. CQC also states that staff must receive training on how to interact appropriately with people with a learning disability and autistic people, at a level appropriate to their role.
• Regulation 19 – Fit and proper persons employed: recruitment and deployment processes must ensure that staff supporting people with mobility, transfers, medicines, equipment or emergency response are suitable and competent.
• Regulation 20 – Duty of candour: where a fall results in a notifiable safety incident, the provider must act openly and transparently, apologise, explain what happened, provide reasonable support and keep records. CQC states that the statutory duty of candour applies to every health and social care provider it regulates.
• Regulation 20A – Requirement as to display of performance assessments: where applicable, the provider must comply with requirements to display CQC performance assessments or ratings.

3.3 Care Quality Commission Registration Regulations 2009

{{org_field_name}} must submit statutory notifications to CQC where required. Falls may require notification where they result in death, serious injury, abuse or alleged abuse, police involvement, an event that prevents the service from running safely and properly, or another notifiable incident. CQC states that providers must notify it about certain changes, events and incidents that affect the service or people who use it.

3.4 NICE NG249: Falls Assessment and Prevention

The organisation will follow NICE NG249, Falls: assessment and prevention in older people and in people 50 and over at higher risk. NICE recommends asking people in community settings about falls, tailoring interventions to individual risk factors, considering structured medication review, offering home hazard assessment and intervention using a validated tool, encouraging tailored exercise programmes delivered by appropriately trained professionals, and providing information to people and families about reducing falls risk and what to do after a fall.

3.5 Other relevant legislation and guidance

This policy also supports compliance with the Care Act 2014, Mental Capacity Act 2005, Equality Act 2010, Health and Safety at Work etc. Act 1974, Management of Health and Safety at Work Regulations 1999, Manual Handling Operations Regulations 1992, Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013, Data Protection Act 2018 and UK GDPR.

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

• Preventing falls is a top priority in every aspect of our care.
• Our team conducts comprehensive risk assessments to identify hazards and take proactive measures to minimise risks.
• We ensure that mobility aids, home adaptations, and safe movement techniques are in place for each service user.

4.2 Person-Centred Approach

• No two service users are the same. At {{org_field_name}}, we tailor all fall prevention strategies to individual needs, preferences, and home environments.
• We consider factors such as medical conditions, mobility levels, lifestyle, and personal choices when implementing fall prevention plans.

4.3 Promoting Independence

• Our goal is to empower service users, not restrict them.
• We encourage safe, supported movement and promote exercise, physiotherapy, and mobility aids to help service users maintain strength and confidence.
• Home adaptations are designed to enhance independence rather than limit movement.

4.4 Dignity and Respect

• Service users should feel comfortable, respected, and in control of their own environment.
• We ensure that fall prevention measures are discreet, non-intrusive, and sensitive to personal preferences.
• Support is always delivered in a compassionate and dignified manner.

4.5 Positive Risk-Taking, Consent and Least Restrictive Practice

Falls prevention must not remove a person’s independence unnecessarily. Staff must support people to understand risks and make informed choices. Where a person with capacity chooses to take a risk, staff must respect this decision while taking reasonable steps to reduce avoidable harm. Where there is concern that the person may lack capacity to make a specific decision about mobility, equipment, support, environmental changes or emergency response, staff must follow the Mental Capacity Act 2005. Any best interests decision must be decision-specific, least restrictive, recorded clearly and involve the person and relevant others as appropriate.

4.6 Training and Awareness

• All {{org_field_name}} staff receive specialist training in falls prevention, risk assessment, and emergency response.
• Our team is equipped with the knowledge and skills to identify early warning signs of mobility decline, balance issues, or home safety concerns.
• Ongoing professional development and refresher training ensure that our staff remain competent and confident in fall prevention strategies.

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 plan assessment. This assessment allows us to identify factors that may increase the risk of falls and put preventative measures in place from day one.

During the initial assessment, we consider:

• Medical conditions that may affect balance, mobility, or coordination (e.g., arthritis, Parkinson’s disease, dementia, stroke recovery).
• Medication side effects that could cause dizziness, drowsiness, or low blood pressure, increasing the risk of a fall.
• Mobility levels, including the ability to walk independently, use mobility aids, or perform daily activities safely.
• Environmental hazards within the home that could contribute to falls, such as loose carpets, poor lighting, cluttered spaces, or slippery flooring.
• History of falls, near misses or loss of balance in the last 12 months, including frequency, circumstances, location, time of day, injuries, symptoms before the fall and whether medical help was required.
• Fear of falling, loss of confidence, reduced activity or avoidance of normal routines following a fall or near miss.
• Gait, balance, transfers, posture, muscle strength, fatigue, pain, vision, hearing, continence, cognition, mood and communication needs.
• Health conditions that may increase falls risk, including diabetes, epilepsy, postural hypotension, osteoporosis, dementia, learning disability, Parkinson’s disease, stroke, arthritis, frailty, infection, delirium or acute illness.
• Medication factors, including recent medication changes, polypharmacy, sedatives, psychotropic medicines, antihypertensives, diuretics, pain relief, medicines associated with dizziness or drowsiness, and medicines associated with dependence or withdrawal.
• Nutrition, hydration, alcohol use, continence needs, sleep patterns and footwear.
• Equipment and assistive technology, including walking aids, wheelchairs, hoists, transfer aids, bed rails, sensor mats, pendant alarms or call systems, where these are used.
• The person’s own views, goals, choices, cultural needs, communication needs and what matters to them.

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.

Staff must not rely solely on a numerical falls risk score or checklist. Tools may support structured assessment, but professional judgement, the person’s history, current presentation, environment and the views of the person and relevant professionals must be considered. NICE NG249 states that falls risk prediction tools should not be used to predict a person’s risk of falling.

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:

• Routine mobility checks to monitor changes in strength, balance, and walking ability.
• Regular communication with healthcare professionals, including GPs and physiotherapists, to adjust fall prevention strategies based on new medical advice.
• Ongoing medication reviews to identify new or increased side effects that may contribute to falls.
• Home environment reassessments whenever a service user’s condition changes to ensure continued safety.

If any significant change is identified, the person’s falls risk assessment and care/support plan must be reviewed without delay. This includes, but is not limited to, a fall, near miss, change in mobility, new or changed medicine, hospital admission or discharge, new equipment, change in cognition, infection, dizziness, new pain, weight loss, dehydration, deterioration in vision or hearing, environmental change, safeguarding concern, or staff/family concern. Any changes must be communicated to all relevant staff and recorded in the person’s care records.

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:

• Identifying trip hazards, such as:
  • Loose rugs, trailing wires, or uneven flooring.
  • Poorly lit stairways or hallways.
  • Cluttered walkways or unstable furniture.
• Recommending home modifications, including:
  • Installation of grab rails in bathrooms, hallways, and stairways.
  • Placement of non-slip flooring or mats in high-risk areas.
  • Improvements in lighting, particularly in bedrooms, staircases, and bathrooms.

Home hazard assessments must be proportionate to the person’s needs and should use a recognised or validated approach where available. Where risks are complex, recurrent, disputed, or require adaptations or specialist equipment, staff must request or recommend referral to an occupational therapist, physiotherapist, falls service, GP or local authority as appropriate.

In supported living, staff must record whether the risk is within {{org_field_name}}’s control. Where the risk relates to the property or tenancy, staff must obtain the person’s consent where required and escalate the concern to the landlord, housing provider, occupational therapist, local authority, family/representative or other responsible party. Where the person refuses an environmental change, this must be recorded with the advice given, the person’s decision, any capacity consideration and any agreed alternative risk reduction measures.

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

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.

Fall prevention plans must be co-produced with the person and, where appropriate, their family, advocate, representative and involved professionals. The plan must identify the person’s specific falls risks, agreed preventative actions, the level of support required, equipment to be used, what staff must do, what the person prefers to do independently, what to do if risks increase, and when the plan must be reviewed.

Each service user’s fall prevention plan includes:

• Encouraging safe mobility practices, such as reminding service users to use mobility aids properly and avoid standing up too quickly.
• Providing appropriate mobility aids, including:
  • Walkers, walking sticks, or frames.
  • Handrails along hallways and staircases.
  • Raised toilet seats or bath seats where needed.
• Adjusting the home environment to ensure easy movement and reduce fall risks.

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:

• Ensuring good lighting to improve visibility, especially in hallways, staircases, and bathrooms.
• Securing loose rugs and carpets or removing them entirely if they present a trip hazard.
• Decluttering walkways to provide clear, unobstructed paths around the home.
• Installing grab rails and handrails in high-risk areas, such as near toilets, bathtubs, and staircases.

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 medicines can increase falls risk by causing dizziness, drowsiness, confusion, low blood pressure, impaired balance, dehydration or changes in alertness. Staff must monitor and report any concerns about medicines that may contribute to falls, including recent changes in medicines, missed doses, side effects, over-sedation or changes in the person’s presentation.

Where a medication-related falls risk is identified, {{org_field_name}} will, with the person’s consent where required, request or recommend a structured medication review by the GP, pharmacist, prescriber or relevant healthcare professional. Particular attention must be given to polypharmacy, antihypertensives, diuretics, sedatives, pain medicines, medicines associated with dependence or withdrawal, and psychotropic medicines.

For people taking psychotropic medicines, staff must ensure concerns are escalated for professional review. The increased risk of falls associated with psychotropic medicines should be discussed with the person by an appropriate healthcare professional, and withdrawal or adjustment should only be planned by the prescriber or specialist service where clinically appropriate.

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:

• Leg strength and stability to support safe movement.
• Balance and coordination to reduce the risk of losing footing.
• Flexibility and mobility to make daily movements easier and safer.

Where appropriate, we:

• Encourage physiotherapy sessions to aid mobility and fall prevention.
• Recommend home-based exercises that focus on balance and strength.
• Support gentle movement activities, such as chair-based exercises or supervised walking routines.

Formal falls prevention exercise programmes must only be recommended, designed or delivered by appropriately trained professionals or under appropriate professional guidance. Programmes should be progressive, tailored to the person’s needs, preferences, goals and abilities, and focus on relevant areas such as balance, coordination, strength, power, mobility and functional activity. Staff may encourage and support agreed exercises only where these are included in the person’s care/support plan and staff have been trained or instructed to support them safely.

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:

• Wearing well-fitted, non-slip footwear with proper grip and support.
• Avoiding long, loose clothing that could become a tripping hazard.
• Using slippers with secure fastenings, rather than loose-fitting options.

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

Nutrition, Hydration, Continence, Vision and Hearing

Falls risk may increase where a person is dehydrated, malnourished, rushing to the toilet, experiencing continence urgency, unable to see hazards clearly, unable to hear prompts, or experiencing dizziness or weakness. Staff must monitor and report concerns about hydration, nutrition, weight loss, appetite, continence, vision, hearing, dizziness or signs of acute illness.

Where concerns are identified, staff must seek consent to involve the GP, pharmacist, optician, audiologist, continence service, dietitian, community nurse, occupational therapist, physiotherapist or falls service as appropriate. Any advice received must be recorded and reflected in the person’s care/support plan.

Equipment and Assistive Technology

Mobility aids, moving and handling equipment and assistive technology must only be used where suitable for the person, properly assessed, correctly fitted or installed, maintained, and included in the person’s care/support plan. Examples may include walking frames, sticks, wheelchairs, transfer aids, grab rails, sensor mats, falls detectors, pendant alarms or call systems.

Staff must not introduce restrictive equipment or monitoring solely for staff convenience. Where equipment may restrict movement, privacy or liberty, staff must consider consent, mental capacity, best interests and least restrictive practice. Concerns about faulty, unsuitable, missing or unsafe equipment must be reported immediately and recorded. Equipment must not be used if staff have not been trained and assessed as competent to use it safely.

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:

• Service users receive immediate care and support following a fall.
• All incidents are thoroughly assessed and documented to identify risk factors and prevent future falls.
• Communication with families and healthcare professionals is prioritised to ensure service users receive the best possible follow-up care.

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: Make the Area Safe, Reassure and Assess Before Moving

Staff must remain calm, reassure the person and make the immediate area safe. Staff must not rush the person, lift them manually, or move them until an initial assessment has been completed.

Staff must check and record, as far as possible:

• Whether the person is conscious, responsive and breathing normally.
• Whether they have hit their head or lost consciousness.
• Whether they have pain in the head, neck, back, hip, leg, arm, ribs or elsewhere.
• Whether there is bleeding, swelling, bruising, deformity, shortening or rotation of a limb, or suspected fracture.
• Whether there is dizziness, confusion, weakness, seizure activity, chest pain, shortness of breath, signs of stroke, signs of shock or sudden deterioration.
• Whether the person is taking anticoagulant or blood-thinning medication, where known.
• Whether the fall was witnessed or unwitnessed.

If there is any doubt about injury or safe movement, staff must not move the person and must seek urgent medical advice or call emergency services.

Step 2: Call 999 Immediately Where Required

Staff must call 999 immediately if the person:

• Is unconscious, has lost consciousness, is difficult to rouse or has a reduced level of consciousness.
• Has hit their head, has a suspected head injury, or is taking anticoagulant/blood-thinning medication and has fallen or may have hit their head.
• Has severe pain, suspected fracture, hip injury, deformity, limb shortening or rotation, suspected spinal injury, or cannot move normally.
• Has chest pain, breathing difficulty, signs of stroke, seizure, severe dizziness, signs of shock, major bleeding or sudden deterioration.
• Has fallen from a height or the mechanism of injury suggests serious harm.
• Cannot get up safely, even if no serious injury is obvious.
• Staff are unsure whether it is safe to move the person.

While waiting for emergency services, staff must keep the person warm and comfortable, preserve dignity, monitor their condition, follow first aid training, and provide clear information to paramedics on arrival.

Step 3: Supporting the Person to Get Up Only Where Safe

Staff may only support the person to get up if there are no signs of serious injury, the person feels able, staff are trained and competent, and the person’s moving and handling plan confirms how support should be provided. Staff must not manually lift the person from the floor.

Where the person can get up independently or with minimal agreed support, staff should encourage them to move slowly, use stable furniture or equipment only where safe and agreed, and sit in a chair before standing fully. Staff must continue to observe for pain, dizziness, confusion or deterioration.

If the person cannot get up safely, staff must make them comfortable, protect their privacy and dignity, monitor them, and seek further assistance or emergency support.

Post-Fall Monitoring

After any fall, staff must continue to monitor the person for delayed symptoms, particularly where the fall was unwitnessed, involved a head injury, involved pain, or the person is frail, cognitively impaired or taking anticoagulant/blood-thinning medication. Monitoring must be proportionate to the person’s condition and any advice received from NHS 111, 999, GP, paramedics or other healthcare professionals.

Staff must report immediately if the person develops headache, vomiting, increasing drowsiness, confusion, weakness, slurred speech, seizure, new pain, reduced mobility, bruising, swelling, breathing difficulty, chest pain, dizziness, bleeding, or any other deterioration. Observations, advice received, actions taken and communication with others must be recorded.

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

All falls, near misses and fall-related injuries must be reported internally in accordance with {{org_field_name}}’s incident reporting procedure. The staff member who discovers, witnesses or responds to the fall must ensure the Registered Manager or delegated senior person is informed as soon as possible.

The incident record must include:

• Staff are unsure whether it is safe to move the person.
• Date, time and exact location of the fall.
• Whether the fall was witnessed or unwitnessed.
• What the person was doing before the fall.
• The person’s account of what happened, where possible.
• Any symptoms before the fall, such as dizziness, weakness, pain, confusion, seizure activity, chest pain or breathlessness.
• Environmental factors, including lighting, flooring, clutter, footwear, equipment, furniture or wet surfaces.
• Injuries or suspected injuries.
• Whether the person hit their head or lost consciousness.
• Whether emergency services, NHS 111, GP, family, advocate, landlord, housing provider, OT, physiotherapist, safeguarding or other professionals were contacted.
• Advice received and actions taken.
• Whether a CQC statutory notification, safeguarding referral, RIDDOR report or Duty of Candour response was considered or completed.
• Immediate changes made to reduce further risk.
• Date and name of the manager reviewing 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: {{out_of_hours}}

CQC Statutory Notifications

The Registered Manager or delegated responsible person must consider whether a fall requires statutory notification to CQC. A notification may be required where the fall results in serious injury, death, abuse or alleged abuse, police involvement, an event that affects the safe running of the service, or another notifiable incident under the Care Quality Commission Registration Regulations 2009.

The decision must be recorded, including whether a notification was submitted, the date submitted, the person responsible, the notification reference where available, or the reason why notification was not required. CQC states that providers must notify it about certain changes, events and incidents that affect their service or people who use it.

Duty of Candour

Where a fall results in a notifiable safety incident, {{org_field_name}} must follow the statutory Duty of Candour. This means acting in an open and transparent way with the person and/or their relevant representative, providing a truthful account of what is known at the time, apologising, explaining what further enquiries will take place, offering reasonable support, and keeping written records.

Saying sorry is not an admission of liability. Staff and managers must ensure that communication is compassionate, timely, accessible and clearly recorded. CQC states that the statutory Duty of Candour applies to every health and social care provider it regulates.

Safeguarding Considerations

A fall, repeated falls or unexplained injury may indicate abuse, neglect, acts of omission, unsafe care, poor moving and handling practice, unsuitable equipment, environmental neglect or failure to follow the care/support plan. Staff must consider safeguarding after every fall where there is unexplained injury, delay in seeking help, inconsistent accounts, repeated incidents, poor supervision, unsafe environment, failure to use agreed equipment, medication concerns, or concerns about neglect by any person or organisation.

Where safeguarding concerns are identified, staff must follow the Safeguarding Adults Policy and make or request a referral to the local authority safeguarding team without delay. Any immediate risk must be escalated to emergency services.

RIDDOR Considerations

The Registered Manager must consider whether a fall is reportable under RIDDOR where it arises out of or in connection with work. This may include incidents involving staff work activity, unsafe equipment, unsafe systems of work, unsafe moving and handling, or an environment under the provider’s control. HSE guidance for health and social care explains that RIDDOR can apply to health and social care incidents and that the same reporting categories may be relevant where the injured person is a service user rather than a worker.

The decision and rationale must be recorded, including whether a RIDDOR report was submitted, the date submitted, the person responsible and any reference number.

Identifying Causes and Risk Factors

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

• Environmental risks:
  • Was the floor wet or cluttered?
  • Was there poor lighting or a lack of support rails?
• Medical factors:
  • Did a medication cause dizziness or drowsiness?
  • Is the service user experiencing balance or mobility decline?
• Behavioural factors:
  • Was the service user rushing, unsteady, or attempting to reach something unsafely?

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:

• Mobility aids:
  • Are they being used correctly?
  • Do they need adjusting or replacing?
• Medications:
  • Should the GP or pharmacist review prescriptions for side effects like dizziness?
• Home environment:
  • Do any modifications need to be made (e.g., grab rails, anti-slip mats, better lighting)?

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

• If a service user experiences a fall, their next of kin must be informed as soon as possible.
• If medical attention was required, we ensure that the service user’s GP or healthcare team is notified for follow-up care.
• Any ongoing concerns about mobility, medication, or environmental risks will be shared with relevant professionals to ensure comprehensive support.

Seeking Medical Review for Recurrent Falls

• If falls become frequent, we work with the GP, physiotherapist, or occupational therapist to:
  • Conduct a full health review.
  • Adjust medications, exercise plans, or mobility aids.
  • Explore specialist interventions to support mobility and strength.

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

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.

Mandatory Training

Mandatory and role-specific training must include, where relevant to the role:

• Falls prevention and falls risk factors.
• Person-centred and positive risk-taking approaches.
• Mental Capacity Act 2005, consent, best interests and least restrictive practice.
• Safeguarding adults, including neglect, acts of omission and unexplained injuries.
• Safe moving and handling, including not manually lifting a person from the floor.
• Safe use of mobility aids, transfer aids, hoists, slings, wheelchairs, alarms or assistive technology where staff are expected to use them.
• Emergency response, first aid arrangements and when to call 999.
• Post-fall reporting, recording and escalation.
• CQC statutory notifications, Duty of Candour and RIDDOR awareness for managers and senior staff.
• Medicines awareness, including medicines that may increase falls risk.
• Learning disability and autism training appropriate to the staff member’s role, in line with current legal and CQC expectations.
• Communication needs, including accessible information and involving families, advocates or representatives where appropriate.

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. Staff must not support transfers, mobility interventions, equipment use or post-fall movement unless they have been trained and assessed as competent for the task. Competency must be recorded and reviewed through supervision, spot checks, observations, refresher training, incident reviews and appraisal. Where a staff member is not competent or confident, they must seek guidance from a senior member of staff and must not proceed in a way that could place the person or themselves at risk.

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.
• Ask about and report falls, near misses, fear of falling and changes in confidence or mobility.
• Follow the person’s falls prevention plan, moving and handling plan and equipment guidance.
• Report faulty, missing, unsuitable or unsafe equipment immediately.
• Record refusals of support, advice given, capacity concerns and agreed alternative measures.
• Escalate any fall, injury, head injury, suspected fracture, unexplained injury, safeguarding concern or deterioration without delay.
• Preserve the person’s dignity, privacy and choice when responding to a fall.
• Share information promptly with colleagues so that risks are known across the staff team.

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.
• Review every fall and near miss to identify immediate and underlying causes.
• Ensure falls risk assessments and care/support plans are updated after falls, near misses or significant changes.
• Consider and record whether CQC notification, safeguarding referral, Duty of Candour or RIDDOR reporting is required.
• Monitor falls trends by person, location, time, staff team, activity, injury type, equipment and environmental factors.
• Ensure lessons learned are shared through supervision, team meetings, handovers, training and quality assurance processes.
• Ensure staff training, competency and supervision records evidence safe practice.
• Escalate unresolved housing, equipment, occupational therapy, physiotherapy or healthcare concerns to the relevant professional or organisation.

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

Staff must involve the person in falls risk assessments, care planning and decisions about preventative measures. Consent must be sought for interventions, referrals, equipment, environmental changes or information sharing unless another lawful basis applies. Family members, advocates or representatives may be involved where the person consents, where they have lawful authority, or where involvement is appropriate under the Mental Capacity Act 2005.

This includes:

• Agreeing to risk assessments to evaluate potential fall hazards.
• Approving home adaptations, such as installing grab rails, anti-slip flooring, or mobility aids.
• Acknowledging recommendations for physiotherapy, exercise plans, or changes to medication that may impact mobility.

If there is reason to believe that the person may lack capacity to make a specific decision about falls prevention, mobility, equipment, environmental changes, referrals or emergency response, staff must follow the Mental Capacity Act 2005. A capacity assessment must be decision-specific and time-specific. Any best interests decision must involve the person as far as possible, consider their wishes, feelings, beliefs and values, involve relevant others where appropriate, and choose the least restrictive option.

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:

• Time, date, and location of the fall.
• Possible causes (e.g., dizziness, trip hazard, loss of balance).
• Immediate actions taken (e.g., emergency response, first aid).
• Recommendations for preventing future falls.
• Communication logs – Records of discussions with families, GPs, and other healthcare professionals regarding fall risks and prevention strategies.
• Falls history and near-miss records.
• Post-fall monitoring records and professional advice received.
• Mental capacity assessments and best interests decisions where relevant.
• Consent, refusal of support, positive risk-taking discussions and agreed alternatives.
• Equipment checks, maintenance concerns and escalation.
• Referrals and correspondence with GP, falls service, occupational therapist, physiotherapist, pharmacist, community nurses, landlord, housing provider, local authority, safeguarding or emergency services.
• CQC notifications, safeguarding referrals, Duty of Candour records and RIDDOR decisions.
• Audit results, trend analysis, action plans and lessons learned.

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.

Reviewing and Updating Care Plans

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

• Changes in health and mobility.
• New medications that impact balance.
• Adjustments to the home environment.

Care/support plans and falls risk assessments must be reviewed:

• At the start of the service.
• At least every six months as a minimum.
• Immediately after any fall, near miss or fall-related injury.
• Following hospital admission, hospital discharge or emergency service attendance.
• Following any significant change in mobility, cognition, health, medicines, continence, nutrition, hydration, vision, hearing, behaviour, environment or equipment.
• Following professional advice from a GP, pharmacist, occupational therapist, physiotherapist, falls service, community nurse, safeguarding team or local authority.
• Where the person, family, representative, staff member or professional raises concern.

Any changes must be communicated promptly to staff and recorded clearly. Where urgent changes are needed, managers must ensure staff know what to do before the next planned visit or support session.

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, Concerns and Feedback

People using the service, families, representatives, advocates, staff and professionals must be able to raise concerns about falls risks, unsafe equipment, poor mobility support, delayed response, environmental hazards, staff practice, communication or follow-up after a fall.

Complaints and concerns must be handled in line with the Receiving and Acting on Complaints Policy and Regulation 16. Information about how to complain must be provided in a format the person can understand, including Easy Read, large print, translated information or communication support where required.

Any complaint or concern relating to falls must be reviewed to identify whether immediate action is needed to keep the person safe, whether safeguarding, CQC notification, Duty of Candour or RIDDOR applies, and whether lessons can be learned. Themes from complaints, incidents, safeguarding concerns and feedback must be included in the provider’s governance and quality assurance processes.

11. Policy Review, Audit and Continuous Improvement

This policy will be reviewed at least annually, or sooner where there are changes in legislation, CQC guidance, NICE guidance, safeguarding requirements, local authority procedures, best practice, organisational learning or serious incidents.

{{org_field_name}} will monitor falls prevention through a structured governance process. This will include:

• Review of all falls, near misses and fall-related injuries.
• Monthly or regular trend analysis proportionate to the size and risk profile of the service.
• Audit of falls risk assessments, care/support plans, incident records and post-fall reviews.
• Review of training, competency, supervision and staffing concerns.
• Review of equipment, environmental risks and outstanding referrals.
• Review of CQC notifications, safeguarding referrals, Duty of Candour records and RIDDOR decisions.
• Feedback from people using the service, families, advocates, staff and professionals.
• Action plans with named responsible persons, timescales and evidence of completion.

Learning from falls must be shared with staff through handovers, team meetings, supervision, alerts, updated risk assessments, training and policy review. The Registered Manager is responsible for ensuring that learning is embedded and that improvements are sustained.

12. Evidence for CQC Assessment

To demonstrate compliance with CQC requirements and the CQC assessment framework, {{org_field_name}} will maintain evidence that falls prevention is safe, effective, person-centred, responsive and well-led. CQC’s current assessment framework is based on five key questions: whether services are safe, effective, caring, responsive and well-led.

Evidence may include:

Feedback from people using the service, relatives, advocates, staff and professionals.

Person-centred falls risk assessments and care/support plans.

Records showing the person’s involvement, consent, choices and positive risk-taking decisions.

Mental capacity assessments and best interests records where relevant.

Staff training, supervision, competency checks and spot checks.

Moving and handling assessments and equipment guidance.

Medication concern records and medication review requests.

Referrals to GP, pharmacist, occupational therapist, physiotherapist, falls service or other professionals.

Incident reports, post-fall reviews and action plans.

CQC notifications, safeguarding referrals, Duty of Candour records and RIDDOR decisions.

Audits, trend analysis, lessons learned and evidence that actions have been completed.

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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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