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Falls: Care of Someone Who Has Fallen (Wales) Policy

Policy Statement

It is recognised that in social care people who use services are often at risk of falls, which can result in serious injury and, where they are persistent, impair their quality of life. This is because their environmental and medical conditions and frailties put them at risk of falls and the risks increase because of, for example, physical inactivity, difficulties in walking and moving around, poor balance, household hazards, etc.

This policy describes the procedures followed in the event of a person suffering from a fall in {{org_field_name}}, in their own home, or outside, while receiving care and support. The policy is in line with the requirements of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, which requires service providers to ensure that their care users experience high quality care and that they have confidence in their carers and their care service.

Although the policy of {{org_field_name}} is to prevent falls by conducting and taking part in the relevant risk assessments and falls prevention plans, it also accepts that falls can occur. In the event of a person falling it is, therefore, important that staff members or whoever finds the person who has fallen take the appropriate action to enable them to recover as quickly as possible, sustaining the minimum physical and psychological damage or injury caused by the fall. It is also important that every occasion is fully recorded and reviewed to prevent reoccurrence.

Acknowledging the NHS and entire health and social care systems are experiencing immense increased pressures and maximum capacity, {{org_field_name}} is aware how important it is that any preventable accidents are kept to a minimum.

This policy incorporates how to safely get the person who uses services from the floor when they have fallen, if appropriate, as not all falls ensue in serious injury, when to call for additional support/advice, eg via NHS 111/999, mindful of health and safety, wellbeing for people who use services and training requirements for staff.

It is stressed on staff members that every occasion is likely to be different and that they will need to respond to individual circumstances, but in line with the following guidance. In most instances, they will find or be summoned to assist a person who has fallen (eg tripped, slipped or fallen because of physical reasons) in their absence but sometimes during their visit to the person’s home. In some cases, care workers might arrive at a residence to find that the person has fallen and has been unable to get up and seek help. In all cases, they will need to:

• stay calm
• make or ask for an immediate assessment of the situation and the extent of the person’s injuries (if any)
• enable the person to recover or call for help depending on the situation
• report, record and help to review the occurrence.

The aims are always to:

• minimise the risk of injury or further injury by ensuring that the environment in which the incident has occurred is made as safe as possible
• put into place measures to help the person recover and to reduce the risk of fracture or further injury to the person
• investigate the underlying causes of the incident
• review the individual’s care plans and risk assessments and any contributory environmental hazards (including equipment and appliances).

Procedures

When a person has fallen, or has been found on the floor, staff members should do the following.

• First, check for any existing hazards or dangers.
• See if the person who has fallen is responsive, ie conscious, albeit temporarily dazed or shocked.
• If they are responsive, provide reassurance and comfort the person.
• Ask the person to stay still before checking, eg for pain, loss of sensation (feeling), loss of movement in arms and/or legs, swellings, visible injury and deformity, which might indicate a fracture. Also, check for sickness, confusion, drowsiness, delirium and agitation.
• Seek medical help from an appropriate source if that is indicated or contact a duty manager for advice.
• If there is no evidence of injury and no signs of a change in health, in line with the person’s wishes allow them to get up independently if possible. For example, ask them to first roll over, then get on their hands and knees before using a safe means of support, eg nearby chairs, to stand up and/or give direct help in line with {{org_field_name}}’s moving and transferring procedures.
• Continue by monitoring the person’s condition, eg checking temperature, pulse, blood pressure and breathing as indicated by their health status and seek medical help if needed for reassurance or treatment.
• However, if the person is evidently unresponsive or unconscious, check their airways, breathing and circulation before calling immediately for medical help, eg emergency GP, NHS 111 or ambulance service — which service to call might be affected by local policies and circumstances — and take further action with the advice given.

Staff are also advised and instructed to act on the following possibilities.

• If it is safe to move an injured person from the floor it is important that staff have the expertise and equipment to do so and can comply with moving and transferring procedures.
• A person who is suspected of having any serious head injury or fracture should not be moved but made as comfortable as possible in their current position until medical help is available.
• In the event of a person being unconscious and appearing seriously hurt or ill it will also be important to check whether they have made out any advanced care plans, do-not-resuscitate statements, etc that will need to be passed on to the medical team.
• They should only carry out actions in line with their training, competence and confidence to do so, eg when helping a person to move to a chair or stand up, otherwise they should ask the person to remain where they are until it is assessed as being safe for them to move.
• In the event of their being present when a person begins to fall, they should always aim to reduce the impact of the fall rather than just prevent the fall itself. Such actions can cause injury in themselves. For example, if a person faints they might help the person to fall more gently by going with the flow of the fall rather than try to prop the person up. Rather than grab a person who is falling they might be able to remove objects that would cause them harm if they crashed into them. Although each situation is different care workers are expected to respond consistently to reduce or minimise injury in that event.

Following the Incident

1. In some cases, it will be necessary to inform relatives/next of kin/a legal representative.
2. Staff must complete the service’s accident/post falls report form and record the incident in the care plan.
3. {{org_field_name}} routinely reviews the overall pattern and trends of falls in people receiving care to inform revisions in policy, protocols and procedures and/or staff training on falls.

Training

Dealing with common accidents and emergencies, such as a fall, will be covered during induction training. All new staff will be expected to be aware of the service’s policy on falls.

Further and specialised training is provided for staff with specific roles and responsibilities for implementing the service’s policy on falls management, including on the development of effective falls prevention strategies.

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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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