Health and Care Standards
Supporting Guidance
Standard 2.3: Falls Prevention
What is the Standard about?
This standard is about minimising the risk of people falling. Falls are the most frequently reported adult in-patient clinical incident and falls in the community are a frequent event. An assessment of the range of factors which are known to increase risk of falling is important in developing a plan of care which aims to prevent individuals from falling and reducing harm and disability.
Who is it for?
All healthcare staff, in all settings.
In relation to the standard criteria below (in bold) the following questions need to be considered:
People are assessed for risks of falling and every effort is made to prevent falls and reduce avoidable harm and disability.
- How do you identify key indicators for a falls risk assessment within the community setting?
- How do you ensure appropriate advice on falls prevention is given either orally or in writing
- How do you ensure awareness of and or referral to local initiatives for falls prevention?
- How do you ensure an initial falls risk assessment is documented for any patient in hospital with intention to assess or admit for greater than 6 hours?
- How do you ensure a plan of care is put in place to prevent falls?
- How do you ensure that a reassessment is undertaken if an individual has fallen, been transferred to a new area or whose condition has changed?
Falls prevention strategies are implemented based on national standards and evidence based guidelines.
- How do you ensure your falls prevention strategies and tools are based on the latest research evidence – such as key recommendations from the Royal College of Physicians National Audit of Inpatient Falls?
- Do you participate in national and local audit programmes?
- How do you monitor compliance with your falls prevention strategies and interventions in all settings?
- Have you referred to the Principles, Framework and National Indicators: Adult In-patient Falls?
People are assessed for risks to their own safety and the safety of others. A plan for managing risk is agreed between the person being cared for and those caring for them.
- Where the patient has been identified as being at risk of falls, is there evidence that there is up-to-date plan of care, tailored to the patient (not generic) which is being implemented and evaluated with an agreed review date?
- How do you ensure the plan is discussed and agreed with the patient and/or their family or carers?
- How do you ensure a copy of the plan of care is sent to the GP?
Staff receive appropriate information, training and supervision to ensure that people and their carers are safe.1
- How do you ensure that staff are aware of the most up-to-date information on rates and trends, falls risk assessment, prevention and management?
- What training and supervision systems are in place to ensure staff are up to date on falls assessment, prevention and management?
- How do you ensure the safe and clinically appropriate use of bed rails?
People are encouraged to develop or maintain the level of independence they wish, striking a responsible balance between risk and safety.
- How do you ensure information on falls prevention has been provided to the patient and or their family or carers either verbally or written?
- How do you ensure access to a range of aids to meet the mobility needs of patients?
- How do you ensure that falls prevention avoids unintended immobilisation of individuals?
- How do you ensure that individuals who are at risk of falling maintain an activity level that prevents decline in muscle loss that may itself increase risk of falls?
- Has an assessment been carried out on the individual’s ability to carry out a range of weight bearing activities that retain muscle strength?
People are able to summon help easily at all times, using a telephone, bell or other convenient means. If unable to do so their needs will be checked regularly.
- How do you ensure that individuals can summon help if needed?
- What systems are in place to ensure that an individual’s needs will be met if they are unable to summon help?
Legislation and Guidance
Toolkits
Good Practice Guides
Ageing Well In Wales – Falls Prevention On-Line Resource Hub
1000 Lives Plus- Reducing Harm from Falls (How to Guide) (2010) (Community Settings)
MHRA – Safe Use of Bedrails (2013)
NPSA - Slips, Trips and Falls in Hospital - 2010 Update Report from Patient Safety Observatory,