Resident safety


A practical guide to preventing falls in care homes


A study led by the University of Nottingham saw a 43 per cent reduction in the rate of falls compared with residents who did not receive the intervention. Here, Professor Pip Logan and Professor Adam Gordon, on behalf of the FinCH study team, set out the learnings of the ACTiON Falls programme and offer practical tips for prevention


A fall for an older person, and especially those living in care homes, can have a devastating impact on their quality of life, with many becoming so fearful they become chair- or bed-bound. This fear is in addition to physical injuries such as fractures, skin tears, bruising and pain which may lead to death.1 Care home staff are equally distraught when a resident falls and families and friends can feel guilty as they may perceive the fall as a lack of good care.2


In addition,


falls can place new demands on health and social care resources, with some residents having to move homes after a fall. Falls are common, with a third of those


over 65 years of age, and half of those over 80 falling at least once a year.3 residents this rate is tripled4 421,000 older people5


and with living in UK care


homes, it is evident that falls is a serious area that needs addressing. However, most falls prevention


programmes are aimed at community In care home


dwelling people who can understand what they need to do for themselves, such as strengthening leg muscles, or using a walking frame. With 80 per cent of care home residents having severe cognitive impairments such as dementia, these programmes are not relevant. In 2010, a group of care home staff, residents, families, NHS clinicians, researchers in the Midlands came together to start to address falls in care homes. We developed a falls prevention programme that guided everyone,6


including the care


taker and the chef in the care home, to what could be done to reduce the risk of a fall. We incorporated the best information,


for example: the definition of a fall as ‘an unexpected event in which the participants come to rest on the ground, floor, or lower level’7


with, existing falls prevention


programmes, clinical guidelines and expert knowledge. The programme was tried and tested in over 40 care homes, and was adapted along the way.


In 2021, the team published the findings of the largest care home study in the UK,8 which compared fall rates in care homes who had used this programme with those that had not and found that falls could be reduced by 43 per cent and each fall averted cost £191.9


The care homes were chosen randomly and with 84 homes and 1,657 residents taking part in ten different UK locations the findings are of key interest to care home owners and staff, policymakers, the Department of Health and Social Care, residents and families. The remaining part of this article describes this falls prevention programme and provides advice about how it could be used.


ACTiON Falls programme Our collaborative research with care home staff identified that the previous name for the programme - Guide to Action to Prevent Falls (GtACH) - confused care home and primary care staff such as GPs. Therefore, the programme is now called ACTiON Falls. The programme consists of a number of different components, which completed together result in a reduction in falls. For example, one resident might need their medications changing, more drinks during the day and a sensor beside the bed. Another resident might need a behaviour change routine to encourage them to use their walking aids.


Alongside the study where we found


we could reduce fall rates, we completed a study to see how the programme was actually delivered in care homes, who did what, when and why.


It is this combination of research


findings over the last ten years that has helped the team pull together the following advice. To deliver this intervention, there


36 www.thecarehomeenvironment.com April 2022


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