Falls prevention
cent in February 2023 to a high of 6.4 per cent in April of the same year. During the trial period, this fell to 3.3 per
cent - roughly one toileting-related fall for every 30 residents each month or a drop in falls relating to toileting by more than a third (35 per cent) as a proportion of occupancy.
Wider potential benefits of decaf Trade association Care England, who partnered in the project, have since worked with other social care providers who have been keen to identify whether decaf by default could have other benefits, aside from falls reduction for those they care for (as well as those looking after them). For example, Cornerstone Healthcare Group explored improving sleep, reducing distress and behaviours that challenge, and need for one-to-one support. Caffeine has long been associated
with poor sleep, and those experiencing sleeplessness are advised by the NHS to avoid caffeine six hours before going to sleep. The Cornerstone study identified that there were potential health benefits among their own working age residents living with complex neurological and cognitive impairments, with an improvement in sleep
patterns, a decrease in agitated behaviours, reduced requirement to use non-abusive physiological physical interventions, and reduced need for one-to-one support for those receiving care. Care England CEO Professor Martin
Green OBE said: “The Decaf Project really is the gift that keeps giving: a simple, low-cost change with the potential to reduce falls, improve continence and sleep, and protect the dignity, independence and quality of life of older people and others drawing on care and support. “Falls remain one of the leading causes of
injury-related death in later life, so anything that can safely reduce risk deserves serious attention. “Yet this is not entirely new practice;
reducing caffeine was promoted years ago by NHS continence nurses, but much of that expertise and routine advice was lost as specialist continence nursing numbers declined. “Encouragingly, since the introduction
of the CQC Single Assessment Framework, we have seen references to caffeine and decaffeinated drinks rise from just one inspection report in 2024, to 18 in 2025 and 51 in 2026, with 59 mentions across Good-
rated and five across Outstanding-rated homes in 2025 and 2026, suggesting the watchdog increasingly recognises this as a marker of thoughtful, preventative care. “Care England is proud to be associated
with the project, which Sarah Coombes first brought to our attention, and with the work Ruth has led to support its adoption nationally across health and social care, improving everyday outcomes for the people we support,” he added.
Project expansion Decaf by default continues to provoke interest as both NHS acute trusts and care homes experience demand, finance and staffing pressures. In some areas, full scale take up of decaf is being rolled out: Northumbria Healthcare NHS Trust comprising nine hospitals and additional intermediate care centres has adopted decaf across all its locations and is working with care homes in the county to encourage wider take up. Its research results reported a 50 per cent fall reduction in care home residents and a 40 per cent drop in overnight incontinence. At University Hospitals of
Northamptonshire, a six-month trial in 2024-25 saw results demonstrate
September 2026
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