Information, advice and guidance that will help you improve the quality of care and meet the expectations of the council, Care Quality Commission, residents and their relatives.

Falls risk and medication

pdf Care homes: Medication and falls (571 KB)

Detailed Guidance for care homes issued by Bristol Clinical Commissioning Group in 2014.

document Falls risk and medication (1 MB)

PowerPoint presentation created by Bristol Community Health.

Dementia: Supporting people with dementia and their carers in health and social care on the NICE website Go to (opens new window)

See pages 28- 30, section 1.7.1, for advice on the use of psychotropic medications and social prescriptions for the management of challenging behaviour.

Guidance from the National Institute for Health and Care Excellence (NICE)

Falls in older people on the NICE website Go to (opens new window)

Although the Quality Standard discusses falls in hospital, the six quality statements provide useful guidance, are applicable to the management of falls in care homes and should be adhered to.

Falls in older people:  assessing risk and prevention on the NICE website Go to (opens new window)

Offers evidence-based advice on preventing falls in older people.

What we expect providers to do

Eight things you must do if someone falls

  1. Before they're moved, check for signs or symptoms of fracture and spinal injury.
  2. Move the person using only safe manual handling methods.
  3. Make sure the individual has a medical examination.
  4. Record the incident in the falls register, including the causes and circumstances of the fall.
  5. If the person who has had a fall needs medical attention, make sure a clinical falls risk assessment is carried out by appropriately trained staff.
  6. Check for bruising and skin damage 24 and 48 hours after the fall and treat appropriately.
  7. Update the care plan and falls register. Record the fall, the results of medical examinations, any treatment provided for injuries, whether a clinical risk assessment was carried out and who by, and what was done to address underlying falls risks (for example UTIs, medications, infections, postural stability).
  8. Identify any hazards that are present where the fall happened. Take appropriate action to remove or reduce them and record what you found and what you did.  

These instructions are based on NICE QS86, and include the relevant requirements of the 2015 service specification.

pdf Service specification (729 KB)

The current service specification contains quality standards that relate to falls risk management.  These are included on the document. Compliance with these standards will reduce the risk of people falling.

What other care homes have done to manage risk

pdf Newsletter (1.26 MB)

A newsletter containing case studies form care homes in Bristol.

document Safety crosses and falls mapping (3.68 MB) (Brunel Care)

A Powerpoint presentation of Brunel Care's involvement with the falls project delivered with the NHS Institute for Innovation and Improvement which introduced the falls plotting approach.

Managing Falls and Fractures in Care Homes in Scotland Go to (opens new window)  (Care Inspectorate Scotland, 2016)

'Managing falls and fractures in care homes for older people' is a good practice self-assessment resource from the Care Inspectorate to help care home staff assess how well falls prevention and management and the prevention of fractures is being addressed in their service and how to make improvements. The resource includes an introduction to falls and fractures in care homes, self-assessment guidance and a range of tools which can be downloaded and used in a care home to help improve or change practice. 

Managing falls risk for people with dementia 

pdf Dementia, falls and fractures (1.85 MB)

Not specific to care homes, but contains background information about why dementia makes falls and fractures more likely. 

Dementia: Supporting people with dementia and their carers in health and social care on the NICE website Go to (opens new window)

Awareness training for care home staff

Staying Steady (Age UK) Go to (opens new window)

An introduction to healthy ageing.  Although aimed at people who are still mostly independent, it provides a guide to ways to maintain independence and manage falls risks. 

Don't mention the ‘F' word (Age UK)

Fear of falling makes falling more likely and we have to be careful not to make people more worried when talking to them about falls. This leaflet explains why, and how.