Supporting managers to minimise the risk of Service users falls in care homes

Factors influencing slips and trips In practical terms many factors can cause slips, trips and falls. These include: methods of cleaning, flooring type, footwear, levels of lighting, contrast between floors, walls and doors, and obstructions or other trip hazards. The practical measures that can be taken will vary in different situations; some measures will reduce the risk to both service users and staff, whereas others may be more targeted. Staff should be made aware that some of the main causes of slips and trips accidents include:

1. Slippery or wet surfaces caused by water and/or other fluids;

2. Slippery surfaces caused by dry or dusty floor contamination such as lint or talcum powder;

3. Obstructions, both temporary and permanent;

4. Trips hazards, uneven surfaces and changes of level, e.g. unmarked ramps; poor levels of lighting.

Control and preventative measures Many slips, trips and falls are preventable. Injuries arising from a fall can be reduced by prior intervention. Post fall assessment, review and remedial action can reduce the likelihood of further falls. It is important that those service users who have fallen and those who may be at risk from falling in the future have regular reviews of reversible risk factors. The risk factors rarely exist in isolation so effective falls management requires a preventive, holistic approach that considers all of the contributory risk factors.

Preventative measures to reduce fall hazards

1. Secure and obvious hand rails will be fitted where appropriate for all steps and stairs – on both sides if necessary for stability.

2. Step and stair edges will be clearly marked.

3. A planned preventive maintenance programme will be in place, linked to regular risk assessment inspections, to ensure that all floor and other entry and exit routes have flat, even surfaces.

4. Protruding or obstructing items of furniture or equipment, especially at low level, will be removed.

5. Beds and chairs will be appropriate to individual needs and in good repair.

6. Lighting should be adequate to enable people to see obstructions and potentially slippery or uneven areas, etc, so that staff can work safely, and service users can move about safely.

7. Lights will be replaced, repaired and cleaned whenever light levels become too low and new lights should be installed wherever poor lighting levels are identified as a hazard.

8. Monitoring of Service Users medication will take place to ensure staff, Service Users and carers are made aware of drug side effects related to falls as the service understands that some medications can disturb balance and mobility.

Support from healthcare professionals To help reduce the risk of falls to service users in a higher risk category the care home should seek regular falls prevention advice from care professionals. Including, physiotherapist and occupational therapist and falls team specialist support where required to implement treatment and prevention strategies.

Summary Falls are a major problem that effects the quality of life of service users in care homes. However, research shows that many falls are preventable. The extract from the Bettal Quality Consultancy Policy identifies some of the preventative measures that can be used to minimize falls. For further information on the policy Slips trips and Falls and other Bettal policies and procedures please visit the Bettal website Albert Cook Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy