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Falls Toolkit

This Event Toolkit supports structured reporting, investigation and management of falls across health and social care settings. It enables rapid risk assessment, multi‑disciplinary follow‑up, legal and safeguarding escalation where required, and captures learning to reduce recurrence and improve safety and independence.

Legislative Requirements

• Care Act 2014 — duties to promote wellbeing, prevent or delay needs and assess care/support. Falls risk must be considered in assessments and care plans; providers must cooperate with NHS partners on prevention, rehabilitation and community interventions.
• Mental Capacity Act 2005 — capacity assessments are decision‑specific. Respect unwise decisions where capacity is present, use least‑restrictive options for prevention (e.g., aids, alarms) and document best‑interest decisions when capacity is lacking.
• Data Protection Act 2018 / UK GDPR — falls records contain special category health data (Article 9). Apply lawful bases, data minimisation, access controls and secure retention when recording incident details, investigations and family communications.

Regulatory Guidance

CQC (England)

• Providers must identify people at risk of falling, complete timely risk assessments (ideally on admission) and develop personalised prevention plans.
• All falls should be recorded; those resulting in moderate or severe harm, or suggesting neglect or systemic failure, may trigger safeguarding, Duty of Candour and regulator notification.
• Inspectors expect evidence of learning, staff competence, environmental safety and governance oversight (Regulations 12, 13, 17, 18, 20).

Care Inspectorate Scotland

• Falls are preventable — services must carry out individualised assessments, record and analyse falls data, and implement multifactorial interventions (per the Good Practice Resource).
• Promote safe environments, staff training and use tools provided in the resource pack to identify patterns and drive improvement.

Care Inspectorate Wales (CIW)

• Falls prevention is a core expectation: assess risk, review medications, adapt the environment and document post‑fall care and learning.
• Serious or repeated falls may require reporting to CIW, safeguarding partners or RIDDOR as applicable.

Statutory Guidance

• Accountability — providers must coordinate with NHS partners, demonstrate timely action after falls and record decisions for governance and inspection.
• Duty of Candour — apply where a fall causes moderate/severe harm: inform the person/family, apologise and provide a full account.
• Safeguarding — treat falls that may result from neglect, omission or unsafe environments as potential safeguarding concerns and follow local procedures.
• Needs assessment — integrate falls risk into care and support planning and review after any incident.

Health care Guidance

• NICE (NG249, QS86) — recommend multifactorial assessment (gait, balance, vision, medication), tailored interventions (exercise, aids, home hazard modification) and post‑fall review.
• National Falls Governance Framework (2025) — supports community responses, remote assessments and non‑conveyance pathways to reduce admissions.
• Wales & Scotland frameworks — hospital and community guidance (WHC/2016/022; Scottish Falls Strategy) emphasise admission screening, multifactorial interventions and national indicators.

Evidence Based Practice

• Use validated multifactorial risk assessment tools and involve physiotherapy/occupational therapy and pharmacists for medication review.
• Target strength and balance programmes, home hazard checks and social prescribing activities to those at risk.
• Corroborate incidents with observations, charts and witness statements; use post‑fall reviews to identify modifiable contributory factors.

Clinical governance and Safety (NHS)

• Embed falls data within safety systems: incident reporting, risk registers and QI programmes. Boards should receive assurance on incidence trends and actions.
• Maintain training records (moving & handling, falls awareness), equipment checks and escalation pathways to clinical teams.
• Link falls outcomes to service improvement activity and monitor adoption of prevention programmes (e.g., Action Falls).

PSIRF

• PSIRF frames falls as patient safety incidents where harm occurs or could occur. Responses should be proportionate and system‑focused: rapid reviews, thematic analysis or in‑depth investigation depending on severity, frequency and learning potential.
• Engage patients, families and staff in learning, apply human factors thinking and avoid individual blame while addressing latent system risks.

Using the Toolkit — Practical Steps

1. Log the Fall — record reporter, date/time, location, who was present, immediate clinical status and any injuries.
2. Assess Immediate Risk — check airway/breathing/circulation, immobilise if necessary, call emergency services where indicated and ensure dignity and privacy.
3. Notify Family & Representatives — inform next of kin promptly and compassionately; log contacts and support offered.
4. Preserve Evidence — secure scene where relevant, retain observation charts, medication records and witness statements.
5. Conduct Post‑Fall Review — perform multifactorial assessment (gait, balance, cognition, meds, vision, environment) and risk‑score; involve PT/OT/pharmacy as needed.
6. Decide Proportionate Response — options include enhanced supervision, equipment provision, care plan changes, safeguarding referral, SJR/PSIRF review or RIDDOR notification.
7. Record Actions & Owners — allocate tasks (reviews, referrals, training, environment changes), set deadlines and capture evidence of completion and outcome measures.
8. Embed Learning — feed validated findings into governance, training, and QI projects; monitor recurrence and intervention effectiveness.
9. Protect Data — ensure lawful processing, minimise identifiable sharing and apply retention and access controls for sensitive records.

Templates & Data Fields (recommended)

• Fall reference, status and reporter (name, role)
• Person identifiers (name, DOB, record/NHS number), location, date/time of fall and discovery
• Immediate clinical observations and injuries (fractures, head injury, loss of consciousness)
• Witnesses, staff present and any immediate actions (first aid, ambulance)
• Risk assessment outcome and score, contributing factors (medications, environment, mobility, cognition)
• Multidisciplinary inputs (PT/OT/pharmacy/GP), referrals and equipment issued
• Safeguarding flag, Duty of Candour trigger, RIDDOR/Regulator notification status
• Action plan, owners, deadlines and evidence of completion
• Outcome measures: repeat falls, functional change, hospital admission, learning shared
• Access controls, sensitivity flag and retention metadata

Monitoring, Audit and Reporting

• Maintain a falls register to track incidents, repeat fallers, action ageing and referral outcomes.
• Dashboards: falls rate per 1,000 bed days, falls with harm, repeat fallers, time to review and intervention uptake.
• Audit completeness of post‑fall reviews, timeliness of multidisciplinary involvement, and adherence to prevention plans.
• Provide extracts for quality committees, safeguarding partners and commissioners demonstrating learning and impact.

Toolkit Statistics

• Prevalence: ~1 in 3 adults aged 65+ and 1 in 2 aged 80+ fall annually; care home residents have higher fall and injury rates.
• Admissions & cost: falls drive substantial emergency admissions and cost to health and social care (multi‑billion estimates nationally).
• Intervention impact: targeted programmes (e.g., Action Falls) have demonstrated substantial reductions in falls (example: 43% reduction in participating homes).

Value Proposition

• Meets statutory, regulatory and best‑practice expectations for recording, review and action following falls.
• Provides a single structured workflow to support rapid clinical response, multidisciplinary prevention and auditable governance.
• Transforms incident data into measurable improvement activity (reduced recurrence, fewer admissions and improved independence).
• Supports evidence for external falls teams, commissioners and inspectors and demonstrates organisational learning.

References

• CQC Regulations (2014)
• Care Act 2014
• Mental Capacity Act 2005
• Health and Social Care Act 2012
• NICE Guideline NG249 (2025); Quality Standard QS86
• National Falls Governance Framework (2025)
• Managing Falls and Fractures in Care Homes for Older People — Good Practice Resource (Scotland)
• Adult In‑Patient Falls: Principles and Framework (WHC/2016/022) (Wales)
• Office for Health Improvement and Disparities — All Our Health: Falls and Fractures
• NHS Patient Safety Incident Response Framework (PSIRF)
• UK GDPR / Data Protection Act 2018

Disclaimer

Radar Healthcare provides configuration templates and implementation guidance to support effective use of the platform. Any legal, clinical, regulatory or data protection examples are for general guidance only and do not constitute legal, clinical or compliance advice. Radar Healthcare acts as a data processor under customer instruction. The customer, as data controller, remains responsible for assessing and managing legal and data protection risks, determining lawful processing, and ensuring compliance with applicable regulations.