Preventing Recurring Falls in Care Homes

Recurrent falls in care homes are a significant concern, not only because they can lead to severe injuries, but also because they indicate potential negligence in safety practices. Falls are complex incidents influenced by a variety of personal and environmental risk factors. This article discusses these factors and outlines the steps care homes should take to prevent falls, ensuring the safety and well-being of their residents.

Risk Factors for Falls

Risk factors for falls in care homes can be broadly divided into personal and environmental categories. Understanding these factors is key to developing effective prevention strategies.

Personal Risk Factors:

Muscle Weakness and Unsteadiness: Conditions like muscle weakness and unsteadiness in walking contribute significantly to falls.

Slow Reactions and Sensory Problems: Slow reaction times and sensory issues such as poor vision or dizziness increase fall risk.

Cognitive and Medical Conditions: Cognitive issues, seizures, continence problems, and certain medications can affect safety.

Psychological Factors: Fear of falling or anxiety can cause residents to avoid movement, weakening muscles and further increasing fall risk.

Age-Related Changes: Natural changes due to aging can affect strength, balance, and coordination.

Environmental Risk Factors:

Unsafe Floor Surfaces: Wet, slippery, or uneven floors are hazardous.

Poor Lighting and Clutter: Insufficient lighting and cluttered spaces can lead to trips and falls.

Inadequate Equipment and Maintenance: Faulty walking aids or wheelchairs with broken brakes pose significant risks.

Inappropriate Furnishings: Chairs, beds, or toilets that are too high or low can be unsafe.

Staffing Level: Low staffing levels, especially at night, can increase the risk of falls. Certain activities, such as getting up to use the toilet at night, are particularly high-risk due to a combination of these factors. Care homes must address both personal and environmental risks to minimize the chance of falls.

Certain activities can be ‘high risk’ because of the specific interaction of risk factors involved, for example, getting up to use the toilet at night. Risk could relate to a person’s strength, balance and walking, but also to their inability to use a call bell to get help, lack of lighting and lower staffing levels at night.

Numerous personal risk factors will come into play with Care Home/ Nursing Home residents which is why it is so important that care homes reduce the number of environmental risk factors for residents.

Fall Prevention in Care Homes

Care homes should implement comprehensive safety measures to reduce fall risks. There are some key steps to consider: –

Risk Assessments

Risk assessments are crucial for identifying and addressing fall risks. Personal risk assessments should be conducted upon a resident’s admission and regularly reviewed, especially after a material change in circumstances such as a fall or a new medical condition. Environmental risk assessments should focus on key areas like seating, toileting, and bathing to ensure a safe environment.

A personal risk assessment should be done on every resident upon admission to the care home. This risk assessment should then be reviewed, and if necessary, updated either after:

1. A passing of specific period of time: (e.g on a quarterly, annual basis) and how often this is done can be based on the resident’s care needs. For example, a particularly vulnerable resident will require more frequent reviews to their falls risk assessment.
2. After a material change in circumstances: i.e if a resident falls ill, is admitted to hospital, suffers a fall, changes room.

Equipment

There should be clear written guidance on how to use specialist equipment in care homes to prevent falls to help residents, staff and family in their use of the equipment. Staff should of course be fully trained in using the equipment. When considering use of equipment for individual residents, it is important to balance competing risks. Regularly used equipment in falls prevention include:

– Bed rails reduce the risk of residents falling out of bed, particularly those who are at risk of strokes, muscle spasms, paralysis or seizures. They should not be used if a resident is agile/mobile and may be confused enough to climb over them.

– Specialist seating seeks to mitigate the risk of falls that occur when residents find it difficult to get up from a chair, sit down safely or when a chair does not provide adequate support. Considerations for the suitability for an individual resident include; width, depth, neck/head support, armrests, firm base (and comfort of course!)

– Restraints (defined as ‘the intentional restriction of a person’s voluntary movement or behaviour’) are designed to prevent from falls and harm, however they carry with them significant risks which may outweigh the benefits, particularly from a psychological perspective. Significant care should be taken when risk assessing the use of restraints as it impacts quality of life and may also cause a deterioration of muscle strength due to inactivity.

– Technology enabled care and support can promote safety whist maintaining independence for residents. Examples include movement detectors, bed or chair occupancy sensors or falls detector.

Engagement with External Services

Care Homes should also, when necessary, collaborate with multi-disciplinary teams, health professionals, and local services for additional support in fall prevention.

Conclusion

Residents of care homes will inevitably be at high risk of suffering from recurrent falls, which is why a comprehensive approach to prevention is required to mitigate such risks. Falls in care homes are preventable with proper risk assessment, safety measures, and staff training. A comprehensive approach, addressing both personal and environmental risk factors, is essential to reduce the risk of falls and ensure the safety of care home residents.

Regrettably, recurring falls can be caused by neglect and abuse in a care home setting. If you or a loved one has experienced a fall due to negligence in a care home, our experienced legal team can help you seek accountability and compensation.

Has your loved one been injuries as a result of neglect or injury in a care home?

For more information, please visit the care home injury compensation page of this website. Or, you can contact Irvings for a no obligation confidential chat by telephone on 0151 475 1999 or use our free phone number 0800 954 0243 and talk to our specialist care home injury team. Alternatively, you can submit your enquiry to us by email to info@irvingslaw.com.