Research to trial new approach to preventing falls in care homes


A £1.8m research project being led by the University of Nottingham is investigating whether new guidance for care home staff could be effective in reducing the number of falls experienced by older residents.

Funded with a grant from the National Institute for Health Research (NIHR), the three-year project is recruiting care homes in the East Midlands, West Yorkshire and East Anglia to trial a new guidelines and training package aimed at reducing the incidence of falls.

If the new approach, designed by academics in the University’s Division of Rehabilitation and Ageing, is found to be effective in protecting residents from the risk of falls, it could be rolled out to care homes across the UK.

Pip Logan, Professor of Rehabilitation Research, said: “Falls among care home residents place a huge financial burden on the NHS including treatment for broken bones, hip replacement surgery and lengthy hospital stays for recovery.

“In addition, this is an important quality of life issue for care home residents. Falling can be a very frightening experience for older people and it can often leave residents extremely fearful of a repeat occurrence, leading them to reduce their mobility and losing independence.

“We know that exercise keeps us and our bones healthy so reducing their mobility can actually lead to them becoming increasingly frail over time.”

The Nottingham team has worked with care home management and staff in Rushcliffe and Nottingham city to devise a set of new guidelines in the form of a 33-point checklist with a list of 33 associated actions that care home staff can follow in a bid to reduce the risk of falls among their residents. These include issues such as ensuring that residents remain sufficiently hydrated to spotting trip hazards and ensuring that they are wearing the correct spectacles.

In addition, the team has developed a bespoke training session to be delivered to staff to educate them in fall prevention and make them aware of the risks to their residents.

The new checklist and training package was then tested in six homes in a feasibility study before this larger study could go ahead.

Wynne Williams, Senior Nurse at Church Farm Nursing Home in Cotgrave, a nursing home for people living with dementia, said: “If an older person in a care home has a fall, then they can be injured and bruise easily, they may not be able to walk as well afterwards and, in some cases, may become scared – it can be quite debilitating for them.

“And for the care home staff it can also be very upsetting – they feel guilty, they ask what they could have done better and whether there was something they could have done to prevent it.

“But you can’t stop people from walking around or keep people sitting all the time just because there is a risk of a fall, you need to give people their freedom and independence to help preserve their sense of self-worth.

“The new training package is very useful. Staff need to know about falls and how they can at least minimise the risk of a resident having a fall. It’s very important that staff are aware of what to do and what not to do in that type of situation.”

The researchers will be aiming to recruit 1308 residents, most over the age of 65, from 66 residential and nursing homes across Nottingham City, Nottinghamshire county, Leicester, Derby, Norwich and Bradford.

Currently many care homes assess residents for risk of fall, giving them a score out of 10 or 20, but don’t always take preventative actions, reacting instead when a fall occurs.

For the study, the homes will be randomly sorted into two groups. One half of the care homes will continue as they are with the researchers logging the incidence of falls among their residents.

The other half will use a falls prevention programme, specifically designed for care homes.  Each care home will receive two weeks of training in which every member of staff will be trained to assess each resident for their risk of a fall and be guided by the associated actions.  The care home will have posters placed around the homes to offer a visual reminder to care home assistants, to use the guide to action tool.

The researchers will monitor the number of falls by residents in these homes and compare them to the homes which have not used the new intervention to assess whether it has made a significant difference in reducing the number of incidents.

At the end of the trial, all care homes will be offered the training so they can adopt the new guidelines and action points should they so wish.

If the study provides evidence that the new guidelines and training are successful in fall prevention, it could become the standard approach adopted by all care homes across the UK.


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