Developing a Falls Management Policy for the Care Environment

It is understood that falls among the elderly cost the government £981 million a year.

Research published in the Journal of Epidemiology and Community Health in 2003 indicates that almost 60% of this cost is borne by the NHS with the remainder spent on long term care. Analysts from the Health Economics Consortium at the University of York examined national databases to evaluate how many people over 60 had experienced a severe fall in 1999. They looked at the number of A&E attendances among the over 75's compared to those in other age groups. The over 75's were found to be eleven times more likely to be hospitalised after a fall compared to those aged 60 to 64. The home is the most common place for falls and 75% of all falls related deaths occur in the home.

It follows then that developing a corporate policy to reduce and manage falls will benefit the client and their family as well as informing the staff of the risks and their roles in managing those risks to enable the best possible outcome.

Establishing the Policy

Like all work-related policies in order to be effective it needs to be clear, unambiguous, practical and enforceable. It is recommended that a number of interested parties be involved in its development these are likely to include managers, care staff representatives, therapists, medical representatives and any other interested parties. This is likely to enable the policy to be better accepted across the organisation.

Opening Statement

The policy may open with the background and reasons for the policy development. This may include data regarding falls prevalence and outcomes within the organisation. There may follow an overall aim of the policy which could take the form of a simple statement such as ‘The aim of this policy is to minimise as much as is reasonably possible, the occurrence and level of injury of slips, trips and falls to our clients, and for our staff, to provide guidance for managing falls effectively when they occur.’ The policy aim may be signed and dated by a senior member of staff. Throughout the document, other policies and procedures are likely to be referenced.

Implementation of the Policy

This section of the policy will describe what the organisation will do in order to implement the previously stated aim. This is likely to include a list of practical actions for instance effective housekeeping and a robust system for repairing damaged floors/stairs etc to limit the possibility of falls. The implementation of falls risk assessments for clients, including a comprehensive review of any medication. Education strategies for the client to inform them of actions to avoid limiting their risk of falling. For care home and clinical settings the use of a ‘call bell’ system that could attach to the clothing/chair so the client is able to summon help. Ensuring that clients who are classed as ‘high risk’ are easily identified by staff. Ensuring these same clients are within easy view of staff. The use of alarms clipped to clothing, floor alarm mats, bed and chair alarms may be appropriate for some clients. The use of special footwear to ensure the client has as good a grip as possible on all types of floors. Ensuring that any walking aids the client is using has been appropriately assessed for their use. The implementation of low beds and ‘hip protectors’ to reduce injury should a fall occur.

From the staff’s point of view clear guidance should be given on what is expected of them in the event of a falling and fallen client. This is likely to include advice on controlling their descent (if applicable) and how they may assist the client to get back up. Guidance on reporting and recording falls should also be included.

Policy Review

Methods for monitoring the effectiveness of the policy should be described. For instance if the aim of the policy was to ‘minimise as much as is reasonably possible, the occurrence and level of injury of slips, trips and falls to our clients, and for our staff to provide guidance for managing falls effectively when they occur.’ Then a system for measuring the incidence and levels of injury to all parties should be described.

The policy should be signed and dated with a proposed date/timeframe for review.

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