Cutting Falls in Care: Simple Changes That Make a Big Difference

Falls are one of the most common and serious risks in UK health and social care. They can lead to injury, hospital admission, loss of confidence, complaints from families, and difficult conversations with inspectors. For providers, having a clear, practical approach to falls prevention is essential for both safety and quality of care.

This article sets out five simple, low‑cost changes that any provider can put in place. They work in care homes, supported living, and domiciliary care, and they are easy for staff to remember and use in everyday practice.

1. Start with Footwear

The simplest place to begin is at ground level – what people have on their feet.

• Make shoe checks part of your daily routine
• Encourage well‑fitting, closed‑back shoes or slippers with non‑slip soles. Avoid loose slippers, backless shoes or worn‑out soles.
• Keep a small stock of non‑slip grip socks so that no one is walking on smooth floors in bare feet or tights.

You can turn this into a quick safety rule: “No walking without safe shoes or grip socks.” That phrase is easy to repeat in handovers and training.

2. Check Beds and Chairs

Many falls happen when people are getting in or out of bed or standing from a chair.

• Standardise bed height: aim for a height where the person can sit with feet flat on the floor and stand up without “dropping” down or struggling up.
• Make sure frequently used chairs are stable, not too low, and have arms to push up from.
• Keep call bells, walking aids and personal items (glasses, water, phone) within easy reach so people aren’t stretching or leaning dangerously.

A quick weekly “bed and chair round”—walking through the service just to check heights and positioning—can prevent a lot of avoidable incidents.

3. Tidy and Light the Environment

Trips and slips often come from small hazards that staff stop seeing over time.

• Do a daily clutter walk on each shift: remove loose mats, trailing cables, boxes and bags from walkways.
• Make sure night‑time lighting is enough for people to see their way to the bathroom, especially for those who wake frequently.
• Check that handrails are fitted where people need them most (corridors, near steps, by toilets) and that they are secure.

You can involve staff in this as a short, shared task: everyone removes one hazard they spot per shift. Over a week, that makes a big difference.

4. Strengthen Observation and Routines

Even with a safe environment, people still fall if they are not supported at the right times.

• Introduce purposeful rounding for those at higher risk: regular checks (for example every 15–30 minutes) that include asking about pain, toilet needs, hunger/thirst and position.
• Clearly flag people who are at higher risk—this might be a discreet symbol on the handover sheet or whiteboard, or a coloured sticker on care plans.
• Make sure agency staff get a short briefing at the start of every shift that covers who is at high risk of falls and what support they need.

Routines should be written down, not just “in people’s heads”, so that they survive staff changes and busy shifts.

5. Learn from Every Fall

No service can prevent every fall, but every fall can teach you something.

• Hold a brief post‑fall huddle within 24 hours with the staff who were on duty. Ask three questions:
  1. What was happening just before the fall?
  2. What might have contributed (shoes, lighting, rush, confusion, medication)?
  3. What three changes can we make right now?
• Update the person’s care plan straight away with any new actions (e.g. closer observation at certain times, different footwear, rearranged furniture).
• Let families know what happened, what you found out, and what you have changed, so they can see you are taking it seriously.

Patterns will start to appear—such as more falls on certain days, areas or times—which you can then act on at service level.

Simple Falls Prevention Checklist for Managers

You can use this as a quick monthly audit:

• Footwear checks are part of the daily routine.
• Bed and chair heights have been reviewed in the past month.
• A regular “clutter and lighting” walk‑through is happening on each shift.
• High‑risk individuals are clearly flagged on handovers and for agency staff.
• Every fall is followed by a short huddle and care plan update.