Introduction

Falls in the care home setting has been a long standing safety issue. This not only a cause of harm to the residents but also leads to potential avoidable hospital admissions.

A common misconception of those caring for our elderly community is ‘falls will happen’ ‘the client base is elderly and unsteady – they are bound to fall – there is nothing we can do about that’

The Improvement academy (IA) has been working with care homes testing ideas to improve resident safety, focussing on reducing falls and pressure ulcers through improvements to team working and communication, through safety huddles.

An example of a care home that has shown measurable impact in reducing falls by the implementation of safety huddles is Fieldhead Court Nursing Home.

Background

Fieldhead Court Nursing Home, Thornhill, West Yorkshire is a 45 bedded home caring for both nursing and residential clients. It is lucky to have an excellent team of staff with a proactive manager providing strong, respected leadership.

It was recognised with unease that the number of residents falling in the home was increasing at an alarming rate. While acknowledging that the client base had changed considerably, the team still realised this was not acceptable and wanted to do anything necessary to reduce falls, so reducing harm.

Kath Tanner, Fieldhead Court Nursing Home manager was captivated by a session on safety huddles presented by the Improvement Academy. She felt sure the introduction of safety huddles in her care home would help reduce the number of falls. 

Following this, contact was made and support was offered by an IA Leadership Fellow in October 2016.

Impact

Prior to introducing safety huddles, the home had on average around 2 falls per week. The first huddle took place in December 2016 and since then the team has achieved its gold certificate for reaching 35 consecutive days with no resident falling and this continued on to 38 days.

Unfortunately on day 39 a resident fell. The team was disappointed but they’d done it before so believed they could do it again. The excellent work continued.

Kath Tanner, Manager, wholeheartedly supports huddles and the success this practice has brought saying “We are having the huddles twice daily; they do work really well bringing the team together”.

Following attendance at the National PSC Conference in London in May17, Kath Tanner and Fran Fisher (Senior Nursing sister) had time to reflect and consolidate information. They felt over time, the huddles had lost some emphasis; they had slipped into mentioning almost all the residents rather than concentrating on those at increased risk, thus diluting the focus and effectiveness.

Fran had a lightbulb moment! She devised a traffic light system whereby 3 lists of residents were produced.

Those on the green list were bedbound or immobile and therefore were at little risk of falling. Those on the amber list were the ‘variables’ those residents who were mostly safe but had a tendency to set off on their own or be unpredictable in their actions. Those on the red list were high risk fallers.

Every member of the Fieldhead Court Nursing Home team has had a significant part to play in the success achieved. Congratulations to everyone.

Fran Fisher is a Senior Nursing Sister at the home. In this blog she tells her personal story of her experience as a valued nurse in a care home.