Building Staff Confidence Through a Shared Learning Model for Falls Management in Care Homes

Introduction

Best practice guidance for falls management with care home residents recommends a proactive approach and care home staff require training to support this. The CHAFFINCH (Co-producing tHe implementAtion oF Falls management IN Care Homes) study co-produced a model for falls management. The second phase of the CHAFFINCH study evaluated the feasibility of delivering the model in real-world care home settings.

Methods

A shared learning model was delivered for 6 months in 10 care homes in Nottinghamshire, United Kingdom. The model included bespoke training and ongoing support, provided by an NHS clinical specialist (falls lead). The Action Falls programme, recommended as best practice and including training and a falls checklist, was used to structure the support. Data collection included a clinician diary of support activities and semi-structured interviews with 14 care home staff across 6 homes. Interviews were analysed thematically using the Consolidated Framework for Implementation Research (CFIR).

Results

The falls lead delivered 132 hours of training, 228 hours of resident reviews, 82.5 hours of informal support, and 15.5 hours of falls huddles, with additional remote support (12 hours). Staff valued the falls lead’s expertise, approachability, and reassurance, and reported improved confidence and competence in managing falls. Ongoing, flexible support and open discussions reduced feelings of isolation and facilitated communication across roles, shifting culture away from blame. The model led to practical changes, such as appointing falls champions, which supported ongoing implementation. Limited integration of the falls checklist into digital platforms was a key challenge.

Conclusions

The co-produced shared learning model for falls management was valued by care home staff and promoted a positive learning culture. Flexible access to ongoing support, specialist expertise, and skills in supporting open conversations were important for successful delivery. Future work is needed to co-design resident and relative information to strengthen collaborative decision-making.