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

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F Hallam-Bowles1,2; A Kilby3; AL Gordon4,5,6; S Timmons7; PA Logan2,8; L Rees9; K Robinson1,2
1. Nottingham University Hospitals NHS Trust; 2. University of Nottingham; 3. Nottinghamshire Healthcare NHS Foundation Trust; 4. Barts Health NHS Trust; 5. Queen Mary University of London; 6. NIHR Applied Research Collaboration- East Midlands (ARC-EM); 7
Scientific Research
SP - Falls
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Abstract

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.

Presentation

Comments

Great study summarised in this poster really well. As a registered nurse working in clinical practice I regularly find that digital integration is a key weakness in many attempts to implement change. Please can you tell me how you overcame this??

Submitted by janice.christi… on

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Thank you for comment. We have been exploring opportunities to work with care software providers to embed embed the Action Falls checklist and this is an ongoing process. Our learning so far is that it's important to engage and build relationships with digital providers at an early stage, and to consider that care software companies have different drivers, such as market forces. I'd welcome any suggestions from your experiences in clinical practice. 

Thank you for your reply. Yes I very much agree, relationships with the digital providers are paramount. Getting them to work alongside the carers using the technology can really help them identify potential key points where workarounds may happen and this can help tailor the product to make it more useable. The competing pressures of finance and time will always be the major barriers until their are national recommendations to encourage adoption.

This is a great piece of work and a nice presentation of the results. From speaking to residential and care homes as part of the Long Lies Study, staff really value such training and collaboration with external partners such as Falls Teams but availability and access to such teams appears to be limited and inconsistent in the UK. Increasing the knowledge, awareness and confidence of individuals working in social support is an excellent long-term strategy.

Submitted by m.kuczawski@sh… on

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Thank you for sharing your learning from the Long Lies study. We have had similar feedback, particularly where this support is provided by NHS services under increasing pressures. I agree that there's a need for sustainable training models to embed this collaborative approach into routine practice. 

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