1. Up and About in Care Homes
The Management of Falls and Fractures in Care Homes for Older People Improvement Project
April 2015
Lianne McInally
National Project Lead
Lynn Flannigan
Deputy Project Lead

2. Workshop Plan Project Overview Case Study - Practical
Development of New Resource

3. Why falls in care homes matter…
Older people in care homes are:
3 times more likely to fall, and
10 times more likely to have a hip fracture.
89% of people in care homes have dementia and have a higher incidence of falls.
6 month mortality for someone with dementia is 71% following hip fracture

4. Managing falls and fractures in care homes for older people Issued in 2011
Get people thinking, talking and doing something about falls and fractures in care homes.
Articulate what ‘good practice’ means.
Provide answers to many of the questions care home managers and staff have.
Provide some practical solutions.
Provide a catalyst for care homes to develop stronger links with the wider health and social care team.
Improve the quality of care.

5. Up and About in Care Homes
Project Team
First time project like this has been done in social care setting.

6. Our approach Phase One: Test out a ‘prototype’ approach
Based on IHI Breakthrough Series Collaborative methodology
Everybody teaches, everybody learns
Share generously (transparency)
Steal shamelessly
Acknowledge graciously
Using the Model for Improvement:
measurement for improvement
small tests of change (involving all staff)
The learning from this period of testing will inform
Phase Two

7. In summary…
… provide focused support to care home managers and staff to:
utilise the Care Inspectorate/NHS Scotland good practice resource and self-assessment tool to best effect,
gather and analyse data to understand and address the local causes and patterns of falls,
provide training,
facilitate integrated working with the local health and social care team, and
through learning sessions, bring together participating care home ‘improvement teams’ and members of the wider MDT, to help foster a support and learning network to ensure sustainability.

8. The project’s improvement aim:
To reduce falls in participating care homes by 50% by the end of 2015.

9. Measurement for improvement: data spreadsheet

11. Achievements (1)
A reduction in the number of falls and the number of falls resulting in injury in care homes who have taken a proactive approach to improvement.
Improved systems for collecting and analysing data for improvement and monitoring.
Key Achievements
1. A reduction in the number of falls and the number of falls resulting in injury in care homes who have taken a proactive approach to improvement. One care home achieved a 74% reduction.
2. Improved systems for collecting and analysing data for improvement and monitoring, resulting in
(a) improved intelligence of the scale and nature of the problem at care home and national level.
(b) understanding of average falls rates, enabling identification of care homes with higher than expected rates, who may benefit from focused support. This was previously unknown.
3. Improved quality of practice, care and resident experience through
(a) increased staff knowledge and skills and improvement capabilities
(b) more integrated working with local health and social care teams and wider community.
4. Proof of the concept that technology can be used to provide virtual specialist support in care home settings.
5. Development of a number of resources and tools for education, information, advice, to support daily practice in the management of falls and fractures.

12. Achievements (2)
Improved quality of practice, care and resident experience through:
increased staff knowledge and skills and improvement capabilities
more integrated working with local health and social care teams and wider community.
Proof of the concept that technology can be used to provide virtual specialist support in care home settings.
Development of a number of resources and tools for education, information, advice, to support daily practice in the management of falls and fractures.

13. Falls story video

14. Pillars for success
Holistic approach to the management of falls and fractures.
Regular and ongoing dedicated support to identify, initiate, implement and sustain improvements.
A systematic and person centred approach to falls risk assessment and management.
Consistent data collection, reporting and analysis to identify trends and highlight areas for improvement using the data collection tool and IT dashboard
Committed and respected care home leadership empowering staff to make falls prevention and management a priority.
Team working and shared responsibility within the care home to sustain improvements.
Working with the integrated health and social care team and wider community.
Sharing and learning from innovations and examples of good practice.
Recognition and acknowledgement of good practice by the Care Inspectorate.

15. Case Study

17. Case Study Feedback

18. Key messages for care homes
Make falls everyone’s business every day.
Self assessment annually.
Implement systems to collect data.
Multifactorial risk assessment and actions.
Analyse falls when they happen (person centred analysis and care planning).
Discuss falls and learning from analysis regularly with everyone.
Involve the wider health and social care team (and community).
Use available resources to support improvement.

19. Up and About in Care Homes Workshop
Please use this thinking mat to capture your thoughts from each conversation
When the prevention and management of falls and fractures really works, what kinds of things happen for you and care home residents?
Walk 12 months down the line and imagine the the prevention and management of falls and fractures really works exceeds all expectations – what will you have to put in place to allow this to happen?
Postcards to the future What will you today if you knew that success was guaranteed?
Postcards to the future....What one thing can you do tomorrow to start this journey?

20. New Resource

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22. THANK YOU FOR LISTENING
For more information please contact:
Lianne McInally
National Project Lead
Lynn Flannigan
Deputy Project Lead