1. 11 The impact of falls risk management on compliance with essential standards Sue Burn, Compliance Manager

2. 2 Compliance Essential standards and the associated regulations 1 – Respecting and involving 4 – Care and Welfare 6 – Cooperating with other providers 7 – Safeguarding 9 – Management of medicines 10 - Safety and suitability of premises 11 – Safety, availability and suitability of equipment 14 – Supporting workers 16 – Assessing and monitoring the quality of service provision 21 - Records

3. 3 Role of the inspector Awareness of key issues Access to relevant guidance and professional advisors Use of the prompts in the GAC Sources of evidence Feedback and signposting Making judgements about compliance and impact Use of the Judgement Framework Reporting and actions Analysis of notifications and safeguarding alerts

4. 4 Expectations All older people who have come into contact with care professionals should have a risk identification There is a falls prevention and management policy Risks are identified during assessment and care planning and reviewed regularly Links with statutory health and social care agencies are in place and there are clear referral pathways Effective interventions are used to prevent falls Staff are trained and updated in falls prevention and access to relevant guidance Clear recording and analysis

5. 5 Outcome 16 – quality monitoring Are incident/accident forms clear – are circumstances of falls properly described? Are reports analysed and used to inform prevention? Do you know if there is an increase/decrease/developing themes? Is your incident/accident reporting system audited for accuracy? Are safe systems of work in place and monitored? How do you cascade the learning from falls and incident analysis to staff? Is there a system for auditing staff training? Are people consulted about their risk assessment and falls measures agreed?

6. 6 Compliance: Judgement in inspections April to December 2012. % meeting the standards OutcomeNursingNon- nursing 188%95% 482%88% 677%97% 789%94% 969%79% OutcomeNursingNon- nursing 1074%78% 1170%83% 1482%87% 1683%86% 2158%60%

7. 7 Using our data Bristol LA area - Outcomes inspected April 2012 to January 2013 86% compliance overall % NON-COMPLIANCE………………… Outcome 4 – 12% Outcome 7 – 4% Outcome 9 – 30% Outcome 10 – 83% Outcome 14 – 18% Outcome 16 – 14% Outcome 21 – 44% Notifications analysis Trends/outliers Worse than expected to better than expected

8. 8 Serious injuries in Bristol care homes 239 registered locations End of January 2013 15 had higher reporting of serious injuries than expected 33 had lower reporting of serious injuries than expected

9. 9 Guidance sources  Guidance about compliance: Essential standards of quality and safety  DH 2009 Falls and fractures – effective interventions in Health and Social care. July  NICE  Bed Rails Safer Practice Notice – NPSA/2007/17 26 Feb  DH 2010 Essence of Care Benchmark Safety  Health and safety Executive EAT too