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Falls in the residential independent care sector—ambiguity in guidelines and policies for healthcare assistants

Scott-Thomas, Jeanette, Graham, Yitka, Ling, Jonathan, Brannigan, Marie and Hayes, Catherine (2017) Falls in the residential independent care sector—ambiguity in guidelines and policies for healthcare assistants. British Journal of Healthcare Assistants, 11 (9). pp. 434-440. ISSN 1753-1586

Item Type: Article


The need for healthcare assistants (HCAs) to have clear policies and guidelines in relation to when falls occur in domiciliary care settings is paramount. If first-line responses are to be appropriately tailored to patient need and discernment is to be used in determining the necessity for intervention by emergency care workers such as paramedics, then standardised frameworks and policies ought to be clearly apparent across care sectors.

Our work focused on the first-line response to patient falls in the independent care sector in a specific geographical region of north-east England. This article provides an insight into what our original findings revealed and how they might be used as a source of reflection for HCAs working in the residential independent care sector.

Using a basic questionnaire, we surveyed 24 (75%) of the 32 independent care sector homes in South Tyneside to establish how policies and guidelines in these organisations were understood by staff. Our findings highlight a diverse array of responses to falls in care home settings. While 96% of homes claimed to have a specific policy on falls, only 80% of them included an assessment of possible injury or harm to residents and 13% included no direct guidance for care staff in instances where residents fell and were still on the floor.

Even in instances where policies did include direct guidance, there was great variation in available information for staff, especially between domiciliary and care home settings. Most commonly, staff were advised to call an emergency ambulance, even in the absence of injury, if patients were found on the floor.

HCAs are working in contexts where there is apparently a high degree of ambiguity around the assessment of injuries sustained as a consequence of falls, particularly where potentially non-visible injuries occur, which are not immediately recognisable or symptomatic. There was also overlap between accident and falls policies, which added a further level of ambiguity to the most appropriate and immediate actions for HCAs to take.

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Depositing User: Catherine Hayes


Item ID: 7805
Identification Number:
ISSN: 1753-1586
Official URL:

Users with ORCIDS

ORCID for Yitka Graham: ORCID iD
ORCID for Jonathan Ling: ORCID iD
ORCID for Catherine Hayes: ORCID iD

Catalogue record

Date Deposited: 21 Sep 2017 08:52
Last Modified: 20 Jan 2023 10:09


Author: Yitka Graham ORCID iD
Author: Jonathan Ling ORCID iD
Author: Catherine Hayes ORCID iD
Author: Jeanette Scott-Thomas
Author: Marie Brannigan

University Divisions

Faculty of Health Sciences and Wellbeing
Faculty of Health Sciences and Wellbeing > School of Nursing and Health Sciences


Sciences > Nursing

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