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13th November 2016

Falls from Height – Identifying Risks in Care Homes

Falls from Height – Identifying Risks in Care Homes

Falls from height are generally associated with working on constructions sites or off scaffolding where a refurbishment project is underway. However, falls from height can occur in care settings too.

A serious incident occurred when an elderly resident with severe dementia wandered through a first floor fire escape door and fell from the fire escape staircase. This fall resulted in a fatality. According to the investigation, the deceased fell down the concrete stairs and fractured his skull, suffering a bleed on the brain which led to his dead. The deceased, who had undergone hip and knee replacements, was often confused, anxious and unsteady. He was known to wander around the home and had previously pushed open fire exit doors to get out. He was not wearing his glasses, reached out for a handrail, when he didn’t find one he fell.

Sentencing Guidelines for Health and Safety Offences

Fines have increased since the Sentencing Guidelines was launched in early 2016. The Health and Safety Offences, Corporate Manslaughter and Food Safety and Hygiene Offences Definitive Guideline were effective from 1 February 2016. The guidance applies to all organisations and offenders aged 18 and older, who are sentenced on or after 1 February 2016.This is regardless of the date of the offence. The guidelines cover health and safety as well as food safety offences, covering both organisations and individuals.

Both the manager of the care home and the  home itself were fined. The manager was sentenced to nine months in prison suspended for two years, and ordered to pay costs of £20,000. The care home business was fined £1.5 million and ordered to pay costs of £200,000. The fine was high for the care home and it has been noted since the sentencing guidelines that fines are increasing within all sectors.

Falls from Height

A fall from height inspection could help a care home identify their risk to staff and residents. The focus of the inspection should be on falls from height only. Other hazards can be identified during a general inspection. Some of the areas that could be identified as a hazard are:

Falling down a couple of steps or stairs. - A hand rail should be present.

Missing a step where there is a change in level. - This has been seen in many buildings where audits are conducted where there are two or three steps leading from one area to another and yet there is no handrail.

The continuation of carpet over two rooms where there is a change in level. - This can be difficult to see particularly for residents with poor eyesight. The change in level needs to be highlighted. It is advisable to place two different floor coverings where there is a change. Different carpet colours will help highlight the change.

Areas where work is being undertaken and where there is a potential to fall into a void below ground level. - Ensure safe systems of work are in place and correct methods of barrier off work areas.

Falls from windows where window restrictors may not be fitted. - Windows need restrictors to help ensure residents or staff do not fall from height when they lean out of a window.

Falling off chairs, beds and slings. - These areas will need to be part of the risk assessment completed on each resident. Ensure risk assessments remain ‘live’ and are reviewed as required.

Include the outside areas in the inspection. - The garden may have areas have potential risk of falls from height.



*All information is correct at the time of publishing. Use of this material is subject to your acceptance of our terms and conditions.

Sally Beck

QCS Expert Health and Safety Contributor

Sally is a multi skilled Chartered Health and Safety Practitioner with extensive experience of health, safety, quality and environmental consulting within the different industry sectors. She is also a Registered Nurse with previous nursing experience in both the private sector and the National Health Services. With extensive experience of CQC standards she has provided support and advice in implementing and managing health and safety.

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