The impact of falls risk management on compliance with essential standards

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

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. 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. 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. 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. Compliance: Judgement in inspections April to December 2012. % meeting the standards

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. 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. 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