Falls screening and assessment tools used in acute mental health settings : An analysis of polices in England and Wales

Background: There is an urgent need to improve the care of older people at risk of or who experience falls in mental health settings. Falls are the most frequently reported patient safety incident. NICE Guidelines recommends the use of multidisciplinary fall risk assessment during individualised treatment and in prevention care plans for older people at risk of falls (NICE, 2004). This poster outlines work underway to explore the policy guidance issued by NHS Mental Health Trusts in England and Health Boards in Wales. Methods: We requested fall policies and other relevant documentation from NHS mental health trusts in England (56) and healthcare boards in Wales (6). Policies are being subjected to a quantitative content analysis to explore guidance given to clinical staff and managers. Findings: We obtained falls policies from 42 mental health trusts in England, and 2 from healthcare boards in Wales. 30 policies were publically available on the internet. 1 Trust told us they did not have a fall-prevention strategy. 1 was currently reviewing their policy. Analysis of fall risk assessment tools show variation in the number of risk-variables included. Few Trusts used validated tools such as STRATIFY, FRASE, MORSE, and MHOA, others used customised falls risk assessment tools. Conclusions •A wide variety of screening and assessment tools are in use, however, the most commonly used are those developed by individual Trusts, or which focus solely on the external environment, with no screening/assessment of individual patients. •Use of invalidated tools raises questions of reliability and effectiveness.