Shared learning database

Type and Title of Submission


Care Home Support Team (CHST) - Reducing Falls


CHST provides therapy, activity, support and education to residents and staff within care homes. It is reducing hospital admissions, facilitating discharge and improving the quality of life for residents. Please note that this example was originally submitted to demonstrate implementation of NICE clinical guideline 21 on the assessment and presention of falls in older people (CG21). The guidance has been updated and replaced by CG161. The practice in this example continues to be in line with the updated guidance.


2010-11 Shared Learning examples

Does the submission relate to the general implementation of all NICE guidance?


Does the submission relate to the implementation of a specific piece of NICE guidance?


Full title of NICE guidance:

CG161 - Falls

Category(s) that most closely reflects the nature of the submission:

Is the submission industry-sponsored in any way?


Description of submission


To provide physiotherapy and occupational therapy to individuals that are resident in care homes in the Amber Valley area, thereby reducing the risk of falls and hospital admission. To provide a therapy service to a group of people that previously did not recieve such support. To be accessible to the care home staff enabling and empowering them to make changes within their current practice to improve resident experience.


To provide older people in care the same access to therapy services as those in the community. To help reduce the risk of falls and thereby reducing hospital admission. To provide support and education to staff that work in care homes therefore ensuring they are better able to assess and manage residents that are at risk of falls. To improve quality of life to all who live and work in the care homes.


Previously referrals were very adhoc and dependent on GP's. Also relied on care home staff in maintaining the treatment plan that was put in place and this was not always maintained. Did local sweeping exercise and involved local homes asking what they would like to receive. Bid for and won an Innovation award to run pilot in one local home - reduced falls in the dementia unit by 60%, reduced hospital admissions and improved quality of life.


We provide a dedicated referral line and advice line number to all care homes. We visited care homes and explained that we could help with therapy, follow up from hospital, advice, equipment choice, access to education for staff, support around poly-pharmacy and provision of equipment. We recieved 370+ referrals from June - Dec 2010. We worked a lot with the home staff to win their trust and to show that they were not there to judge or criticise. Costs have been met by current budgets with Intermediate Care Services but we are continually working with commissioners and executive boards so that funding can be agreed to establish the service across Derbyshire County. It has been difficult working with Business Development and commissioners as we are predominantly clinicians and although passionate about the service, we are unsure at times on how to sell or market it so that it becomes established.

Results and evaluation

We have had regular feed back from residents, staff and families on the input from CHST. We have looked at the number of falls within homes and continue to see if they are reducing. Where there are issues with falls within a home we look at it from a multidisciplenary approach. In one home we reduced falls in the residential unit by 50% and on the dementia unit by 25%. By providing theraputic activity into the home the quality of life was improved for all as well. We have generated new work for the Intermediate Care Team and although the cost does not appear to be making a huge amount of savings at the moment we feel that over time these will appear.

Key learning points

Collect everything!!!! Start with a good base line. Engage with the homes and make sure that they are on board with what you are trying to undertake. Find out what is happening elsewhere in the PCT with regard to care home support. Look to have the support of business development and make sure they are up to speed with what you are attempting to undertake.

View the supporting material

Contact Details

Name:Samantha Pessoll
Job Title:Team Leader Care Home Support Team
Organisation:Derbyshire Community Health Services
Address:Babington Hospital
Postcode:DE56 1WH
Phone:01773 525081


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This page was last updated: 07 February 2011

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Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.