Falls Prevention Training for Care Staff in England

Falls prevention training for care staff should teach people to spot the reasons a person may fall, act on them promptly, help residents stay active, and know what to do if a fall happens. No English law names a specific falls course or sets a refresher interval. The legal duty to train comes from the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and the clinical content comes from NICE guideline NG249, published in April 2025. This post covers England and CQC-regulated care.

What the law requires

Regulation 18 says people employed to provide a regulated activity must "receive such appropriate support, training, professional development, supervision and appraisal" as is necessary to carry out their duties. Regulation 12 requires care to be provided safely, which includes assessing the risks to people's health and safety, doing all that is reasonably practicable to mitigate them, and ensuring that the people providing care have the qualifications, competence, skills and experience to do so safely.

Falls are not named in either regulation, but they are a clear risk to assess and train for in services that support older or frail people. Our guide to statutory versus mandatory training for UK care workers explains how providers decide which courses to make compulsory.

The current NICE guideline: NG249

NICE published NG249, Falls: assessment and prevention in older people and in people 50 and over at higher risk, in April 2025. It updates and replaces the 2013 guideline CG161. It covers adults aged 65 and over, and people aged 50 to 64 with a condition or conditions that may put them at risk of falls. NICE lists care home staff among its intended users. In May 2025 NICE made a minor change to recommendation 1.2.1, clarifying that people in a hospital inpatient or residential care setting do not need to meet any other criteria to be offered a comprehensive falls assessment.

If your training material still refers to CG161 or to falls risk tools, it is worth updating. Recommendation 1.1.1 of NG249 says: "Do not use falls risk prediction tools to predict a person's risk of falling."

What NICE says for residential care

Several recommendations are written for people living in residential care, and they shape what staff need to understand:

• Comprehensive falls assessment (1.2.1): offered to people in residential care settings, with no other criteria needed.
• Risk factors to assess (1.2.2): where appropriate, these include medication review, gait, balance, mobility and muscle strength, cognition and mood, delirium, visual impairment, hearing impairment, footwear and foot condition, urinary continence, diet, fluid intake and weight loss, dizziness and lying and standing blood pressure, and long-term conditions such as dementia, diabetes or Parkinson's.
• Act on what you find (1.2.3): risk factors identified should be promptly addressed.
• Tailored interventions: interventions should reflect the person's own risk factors.
• Medicines: a structured medication review, and a review of psychotropic medicines with a discussion of the increased risk of falls.
• Vitamin D: NICE found insufficient evidence for vitamin D supplements to prevent falls in this setting, and points people to NHS advice on bone and muscle health.
• Activity (1.3.24 and 1.3.25): reassure people they should not avoid moving around, build in regular opportunities to stand and walk, and for people able to exercise consider a programme addressing balance, coordination, strength and power.
• Information (1.5.1 and 1.5.3): discuss what to do if they have a fall, including how to get up, and when and how to seek help.

The guideline does not set a specific training requirement for residential care staff. It does say, in the community section, that falls prevention exercise programmes should be delivered by appropriately trained professionals, and its definition of a comprehensive falls assessment describes it as carried out by a trained single professional or a multidisciplinary team. So, for care assistants, the practical training goal is to understand the risk factors, notice change, report it and support the plan, rather than to carry out clinical assessments.

What care staff training should cover

Turning NG249 and NHS advice into a course outline gives a sensible core:

Why people fall

Use the NICE risk factor list as the framework. Staff should link what they see (new confusion, dizziness on standing, poorly fitting slippers, a new medicine, urgency to get to the toilet) with a factor that should be reported and reviewed.

Everyday prevention

The NHS advises strength and balance activities at least twice a week, well-fitting shoes or slippers with good grip, regular eye tests and hearing checks, asking a GP or pharmacist whether medicines could affect balance, and keeping clutter and trip hazards out of the way. It also recommends eating well and drinking enough to avoid feeling lightheaded or faint. Those points translate directly into care plans and daily routines.

Keeping people moving

NICE is clear that reassuring people they can still get up and move is part of prevention. Training should help staff balance safety with independence, rather than defaulting to restricting movement.

After a fall

NHS advice for the public is to check for pain or injury before moving, to call 999 if someone may have injured their head, back, neck or hip or cannot get up, and, where someone cannot get up, to help them change position about every 30 minutes to help prevent pressure sores. In a care setting, your post-fall procedure, clinical advice and escalation route should come from your own policy, written with your clinical lead or GP. NG249's recommendations for residential care do not contain a step-by-step post-fall protocol, so do not assume the guideline will tell staff what to do in the moment.

Quick reference

Frequently asked questions

Is falls prevention training mandatory in care homes?

There is no named mandatory falls course. Regulation 18 requires appropriate training for the duties staff perform, and falls are a foreseeable risk, so providers need to be able to show how they have covered it.

How often should falls training be refreshed?

Neither the regulations nor NG249 set an interval. Providers set their own, usually informed by a training needs analysis; our guide to renewing health and safety training explains how to think about refresher cycles.

Should we use a falls risk score?

NICE says not to use falls risk prediction tools to predict a person's risk of falling. It recommends a comprehensive assessment of individual risk factors instead.

Does NG249 apply to people under 65?

It covers people aged 50 to 64 who have a condition or conditions that may put them at risk of falls, as well as those aged 65 and over.

Where should training records go?

Record who completed what, and when, in a training matrix so you can show it to an inspector. See our training matrix template.

Where to go next

Start by checking that your falls policy and training refer to NG249 rather than the old guideline, that the NICE risk factors are reflected in your care plans, and that staff know who to call after a fall. You can browse the wider Learnsignal CPD hub for professional development options.

This article is general information, not regulatory, legal or clinical advice. Check the current NICE and CQC guidance and follow your own service's policies and clinical advice.