After a fall: recovering a person from the floor safely

In one line: a person on the floor is a clinical situation first and a handling task second — and the handling task is never a manual lift.

Before anyone moves anything

Check for injury, pain, bleeding, loss of consciousness and whether the person can move each limb. If there is any suspicion of a fracture, a head injury or a medical cause, the person stays where they are, made warm and comfortable, and emergency services are called. The moving and handling plan should state this in the first line of the falls section.

If the person is uninjured

• Can they get up themselves, with instruction? Many people can, when talked through it in stages — onto the side, onto hands and knees, up to kneeling at a stable chair, one foot forward, up and turn to sit. This is a taught skill and a rehabilitation goal, not an emergency improvisation. We teach it where the person has the ability.
• If not, use equipment. An inflatable lifting cushion or chair, or a mobile or overhead hoist with a suitable sling, brings the person up without any carer taking their weight. For plus-size people this equipment must be available in the setting and its safe working load confirmed in advance.

What is not acceptable

Lifting a person under the arms, “drag lifting”, or two carers hauling by the trousers and belt. These are the techniques most strongly associated with injury to both people, and they are still seen because nobody planned an alternative.

The falling person

A carer cannot safely catch a falling adult. What they can do is step clear, guide the direction of the fall away from hazards where possible, and protect the head. Training that pretends otherwise creates injured carers.

After the fall

A fall is a review trigger. The plan comes back for reassessment: what changed — strength, balance, cognition, footwear, environment, medication? Was the person trying to do something the care package no longer allowed time for? A fall is very often the first visible sign that a person’s function has changed in either direction, and it should prompt a rehabilitation question as well as a safety one.

What a provider should be able to show

A falls procedure that names the recovery equipment on site, staff trained in it, a record of each fall with the actions taken, and evidence that the person’s handling plan was reviewed afterwards. This is exactly what an inspector will ask for.