Abstract Background Falls are a leading cause of morbidity among older people living in care homes. The Action Falls programme consists of training and support for staff using a multicomponent falls risk assessment and guide to mitigating actions. The Action Falls programme has been shown to reduce falls in care homes by 43% in clinical trial. This study aimed to assess the feasibility and acceptability for wider implementation of Action Falls in care homes. Methods A mixed-methods implementation study was conducted across 57 care homes in four English regions. Care home staff were trained and supported to use the Action Falls programme for 12 months. Normalisation MeAsure Development questionnaire (NoMAD) surveys based on Normalisation Process Theory (NPT) were used to indicate how ready and engaged care homes were to use the new intervention. Qualitative data were also collected through observation fieldnotes and action plans resulting from quality improvement events held in each study region. Results 60% of care home staff received Action Falls training. Staff who attended training indicated stronger engagement and confidence in using the intervention. Key facilitators included strong leadership from care home managers and a perceived alignment with person-centred care. Barriers included staff shortages, competing priorities, and challenges integrating the Action Falls checklist into digital care systems. Observations highlighted the value of ongoing support from trained Falls Leads. The average cost of training delivery per home was £331.60 (excluding backfill costs). Conclusions The Action Falls programme is feasible, acceptable, and has potential for wider implementation across diverse care home settings. However, successful spread at scale is dependent on digital integration, and policy alignment. Future research should investigate potential new mechanisms for inhouse, care home training delivery and how to ensure sustainability through changing demands and focus.
Allen et al. (Sun,) studied this question.