Free falls risk assessment template for domiciliary care (2026)

The template, section by section

Each section appears in the Word file with the same guidance. Two design choices run through the whole template. First, it is judgement, not arithmetic: prompts to work through with the person, with no scores to add up, and the template says so plainly on its face. Second, it is domiciliary first: the assessment happens in the person’s own home, often delivered by lone-working carers, so the home environment and the post-fall plan carry as much weight as the health factors. The safeguards you agree here should flow into the person’s care plan, where hard lines belong in the fixed boundaries section of our care plan template and the thinking behind them is covered in the CQC care plan guide.

1. 1

   Falls history: each fall as a story

   For each fall the person remembers (and any falls found by others), record when it happened, where in the home, what the person was doing, any injury, and what changed afterwards: new equipment, new caution, new fear.

   What good looks like The pattern matters more than the count. Three trips on the same night route to the bathroom tell you more than “two falls this year”.

2. 2

   Health factors: prompts for judgement, not scores

   Work through each prompt with the person and record what you observe and what they tell you. Flag anything that needs the right professional rather than diagnosing it yourself. Prompts: mobility and balance (how they move, transfers, whether walking aids are actually used); medication (anything causing dizziness or drowsiness, recent changes; flag for a prescriber or pharmacist review); vision (are glasses worn and current, can they see the night route); continence (urgency, night-time trips); cognition and confusion (do they remember the aid, can they judge hazards); footwear (what they actually wear at home).

   What good looks like Observations and the person's own account, with onward flags. “Says the new tablets make her woozy before lunch; asked GP surgery to review” beats a ticked box.

3. 3

   The home environment

   Walk the routes the person actually takes, with them: bed to bathroom at night, chair to kitchen, front door. The home is theirs; record what they are willing to change, not just what looks wrong to you. Prompts: rugs, clutter and trailing cables on those routes; lighting, especially the night route to the bathroom; stairs and rails; the bathroom (grab rails, mats, access); pets underfoot; equipment condition and whether it is actually used.

   What good looks like Route-by-route notes agreed with the person, not a generic hazard sweep. This is the section that makes a domiciliary assessment different from a care home one.

4. 4

   What the person can and wants to do for themselves

   Record what the person can do, wants to keep doing, and their own view of the risk. Frame risk as how we help them keep doing this safely, not as a list of things to stop.

   What good looks like “A walk to the corner shop with an agreed check-in” rather than “do not allow to leave the property”. Enabling with safeguards, not blanket restrictions.

5. 5

   Agreed safeguards, each with its reason

   List the safeguards agreed with the person and give the reason for every one. Any safeguard that is a hard line for carers belongs in the care plan's fixed boundaries too.

   What good looks like Specific and reasoned. “Bedside lamp left on at night since the December fall” beats “ensure environment is safe”.

6. 6

   If a fall happens: the post-fall plan

   Record the agency's agreed plan so a lone-working carer does not have to improvise: how they summon help, who is called and in what order, how the fall is recorded and reported, and who supports the carer afterwards.

   What good looks like Names and numbers, not roles alone. On a lone-working visit the plan is only as good as what one carer can do from the hallway.

7. 7

   Review date and triggers

   Set the planned review date and list the events that trigger an earlier reassessment: a fall, a hospital stay, a medication change, or a change in how the person is coping.

   What good looks like A visible review rhythm. An assessment that has not moved since the last fall is evidence of a process that is not working.

Falls risk also shows up in our CQC Readiness Self-Check: current, enabling risk assessments and trigger-based reviews are two of the questions agencies most often answer Partly.

How VircareOS helps here

A falls assessment can live in a Word file; this one is built to. What the document cannot do is stay connected to the daily record. In VircareOS, risk assessments live alongside the care plan and the visit notes, so the safeguards agreed here are in front of the carer on the visit, a fall in the notes is a visible trigger for reassessment, and the record CQC triangulates stays in one place. If you are filling this in for the first time, that is the workflow it was designed to grow into.