Carionex® — Care Simplified
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Falls Risk Assessment Template

Identify and reduce falls risk

An editable falls risk assessment covering environment, mobility, medication and history.

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Preview of Falls Risk Assessment Template
Format:DOCX
Size:44 KB
Pages:6
Version:1.0
Updated:7 October 2026

What's included

  • Person and assessment details
  • Person-centred involvement and consent
  • Immediate safety screening
  • Falls history and circumstances
  • Multifactorial falls risk assessment
  • Environmental and home safety checklist
  • Risk judgement and supporting rationale
  • Intervention and action plan
  • Escalation and referral record
  • Post-fall review
  • Review triggers and reminders
  • Sign-off and review log

Benefits

Record falls risks in a consistent, structured format

Consider individual needs, preferences and home circumstances

Turn identified concerns into clear actions and responsibilities

Document referrals, follow-up and post-fall learning

Keep assessments up to date as needs change

Support clear communication across the care team

The Falls Risk Assessment Template is an editable, six-page Word resource from Carionex for home-care and community care services. It helps teams document factors that may contribute to falls, agree person-centred actions and review whether existing support remains appropriate.

The template covers falls history, mobility and transfers, cognition, dizziness, medication, vision and hearing, continence, footwear, nutrition and hydration, and environmental hazards. It also includes space to record the person’s views, preferences and involvement in the assessment.

Teams can document their overall risk judgement, assign actions and responsibilities, record referrals and review the assessment following a fall or a change in needs. Dedicated sign-off and review sections support ongoing record keeping.

Adapt the template to your service, local procedures and staff competencies. It supports professional judgement and does not replace clinical assessment or guarantee regulatory compliance.

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