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CQC2026-06-10

CQC Responsive key question and the built environment: how falls prevention design affects your rating

CQC Responsive key question includes assessment of whether the environment supports residents to live as they wish. Inspectors consider lighting levels, flooring consistency, wayfinding design and the absence of trip hazards as environmental factors in falls prevention and expect these to be risk-assessed and documented.

Why this matters

Falls-related incidents are the most common serious injury event in care homes. CQC treats a high falls rate without documented environmental risk assessment as evidence of poor responsiveness. The built environment is your most durable falls prevention tool and the evidence of what you have done is as important as the work itself.

What to do
  • 1Commission or carry out a formal environmental falls risk assessment, covering lighting levels, flooring transitions, handrail provision and contrast on stairs and ramps.
  • 2Document improvements made as a result of the assessment we identified X and we fixed it by Y is the evidence pattern CQC looks for under Responsive.
  • 3Ensure your falls log links individual falls to environmental factors where relevant this demonstrates that the environment is actively managed.
  • 4Brief your registered manager on how to discuss the environmental falls prevention programme with an inspector.
Primary source
NICE Falls in Older People: Assessing Risk and Prevention (CG161)
View source
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