Falls Prevention at Home: A Room-by-Room Checklist

In short: Falls prevention means clearing hazards room by room, checking footwear, eyesight and medicines, and doing strength and balance exercises at least twice a week (NHS, as at November 2026). After a fall, call 999 if a head, back, neck or hip injury is possible or the person cannot get up, and 111 if they are hurt or unwell.

Falls prevention at home: where to start

Falls prevention starts with three things: tidy the home so there is nothing to trip on, check the person’s health (eyes, medicines, balance), and keep them active. The NHS lists muscle weakness, low blood pressure, medicine side effects, eyesight or hearing problems and dementia among the common causes of falls in older age (NHS, as at November 2026).

NICE guideline NG249, reviewed in April 2025, covers people aged 65 and over, and people aged 50 to 64 with a condition that raises their risk. It is written for families, carers and care staff as well as clinicians, and covers spotting risk, a full falls assessment and interventions to reduce risk. Preventing falls in older people is rarely one fix. It is usually a mix of home changes, health checks and exercise.

A sensible order is to work through the room-by-room checklist below, book a sight test and a medicines review, and ask the GP about a local falls service. If the person has already fallen, say so when you ask.

Room-by-room falls prevention checklist

The simplest way to carry out falls prevention at home is to walk each room with the person and check the points below. These points draw on RoSPA and NHS advice (as at November 2026).

Front door, hall and living room

• Paths, steps and patios are even, and any steps have a handrail.
• Door mats and rugs are fixed down or removed, and carpets are in good condition and not heavily patterned.
• Shoes, bags and books are off the floor, and lamp and charger cables run along the edge of the room.
• Walking routes are clear of furniture.

Stairs and landing

• Steps are free of papers, clothes and anything stored for later.
• Handrails are secure on both sides where possible.
• Lighting is bright, with switches at the top and bottom.

Bathroom

• A non-slip mat sits in the bath or shower, as the NHS advises.
• The NHS suggests considering grab rails in the bathroom. See the section on grab rails below before anything is fitted.

Bedroom

• The floor around the bed is clear.
• A lamp is within reach of the bed, and night lights or sensor lights light the route to the toilet.
• Slippers are in good condition and fit well.

Kitchen

• Floors are slip resistant and spills are wiped up straight away.
• Everyday items are within easy reach, so nobody has to stretch or climb. If a step is needed, it should be a sturdy one with a handle.

Garden

• Paths and patios are even, free of moss, leaves and pots, and well lit after dark.
• The NHS advises older people to avoid difficult tasks such as heavy lifting or reaching, so ask someone else to do the high pruning or the ladder work.

For night-time risks, such as getting up to use the toilet, see our guide to night-time care for elderly people.

Footwear, vision and medicines review

Three health checks belong in any falls prevention plan.

Footwear

The NHS says to wear shoes or slippers that fit well, do not slip off and have a good grip. Age UK adds that open-backed slippers and loose trousers that trail on the floor are best avoided (Age UK, as at November 2026).

Vision and hearing

Have eyes and hearing checked regularly, because ear problems can affect balance. Age UK says people aged over 60, or on certain benefits, can get a free NHS eye test at least every two years, and that a home eye test may be possible if getting to an optician is hard. Check eligibility on NHS.uk or with the optician.

Medicines

Ask the GP or pharmacist whether any medicine could be affecting balance. The RoSPA checklist suggests regular reviews, especially for anyone taking four or more medicines. Never stop a medicine without checking with the GP first. If tablets are being missed or doubled, our guide to medication support at home explains the options.

The NHS also advises eating and drinking enough, because too little can cause faintness, and keeping alcohol low.

Strength and balance exercises for falls prevention

The NHS recommends strength and balance activities on at least two days a week for older adults, and says they help if you have fallen or are worried about falling (NHS, as at November 2026).

The NHS balance routine for older people includes:

• Sideways walking: 10 steps each way.
• Heel-to-toe walking: at least 5 steps.
• One-leg stand with fingertips on a wall: hold for 5 to 10 seconds, three times each side.
• Step-ups using a step beside a wall or rail: up to 5 on each leg, done slowly.

Do them next to a wall or a stable chair in case balance is lost, build up gradually, and speak to a GP first if the person has not exercised for some time or has medical conditions. RoSPA suggests heel raises and practising standing up from a chair. Age UK mentions Tai Chi and says a GP can point to local strength and balance classes.

Exercise is a core part of falls prevention only when it becomes routine, so tie it to something daily.

What to do after a fall, and when to call 999 or 111

Call 999 if the person may have injured their head, back, neck or hip, or cannot get up. That is the NHS advice, and nidirect gives the same for Northern Ireland. Do not try to lift them yourself, and keep them warm until help arrives.

Call 111, or use NHS 111 online, if someone has fallen and may be in pain, injured or unwell but is not in an emergency. See the GP after any fall, or if you are worried about balance.

Getting up safely

Stay calm and check for pain first. If there are no signs of injury, the NHS and Age UK describe the same method:

1. Roll onto your side, then push up onto your hands and knees.
2. Crawl to something sturdy, such as a chair, bath or sink. Avoid furniture that could tip.
3. Put one foot flat, then rise slowly, holding on.
4. Sit down and rest. If you feel faint, wait before trying again.

If they cannot get up

Use an alarm or phone if within reach. Otherwise shout or bang on a wall or floor. Cover up with a coat, towel or blanket, move arms and legs gently, and change position about every 30 minutes to reduce the risk of pressure sores. Our guide to bed sores and pressure ulcers explains why a long time on the floor matters.

After any fall, ask the GP about a falls assessment. The NHS says this may include a balance check, a medicines review, an eyesight check and a home safety assessment, and some areas allow self-referral to falls services. Ask the surgery or the local integrated care board.

Pendant alarms, fall detectors and telecare

A pendant alarm lets someone call for help at the press of a button without reaching a phone, and the NHS recommends wearing a personal alarm or carrying a mobile phone. Age UK explains that some alarms add automatic fall detection, which can alert a monitoring centre when a hard fall is detected even if the person cannot press the button.

Age UK’s disability equipment factsheet (March 2026) describes community alarms as a link to a central service offering help in an emergency at any hour, and telecare as remote monitoring that includes items such as fall detectors. Availability and charges vary by council, so ask the council’s adult social care team what it offers, what it costs and whether an assessment is needed first.

Independent Age notes that telecare sensors can alert a carer or call centre if someone gets up from a bed or chair and does not return within a set time. This suits people at risk at night, and is a useful layer of falls prevention.

Two practical checks. First, the alarm must be worn all the time, including in the bathroom and at night, to be of use. Second, Age UK warns that changes to landline telephones may affect telecare and personal alarms, with the switch intended to be completed by January 2027. Ask the alarm provider whether the model will work on a digital line.

Occupational therapy assessments and grab rails

You can ask the council for a free assessment, and an occupational therapist (OT) may visit the home to see where the person struggles (NHS, as at November 2026). The visit usually lasts at least an hour, and a relative can attend. Our guide to preparing for a care needs assessment shows what to have ready, and the Care Act 2014 explains the rights behind it.

Waiting times can be long. Age UK says there is no time limit for providing equipment, but high-risk needs should be assessed promptly, so make it clear that falls have happened or are likely. Any falls prevention plan should be reviewed after each fall.

Grab rails: get advice before fitting

The NHS suggests considering grab rails in the bathroom and safety rails on steps, but position, height and fixing matter. Age UK advises seeking independent or professional advice when choosing equipment, and notes walls may need checking for correct fixing. Ask an OT or the council before buying, because a badly placed or weakly fixed rail can cause a fall.

Councils in England should pay for minor adaptations costing less than £1,000, which often include grab rails (NHS and Age UK, as at November 2026). For bigger work, such as a wet room, a means-tested Disabled Facilities Grant may be available. Age UK gives the maximum mandatory grant in England as £30,000, with the council deciding within six months of a complete application.

If the person is moving to a hospital bed or using mobility equipment, see our pages on hospital beds at home and mobility aids.

Dementia and falls, and differences across the UK

Dementia is a recognised cause of falls, and Alzheimer’s Society explains why: people can misread what they see, so falls prevention through home design matters more (Alzheimer’s Society, as at November 2026).

• Lighting: dark areas and shadows can be confusing, so use the brightest suitable bulbs, touch or sensor lights, and keep a torch by the bed.
• Floors: shiny surfaces can look wet, and dark rugs can look like holes. Plain, matt flooring is preferred, and loose rugs should go.
• Patterns: stripes and busy designs can look uneven, so keep surfaces plain.
• Stairs: make step edges stand out with contrasting tape or paint, and fit rails in a colour that contrasts with the wall.
• Furniture: chairs with arms are easier to stand from than low or backless seats.

A person with dementia may not remember to press an alarm, so a fall detector or sensor may be better than a button alone. For wider advice see dementia care at home.

The details above are written for England. In Scotland, Wales and Northern Ireland, council, health board and equipment services are organised differently and grant rules differ, so check with the local council or health body. The 999 advice after a fall is the same in Northern Ireland, according to nidirect.

Frequently asked questions

What is the best way to start falls prevention at home?

Walk through each room and remove trip hazards, improve lighting and check footwear. Then book a sight test and a medicines review, and ask the GP about a falls service. The NHS also advises staying active, with strength and balance activity at least twice a week.

When should I call 999 after a fall?

The NHS says to call 999 if someone has fallen and may have injured their head, back, neck or hip, or cannot get up. Do not try to lift them yourself. Keep them warm and comfortable until help arrives.

When should I call 111 after a fall?

Call 111, or use NHS 111 online, if someone has fallen and may be in pain, injured or unwell but is not in an emergency. It is also sensible to see the GP after any fall, or if you are worried about balance.

How do you get up safely after a fall?

If there are no signs of injury, roll onto your side, push up onto hands and knees, and crawl to something sturdy. Put one foot flat and rise slowly while holding on. Sit down and rest. If you cannot get up, use an alarm or call out.

Do pendant alarms detect falls?

Some do. A basic pendant needs the person to press the button, while some alarms include automatic fall detection that can alert a monitoring centre after a hard fall. Ask the supplier or council what each model does and whether it works on digital phone lines.

Can the council help with grab rails and alarms?

Yes, you can ask the council for an assessment. In England, councils should pay for minor adaptations costing under £1,000, which often include grab rails. Community alarm and telecare availability and charges vary by council, so ask what is offered locally.

Should I fit grab rails myself?

Get advice first. The NHS suggests considering grab rails, but Age UK advises seeking independent or professional advice on equipment and notes walls may need checking for correct fixing. An occupational therapist or the council can advise on position and type.

Official sources

• NHS: Falls
• NHS: Balance exercises for older people
• NHS: Physical activity guidelines for older adults
• NHS: Home adaptations
• NICE: Falls, assessment and prevention in older people (NG249)
• Age UK: What to do after you fall
• Age UK: Factsheet 42, Disability equipment and home adaptations (March 2026)
• Independent Age: Staying steady on your feet
• RoSPA: Falls at home checklist
• Alzheimer’s Society: Keeping safe, reducing the risk of a fall at home
• nidirect: Falls

This page is general information, not legal, medical or financial advice. The Care Panel is an independent guide and is not part of any government body or care provider. Last checked 9 November 2026.

Related: Night-time care for elderly people · Dementia care at home · How to arrange home care

More guides: Walking aids guide · Rollator or walking frame

Related guides: What to do after a fall · Pendant alarms and fall detectors · Night lights and safe bedrooms · Fall risk factors · Bathroom aids

Reviewed by The Care Panel team on 9 November 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.