Falls and Concerns Record

Who this is for

A dated record of falls, near misses and anything that worried you. Each line records when and where it happened, what happened in plain words, any injury you noticed, who was told, what was done and whether the follow-up has been closed — and the sheet counts the events and the follow-ups still open.

Family carers, agency carers and personal assistants who have been asked to keep a record, households where one fall has become several, and anyone who needs to show a nurse, doctor or care manager a clear list of what happened and when.

What this helps you track

• Every fall, near miss or concern with the date, time and place
• What happened, written as it was seen and not as it was explained
• Any injury noticed, in your own words, and who was told
• What was done at the time and whether the follow-up was completed
• How many events there have been and how many follow-ups are still open

How to use it

1. Write the person's name, the setting and who the care plan says to report to at the top.
2. Add a line as soon as you can after the event: date, time, where and what happened.
3. Note any injury you saw in plain words, then who you told and when.
4. Record what was done at the time in the action column, and tick the follow-up once whatever was agreed has actually been done.
5. The browser and spreadsheet versions count the events and the open follow-ups; on paper, count them at the foot.
6. Take the sheet to the next review or appointment rather than describing the events from memory.

Formats

• Printable PDF (A4 and US Letter)
• Fillable PDF with form fields
• Fill in online, saved in your browser
• Excel / Google Sheets workbook

The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The workbook uses plain formulas only — SUM, IF, COUNTIF and the like — so it opens in Excel, LibreOffice and Google Sheets without anything breaking, and every calculated cell is grey so you can see which figures it worked out.

How to print

Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.

Questions

Does the sheet say what to do after a fall?

No. It records what happened and who was told; it does not assess anything and gives no guidance. Report every event to whoever the care plan names and let them decide what happens next.

What counts as a concern?

Anything you would want the next person to know about: a near miss, a change you noticed, something that felt wrong. Writing it down costs a line; leaving it out costs the pattern.

Why record the place?

Because a run of events in the same place — the bathroom, the back step, beside the bed — is exactly the kind of thing somebody reviewing the care will want to know, and it is invisible unless each line says where.

What is the open follow-ups figure?

The number of events without a tick in the follow-up column. It is arithmetic on the ticks, nothing more, and it is there so that nothing agreed at the time is quietly forgotten.