Introduction
Falls remain one of the main reasons older people are admitted to hospital. Those living in care homes face a higher risk than people living at home. In 2024, several Cornwall care homes piloted sensor based falls prevention (SBFP) technologies. The aim was to see whether digital tools could help staff:
anticipate risks
respond more quickly
and better understand the circumstances around a fall.
This work sits within a wider national push to digitise health and social care and to expand technology enabled care. The evaluation summarised here was undertaken by HDRC Cornwall. It looks at what was tried, what changed, and what it means for residents, families, and providers.
What was tried and where
Nine care homes initially joined the pilot and seven completed implementation during 2024. Each participating home chose one of four approved technologies to trial. Although the products differed, the goal was consistent. This was to:
spot risk behaviours earlier
alert staff discreetly
and build a clearer picture of residents’ movement and routines around the time of a fall.
Some tools were ceiling mounted systems. These use optical sensors and artificial intelligence to detect falls and track movement. Others relied on acoustic and motion sensing or combined room sensors and wearables. The pilot reflected the real world diversity of technologies now available to care settings.
How the evaluation worked
To understand change over time, the evaluation combined both numbers and narratives. Ambulance call out records from April 2021 to December 2024 provided a long view of falls related activity in 183 Cornwall care homes. This enabled comparisons between the seven pilot homes and the rest of the county. Alongside this, interviews and email feedback captured staff experiences. They were asked about installation, training, day to day use and technical support. The evaluation began after the technologies were already being used. Typically one staff member per site shared their views. As a result the qualitative evidence is informative but not comprehensive. Nonetheless, taken together the datasets offer a balanced picture of what improved, what did not, and why.
What the numbers show
Across Cornwall as a whole, falls and falls related ambulance call outs were already trending down before the pilot. That downward trend continued through 2024. The pilot homes followed this broader pattern. This means we cannot confidently attribute the observed reductions to the technology alone. The safest conclusion is that any direct effect from SBFP systems was at best modest across the group. Even so, the report highlights promising signals in several sites using the same ceiling mounted system. Individual homes recorded very low incident numbers while live. Three homes had a single fall each and one reported none during their trial period. Hospital admissions after a fall showed a slight improvement from July 2024, when all pilot homes were live. But the number of these events was small. More time and data are needed to confirm whether this represents a genuine effect rather than normal month to month variation.
Understanding ambulance patterns
A key piece of context is the system wide shift in Cornwall toward the NHS “Hear & Treat” approach. This is where suitable incidents are resolved by telephone rather than by dispatching an ambulance. This change has been gathering pace since early 2023 and reduces ambulance attendance even when incidents are logged. The pilot homes reflect this wider change, which helps explain the observed decline in ambulance call outs during the trial. In other words, the reduced number of ambulances at care homes appears mainly to be due to county wide practice. The result cannot be solely put down to the installation of SBFP technologies.
What staff experienced
Staff experiences differed markedly between sites and products. Where:
training was structured and timed to coincide with rollout
and providers remained responsive during setup and troubleshooting
confidence was higher and the technology became part of the daily routine. In these settings, staff described timelier, more informative alert. This was particularly the case with the ceiling-mounted system. They had a better understanding of residents’ night time habits. And this was more dignified, discreet monitoring compared with repeated physical checks. Some homes also described using the technology to understand the “why” behind incidents. This enabled practical changes to rooms and routines that may reduce risk. By contrast, other homes struggled with systems triggered by environmental noise. For example, televisions or radios. Some were difficult to place in older buildings with creaky floors. Others suffered from gaps in user access and device management. False alerts and missed detections eroded trust. And without good integration into workflow, the technology could add tasks rather than reduce them. These experiences underline that the success of digital care tools depends as much on human factors such as
training
support
and the environment,
as on the technology itself.
What it means for residents and families
When
reliable
well supported,
and thoughtfully embedded in care,
SBFP technologies can help residents live more safely and independently. They are not a replacement for staff. The most positive accounts came from homes that used technology to augment attentive care. They used insights from alerts and recordings to adapt care plans and spot patterns. And they could reassure residents in real time without intrusive alarms in the room. For families, this can translate into greater peace of mind. Care homes need to be clear about what the technology does and does not do, and how residents’ privacy is protected.
Limits and cautions
Several limitations mean the findings should be interpreted with care. The evaluation covered a small number of homes trialling four different technologies. This makes direct comparison difficult. Falls are relatively infrequent events in many individual homes. So a change from two incidents to one may look large as a percentage but does not provide firm statistical evidence. The evaluation also began after rollout. This limited the opportunity to design consistent data collection from the start. Only a single staff member per site typically contributed feedback. Technology providers were not interviewed. So some perspectives are missing. These factors together make it hard to draw strong cause and effect conclusions at this stage.
Recommendations and what happens next
The evidence to date suggests promise. This is particularly for the ceiling mounted approach in the homes where implementation and support were strong. But sustainable benefits depend on getting the basics right. The report recommends extending data collection to confirm whether the tentative improvements persist. Future trials should be focussed on one or two well supported technologies to allow cleaner comparisons. Pre installation checks should be mandatory. These can identify issues like connectivity constraints, building characteristics and sources of interference. Training should be standardised, with refreshers accessible to all shifts. Homes should adopt clear processes for user access and device management. Finally, there should be closer coordination between the Council, providers and homes. This should cover funding flows, installation logistics and ongoing support. This will help embed the technology. And it will ensure future evaluations can track not only falls but also outcomes important to residents.