The PainChek Blueprint: Reducing Falls and Strengthening Care Home Resilience

This is the first article in a series that explores how care providers are building PainChek into general practice to deliver significant outcomes. Drawing on provider interviews and process reviews, it highlights the common routines behind these outcomes and why PainChek’s design makes them difficult to replicate through other pain assessment approaches, even when fully digitised.

Falls remain one of the most significant challenges facing residential and nursing homes. They can lead to injury, loss of confidence, hospital admission and increased pressure on care teams. While falls prevention is often discussed in terms of mobility, medication, hydration and the environment, one factor is sometimes harder to identify: pain.

For residents living with dementia or communication difficulties, pain is not always expressed in words. It may show up as reduced mobility, reluctance to move, changes in posture, agitation or disturbed sleep, all of which can increase falls risk if the underlying pain is missed. This is why consistent, structured pain assessment is so important: it helps care teams recognise pain earlier, respond more proactively and reduce avoidable deterioration.

PainChek’s consistency comes from being a clinically validated, regulatory-cleared medical device, not just a digital checklist.

Like a blood pressure monitor or thermometer, it gives care teams an objective way to detect, score and monitor pain. This governance builds trust, protects people who cannot always explain their pain, and gives carers more accurate insight to engage nurses, GPs and wider clinical teams with confidence.

Why pain matters in falls prevention?

Pain is not just a symptom, it actively increases the risk of falls. When someone is in pain, they move differently by the means of walking slower, shifting weight, or avoiding certain movements. These adjustments disrupt balance and stability, making everyday actions less safe. Over time, reduced movement also weakens muscles, further increasing vulnerability.

Crucially, pain is often hidden and overlooked. Yet people experiencing pain are far more likely to fall, and pain can also reduce confidence, leading to fear of movement and inactivity. In simple terms, if pain isn’t identified and managed, one of the most preventable and impactful drivers of falls remain unaddressed.

Practical Blueprint: Using PainChek to monitor Pain post-movement

By completing PainChek assessments at appropriate points across the day, including during or after movement, care teams can build a clearer picture of when pain occurs and how it may be influencing mobility. This supports more targeted care planning, better communication between carers and nurses, and earlier review where pain at movement may be contributing to falls risk.

A key differentiator of PainChek is its ability to assess pain post-movement, seamlessly embedded within the assessment workflow, where indicators of discomfort are often most pronounced.

As a medical device in the pocket, it can be used at the point of care by any trained caregiver and built into everyday workflows that involve moving a resident, such as sit-to-stand transfers, walking to the bathroom, repositioning in bed, hoisting or personal care. This helps teams capture pain in the moments that matter, rather than relying only on resting assessments or verbal reports.

Practical Blueprint: Using PainChek to support residents with lower body osteoarthritis

Residents with lower body osteoarthritis are at greater risk of falling because joint pain in the hips, knees, and ankles directly affects how they stand and walk. Stiffness, reduced range of movement, and compensatory walking patterns all disrupt balance and stability, making even simple movements like turning or stepping unsafe. Muscle weakness around painful joints further reduces control.

Managing pain effectively in this cohort is critical because it restores safer movement and confidence. When pain is reduced, residents are more able to move normally, maintain strength, and stay active, all key factors in preventing falls. Without addressing pain, falls prevention strategies are only tackling part of the problem.

In a focused study of residents with lower body arthritis experiencing frequent falls, pain was assessed four times daily using PainChek. Within six months, this cohort saw a 45% reduction in falls and a 47% reduction in hospital admission following a fall.

PainChek achieves this by providing a consistent, reliable pain assessments by replacing subjective variation with a structured process any trained caregiver can follow.

Completed at the point of care in under two minutes, it makes frequent assessments, practical within busy workflows. Evaluation by Edinburgh Napier University also supports its ease of use in care settings.

Crucially, PainChek also provides management teams with visibility and assurance that assessments are actually being completed as indicated within the care plan. While other tools could theoretically be used multiple times per day, this is rarely sustainable in practice due to time constraints and inconsistencies.

PainChek bridges this gap by combining speed, accessibility, and oversight, making reliable, frequent pain assessment not just possible, but achievable at scale.

Practical Blueprint: Post-fall monitoring

Pain should be closely monitored after a fall because injuries are not always immediately visible or fully understood. Pain can emerge or worsen hours or days later, signalling underlying issues such as fractures, soft tissue damage, or complications that may otherwise go unnoticed. Ongoing pain also affects mobility, balance, and confidence, increasing the risk of further falls.

Falls are one of the most common reasons for emergency ambulance callouts from care homes. Even when injuries seem minor, uncertainty around pain, safeguarding, or clinical risk often leads to residents being taken to hospital “just in case.”

This is why care providers are monitoring pain over 72 hours following a fall using PainChek. Monitoring pain post-fall is equally important for recovery and prevention. By consistently assessing pain, care teams can intervene early, optimise treatment, and support safer, more confident recovery.

Through use of PainChek®, Three South West London ICB Care Homes has seen a 36% reduction in incidents necessitating ambulance call outs and the rate of conveyance from the home to hospital increase from 74% to 82% with PainChek due to the fact residents’ pain levels were being accurately measured.

PainChek uniquely strengthens post-fall monitoring by ensuring follow-up assessments are not only completed, but actively tracked and visible. Unlike traditional pain assessments within digital care systems, PainChek flags when follow-up assessments are overdue directly within the application and, through its integrations, provides immediate visibility to carers at the point of care, closing the gap between intention and action. This level of real-time accountability and oversight is not available with other pain assessment approaches.

Beyond completion, PainChek’s data analytics enable teams to go further, identifying patterns in pain over time and building a richer, individualised understanding of each resident’s response following a fall. This allows care teams to detect worsening pain early, recognise profiles linked to increased fall risk, and intervene proactively. In combining real-time monitoring, visibility, and actionable insights, PainChek stands apart as the only solution that turns pain assessment into continuous, meaningful fall prevention intelligence.