Falls prevention · Updated October 2026
FRAT falls risk assessment tool
Score a person’s falls risk with the Falls Risk Assessment Tool (FRAT), flag their risk factors, and get a practical action plan. Then use the guide below to compare FRAT with other common falls assessment tools.
For guidance only. FRAT supports, but does not replace, professional judgement and a full multifactorial falls assessment. Nothing you enter is saved or sent anywhere.
What is the Falls Risk Assessment Tool (FRAT)?
The Falls Risk Assessment Tool (FRAT) was developed by Peninsula Health in Victoria, Australia, to help staff identify people at risk of falling. It is used widely in care homes, community services and sub-acute care, and combines a short risk score with a checklist of risk factors and an action plan.
Part 1: Falls risk status
Four scored questions on recent falls, medication, psychological and cognitive status. The total gives a low, medium or high risk level.
Part 2: Risk factor checklist
Eight areas, such as vision, mobility and continence, that point to the causes of falls risk.
Part 3: Action plan
The steps you will take for each risk factor, recorded in the person’s care plan.
Free download
FRAT falls prevention assessment tool (PDF)
A printable FRAT form to complete on paper and keep in the person’s care records.
How to use the FRAT tool
- 1Gather informationSpeak to the person and their family, read their records, and observe how they move.
- 2Score Part 1Answer the four questions, and check whether automatic high risk applies.
- 3Tick risk factorsWork through the Part 2 checklist. Each factor you tick adds actions to the plan.
- 4Act and recordCopy the assessment into the care plan, agree actions with the person, and set a review date.
FRAT scoring guide
| Risk area | Points |
|---|---|
| Recent falls | None in last 12 months: 2 · Between 3 and 12 months ago: 4 · In last 3 months: 6 · In last 3 months while an inpatient or resident: 8 |
| Medications | None: 1 · One: 2 · Two: 3 · More than two: 4 |
| Psychological | None: 1 · Mild: 2 · Moderate: 3 · Severe: 4 |
| Cognitive status (AMTS) | 9–10: 1 · 7–8: 2 · 5–6: 3 · 4 or less: 4 |
Use standard falls precautions and review regularly.
Act on each risk factor and review more often.
Put a full falls prevention plan in place now.
Automatic high risk: anyone with a recent change in function or mobility-affecting medication, or with dizziness or postural hypotension, is high risk whatever their score.
Falls prevention guidelines
When to complete a falls risk assessment
- When the person moves in, is admitted, or starts receiving care.
- After any fall, even if there was no injury.
- When their health, medication, mobility or behaviour changes.
- At every planned care review, or at least as often as your policy sets out.
Multifactorial falls interventions
Falls usually have more than one cause, so a score alone is not enough. Look at every risk factor and act on each one.
Strength and balance
Exercise programmes that build strength and balance are among the most effective ways to prevent falls.
Medication review
Ask a GP or pharmacist to review medicines that cause drowsiness, dizziness or low blood pressure.
Vision and hearing
Arrange regular checks, and make sure glasses and hearing aids are worn and working.
Feet and footwear
Well-fitting, enclosed shoes or slippers with grip. Refer to podiatry for foot problems.
Continence
A toileting routine and night-time options reduce rushed trips to the bathroom.
Environment
Clear clutter, add grab rails and night lights, and keep frequently used items within reach.
Bone health
Consider an osteoporosis review for people at risk of fractures.
Involve the person and their family
Explain the risks and agree the plan together. Balance safety with independence and choice: people have the right to take positive risks, and too many restrictions can reduce mobility and increase falls risk over time.
What to do after a fall
- Stay calm and reassureDo not rush to move the person. Make them comfortable and keep them warm.
- Check for injuryLook for pain, bleeding, head injury or signs of a broken hip. If you suspect a serious injury, do not move them and call 999.
- Get up safelyIf they are uninjured, use a safe technique or lifting equipment. Never lift someone manually from the floor.
- MonitorWatch for changes over the next 24 to 48 hours, especially after a head injury or if the person takes blood thinners.
- Record and reportComplete an incident report, inform family and the GP, and notify the CQC or safeguarding team if required.
- ReviewRedo the falls risk assessment and update the care plan to prevent another fall.
Other common falls risk assessment tools
FRAT is one of several falls assessment tools. Each was designed for a different setting, so use the one your organisation recommends.
| Tool | Typical setting | What it looks at | Score range | Higher risk |
|---|---|---|---|---|
| Morse Fall Scale | Hospital inpatients | History of falling, other diagnoses, walking aid, IV or drip, gait, mental status | 0–125 | 45 or more is often used for high risk |
| STRATIFY | Hospital inpatients | Recent fall, agitation, vision, toileting needs, transfers and mobility | 0–5 | 2 or more |
| Hendrich II Fall Risk Model | Hospital inpatients | Confusion, depression, elimination, dizziness, gender, certain medicines, Get Up and Go test | 0–16 or more | 5 or more |
| Timed Up and Go (TUG) | Community, clinics, care homes | Time to stand from a chair, walk 3 metres, turn, walk back and sit | Seconds | 12 seconds or more is a common cut-off |
| Berg Balance Scale | Rehabilitation, physiotherapy | 14 balance tasks, such as standing, reaching and turning | 0–56 | Below 45 suggests higher risk |
| Tinetti (POMA) | Older people, physiotherapy | Balance and gait | 0–28 | Below 19 high risk, 19–24 moderate |
| 30-second chair stand | Community, clinics | How many times the person can stand up from a chair in 30 seconds | Count | Below the expected number for their age |
| FRAT (this tool) | Care homes, community, sub-acute care | Recent falls, medication, psychological and cognitive status, plus a risk factor checklist | 5–20 | 16 or more, or automatic high risk |
Cut-offs vary between studies and organisations. Always follow your local policy.
NICE guidance on falls risk assessment
In England, NICE guidance recommends a multifactorial falls risk assessment for people at higher risk, followed by interventions tailored to each person. It does not recommend relying on a risk score alone. For older people in hospital, NICE has advised treating them as at risk of falling rather than using a prediction tool to decide who is at risk.
Falls risk tools are most useful as a structured prompt to find and act on risk factors, not as a pass or fail test.
About this FRAT tool
- Scoring follows the Peninsula Health FRAT: Part 1 scores 5–20, with automatic high risk for recent change or dizziness.
- The action plan is a starting point. Tailor it to the person and record it in their care plan.
- Cognitive status uses the Abbreviated Mental Test Score (AMTS). Complete the AMTS separately if you have not already.
- This tool does not replace clinical assessment, professional judgement or your organisation’s falls policy.
Frequently asked questions about falls risk assessment
What is FRAT?
FRAT stands for Falls Risk Assessment Tool. It was developed by Peninsula Health in Australia and is widely used in care homes, community care and sub-acute settings to identify people at risk of falling and plan ways to reduce that risk.
How is the FRAT scored?
Part 1 scores four areas: recent falls (2–8), medications (1–4), psychological status (1–4) and cognitive status (1–4). The total runs from 5 to 20. A score of 5–11 is low risk, 12–15 medium risk and 16–20 high risk.
What makes someone automatically high risk on the FRAT?
A recent change in function or in medicines that affect safe mobility, or dizziness or postural hypotension. If either applies, the person is high risk whatever their score.
Is there a free printable FRAT form?
Yes. You can download the free FRAT falls prevention assessment tool (PDF) to print and complete on paper.
How often should a falls risk assessment be done?
On admission or when care starts, after any fall, when the person’s health, medication or mobility changes, and at regular care plan reviews.
What is the AMTS?
The Abbreviated Mental Test Score is a short 10-question test of memory and orientation. FRAT uses it to score cognitive status.
Which falls risk assessment tool is best?
There is no single best tool. FRAT is common in care homes and community care, Morse and STRATIFY in hospitals, and TUG or Berg are used by physiotherapists. Use the tool your organisation recommends, and always add a full multifactorial assessment.
Does NICE recommend falls risk tools?
NICE guidance focuses on multifactorial falls risk assessment and interventions rather than a score alone. For older hospital inpatients, NICE has advised against relying on falls risk prediction tools and recommends treating them as at risk. Check the current NICE guideline for your setting.
What should I do after someone falls?
Make the person safe, check for injury before moving them, get medical help if needed, and use safe equipment to help them up. Record the fall, inform family, and review the falls risk assessment and care plan.