September 14, 2023 | Terry Smith

HelpFall vs ISTUMBLE; which is the best fall assessment tool for your care home?

Why is a post-falls decision support tool needed? A lack of confidence among care staff to safely assess and respond to falls that occur in care homes and in the community is a major reason for high numbers of unnecessary ambulance call-outs to falls. 

Many care homes are actively looking at how they can solve this problem, with most looking at implementing post falls decision-making tools and training to empower and upskill their staff to respond to falls themselves. 

In this article, we will be comparing the two main post-fall decision support tools, HelpFall and ISTUMBLE, covering the positives and drawbacks of each tool to help you in your decision. 


The ISTUMBLE App is trademarked by Mangar, part of the Winncare Group. The ISTUMBLE app has been designed to perform a health assessment on a fallen person and check for injury, before lifting them on a Mangar lifting cushion.

ISTUMBLE is based on guidance from West Midlands Ambulance Service.  Originally available as a paper flowchart, it was written in the early 2010s and developed into an app in 2019.

Positives of ISTUMBLE

  • Free of charge. ISTUMBLE is a free-of-charge app, available in app stores for anyone to download and use.
  • Easy to use. ISTUMBLE has been designed to be intuitive and simple for carers to use, and by answering a few short questions they can decide whether to call 999 for an ambulance. It also includes videos on how to lift using the Mangar cushions at the end of the assessment. 
  • Established. One of the first post-falls algorithms to be developed, ISTUMBLE has become well-known across NHS and social care settings.
  • Customisable. ISTUMBLE can be customised with tailored clinical pathways to reflect the pathways in place in your area. 
  • Certified. ISTUMBLE is ORCHA certified.

Drawbacks of ISTUMBLE

  • Only able to be used with Mangar cushions. Winncare state that the ISTUMBLE app is ‘only compatible with Mangar lifting cushions’, which restricts its use if your care home uses alternative equipment such as Raizer chairs or mobile hoists. 
  • Requires access to a phone or tablet. ISTUMBLE is an app, available for Android or iOS, so it can only be used if your staff have access to a phone or a tablet with app store access.
  • Lack of detailed guidance. The guidance can be ambiguous; you are either told to call 999 or lift the fallen person yourself and there is no middle-ground for minor-injury falls, leading to more 999 referrals than may be necessary. 


What is HelpFall?

HelpFall is the digital post-falls decision-making and reporting tool that supports your care staff to safely assess a person who has fallen and helps them decide whether to lift them from the floor using safe manual handling techniques and equipment. 

HelpFall has been designed alongside ambulance services and NHS ICBs and uses a traffic light system to categorise the falls and suggest what actions care staff should take based on their answers.  HelpFall is based on the South Western Ambulance NHS Foundation Trust Post Fall Assessment Checklist (🡥).

You can find out more about HelpFall here. 

Positives of HelpFall

  • Prioritises reducing pressure on the NHS. One of the key problems the NHS and ambulance services identified with traditional tools was the risk-averse nature of the guidance. For example, if a person has fallen and suffered a minor cut to the arm, traditional tools would tell the responder to call 999. In reality, ‘minor injury’ falls can usually be treated within your care home or by an Urgent Community Response team, and we have built HelpFall to reflect this and to only revert to 999 for major injury falls. 
  • Up-to-date guidance. HelpFall has been built to reflect the most up-to-date guidance from NICE and NHS England. HelpFall’s traffic light system directly reflects the three tiers for falls, set out by NHS England in their ‘Going Further for Winter’ guidance – see here. More than just a checklist, HelpFall suggests actions your care staff should take in each situation. 
  • Reporting. Every time HelpFall is used, an incident report is generated and sent to your care home, which you can upload to your patient record systems and share with the appropriate teams. 
  • Can be used in conjunction with any lifting equipment. Whilst we supply the Raizer lifting chair at Felgains, we have designed HelpFall to be able to be used regardless of the type of equipment you use to lift the fallen person off the floor. In fact, at the end of the assessment we have included instructional videos explaining how to lift a fallen person using either a Hoist, Mangar Cushion, Raizer Chair, or with no equipment at all. 
  • Customisable. HelpFall can be customised with tailored clinical pathways to reflect the pathways in place in your area.
  • Certified. HelpFall is NHS DTAC-ready and ORCHA Certified. 

Drawbacks of HelpFall

  • Cost. HelpFall is not a free-of-charge tool; we cover pricing in detail on this page
  • Requires access to a web app. The HelpFall tool is hosted on the web and accessed via a QR code or weblink, so an electronic device with broadband or mobile signal will be needed to use HelpFall (a hard-copy checklist is available as a backup).  If a phone or tablet isn’t available, a PC can be used. 


Which option should you choose?

What post-falls decision support tool your care home actually chooses to implement will come down to a number of factors that will be unique to you, however, I hope this article has given you a better idea of what each tool does, and the positives and negatives of each. 

Feel free to get in touch with us on 01473 741144, or by using the form at the bottom of this page to get started with a post-falls assessment tool.



Related articles

The Best Falls Lifting Equipment for Care Homes in 2023

Raizer Lifting Chairs vs Mangar Inflatable Lifting Cushions; An Honest Comparison

How Mid and South Essex Health Care Partnership have Reduced Ambulance Callouts to Care Homes by 69%



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Terry Smith

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