Subject	Question	Answer
Exercise	What qualification do I need to hold to deliver Chair Based Exercise?	You will need to complete the 4-day level 2 chair-based exercise course with HCPA. Once passed the qualification you will be able to deliver chair-based exercise at your organisation.
Exercise	Do I need to hold insurance?	Risk is always going to be an element whenever exercise and health are concerned. As professionals we do our best to minimise this risk, but it is also a comfort to know we are well covered should the worst-case scenario materialise. Check with your organisation on what the insurance requires, it is best to let the insurers know that you will be teaching exercise at your organisation. Individuals can also utilise REPS insurance packages, as Chair Based Exercise Level 2 is a recognised qualification for exercise professionals, you can benefit from up to £10 million fitness cover. https://www.exerciseregister.org/insurance
Exercise	Where do I order resistance bands from?	You can order resistance bands from amazon or Meglio directly. https://www.amazon.co.uk/s?k=meglio+bands&hvadid=80470538936042&hvbmt=be&hvdev=c&hvqmt=e&tag=mh0a9-21&ref=pd_sl_6et23l76gu_e https://mymeglio.com/collections/resistance-exercise-products
Exercise	What paperwork needs completing before I start delivering chair-based exercise classes?	You will need to have the medical information of all your participants, so you are sure it is safe for them to exercise. You will need to complete a risk assessment of the room where you will be delivering exercise, this is making sure that the environment is safe for exercise. Consent forms should also be used as best practice. <br> » Physical Activity Readiness Questionnaire (PARQ) - https://www.hcpastopfalls.info/wp-content/uploads/2020/06/PARQ-GDPR-Consent.docx <br> » Health and Safety Planning Document - https://www.hcpastopfalls.info/wp-content/uploads/2020/06/Exercise-Health-and-Safety-Planning-Documentv2.docx <br> » StopFalls Exercise Consent Form - https://www.hcpastopfalls.info/wp-content/uploads/2020/06/StopFalls-Exercise-Consent-Form.pdf <br>
Exercise	How many participants is it safe to deliver to?	We suggest delivering exercise for a maximum of 12 participants. This way you can give enough attention to everyone. If it is a group that required a lot of additional support an additional member of staff is recommended.
Exercise	What is the recommended frequency, intensity and time?	<p>Chair-based exercise should be running as regularly as possible, running a minimum of once a week. A full session should last 40 – 60 minutes. Have regular drink breaks if needed to encourage hydration. The intensity should be dependent on how experienced the group are. Start with a relatively low intensity, you can improve this when the participant’s become more confident. </p> <p>Absolute contra-indications (reasons not to take part): </p> <ul><li>sudden joint and muscle pain</li> <li>severe orthopaedic conditions</li> <li>recent blood clot</li> <li>chest pain, dehydration</li> <li>abdominal pain</li> <li>onset of breathlessness</li> <li>extreme blood pressure</li> <li>uncontrolled diabetes</li> <li>thyroiditis</li> <li>calf pain</li> <li>chest Pain</li> <li>acute illness</li> <li>light headiness </li> </ul> <p>Cautions to exercise: </p> <ul> <li>protected wound</li> <li>infection control</li> <li>latex allergy</li> <li>observable pain of known origin</li> <li>identified current injury</li> <li>uncontrolled hypertension</li> <li>irregular heart rhythm</li> <li>inability to safely maintain balance when seated</li> <li>problems with understanding instructions</li> </ul> <p>Progression advice for participants: </p> <ul> <li>participant to lift with correct form for 10 repetitions with light weight</li> <li>once completed then move onto higher resistance</li> <li>if they can reach 12 repetitions with good form then they can progress to next resistance</li> <li>this is to be reassessed every 3 weeks</li> </ul>
Exercise	Where can I access advice and support?	Please get in touch with the exercise team: stopfalls@hcpa.info
Exercise	Environmental considerations	Take into consideration the flooring, is it safe for exercise? What is the temperature of the room? Make sure there is enough ventilation and that windows can be opened. Make sure that there isn’t any trip hazards and that chairs and tables that aren’t being used are put away.
Exercise	Do I need a first aid qualification?	This isn’t a requirement for level 2 chair-based exercise, but it is advised. You can take a first aid qualification at HCPA or google the nearest one to you.
Exercise	Resources	Session plan template: This is so you can write down your session and plan week to week, it will also help you track progress. <br> FRAT: The Falls Risk Assessment Tool is used to assess an individual falls risk. You can find this tool on the stop falls app or on the stop falls website. The greater number of ‘yes’ answers on the question sheet the higher the participant’s risk of falls is. This can be used as you start teaching you exercises session and reassessed every 10 weeks. The results of the FRAT should be included in each individual’s care plan along with the interventions used to improve the risk. <br> ParQ: Every participant must have a ParQ, so you are aware of their medical conditions, it is important for their safety. <br> Consent forms: Every participant would need to sign a consent form, so that they aware of any possible risks of exercise. If they are unable to sign for themselves, then either a relative or carer. <br> Example risk assessment: A risk assessment would cover all environment factors. It is used as evidence that you have made sure the room that is being used for exercise is safe. <br> Measuring progression: Write down when a participant is ready to progress to a heavier band or can do more repetitions. It is helpful to write down any difficulty’s that participant’s are experiencing as well as day to day improvements. This way you can get a detailed idea of their progression and quality of life. <br> Confidence questionnaire: The confidence questionnaire can help track each participants wellbeing and confidence. You can complete this document week one and then again at the end of 10 sessions to compare the results. These results can be documented as you continue to improve the participant’s confidence.
General	What is the definition of a fall?	An unintentional event when an individual rests on the ground or on a lower level. (BMJ, 2016).
General	How much do falls cost the NHS each year?	2.3 billion pounds a year
General	Where can I access advice and support?	You can contact HCPA and ask for a Health Promotion Educator. Alternatively, there are lots of support services available to you: <br> • StopFalls app<br> • NHS live well<br> • NHS app<br> • Slipper swap<br> • Unforgettable.org <br> • Herts help<br> • Royal Osteoporosis Society<br> • Parkinson’s UK <br> • Stroke Association<br>
Intervention	What do I do when someone cannot get up from the floor?	Once checked that the individual is free of injury and responsive. Use the falls checklist in the brochure and follow the instructions. If there aren’t any Yes’s, then verbally talk through the rising from the floor protocol if the individual is independent. If they are dependent, the appropriate equipment may be used to lift the individual from the floor, depending on the internal processes. If it isn’t safe to move the person then call 999.
Intervention	What do I do if there has been an obvious injury sustained?	Do not move the person unless they are in immediate danger. Alert senior staff and assess the level of injury by administering first aid. If they still aren’t ok to call 999. Call immediately for chest pain, a stroke and loss of consciousness.
Intervention	What happens if there has been an unwitnessed fall?	Check if the individual is in any danger and start to administer First aid. If they aren’t ok call 999. If they are ok call 111 for advice.
Intervention	What do I need to monitor once someone has fallen?	Post falls monitoring for 24 hours checking: <br> • Mobility <br> • If the individual is their normal self<br> • Any new or worsening pain, acute confusion<br> • Vomiting or memory loss <br> • Any changes to their well-being and confidence<br> If there is anything new or worsening pain, then call 111 or 999.
Intervention	Who do I need to inform after someone has fallen?	Follow organisation procedures
Intervention	What can happen to a person after a fall?	• Hospital admission <br> • Increased level of care<br> • Loss of confidence<br> • Lack of mobility and strength<br> • Visible injuries and pain
Intervention	What do I say to the ambulance service when I call 999?	Follow the SBAR communication tool in the booklet, this can be utilised to assess the situation. Communicate the situation, background, assessment and then explain what you need through recommendation.
Intervention	How and when do I contact the Emergency Intervention Vehicle?	The EIV is an immediate response from screened 999 calls to residents in East and North Hertfordshire. The main aim to is to support elderly residents in their own homes and care homes. The EIV will not respond to life threatening conditions, drug or alcohol cased and are not equipped to take people to hospital. <br> Once called 999 they will ask if there any red flags. If there aren’t any red flags then the following questions will be asked, if yes to any of the following then the EIV will be sent. <br> • Is the individual 65 and over?<br> • Dehydration?<br> • Dementia? <br> • UTI’s?<br> • Falls?<br> • Minor head injuries?<br> • Rapid decline in function?
Intervention	When do I call the Emergency Care Practitioner (ECP)?	The ECP is available 7 days a week from 6:30am to 23:00 for the below symptoms in care homes. Ensure that the resident is with you when you call. The number for the ECP is 0345 601 0552 <br> • Head Injuries (without loss of consciousness)<br> • Wounds<br> • Burns and scalds <br> • Joint and limb injuries <br> • Soft tissue injuries <br> • Rib injuries <br> • Back pain <br> • Chest Infection <br> • UTI’s<br> • Dizziness/vomiting/allergic reactions.
Intervention	Do I catch someone falling?	If you are supporting someone then you may use the correct technique to support someone to the floor. <br> • Standing slightly behind the individual with one foot in front of the other to form a stable base with the front knee slightly bent.
Intervention	Can I redirect a fall?	• If an individual was falling towards a dangerous situation then you should attempt to redirect the fall away from the danger.<br> • If the individual is transferring towards two surfaces such as a bed and chair, then it may be possible for you to redirect the fall onto the bed or chair.
Intervention	What do I do if someone falls on the stairs?	If an individual fall’s on stairs or steps it may be possible to redirect them to a higher stair or step. If you are positioned slightly behind the individual and are following them up the stairs, then you may be able to use your body weight to push the person towards a wall or banister. You should never stand directly behind the individual.
Prevention	What are the things I can do to reduce a person’s falls risk?	Mobility and flexibility exercises, assess footwear, assess medication, be aware of medication side effects, nutrition and hydration factors, reduce fall and trip hazards.
Training	What specific training is available?	HCPA offers the following training: Falls, Nutrition and hydration, Frailty, First aid, and Level 2 Chair- Based Exercise