Falls prevention in care home residents Mental and Behavioural Disorders Falls prevention in care home residents
Conditions
Interventions
Care homes will be randomised on a 1:1 basis to one either: intervention (which will be GtACH fall prevention programme) or control (which will be usual care). Randomisation of homes to allocation wil
Sponsors
University if Nottingham
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Care Home inclusion criteria: 1. Long stay with old age and/or dementia registration 2. 10 or more potentially eligible residents 3. Routinely record falls in resident personal records and on incident sheets 4. Consent of care home manager to comply with the protocol and identify a care home fall champion Resident inclusion criteria: All long term care home residents. Staff Inclusion Criteria (Process Evaluation Only) 1. Employed by a Care Home participating in FINCH and selected for participation in the Process Evaluation 2. Employed in a caring role
Exclusion criteria
Exclusion criteria: Care Home exclusion criteria: 1. Participated in GtACH pilot/feasibility studies 2. Homes exclusively providing care for those with learning difficulties or substance dependency 3. Homes with contracts under suspension with health or social providers, or that are currently subject to safeguarding investigations or homes under CQC special measures 4. Homes with a significant proportion of beds taken up by health-service commissioned intermediate-care services 5. Trained and routinely using a systematic falls prevention programme Resident exclusion criteria 1. Residents on short-term care (e.g. respite), 2. Residents identified to be in the last few days of life Staff Exclusion Criteria (Process Evaluation Only) 3. Have a significant proportion of time caring for residents in health-service commissioned intermediate-care services funded beds
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Falls rates recorded by the care homes during the 3 month period comprising months 4, 5 and 6 post randomisation. This will be collected at the 6 month time point. Data will be collected from care home records and incident report forms. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Physical activity is measured using the Physical Activity and Mobility in Residential Care Scale (questionnaire) completed by care home staff and collected at baseline and 3, 6, 9 and 12 months post randomisation 2. Fracture rate is measured using fractures recorded in care home records and incident report forms at baseline and 3, 6, 9 and 12 months post randomisation. Fractures will be cross checked with hospital episode statistics (HES) data to ensure maximal data collection. 3. Days in hospital is measured using care home records and incident report forms at baseline and 3, 6, 9 and 12 months post randomisation and HES data. 4. Functional ability is measured using the Barthel Index of Activities of Daily Living completed by care home staff and, completed by care home staff at baseline, 3, 6, 9 and 12 months. 5. Economic evaluation is conducted by Tracey Sache at University of East Anglia. Economic evaluation will use health care resource use data collected for the 3 months prior to baseline and 3, 6, 9 and 12 months post randomisation and Quality of life using the DEMQOL-U-5D, DEMQOL-U-4D, EQ-5D-5L, EQ-5D-5L-P. 6. Process evaluation is conducted by Paul Leighton at University of Nottingham. The evaluation will use information from 12 focus groups and a minimum of 30 interviews. The evaluation will cover Training of Fall prevention Leads, training of care home staff and implementation of the GtACH will be observed and assessed against a standard fidelity checklist. Care home records will be reviewed to consider broad compliance with GtACH. Key stakeholders will be interviewed to explore the experience of introducing GtACH. 7. Falls recorded in the care home records and incident report forms will be recorded during the 3 months periods comprising months 7, 8 and 9 and 10, 11 and 12 post randomisation. This will be collected at the 9 and 12 month time point. | — |
Countries
England, United Kingdom
Contacts
Public ContactGail Arnold
Outcome results
None listed