Specialty: Ageing, Primary sub-specialty: Ageing
Conditions
Interventions
Participating care homes will be randomised (after consent and completion of all baseline assessments) on a 1:1 basis to receive either the Skilful Care Training Package (SCTP) or to continue with Usu
Sponsors
Bradford Teaching Hospitals NHS Foundation Trust
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Care Homes: 1. A residential or nursing home with residents aged 65+ 2. Care Home manager in post for at least six months and likely to remain in post for the study period (indicates a stable care home environment) 3. Care Home manager willing to release staff to receive the intervention training and contribute to data collection 4. Training in Manual Handling is provided to all direct care staff 5. Anticipate 15 eligible residents could be recruited to take part in the trial (sufficient number of residents for outcome assessment) Residents: 1. Aged 65 years and over (male and female) 2. Permanent resident within the care home – defined as a person residing in the care home and not present for receipt of respite, day-care or short-term rehabilitation 3. Appropriately consented (in accordance with the Mental Capacity Act and clinical trials guidance on informed consent)
Exclusion criteria
Exclusion criteria: Care homes: 1. In the view of the research team, is not suitable for inclusion due to being subject to CQC improvements in areas relevant to the trial, enforcement notices / inadequate ratings, admissions ban, or relevant moderate or major compliance breaches 2. Is receiving other special support for specific quality concerns, such as being currently subject to, or have pending, any serious safeguarding investigations, voluntary or compulsory admissions bans, or local commissioning special support 3. Homes that have had physiotherapy training delivered to staff which involved postural management and physical activity in the last 12 months 4. A home where the SCTP has already been delivered 5. Homes taking part in other trials or initiatives which would conflict with the SCTP and / or with data collection required for this trial Residents: 1. Residents who are independently mobile (for previous week) measured by score 5 or 6 of the Functional Ambulation Classification will be excluded as they will gain little from the care staff’s new skills and knowledge 2. Residents who are currently undergoing a course of NHS or private physiotherapy, occupational therapy or speech and language therapy 3. Expectation of less than three months’ survival
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Residents: 1. Cognition is measured via researcher administration of the six-item cognitive impairment test (6-CIT) at baseline, 3 and 6 months 2. Pain is assessed using a researcher-administered visual analogue scale (VAS) at baseline, 3 and 6 months 3. Quality of life is measured via researcher administration of the EQ-5D-5L at baseline, 3 and 6 months (this is administered to both residents and care staff; the latter for proxy assessment) 4. Activity and mobility is assessed using the Physical Activity and Mobility in Residential Care (PAM-RC) at baseline, 3 and 6 months 5. Mobility is assessed using the Functional Ambulatory Classification (FAC) at baseline, 3 and 6 months 6. Activities of daily living are assessed using the Barthel Index (Activities of daily living) at baseline, 3 and 6 months 7. Movement ability is assessed using the Continuing Care Ability Measure (CCAM) at baseline, 3 and 6 months 8. Residents’ posture is assessed via researcher observation and completion of a postural observation tool at baseline, 3 and 6 months 9. Health resource use data are collected from care notes at baseline, 3 and 6 months 10. Safety data (e.g. falls, pressure ulcers, hospital admissions) are collected for all participating residents on a monthly basis from randomisation until 6 months over the telephone, and also from care notes at baseline, 3 and 6 months Staff members 11. Empathy will be assessed via staff completion of the Kiersma Chen Empathy Scale (KCES) at baseline, 3 and 6 months 12. Person-centred care approaches will be assessed via staff completion of the Person-Centred Care Assessment Tool (P-CAT) at baseline, 3 and 6 months 13. Knowledge of posture and movement will be assessed via staff completion of a posture and movement questionnaire at baseline, 3 and 6 months Whole-home data 14. Anonymised whole-home level data will be collected from the care home manager regarding care home demographics, health care resource use, resident safety and mobility le | — |
Secondary
| Measure | Time frame |
|---|---|
| No secondary outcome measures | — |
Countries
England, United Kingdom
Contacts
Public ContactLiz Graham
Outcome results
None listed