title: The Falls In Care Home study: a feasibility randomized controlled trial of the use of a risk assessment and decision support tool to prevent falls in care homes.
abstract: OBJECTIVE
  To explore the feasibility of implementing and evaluating the Guide to Action Care Home fall prevention intervention.
  
  
  METHODS
  Two-centre, cluster feasibility randomized controlled trial and process evaluation.
  
  
  METHODS
  Purposive sample of six diverse old age/learning disability, long stay care homes in Nottinghamshire, UK.
  
  
  METHODS
  Residents aged over 50 years, who had fallen at least once in the past year, not bed-bound, hoist-dependent or terminally ill.
  
  
  METHODS
  Intervention homes (n = 3) received Guide to Action Care Home fall prevention intervention training and support. Control homes (n = 3) received usual care.
  
  
  RESULTS
  Recruitment, attrition, baseline and six-month outcome completion, contamination and intervention fidelity, compliance, tolerability, acceptance and impact.
  
  
  RESULTS
  A total of 81 of 145 (56%) care homes expressed participatory interest. Six of 22 letter respondent homes (27%) participated. The expected resident recruitment target was achieved by 76% (52/68). Ten (19%) residents did not complete follow-up (seven died, three moved). In intervention homes 36/114 (32%) staff attended training. Two of three (75%) care homes received protocol compliant training. Staff valued the training, but advised greater management involvement to improve intervention implementation. Fall risks were assessed, actioned and recorded in care records. Of 115 recorded falls, 533/570 (93%) of details were complete. Six-month resident fall rates were 1.9 and 4.0 per year for intervention and control homes, respectively.
  
  
  CONCLUSIONS
  The Guide to Action Care Home is implementable under trial conditions. Recruitment and follow-up rates indicate that a definitive trial can be completed. Falls (primary outcome) can be ascertained reliably from care records.
authors.affiliation: Division of Psychiatry, University of Nottingham Innovation Park, Nottingham, UK Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: Gemma M
authors.initials: GM
authors.lastname: Walker
authors.affiliation: Research Design Service, University of Nottingham, Nottingham UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Armstrong
authors.affiliation: Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Gordon
authors.affiliation: Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: John
authors.initials: J
authors.lastname: Gladman
authors.affiliation: Nottinghamshire Healthcare NHS Trust, Nottingham, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Robertson
authors.affiliation: Nottingham Citycare Partnership, Nottingham, UK.
authors.forename: Marie
authors.initials: M
authors.lastname: Ward
authors.affiliation: Geriatric Medicine, University Hospitals of Leicester, Leicester, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Conroy
authors.affiliation: Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: Gail
authors.initials: G
authors.lastname: Arnold
authors.affiliation: Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Darby
authors.affiliation: Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK.
authors.forename: Nadia
authors.initials: N
authors.lastname: Frowd
authors.affiliation: Church Farm Nursing Home, Nottingham, UK.
authors.forename: Wynne
authors.initials: W
authors.lastname: Williams
authors.affiliation: Rushcliffe Community & Voluntary Service, Nottingham, UK.
authors.forename: Sue
authors.initials: S
authors.lastname: Knowles
authors.affiliation: Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK Nottingham Citycare Partnership, Nottingham, UK pip.logan@nottingham.ac.uk.
authors.forename: Pip A
authors.initials: PA
authors.lastname: Logan
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D000066491:Clinical Decision-Making; D003661:Decision Support Techniques; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D018570:Risk Assessment; D016037:Single-Blind Method
keywords: Accidental falls; fall prevention intervention; feasibility studies; nursing homes; randomized controlled trial