East Midlands to inform national care homes project

Researchers in the region have been working on a study which involved talking to care homes and stakeholders in the East Midlands to find out the best ways to embed a Falls programme into their everyday practice. Enabling staff to identify the reasons residents fall and then carry out actions to reduce risks. 

The learning from the Falls in Care Homes (FinCH) Implementation East Midlands Study will inform the new national FinCH Implementation study as part of a research programme launched in the summer focused on the health challenges facing our growing older population.

ARC East Midlands and the University of Nottingham is leading two of the projects, including the Falls in Care Homes National Implementation Study due to be completed by July 2023. 

National launch

Speaking at the launch of the national study, Principle Investigator Professor Pip Logan, who is also part of the East Midlands study, said: “The project we are going to be doing is about reducing falls in care homes and this is a really important issue. As we know people move into care homes quite often when they have had a horrible fall at home, but people still fall when they are in the care home as they are walking about, as they are moving as they are doing their normal activities.

“We know these falls can have a really traumatic effect on people, they can suffer fatal fractures, end up in hospital, have horrible skin tears, massive bruising and then also develop a real fear of falling. They can become quite chair dependent and unable to move around because of the fear they have.”

Building evidence

The ACTiON FALLS programme trains and supports care home staff to identify the reasons why residents fall and then guides them to complete actions to reduce falls.

In a study trial, the ACTiON FALLS programme was cost-effective and reduced falls by 43%. The national study, like the East Midlands study, will assess how to deliver the ACTiON FALLS programme in ‘real life’ outside a research trial.

As well as the East Midlands, South London, West Midlands and the North-East will be working to develop and research ideas about taking up the ACTiON FALLS training programme which can be used nationwide. 

Using an approach to talking to people in care homes called Normalisation Process Theory (NPT), the researchers will consider the work that people do in managing falls to assess whether the ACTiON FALLS programme becomes routine practice. 

The study has three work packages:

• Quality Improvement Collaboratives (QIC) will bring care home and healthcare staff together to develop and research ways to implement ACTiON FALLS.
• The QIC site teams will implement ACTiON FALLS in 15 care homes per region (60 in total). Data from all homes and residents (about 2000 residents) will tell us the extent to which has been taken up in the homes.
• We will develop ‘toolkits’ of materials for care homes; containing the ACTiON FALLS, a ‘return on investment’ calculator, the implementation package, and a ‘how to’ guide for establishing Communities of Practice to deliver and sustain ACTiON FALLS across regions.

This study has been developed in collaboration with care home managers, care home staff, NHS clinicians and an active Patient, Public, Involvement (PPI) group which is co applicants.

Latest evidence

In a study published by The BMJ, the Falls Prevention Intervention which will be implemented in the new study was associated with a reduction in fall rate and cost effectiveness, without a decrease in activity or increase in dependency. 

The researchers compared the multifactorial falls prevention programme with usual care in UK care homes for older people in the multicentre cluster randomised controlled trial with economic evaluation.