Exploring how to enable care homes in the UK to use the Action Falls Programme (Formerly GtACH) in day-to-day care
| ISRCTN | ISRCTN79131660 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN79131660 |
| IRAS number | 310091 |
| Secondary identifying numbers | CPMS 51826, IRAS 310091 |
- Submission date
- 29/03/2022
- Registration date
- 19/04/2022
- Last edited
- 17/03/2025
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Injury, Occupational Diseases, Poisoning
Plain English Summary
Background and study aims
People who live in care homes are at great risk of falling. Falls are common, harmful, costly, and difficult to prevent. The Action Falls programme (formally GtACH) 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 large multicentre randomised controlled trial called the FinCH trial, the Action falls programme was cost-effective and reduced falls by 43%. Therefore, the Action Falls programme has already demonstrated its effectiveness. The aim of this study is to examine what helps and what hinders its use in Care homes for day-to-day care.
Who can participate?
We are working with four regions – East Midlands, West Midlands, South London and the North-East - to develop and research ideas about how to put the Action falls programme into use nationwide. We are looking to work with 60 care homes across these regions representing a mixture of registrations, size and management structure.
What does the study involve?
Participating in the study involves:
• Using the Action falls programme for 12 months: This involves staff training on using Action Falls,
• Taking part in up to 3 Action Collaboration Events which will bring care home and healthcare staff together to develop and research ways to implement Action falls.
• Providing anonymised data on the number of falls in the care home per month.
• Care home employees will be invited to fill out a multiple-choice questionnaire on two occasions, about their experiences of using Action Falls.
• Some care home staff (up to 48 in total) will be invited to take part in an interview about their experiences of using Action Falls
What are the possible benefits and risks of participating?
There are no specific personal benefits to taking part in this study. However, views from these interviews will support the use of the Action Falls programme as a way of reducing resident falls in care homes. All care home staff who take part in two surveys or attend an Action Falls Collaborative event will receive a shopping voucher as a thank you for their time.
There are no direct risks in taking part in this study. If during the study participating care home staff tell researchers about care which is harmful, researchers will be required to report to the Adult Safeguarding Committee and care home management who may wish to explore this further.
Where is the study run from?
University of Nottingham (UK)
When is the study starting and how long is it expected to run for?
October 2021 to September 2024
Who is funding the study?
NIHR Applied Research Collaboration for Wessex (UK).
Who is the main contact?
Dr Fran Allen, frances.allen@nottingham.ac.uk
Contact information
Scientific
University of Nottingham Medical School
B114
QMC
Nottingham
NG7 2UH
United Kingdom
 ORCID ID |
0000-0001-7265-0676 |
|---|---|
| Phone | +44 115 8230228 |
| frances.allen@nottingham.ac.uk |
Study information
| Study design | Interventional non-randomized |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Non randomised study |
| Study setting(s) | Other |
| Study type | Prevention |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet. sandra.burgess@nottingham.ac.uk |
| Scientific title | Implementation of the ACTiON FALLS prevention programme (formally GtACH) into UK care homes |
| Study acronym | FinCH Implementation Study |
| Study hypothesis | 1. How do care homes (and parent organisations) best implement the ACTiON FALLS programme? 2. What are the real-world barriers and facilitators to care homes when using ACTiON FALLS? 3. Can ACTiON FALLS yield the same successful trial outcomes and how is this sustained (opportunity costs)? 4. How do we increase spread and uptake of ACTiON FALLS? 5. How do care home staff remain skilled to use the ACTiON FALLS programme? |
| Ethics approval(s) | Approved 14/02/2022, (), ref: 22/EM/0035 |
| Condition | Falls prevention in care homes |
| Intervention | The ACTiON FALLS Collaborative Events will take the form of workshops and include: • Activities to encourage feedback on the use of the ACTiON FALLS programme • Networking time for discussion between staff from different • Training provided by NHS staff and researchers • Collaborative engagement between care home staff, researchers, clinicians and policy makers together to develop implementation tools and techniques. • Agreed actions for adaptations to the use of the ACTiON FALLS Programme to be taken forward by care home staff and research teams. Feedback from ACTiON FALLS Collaborations (AFC) will inform the quality improvement cycle and help us to understand the barriers and facilitators to using the ACTiON FALLS Programme in day-to-day care within care homes. Therefore, the ACTiON FALLS programme will be used within the participating care homes and adapted to assist with it's use in real time. Local NHS Falls Leads will be trained and deliver training to care home staff in the use of the ACTiON FALLS programme. Data will be collected via: • Observation and field notes made by researchers from AFC meetings. • Interviews and focus groups of Care home staff in the homes which will take place within their workplace (care home), via VOIP e.g. Microsoft Teams or at the AFC events. • NOMAD questionnaires completed by care home staff either electronically or via paper copies of the questionnaire sent to care homes. The data from each of the four sites will be brought together to compare and contrast findings and to produce the final tool kit. Participating care homes and staff will be enrolled in the study for 12 months. Within this time participating care home staff will be: • Asked to take part in ACTiON FALLS training provided by the NHS falls leads within the care home, or remotely via VOIP e.g. Microsoft Teams. • Encouraged to use the ACTiON FALLS programme within their day-to-day work with residents within the care home. • Invited to up to three AFC events which will be held locally by the relevant ARC site team. The duration of these events will be decided locally based on care home staff availability as we acknowledge that this may vary depending on the current impact of Covid-19 on care home staffing. • Invited to complete up to 2 NOMAD questionnaires. Sent out to care homes prior to each AFC event. • Up to 12 members of care home staff from each ARC site will take part in interviews, these will be purposively selected based on their responses to the NOMAD questionnaire. • Each care home will be asked to provide anonymised data regarding their number of falls each month. This is in line with data already provided by homes to regulatory authorities. The methodology to this study has been derived following consultation and support from PPI and stakeholder groups including care home staff and residents. This was through interviews from the process evaluation within the previous FinCH RCT, stake holder forums held within the recent FinCH Implementation East Midlands study and PPI members within the co-applicants for the FinCH Imp National study. This involvement has lead to changes within the methodology including changing the name of the programme from GtACH which was poorly recognised and understood by the wider health and social care community to the more descriptive ACTiON FALLS programme. This has also led to the Quality Improvement Collaboratives renamed to AFCs as more acceptable to care home staff. |
| Intervention type | Behavioural |
| Primary outcome measure | 1. Understand the extent to which the collaborative approach has enabled effective implementation of the ACTiON FALLS programme across participating regions and homes. This will be achieved through measuring participation in collaborative events, reviewing the use of the ACTiON FALLs programme with residents, responses from the NOMAD instrument and using qualitative interviews 2. Collect monthly falls data from up to 1,770 residents (anonymous) using routinely collected data 3. Collect case studies at an individual resident, care home and regional level, of how the ACTiON FALLS programme has impacted on outcomes |
| Secondary outcome measures | There are no secondary outcome measures |
| Overall study start date | 01/10/2021 |
| Overall study end date | 30/09/2024 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Adult |
| Sex | Both |
| Target number of participants | Planned Sample Size: 48; UK Sample Size: 48 |
| Total final enrolment | 57 |
| Participant inclusion criteria | Care Home inclusion criteria: 1. Long stay with old age and or dementia registration 2. Routinely record falls in resident personal records and on incident sheets Care Home staff inclusion criteria: 3. Employed by a Care Home participating in FinCH Imp study 4. Employed in a caring role Falls Leads inclusion criteria: 5. Participated in ACTiON FALLS trainer training 6. Provided ACTiON FALLS training in at least one participating care home |
| Participant exclusion criteria | Care Home exclusion criteria: 1. Homes exclusively providing care for those with learning difficulties or substance dependency 2. Homes with contracts under suspension with health or social providers, or that are currently subject to safeguarding investigations Care Home staff exclusion criteria: 3. Not employed directly by the care home e.g., agency worker or student Falls lead exclusion criteria: 4. None, provided inclusion criteria are met |
| Recruitment start date | 01/04/2022 |
| Recruitment end date | 30/09/2022 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centres
NG7 2UH
United Kingdom
Innovation Park Jubilee Campus
Triumph Road
Nottingham
NG7 2TU
United Kingdom
Institute of Psychiatry, Psychology & Neuroscience
Main Building, Room E2.19
De Crespigny Park
London
SE5 8AF
United Kingdom
Jubilee Road
Gosforth
Newcastle Upon Tyne
NE3 3XT
United Kingdom
Room B146, 1st Floor, Health Sciences
Warwick Medical School
University of Warwick
Coventry
CV4 7AJ
United Kingdom
1st Floor Leicester Royal Infirmary
Leicester
LE1 5WW
United Kingdom
Headington
Oxford
OX3 9DU
United Kingdom
North Shields
NE29 8NH
United Kingdom
London
SE1 2TZ
United Kingdom
Sponsor information
University/education
University Park
Nottingham
NG7 2RD
England
United Kingdom
| Phone | +44 1158467906 |
|---|---|
| sponsor@nottingham.ac.uk | |
| Website | http://www.nottingham.ac.uk/ |
"ROR" |
https://ror.org/01ee9ar58 |
Funders
Funder type
Government
No information available
Government organisation / National government
- Alternative name(s)
- National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
- Location
- United Kingdom
Results and Publications
| Intention to publish date | 30/06/2025 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Stored in publicly available repository |
| Publication and dissemination plan | We plan to widely share the results from the study, within approximately 1 year of the study completion date (therefore, prior to October 2024). Dissemination activities will be aimed at relevant parties such as care home staff, owners and residents as well as commissioners and those with a responsibility for service planning and delivery. Dissemination activities will include: • Peer reviewed journal articles • Presentations at Care Home peer support networks • Evidence summaries and infographics • Video clips and social media posts • Media coverage will be sought in the from of local newspapers, television and radio outlets. • Requests will be sent to relevant agencies to feature the research project in their newsletters and websites. • A study web page will feature on the ARC Wessex collaboration website. |
| IPD sharing plan | The only quantitative datasets produced by the study will be the care home level falls rate data (number of falls per month and number of residents). • repository name/weblink, - Virtual International Care Home Trials Archive (VICHTA), which will be a subsidiary of the Virtual Trials Archive (based at University of Glasgow) • Type of data that will be shared –care home level data • When the data will become available–after main results papers have been published. • For how long - No fixed end date for how long data will be available • By what access criteria the data will be shared including with whom - Data access managed by Virtual Trials Archive (VTA) and overseen by Trialist Steering Committee • For what types of analyses, and by what mechanism, • Whether consent from participants was obtained – there will be a care home agreement on place for their participation. Individual participants who take part in qualitative interviews will only produce qualitative data. For NoMAD questionnaires, consent is implied by the completing of the survey, so not formal consent form is completed. • Comments on data anonymisation – all data will be fully anonymised by sender before it is transferred to VTA • Any ethical or legal restrictions – all future analysis of pooled trial data must be performed on Virtual Trials Archive online platform – data remains on VTA server. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol file | version 1.0 | 11/01/2022 | 06/04/2022 | No | No |
| HRA research summary | 28/06/2023 | No | No |
Additional files
Editorial Notes
17/03/2025: Total final enrolment was added and the intention to publish date was changed from 30/12/2024 to 30/06/2025.
11/09/2024: The following changes were made:
1. The overall study end date was changed from 30/09/2023 to 30/09/2024
2. The intention to publish date was changed from 30/09/2024 to 30/12/2024.
29/03/2022: Trial's existence confirmed by the National Institute for Health Research (NIHR) (UK).
