Evaluation of the Guide to Action Care Home fall prevention programme in care homes for older people: protocol for a multi-centre, single blinded, cluster randomised controlled trial (FinCH)

Background: Falls in older care home residents are at least five times more frequent than in community dwelling adults and have higher direct costs. Care home research is limited but suggests that fall-related injuries might be prevented by fall prevention interventions such as the Guide to Action Care Homes (GtACH) Tool. We are conducting a multi-centre, cluster randomised controlled trial to evaluate the use of the GtACH tool with residents in care homes. Methods & analysis: Adult care homes in England will be randomised on a one to one basis to training and use of the GtACH tool, or standard care. A total of 78 care homes and 1482 residents will be recruited with resident’s participation based on the care homes randomisation. Outcome measures will be collected from care home records and incident report forms by researchers (blind to allocation) at baseline, three, six, nine and twelve months post randomisation. The primary outcome, rate of falls per participant in the three months prior to six months post randomisation, will be expressed as the number of falls per 1,000 resident days for each group. Secondary outcomes are i) the rate of falls per participant in the three months prior to nine and twelve months post randomisation, ii) number & type of fall injuries, iii) physical activity & mobility, iv) functional ability, v) quality of life, vi) cost-effectiveness, and vii) number of deaths. In addition, six care homes using the GtACH tool will be selected for process evaluation of GtACH assessments and actions. Ethics & dissemination: Favourable ethical approval has been received from the NHS Health Research Authority and NHS sites. (Yorkshire & The Humber - Bradford Leeds Research Ethics Committee, 11/04/2016, ref: 16/YH/0111). Dissemination of findings will include quarterly newsletter updates to care home staff and residents, sponsor hosted events, community meetings, peer-reviewed publications and presentations at academic conferences.