History

So often it is the most obvious things that can make the biggest difference. The launch of a multi-centre cluster randomised controlled trial, focusing on a falls prevention intervention (FinCH) provides an opportunity to develop research in the care home sector. The background to the study, started many moons ago, was when a Community Falls Specialist, Kate Robertson, and her colleagues from Health and Social Care in Nottinghamshire, developed a Guide to Action tool, in an attempt to help prevent falls. As the tool evolved and developed jointly with health and care home staff for specific use in care homes, a recent feasibility study led by Professor Pip Logan, concluded a systematic ‘Guide to Action Care Homes’ (GtACH) process was implementable in care homes [1].

Funding

The award to evaluate the clinical and cost effectiveness of GtACH intervention, and to determine whether it is effective in reducing the rate of falls in elderly care home residents, is funded by the National Institute for Health Research, Health Technology Programme.

Recruitment Sites

The study aims to recruit 66 care homes and 1308 residents from six centres initially. The sites will be located in Nottingham, Nottinghamshire, Derby, Leicestershire, Norwich and Bradford. Once these sites are up and running there may be potential to invite further sites to enrol.

Why Falls in Care Homes?

The Chief Investigator, Professor Pip Logan leading the research talks about why this research is important:
‘A fall can often lead to sustaining a serious fracture, or develop a fear of falling, associated with activity restriction and associated depressive symptoms. Having a fall therefore, can severely affect the quality of people’s later life and we are keen to find ways to prevent this happening, if we can. Care home research has been underrepresented in the past. Therefore, taking the opportunity to broaden our engagement with care homes to help understand the complexities they face on a day to day basis, often with limited support, is something we are very keen to embark on’. 

The Shining of a Spotlight

In addition to the primary and secondary outcome data, an essential part of this trial is the process evaluation, led by Dr Paul Leighton.  As it is likely the intervention will work differently in each care home, capturing the components of the intervention that may not be directly observable is described: 
 ‘Exploring what works, for whom and when, by layering up the data is the aim. We want to use six care homes as case studies to give us a comprehensive understanding as to what might be happening, almost like shining a spotlight on the process to help with a more detailed analysis’. 

FinCH Timeline

FinCH is a three year trial which commenced in May 2016.  Recruitment aims to start in November 2016, with the help of the Clinical Research Networks.  The aim is to recruit for one year, and the final date for the completion of the study is April 2019.

FinCH Contacts

For further information regarding the study, please contact Trial Administrator Gail Arnold (Gail.Arnold@nottingham.ac.uk), Intervention Trial Manager Jane Horne (Jane.Horne@nottingham.ac.uk) or Chief Investigator Pip Logan (Pip.Logan@nottingham.ac.uk); or visit the trial website:
http://www.nottingham.ac.uk/research/groups/communityrehabilitation/projects/falls-in-care-homes-finch.aspx
 

1. Walker, G.M., et al., 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. Clinical rehabilitation, 2015: p. 0269215515604672.
Photograph:  Professor Pip Logan