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Study trials new approach to preventing falls in care homes

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A £1.8m research project is investigating whether new guidance for care home staff could be effective in reducing the number of falls experienced by older residents.

The three-year project is recruiting care homes in the East Midlands, West Yorkshire and East Anglia to trial a new package of guidelines and training aimed at reducing the incidence of falls.

“Falls among care home residents place a huge financial burden on the NHS”

Pip Logan

If the new approach, designed by the University of Nottingham, is found to be effective in protecting residents from the risk of falls, it could potentially be rolled out to care homes across the UK.

The study team has worked with care home management and staff in Rushcliffe and Nottingham city to devise a checklist of 33 actions that staff can follow in a bid to reduce the risk of falls.

These include issues such as ensuring that residents remain sufficiently hydrated to spotting trip hazards and ensuring that they are wearing the correct spectacles.

In addition, the team has developed a bespoke training session to be delivered to staff to educate them in fall prevention and make them aware of the risks to their residents.

The researchers will be aiming to recruit 1,308 residents from 66 residential and nursing homes across Nottingham City, Nottinghamshire county, Leicester, Derby, Norwich and Bradford.

“It’s very important that staff are aware of what to do and what not to do in that type of situation”

Wynne Williams

They noted that, currently, many care homes assessed residents for risk of fall, giving them a score out of 10 or 20, but did not always take preventative actions, reacting instead when a fall occurs.

For the study, the homes will be randomly sorted into two groups. One half of the care homes will continue as they are with the researchers logging the incidence of falls among their residents.

The other half will use a falls prevention programme, specifically designed for care homes.

Nottingham University

Research to trial new approach to preventing falls in care homes

Pip Logan

Each care home will receive two weeks of training in which every member of staff will be trained to assess each resident for their risk of a fall and be guided by the associated actions.

The care home will have posters placed around the homes to offer a visual reminder to care home assistants, to use the guide to action tool.

Researchers will monitor the number of falls in the homes and compare them to those that have not used the new intervention to assess whether it has made a significant difference.

At the end of the trial, all care homes will be offered the training so they can adopt the new guidelines and action points should they so wish.

If the study provides evidence that the new guidelines and training are successful in fall prevention, the researchers hope it could become the standard approach adopted by all care homes.

Study lead Professor Pip Logan said: “Falls among care home residents place a huge financial burden on the NHS including treatment for broken bones, hip replacement surgery and lengthy hospital stays for recovery.

“In addition, this is an important quality of life issue for care home residents,” she said. “Falling can be a very frightening experience for older people and it can often leave residents extremely fearful of a repeat occurrence, leading them to reduce their mobility and losing independence.

“We know that exercise keeps us and our bones healthy so reducing their mobility can actually lead to them becoming increasingly frail over time,” she added.

The new checklist and training package has already been tested in six homes in a feasibility study before the larger study could go ahead.

Church Farm Nursing Home in Cotgrave

Research to trial new approach to preventing falls in care homes

Church Farm Nursing Home in Cotgrave

Wynne Williams, senior nurse at Church Farm Nursing Home in Cotgrave, which looks after residents with dementia, said: “If an older person in a care home has a fall, then they can be injured and bruise easily, they may not be able to walk as well afterwards and, in some cases, may become scared – it can be quite debilitating for them.

“And for the care home staff it can also be very upsetting – they feel guilty, they ask what they could have done better and whether there was something they could have done to prevent it,” she said.

“The new training package is very useful,” she said. “Staff need to know about falls and how they can at least minimise the risk of a resident having a fall.

“It’s very important that staff are aware of what to do and what not to do in that type of situation,” she noted.

The new study is being funded with a grant from the National Institute for Health Research.

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