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A posture and mobility training package for care home staff: results of a cluster randomised controlled feasibility trial (the PATCH trial)

Graham, Liz; Ellwood, Alison; Hull, Karen; Fisher, Jill; Cundill, Bonnie; Holland, Michael; Goodwin, Madeline; Clarke, David; Hawkins, Rebecca; Hulme, Claire; Patel, Ismail; Kelly, Charlotte; Williams, Rachel; Farrin, Amanda; Forster, Anne

Authors

Liz Graham

Alison Ellwood

Karen Hull

Jill Fisher

Bonnie Cundill

Michael Holland

Madeline Goodwin

David Clarke

Rebecca Hawkins

Claire Hulme

Ismail Patel

Rachel Williams

Amanda Farrin

Anne Forster



Abstract

Background
provision of care for care home residents with complex needs is challenging. Physiotherapy and activity interventions can improve well-being but are often time-limited and resource intensive. A sustainable approach is to enhance the confidence and skills of staff who provide care. This trial assessed the feasibility of undertaking a definitive evaluation of a posture and mobility training programme for care staff.

Design and setting
a cluster randomised controlled feasibility trial with embedded process evaluation. Ten care homes in Yorkshire, United Kingdom, were randomised (1:1) to the skilful care training package (SCTP) or usual care (UC).

Participants
residents who were not independently mobile.

Intervention
SCTP—delivered by physiotherapists to care staff.

Objectives and measurements
key objectives informed progression to a definitive trial. Recruitment, retention and intervention uptake were monitored. Data, collected by a blinded researcher, included pain, posture, mobility, hospitalisations and falls. This informed data collection feasibility and participant safety.

Results
a total of 348 residents were screened; 146 were registered (71 UC, 75 SCTP). Forty two were lost by 6 months, largely due to deaths. While data collection from proxy informants was good (>95% expected data), attrition meant that data completion rates did not meet target. Data collection from residents was poor due to high levels of dementia. Intervention uptake was variable—staff attendance at all sessions ranged from 12.5 to 65.8%. There were no safety concerns.

Conclusion
care home and resident recruitment are feasible, but refinement of data collection approaches and intervention delivery are needed for this trial and care home research more widely.

Journal Article Type Article
Journal Age and Ageing
Print ISSN 0002-0729
Electronic ISSN 1468-2834
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Article Number afaa046
APA6 Citation Graham, L., Ellwood, A., Hull, K., Fisher, J., Cundill, B., Holland, M., …Forster, A. (in press). A posture and mobility training package for care home staff: results of a cluster randomised controlled feasibility trial (the PATCH trial). Age and ageing, https://doi.org/10.1093/ageing/afaa046
DOI https://doi.org/10.1093/ageing/afaa046
Keywords Older people; Long-term care; Cluster randomised trial; Posture and mobility; Staff training
Publisher URL https://academic.oup.com/ageing/advance-article/doi/10.1093/ageing/afaa046/5814048

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Copyright Statement
© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.





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