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

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, UK were randomised (1:1) to SCTP or usual care (UC).

Participants: Residents who were not independently mobile.

Intervention: Skilful Care Training Package (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, falls. This informed data collection feasibility, and safety.

Results: 348 residents were screened; 146 were registered (71 UC, 75 SCTP). 42 were lost by 6-months, largely due to deaths. Whilst 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% - 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.