Cook serving food to a group of elderly residents in a nursing home
We are looking for care homes in or close to Devon, Dorset, Hampshire and the West Midlands to participate in the REFRESH study.
The study will test how best to treat malnutrition in older adults (aged over 65 years) living in care homes.
Older people who live in care homes are at risk of malnutrition, which harms their health, reduces their quality of life, and increases the risk of falls and infections. Managing malnutrition better can help maintain mental and physical health and improve the wellbeing of residents. Improving nutritional care will help improve quality of life by making eating more pleasurable, supporting independence for residents, and reducing the burden for staff and associated costs.
Care homes that join the study will be randomly put into one of three groups:
  1. ONS Group; we will provide eligible residents with oral nutrition supplements (ONS)
  2. FF Group; the eligible residents will be provided with fortified food (FF) and drink
  3. Usual Care Group; the care homes will carry on with their usual routines for managing malnutrition.
 
 
Young nurse bonding with her senior patients during a tea party

Payments and incentives

There is no payment for taking part in the study, but your costs will be reimbursed.

Care home eligibility

We are looking for 90 care homes who are keen to take part and who are willing to manage eligible residents using one of the approaches. We are keen to work with large care homes and are aiming to recruit about 17 residents per care home.

Resident eligibility

Residents aged 65 years and over who are living in your care home permanently and at risk of malnutrition will be eligible.

Processes and activities involved in the study

The research team will support the study at your care home. Initially, we will meet with you and your team to discuss the study in more depth. We would then work with you and your team to make sure that anyone involved has the appropriate training and support needed.
We would expect staff to:
  • Participate in the training we provide
  • Identify which residents are suitable for the study (we will provide the full eligibility criteria)
  • Assist in recruiting residents by talking to them or their families about the study or giving out written information
  • Work with the research team to obtain consent from residents or their families and collect data
  • Provide the fortified food or ONS according to the guidance we provide (depending on which one your care home is randomly allocated)
The exact time commitment will be discussed with you in more detail if you choose to register your interest.

Likely benefits for the residents and care homes

Taking part in this study will provide you and your care home with the opportunity to focus on the nutritional care you give to your residents, demonstrating your commitment to improving outcomes, supporting high quality leadership, and becoming more responsive to the needs of your residents. The care homes in the ONS or FF groups will get additional training for their staff, and this will be made available to the care homes in the usual care group at the end of the study.
The Care Quality Commission is aware of this study and is interested in the results we produce. It is likely that they will apply the findings of this study in future 'good practice' guidance and monitoring for care homes.
Thank you for taking the time to read and consider this taking part in this study.
If you would like to express your interest in participating in the study, please follow the link to our expression of interest form
If you have further questions or want to discuss the study further before submitting the form, please don’t hesitate to contact the research team by email: refresh.penctu@plymouth.ac.uk
 
 

Study background

REFRESH has been funded by a National Institute of Health and Care Research (NIHR) Health Technology Assessment grant. This is UK government's major funding body for health and care research.
The Universities of Plymouth and Bournemouth are collaborating on this study, which is led by Professors Mary Hickson and Jane Murphy.
The University of Plymouth is taking responsibility for the governance of this study.
We are currently working to obtain the national ethics approvals and hope to receive the approval to start recruiting participants for the study by October 2025.