Introduction Older people living in care homes are at increased risk of harm during acute hospital admissions. In England, care home residents have more than twice as many emergency department (ED) attendances as people of the same age living at home. Up to 40% of emergency hospital admissions of older care home residents may be avoidable with different models of care within their homes.In 2023, National Health Service England introduced the updated Enhanced Health in Care Homes (EHCH) framework, a set of recommendations to support ‘joined up’ and enhanced care for people living in care homes. A stated aim of the framework is to reduce ED attendances and inpatient admissions of residents. There is limited available evidence regarding how implementation of the EHCH framework differs regionally and whether variation in implementation may impact on hospitalisations of care home residents.Aims We aim to explore regional differences in care elements developed from the EHCH framework and assess how these differences may contribute to variation in hospitalisations of care home residents over the age of 65.Methods and analysis This is a comparative qualitative case study of six care home-containing postcode districts in England embedded within three Integrated Care Boards (ICBs). ICBs are regional organisations responsible for commissioning healthcare services in England. Case study districts and ICBs were selected due to contrasting case-mix adjusted admission rates and other characteristics (eg, deprivation). Data will be collected through semistructured interviews. We will interview health and social care professionals who are responsible for commissioning, overseeing and delivering enhanced care in care homes, care home professionals, residents over the age of 65 and their family and friends. Interview data will be analysed through a framework approach, with comparisons drawn within cases, across cases and across ICBs. Through our analysis, we will characterise the EHCH framework care elements and identify differences in implementation that may cause variation in hospital admissions. We will also identify perceived appropriate, effective and replicable enhanced care models.Patients and the public have informed the design of this study, and will advise the research practice, support the analysis of data and guide dissemination plans.Ethics and dissemination This study has received Social Care Research Ethics and Health Research Authority Approval (25/IEC08/0014). All participants will be required to provide informed consent. The findings will inform a national survey of ICBs to map appropriate and effective enhanced care in England. Findings will be shared with key stakeholders and academic audiences.

Objective To describe how care home staff experience bereavement and their perspectives on providing bereavement care within care home settings.Design Qualitative descriptive study using focus groups analysed with the Framework Method.Setting Seven residential and nursing care homes for older adults in Scotland.Participants 37 care home staff were recruited through the Enabling Research In Care Homes (ENRICH) Scotland research network. Participants included registered nurses, care workers, senior care workers, managers and ancillary workers with experience of resident death and bereavement practice.Results Bereavement was woven through everyday care home life, understood as a tapestry of experiences, relationships and practices that involved staff, residents and their relatives. Three themes that connected to the tapestry metaphor were identified: Warps: structural threads grounding bereavement within the culture of homely living, where close bonds normalise death and dying, and pragmatic acceptance. Wefts: strengthening practices nurturing resilience, including relational trust, mutual support, rituals and follow-up with relatives. Moths: disruptions undermining bereavement practice include family secrecy, hospital deaths with withheld information, difficulty supporting residents with advanced dementia and dissatisfaction with online training.Conclusions Bereavement in care homes is collective, relational and embedded in routine practice. Organisational recognition of grief improved interservice communication. Tailored reflective support for staff is needed to sustain compassionate care. Further research should explore how residents experience repeated exposure to death and bereavement within communal living environments.

Introduction Health and care data are routinely collected about care home residents in England, yet there is no way to collate these data to inform benchmarking and improvement. The Developing research resources And minimum data set for Care Homes' Adoption and use study has developed a prototype minimum data set (MDS) for piloting. Methods and analysis A mixed-methods longitudinal pilot study will be conducted in 60 care homes (approximately 960 residents) in 3 regions of England, using resident data from cloud-based digital care home records at two-time points. These will be linked to resident and care home level data held within routine National Health Service and social care data sets. Two rounds of focus groups with care home staff (n=8-10 per region) and additional interviews with external stakeholders (n=3 per region) will explore implementation and the perceived utility of the MDS. Data will be assessed for completeness and timeliness of completion. Descriptive statistics, including percentage floor and ceiling effects, will establish data quality. For validated scales, construct validity will be assessed by hypothesis testing and exploratory factor analysis will establish structural validity. Internal consistency will be established using Cronbach's alpha. Longitudinal analysis of the pilot data will demonstrate the value of the MDS to each region. Qualitative data will be analysed inductively using thematic analysis to understand the complexities of implementing an MDS in care homes for older people. Ethics and dissemination The study has received ethical approval from the London Queen's Square Research Ethics Committee (22/LO/0250). Informed consent is required for participation. Findings will be disseminated to: academics working on data use and integration in social care, care sector organisations, policy makers and commissioners. Findings will be published in peer-reviewed journals. Partner NIHR Applied Research Collaborations, the National Care Forum and the British Geriatrics Society will disseminate policy briefs.

ObjectivesMortality trends among people living in long-term care settings have been poorly understood. Linking data offers the potential to provide real-world, long-term national follow-up. Our aim was to describe patterns and associations with mortality among people moving-in to care homes in Scotland.MethodsA retrospective cohort study was undertaken using routinely collected national social care data from the Scottish Care Home Census. These data were indexed and linked to national health data and mortality records for individuals moving- in to care homes in Scotland between 1 April 2013 and 31 March 2016. Location of death, underlying causes and time to death are reported. Survival analysis was undertaken using the Gompertz model for human mortality adjusted for key variables.ResultsOf 23 892 individuals moving-in to care homes, 20 250 (84.8%) died by 31 May 2020. Most deaths occurred in the care home setting (77.5%), with a fifth (20.5%) occurring in the hospital. 0.1% died the day they moved-in, 3.2% within a month, 24.2% within a year and 85% by 7 years. Dementia codes account for more than a third of all deaths (35.1%). Median survival time was shorter (701 vs 951 days; 23 vs 32 months) for those moving-in from the hospital, compared with the community. The adjusted HR for moving-in from the hospital was 1.19 (95% CI 1.15 to 1.22).ConclusionsMortality is common in Scotland’s care homes but varies in timing. Dementia is the most common cause. Those moving-in from the hospital are more likely to die sooner, and this evidence provides opportunities to improve support for all involved.

Objectives To assess the feasibility of capturing older care home residents’ quality of life (QoL) in digital social care records and the construct validity (hypothesis testing) and internal consistency (Cronbach’s alpha) of four QoL measures.Design Cross-sectional data collected in wave 1 of the DACHA (Developing resources And minimum dataset for Care Homes’ Adoption) study, a mixed-methods pilot of a prototype minimum dataset (MDS).Setting Care homes (with or without nursing) registered to provide care for older adults (>65 years) and/or those living with dementia. All homes used a digital record system from one of two suppliers.Participants Data were extracted from 748 residents. All permanent residents, aged 65 years or older, were eligible to participate, including those lacking capacity to consent. Temporary residents and residents in their last weeks of life were excluded.Outcome measures and analysis The English language versions of Adult Social Care Outcomes Toolkit (ASCOT)-Proxy-Resident, ICEpop CAPability measure for Older people (ICECAP-O), EQ-5D-5L proxy and the QUALIDEM were added to the digital record. As there have not been any previous studies of the structural validity of the English language version of the QUALIDEM, ordinal exploratory factor analysis (EFA) was applied for this measure only. Feasibility (% missing by software provider and measure), % floor/ceiling effects (>15% at lower/upper end of the scales), convergent or divergent construct validity (criterion of >75% of hypotheses accepted) and internal consistency (Cronbach’s alpha ≥0.7) were assessed for all four measures.Results The ordinal EFA of QUALIDEM did not replicate the findings of previous research. A six-factor (36 item) solution was proposed and used in all subsequent analyses. There were low rates of missing data (<5%) for all items, except ASCOT-Proxy-Resident Control (5.1%) and Dignity (6.2%) and QUALIDEM item 35 (5.1%). Ceiling effects were observed for the ASCOT-Proxy-Resident and two of the QUALIDEM subscales. None of the scales had floor effects. Cronbach’s alpha indicated adequate internal consistency (α ≥0.70) for the ASCOT-Proxy-Resident, ICECAP-O and EQ-5D-5L proxy. There were issues with two QUALIDEM subscales. Construct validity for all measures was adequate.Conclusions The findings support the use of EQ-5D-5L, ASCOT-Proxy-Resident and the ICECAP-O in care homes for older people. The choice of measure will depend on the construct(s) of interest. More research is needed to establish the psychometric properties of the QUALIDEM in an English care home setting.

Digitalisation within English care homes offers potential to make more effective use of substantial data collected by staff during care planning and recording. A pilot minimum data set was co-designed with stakeholders based on two digital care records with additional structured measures. Our objectives were to explore (1) care home staff opinions and experiences of collecting structured measures of quality of life, cognition and function for residents and (2) how a minimum data set data might be used by staff and other professionals interested in care homes. Between June and October 2023 focus groups and interviews involving care home staff and Integrated Care System participants from three regions of England were undertaken. Integrated Care System staff work externally from care homes and support commissioning of services for care homes and reviewing data. We used a semi-structured topic guide. Two waves of care home focus groups were conducted after each wave of minimum data set data capture. A single wave of focus groups/interviews were undertaken with Integrated Care System participants. Reflexive thematic analysis was used to develop themes. Twenty-four staff from 22 care homes and 16 staff from 15 care homes participated in five wave one and four wave two focus groups respectively. Ten Integrated Care System participants from two of three study regions participated in one focus group (seven participants) and three individual interviews. Three themes were developed: the care home context and the importance of a minimum data set for care, appropriateness and relevance of quality of life measures to resident care, and data quality and purpose. Care home staff can collect structured measures on resident quality of life, function and cognition using digital care records to contribute to a minimum data set. The data generated can inform and enhance resident care. However, implementation is an evolving process requiring support, trust-building and confidence among those collecting and interpreting data and incorporation as part of routine care.

Abstract Introduction People living with multiple long-term conditions (MLTC) are more likely to experience hospital admission, which is often associated with unintended consequences. Preventing or providing alternatives to admission by predicting adverse admission-related outcomes is important. This study aims to provide an overview of the association between MLTCs and adverse outcomes following hospital admission through a systematic review of systematic reviews. Method We searched Medline, Embase, CINAHL, Web of Science and PsycINFO for systematic reviews assessing risk factors/predictors of functional decline (FD), nursing home admission (NHA), or changes in quality of life among adults (≥18 years) experiencing unscheduled acute hospital admission. Eligible reviews had to assess MLTC (LTC counts, indices, or individual LTCs), either alone or with other predictors. Titles/abstracts and full texts were screened in duplicate and candidate predictors were extracted. Results 14 systematic reviews assessed predictors of FD (n = 8) or NHA (n = 6). Reviews focused on studies of general inpatients/mixed presentations (n = 8: 6 FD, 2 NHA); hip fracture (n = 2: 1 FD, 1 NHA); stroke (n = 2: 1 FD, 1 NHA) and cognitive impairment (n = 1, NHA) or delirium (n = 1, NHA). Assessment of MLTC was heterogenous: comorbidity indices (n = 4), counts of LTC (n = 2), specific LTC (n = 8), and ‘comorbidity’ without further qualification (n = 3). Higher comorbidity indices, higher counts, and a range of specific comorbidities (most notably dementia) were associated with FD and NHA. Reviews assessing MLTC alongside other predictors highlighted a broad range of sociodemographic, functional, social, and admission-related factors that were associated with FD and NHA. In general, reviews did not assess the relative importance of MLTC alongside other predictors. Conclusion While MLTC may predict unwanted outcomes following admission their qualification is often inconsistent and their relative importance as predictors, alongside broader factors such as social complexity, is rarely assessed in existing systematic reviews.

Background Care home residents are a highly vulnerable group, but identifying care home residents in routine data is challenging. This study aimed to develop and validate Natural Language Processing (NLP) methods to identify care home residents from primary care address records. Methods The proposed system applies an NLP sequential filtering and preprocessing of text, then the calculation of similarity scores between general practice (GP) addresses and care home registered addresses. Performance was evaluated in a diagnostic test study comparing NLP prediction to independent, gold-standard manual identification of care home addresses. The analysis used population data for 771,588 uniquely written addresses for 819,911 people in two NHS Scotland health board regions. The source code is publicly available at https://github.com/vsuarezpaniagua/NLPcarehome. Results Care home resident identification by NLP methods overall was better in Fife than in Tayside, and better in the over-65s than in the whole population. Methods with the best performance were Correlation (sensitivity 90.2%, PPV 92.0%) for Fife data and Cosine (sensitivity 90.4%, PPV 93.7%) for Tayside. For people aged ≥65 years, the best methods were Jensen-Shannon (sensitivity 91.5%, PPV 98.7%) for Fife and City Block (sensitivity 94.4%, PPV 98.3%) for Tayside. These results show the feasibility of applying NLP methods to real data concluding that computing address similarities outperforms previous works. Conclusions Address-matching techniques using NLP methods can determine with reasonable accuracy if individuals live in a care home based on their GP-registered addresses. The performance of the system exceeds previously reported results such as Postcode matching, Markov score or Phonics score.

The Scottish Intercollegiate Guidelines Network (SIGN) have recently published their guideline SIGN168 on ‘Assessment, Diagnosis, Care, and Support for People with Dementia and their Carers’. The guideline makes evidence-based recommendations for best practice in the assessment, care and support of adults living with dementia. Topics featured in this guideline are limited to those prioritised by stakeholders, especially people with lived and living experience, and those not well covered under pre-existing guidance. We summarise the guideline recommendations related to identification and diagnosis of dementia, investigative procedures, postdiagnostic support living with dementia, including non-pharmacological approaches for distressed behaviours, using technology to support people with dementia, grief and dementia and changing needs of people with dementia. The guideline content is summarised as officially published, with additional commentary in the final section.

Background Pathways into care-homes have been under-researched. Individuals who move-in to a care-home from hospital are clinically distinct from those moving-in from the community. However, it remains unclear whether the source of care-home admission has any implications in term of costs. Our aim was to quantify hospital and care-home costs for individuals newly moving-in to care homes to compare those moving-in from hospital to those moving-in from the community. Methods Using routinely-collected national social care and health data we constructed a cohort including people moving into care-homes from hospital and community settings between 01/04/2013-31/03/2015 based on records from the Scottish Care-Home Census (SCHC). Individual-level data were obtained from Scottish Morbidity Records (SMR01/04/50) and death records from National Records of Scotland (NRS). Unit costs were identified from NHS Scotland costs data and care-home costs from the SCHC. We used a two-part model to estimate costs conditional on having incurred positive costs. Additional analyses estimated differences in costs for the one-year period preceding and following care-home admission. Results We included 14,877 individuals moving-in to a care-home, 8,472 (57%) from hospital, and 6,405 (43%) from the community. Individuals moving-in to care-homes from the community incurred higher costs at £27,117 (95% CI £ 26,641 to £ 27,594) than those moving-in from hospital with £24,426 (95% CI £ 24,037 to £ 24,814). Hospital costs incurred during the year preceding care-home admission were substantially higher (£8,323 (95% CI£8,168 to £8,477) compared to those incurred after moving-in to care-home (£1,670 (95% CI£1,591 to £1,750). Conclusion Individuals moving-in from hospital and community have different needs, and this is reflected in the difference in costs incurred. The reduction in hospital costs in the year after moving-in to a care-home indicates the positive contribution of care-home residency in supporting those with complex needs. These data provide an important contribution to inform capacity planning on care provision for adults with complex needs and the costs of care provision.

BACKGROUND:Assessment of functional status is an integral part of older adult healthcare and research. Therefore, it is essential that tools to capture function are contextually appropriate. Many tools designed to evaluate extended Activities of Daily Living (eADLs) were developed decades ago. OBJECTIVE:Our aim was to explore which eADL tasks are commonly performed by older adults and map these tasks to popular eADL scales, seeking stakeholder perspectives to inform recommendations on scale content. DESIGN:Online survey with quantitative questions and free text followed-by semi-structured interviews. SUBJECTS:Older adults (≥60-years), carers and health, social care and voluntary/community professionals. METHODS:We extracted eADL tasks from existing scales to develop a survey on frequency of performance, with space for additional comment. The survey was disseminated via Join Dementia Research and other clinical and professional networks. Online semi-structured interviews were undertaken with thematic analysis of verbatim transcripts. RESULTS:From 2244 online survey responses, 87% came from older people and two-thirds of respondents were female. Some eADL tasks were never performed by many participants. Tasks not part of existing tools included online banking and mobile phone use. From fifteen interviews, a recurring theme was that technological and societal changes have altered daily tasks. CONCLUSIONS:Commonly used eADL scales contain obsolete tasks and omit tasks older people consider part of their everyday lives. There is a need to work collaboratively to update eADL tools to reflect the priorities and activities of older people to ensure these remain valid measures for use in practice and research. To complement this abstract, a video abstract is available online. A more detailed video-based summary of the content is also available as supplemental material.

AbstractBackgroundCare home residents have complex needs, and minimum data sets (MDSs) provide a unique source of information on their health and wellbeing. Although MDSs were first developed to monitor quality and costs of care, they can make an important contribution to research.AimTo describe the research applications of data from care home MDSs, and identify key outcome variables and measures used.DesignMapping review of published empirical studies using data generated from minimum data sets in long term care facilities for older adults.MethodsWe performed a comprehensive search of electronic databases (Medline OVID, CINAHL, Embase and ASSIA), using bespoke search strategies to identify English language publications 2011 - 2024. Articles were screened by two independent reviewers. They were grouped by study topic and data (on publication date, country, MDS, outcome variables and specific items or measures) were charted without quality assessment. The key features of the data are described in a narrative synthesis.FindingsSearches identified 18588 articles published 2011-2024, of which 661 met inclusion criteria. 72% were from the USA, 12% from Canada and the remaining 16% from four European countries, South Korea and New Zealand. The studies encompassed individual resident functioning (e.g. mobility, incontinence), health conditions and symptoms (e.g. depression, pain), healthcare in the home (e.g. prescribing, end of life care), hospital attendances and admissions, transitions to and from care homes, quality of care and systemwide issues. Measures used reflected the content of the major MDSs, but there was a mismatch between the importance of some topics to care homes (e.g. incontinence) and the range of published papers, and limited consensus over how to measure quality of life.ConclusionsCare home MDSs are a unique resource to support study of care home residents and impact of interventions over time. They are a powerful resource when linked to other datasets, and as an adjunct to primary data collection This analysis may serve as an accessible guide to the content and applications of MDS, allowing researchers to consider the sort of questions that can be posed and the different components of resident care or experience that can be evaluated.

BACKGROUND:The impact of the COVID-19 pandemic on long-term care residents remains of wide interest, but most analyses focus on the initial wave of infections. OBJECTIVE:To examine change over time in: (i) The size, duration, classification and pattern of care-home outbreaks of COVID-19 and associated mortality and (ii) characteristics associated with an outbreak. DESIGN:Retrospective observational cohort study using routinely-collected data. SETTING:All adult care-homes in Scotland (1,092 homes, 41,299 places). METHODS:Analysis was undertaken at care-home level, over three periods. Period (P)1 01/03/2020-31/08/2020; P2 01/09/2020-31/05/2021 and P3 01/06/2021-31/10/2021. Outcomes were the presence and characteristics of outbreaks and mortality within the care-home. Cluster analysis was used to compare the pattern of outbreaks. Logistic regression examined care-home characteristics associated with outbreaks. RESULTS:In total 296 (27.1%) care-homes had one outbreak, 220 (20.1%) had two, 91 (8.3%) had three, and 68 (6.2%) had four or more. There were 1,313 outbreaks involving residents: 431 outbreaks in P1, 559 in P2 and 323 in P3. The COVID-19 mortality rate per 1,000 beds fell from 45.8 in P1, to 29.3 in P2, and 3.5 in P3. Larger care-homes were much more likely to have an outbreak, but associations between size and outbreaks were weaker in later periods. CONCLUSIONS:COVID-19 mitigation measures appear to have been beneficial, although the impact on residents remained severe until early 2021. Care-home residents, staff, relatives and providers are critical groups for consideration and involvement in future pandemic planning.

Abstract Background People living with dementia are more likely to move into care homes. The true prevalence of dementia among care home residents in Scotland is not known. People living with dementia often interact with multiple social and healthcare services, thus routine data may offer a way to enhance understanding. Aim To compare national health and social care data sources recording dementia status for Scottish care home residents. Methods A retrospective cohort study of adult (≥ 18 years) care home residents in Scotland during financial years 2012/13 and 2013/14. An indexing process linked data from the Scottish Care Home Census (SCHC) to Community Health Index numbers to allow linkage to healthcare datasets. Anonymised individual data was accessed in a secure environment, within the National Safe Haven. A linked dataset with acute/general and psychiatric hospitalisations (SMR01, SMR04), prescriptions (Prescribing Information System), Scottish Patients at Risk of Admission and Readmission (SPARRA) data, and National Records of Scotland (NRS) mortality records was analysed. Dementia recording was studied across these datasets. Results In 2012/13 and 2013/14, 31,589 and 31,504 care home residents were included for analysis. In 2012/13, 17,548 (55.5%) had dementia according to SCHC. PIS and SMR01 confirm 4,701 (26.8%) and 4,254 (24.3%) SCHC dementia records, respectively. SMR04 and SPARRA confirm 1,830 (10.4%) and 964 (5.5%). Among 2012/13 residents, 19,593 (62.0%) have at least one dementia record across datasets. Of these, 10,445 (53.3%) have one record – 83.9% SCHC records, 7.3% SMR01 records, and 5.0% PIS records. Of 15,781 residents who die within 5 years from 2012/13, 6,984 (44.3%) have death records confirming dementia. Results for 2013/14 are similar. Conclusion Routine data enhances dementia ascertainment amongst care home residents, with most confirmation from general hospitalisations and prescriptions. Primary care data and analysis of more financial years would enable further exploration of dementia recording patterns.

BACKGROUND:The serious outcomes of outbreaks of COVID-19 in care homes have been described internationally. The experiences of professionals working through outbreaks has received less attention, missing opportunities to acknowledge and learn lessons. Our aim was to explore the experiences of care home staff in Scotland of managing COVID-19 within their homes to help inform understanding and future practice.METHODS:From April to August 2022, 34 individual semi-structured interviews were conducted with care home staff working in homes which experienced an outbreak(s) of COVID-19. Reflexive thematic methods were used to analyse verbatim deidentified transcripts.FINDINGS:There was no singular experience of COVID-19 outbreaks within care homes. We identified four broad groupings of homes with outbreaks (significant outbreaks, managed outbreaks, outbreaks in remote/rural homes & outbreaks in homes supporting younger adults), with overlaps in timing and severity and variation in the support received and impact. The national response to the COVID-19 pandemic resulted in fundamental change to care home relationships. Staff responded by adaptation in uncertainty. However, they were challenged by emerging inequalities influencing residents' care. There were tensions between staff experience and evolving external approaches to regulation and oversight. All this change resulted in psychological impacts on staff. However, there was also widespread evidence of compassionate leadership and teamwork in their responses. Effective sources of support were underpinned by respectful relationships and continuity, tailored to individual contexts.CONCLUSIONS:The lived experiences of care home staff during the COVID-19 pandemic provide valuable insights applicable beyond the pandemic context. This includes: recognition of the specialism, complexity and diversity of care home practice; the value afforded by embedding genuine representation and involvement in planning, policy-making and research; the need for individualising to people in their contexts and the value of fostering respectful relationships across professional groups to support residents.

Abstract Background Care homes are increasingly important settings for intervention research to enhance evidence-informed care. For such research to demonstrate effectiveness, it is essential that measures are appropriate for the population, setting and practice contexts. Objective To identify care home intervention studies and describe the resident outcome measures used. Design Scoping review. Methods We reviewed international care home research published from 2015 to August 2022. We searched MEDLINE, EMBASE, CINAHL and ASSIA. We included any intervention study conducted in a care home, reporting resident outcomes. We extracted resident outcome measures, organised these using the domains of an adapted framework and described their use. Results From 7,330 records screened, we included 396 datasets reported in 436 publications. These included 12,167 care homes and 836,842 residents, with an average of 80 residents per study. The studies evaluated 859 unique resident outcomes 2,030 times using 732 outcome measures. Outcomes were evaluated between 1 and 112 times, with 75.1% of outcomes evaluated only once. Outcome measures were used 1–120 times, with 68.4% of measures used only once. Only 14 measures were used ≥20 times. Functional status, mood & behaviour and medications were the commonest outcome domains assessed. More than half of outcomes were assessed using scales, with a fifth using existing records or administrative data. Conclusions There is significant heterogeneity in the choice and assessment of outcomes for intervention research in care homes. There is an urgent need to develop a consensus on useful and sensitive tools for care homes, working with residents, families and friends and staff.

Figure S3: Pharmacodynamic changes in peripheral blood

Introduction Randomised controlled trials (RCTs) conducted in care home settings address a range of health conditions impacting older people, but often include a common core of data about residents and the care home environment. These data can be used to inform service provision, but accessing these data can be challenging. Methods The Virtual International Care Home Trials Archive (VICHTA) collates care home RCTs conducted since 2010, with >100 participants, across multiple conditions, with documented eligibility criteria, initially identified from a scoping review. A Steering Committee comprising contributing trialists oversees proposed uses of fully anonymised data. We characterised available demography and outcomes to inform potential analyses. Data are accessible via application to the Virtual Trials Archives, through a secure online analysis platform. Trial recruitment is ongoing and future expansion will include international studies. Results The first phase of VICHTA includes data from six UK RCTs, with individual participant data (IPD) on 5,674 residents across 308 care homes. IPD include age, sex, dementia status, length of stay, quality of life, clinical outcome measures, medications, resource use, and care home characteristics, such as funding, case mix, and occupancy. Follow-up ranges between four and sixteen months. Conclusions VICHTA collates and makes accessible data on a complex and under-represented research population for novel analyses, and to inform design of future studies. Planned expansion to international care home RCTs will facilitate a wider range of research questions. Interested collaborators can submit trial data or request data at www.virtualtrialsarchives.org.