Objectives: Maintaining physical activity for older residents in care homes maximises their physical and mental health and wellbeing, independence, dignity and quality of life. Unfortunately, most residents do not participate in regular physical activity. Active Residents in Care Homes, ARCH, was designed to increase physical activity by facilitating whole-system change in a care home. We evaluated whether ARCH can be delivered, its effects on resident's physical activity, wellbeing and costs. Design: Feasibility study. Setting: Three residential care homes. Participants: Care home residents and staff. Intervention: Occupational and physiotherapists implemented ARCH over 4 months with an 8month follow-up. Main outcome measures: Assessment of Physical Activity, Pool Activity Level, EQ5D-5L, Dementia Care Mapping, cost of implementing ARCH, health and social care utilisation. Results: After implementing ARCH, residents displayed more positive behaviours, better mood and engagement and higher physical activity levels, but these improvements were not sustained at 8-month follow-up. The cost (2016 prices) of implementing ARCH was £61,037, which equates to £1,650/resident. Healthcare utilisation was £295/resident (SD320) in the 4 months prior to ARCH, £308/resident (SD406) during the 4-month implementation and £676/resident (SD438) in the 8month follow-up. Conclusions: The ARCH programme can be delivered, it may have some short-term benefits and is affordable. Rather than have unrealistic increases in the health and longevity of older care home residents, ARCH may slow the decline in physical, mental and emotional well-being usually seen in older people in care homes, return some dignity and improve their quality of life in their last months or years.

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Background: Day centres can enable people with mild-to-moderate physical and mental health conditions to continue living at home, delaying their move into residential care. ‘Access to Wellbeing’ is a programme designed to help day centres improve service users’ health and participation in meaningful physical, mental and social activities. This paper documents the programme and people's experiences of its implementation. Methods: This study used a retrospective observational design, and studied a day centre that caters for 40 disabled and/or frail adults daily. The Access to Wellbeing programme development started with a structured assessment of the day centre to identify aspects of the environment and working practices that impeded physical activity. Service users were interviewed to understand their needs, abilities and interests, and establish meaningful activities to improve their health and wellbeing. Alterations to organisational structures, the physical environment and work practices were instigated to increase opportunities for physical activity and involvement. Shortly after implementation of the Access to Wellbeing programme in a day centre, semi-structured interviews were conducted with three day centre staff and three members of the community rehabilitation team exploring their experiences of the programme and its implementation. Findings: Despite staff's initial scepticism about the programme and concerns about their increased workload, and its effect on their relationship and interaction with service users, the programme was successfully implemented. The programme increased service users’ physical health and wellbeing, and satisfaction with the service, and improved staff motivation and job satisfaction. A committed team working together was the most important factor determining successful implementation. Few additional resources were required. Conclusions: A holistic programme that aims to improve meaningful activities can be implemented in day centres. These programmes can bring wide-ranging benefits to service users health, wellbeing and participation, and staff motivation job satisfaction and productivity.