Life in a care home, what's it really like?

News - 10 August 2017

Between January 2016 and April 2017, local Healthwatch visited 197 care homes across 63 different local authority areas in England to find out what life is really like for people living in care homes. Our new report explains what we found.

Two elderly women and a man having tea together

Our new report 'What's it like to live in a care home?' outlines key next steps for care homes in how feedback can be used to identify a whole host of small, low cost changes that ensure all residents feel ‘at home’.

The majority of residents and relatives Healthwatch spoke with considered the care they received to be good, with innovative homes showing what is possible without breaking the bank. For example, in Warrington one home really impressed through its use of technology, using a simple combination of a laptop and Google Street View to take residents on interactive virtual tours of places they have always wanted to visit.

Local Healthwatch representatives also saw staff going above and beyond the call of duty to connect with those they care for and really helping them to live their lives - including one activities coordinator from Cheshire who arranged for her own wedding reception to take place in the care home she worked at to enable residents to join in with the party.

Yet too often Healthwatch volunteer visitors also witnessed homes not getting the basics right with even those providing excellent care failing to tick all the boxes.

Residents themselves identified issues around both dignity and choice with things as simple as getting dressed. For example, one person in Wiltshire told her local Healthwatch that “the staff just pull things out of the wardrobe and say “that’s nice” and put it on me – they don’t ask what I would like to wear”. Another resident from Wolverhampton reported “my laundry is not always returned and is worn by others; though it does turn up eventually”.

Environment: 67 reports talked about the environment within care homes being an issue, with reports of wall paper peeling off walls, dead plants littering communal spaces and 11 local Healthwatch having to recommend an immediate 'deep clean' after relatives reported their loved ones living in dirty conditions. Our visitors also highlighted the lack of appropriate adaptations such as grab rails, dementia friendly signage and accessible toilet facilities.

Activities: 47 reports outlined strong feedback about the need for more or better activities. One resident told her local Healthwatch that she had only had one opportunity to do any exercise in the last five weeks. Of the 14 local Healthwatch reports that looked specifically at the use of technology half found that residents had no access to the internet, restricting their options for staying in touch with family and friends.
Staffing: 43 reports focused on concerns regarding staff numbers, training and turnover, with residents of the homes covered by these reports saying they felt this was affecting the continuity of care they receive. Whilst they praised staff for their attitude, enthusiasm and professionalism, ultimately it was felt they didn’t get enough time to connect with those caring for them.

Wider health needs: 34 reports talked about the access residents have to health services outside of the care home including GPs and dentists. Half were very positive whilst the other half painted a picture of residents having to struggle to make their own arrangements, with awareness of oral health issues a particular concern.

Although many of the reports produced by local Healthwatch organisations raise concerns about people’s experiences, the vast majority of care home managers have responded to the feedback very positively, often agreeing to review processes and making changes very quickly.

However, despite there being a statutory duty on providers of health and care services to respond to the recommendations made by local Healthwatch, 51 of the care homes visited over the last year and half have not yet responded. This, combined with some of the basic problems highlighted in these reports, raises concerns about a worrying culture of apathy towards the views and experiences of residents in some homes.

This report has therefore been produced to provide a benchmark of residents’ experiences and to encourage care home managers to work with their local Healthwatch to actively seek out and use feedback to drive improvement.

Our National Director, Imelda Redmond, said:

"It’s not easy running a care home, particularly as the sector as a whole is trying to get to grips with the dual challenge of managing rising demand with limited resources. But getting the basics right doesn’t have to cost the earth and should be the least we should all be able to expect for our loved ones and ourselves should we need care support.

“Even the best homes we visited aren’t perfect, and it is vital that managers and care staff regularly speak with their residents to work out what’s going well and where they might need to improve. None of us would want someone dictating how we should live our lives in our own homes, so why should we expect care home residents to tolerate it?

“Care homes are not institutions, they are people’s homes, and the only way to ensure they feel like this for residents is to put them at the heart of shaping how the care home runs. Healthwatch is here to help with this and I would urge anyone who wants to share their experiences, good or bad, to get in touch.”

See what organisations from across the health and care sector have said in response to our report .