Report: Ambitions for change: improving healthcare in care homes

This new report from the British Geriatrics Society describes the care home sector across the UK as it currently stands and recent initiatives taken to improve health care for care home residents, including specific initiatives during the Covid-19 pandemic. It describes how health and wellbeing has traditionally been supported in care homes and sets out what good health care provision in a care home environment should look like.

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The British Geriatrics Society has published a new report aimed at improving the quality of healthcare for care home residents. The COVID-19 pandemic has had a devastating impact on older people, with 35.6% of the 130,000 deaths in the UK occurring in people living in care homes. Many others suffered from worsening physical, mental and emotional health as a result of lockdowns and visiting restrictions. This new report sets out how care home staff and visiting healthcare professionals can work together to ensure high-quality healthcare is delivered for the more than 400,000 older people who live in care homes.

The report, Ambitions for change: Improving healthcare in care homes, describes how healthcare is currently provided in these diverse settings, which range from small privately-owned care homes to large purpose-built homes run by care home chains. The COVID pandemic created extraordinary challenges for care homes, and this report argues that government, commissioners, care home providers and other stakeholders must now ensure that the structures, support and skills are consistently in place to ensure care home residents have access to the same standard of healthcare as other citizens.

Most residents of care homes live with frailty and have complex care needs. Following on from BGS guidance produced at the start of the pandemic, this report sets out common health concerns experienced by older people living in care homes, advocating for treatment on site whenever possible, to avoid the potential harms of hospitalisation. The delivery of person-centred, compassionate care is paramount, recognising that many care home residents are in the last two years of life. The report recommends the systematic use of Comprehensive Geriatric Assessment to ensure personalised individual care.

A care home is not a temporary residence and nor is it a hospital. It is the place that its residents call home. Recent developments have enabled more hospital-style care to be delivered in people’s homes, and the report encourages further development of this model. It makes recommendations to enable the delivery of healthcare in care homes which include the skills needed by both care home staff and visiting primary care teams, the use of digital communication and the sharing of data across healthcare providers. The recommendations can be implemented across the four nations of the UK, despite their different arrangements for funding and delivering social care.

The BGS believes older people’s experience of healthcare in care homes can be significantly enhanced by the adoption of these recommendations. After the traumatic period of the COVID pandemic, the report argues that now is the time to put in place improvements to how healthcare is delivered, to enable care home residents to live well for longer.

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