Stigma undermining care homes’ potential to improve lives, finds study

Care homes’ potential to deliver a positive experience for residents is being undermined by stigma and mistrust surrounding staff and residents, a three-year study has warned.

The My Home Life programme found a culture of negativity – fuelled by media reports of abuse – devalued the complex work that care home staff did and made some embarrassed to tell their friends what they did.

Mistrust and isolation

“While we know there is lots of good practice out there, too many care homes experience mistrust from the community and statutory services which only serves to increase their feeling of isolation and reduce their capacity to deliver a positive experience for older people,” said My Home Life director Tom Owen. “Quality in care homes has to be the responsibility of the whole community, not just the staff.”

My Home Life, which seeks to identify and spread good practice in residential care, said it had gathered case studies that demonstrated how care homes could help older people regain a sense of identity, involve them in decision-making and provide them with choice over their support (see right).

Success was based on “relationship-centred practice”, in which staff and residents forged strong relationships with each other and with local communities.

Negative media portrayal

However, the report said the negative portrayal of care homes in the media and elsewhere isolated them from their communities and sapped the confidence of staff and managers to work positively with older people. This, along with the significant demands for information from regulators, commissioners and safeguarding teams, bred risk-averse practice.

“Constant bombardment from external bodies, lack of trust and support from both within and outside of the care home, and the fear that they might make a mistake, can all result in managers leading care homes from a position of defensiveness, stress and anxiety,” said the report. “Trying to control everything that is going on in a care home goes against the evidence of what constitutes good leadership, often resulting in staff simply taking orders from managers and a focus on getting tasks done.”

Recommendations

The report said changing the negative perception of care homes would involve strengthening the leadership role of managers, empowering staff and residents, and reducing unnecessary paperwork and bureaucracy.

Specific recommendations included:-

• For care providers to allocate specific time and budgets for the continuing professional development of managers, and reflect on how their actions affect managers’ ability to deliver improvements in the home;
• For managers to take responsibility for their own professional development and pilot more creative ways of engaging with older people;
• For staff to have protected time to foster relationships with residents and their families;
• For commissioners and regulators to assess the resource implications of new requirements for care homes in terms of paperwork;
• For government to consider how duplication of monitoring of care homes can be reduced and commission schemes to improve residents’ access to advocacy.

My Home Life is funded by Age UK, the Joseph Rowntree Foundation, City University and Dementia UK. The report, which was released at the National Children and Adult Services Conference, was based on analysis of case studies, a review of relevant literature, and interviews with care home leaders.

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