Resident voices in residential care homes

This report, "Resident Voices in Residential Care Homes”, presents findings from a pilot project conducted by Healthwatch Hertfordshire across three residential care homes. The project explored residents' experiences of daily life, focusing on independence, safety, personal care, relationships and community connections, and aimed to understand how Hertfordshire’s Connected Lives model is working in practice.

Overall findings

The report found that all three care homes provided warm, caring and person-centred environments. Residents generally felt safe, respected and well cared for, while strong staff retention helped foster positive and trusting relationships between staff and residents. Despite differences between the homes, many common strengths and challenges emerged. 

Residents' experiences

Residents consistently valued having choice and control over their daily lives. They appreciated being able to decide when to get up, what to eat, whether to participate in activities and how to personalise their own rooms. Many residents reported feeling supported to maintain their independence, including managing their own finances, technology and community activities where possible. 

Residents also generally felt safe and secure within their homes. Staff were frequently described as kind, friendly and attentive, and the homes were seen as comfortable and homely rather than institutional. One home highlighted particularly strong end-of-life planning, with most residents able to have their wishes respected regarding where they wanted to spend their final days. 

Activities, purpose and social connections

Activities played an important role in residents’ wellbeing. Homes offered a wide variety of activities, including arts and crafts, music, baking, bingo, faith services, sporting events and community outings. Activities were often tailored to residents’ interests, histories and abilities, helping people remain engaged and maintain a sense of identity.

Many residents also gained a sense of purpose through meaningful roles within their homes, such as assisting fellow residents, helping with meals, running small services for other residents or showcasing creative work in the community. These opportunities helped residents remain active and feel valued. 

Relationships were central to quality of life. Residents benefited from strong relationships with staff and enjoyed support to maintain family connections through open visiting arrangements and regular communication with relatives. However, some residents, particularly those who preferred to remain in their rooms, reported occasional feelings of loneliness. 

Community engagement

The homes actively encouraged residents to remain connected to the wider community. Community involvement included school visits, intergenerational programmes, church services, fundraising events, trips and public displays of residents’ artwork. Residents valued both opportunities to visit the community and opportunities for community members to visit the homes.

Examples of good practice

The report highlighted a number of innovative approaches. These included pre-admission home visits to build trust before residents moved in, buddy systems pairing residents with dedicated staff members, resident-led feedback systems, direct engagement between chefs and residents over meal quality, memory boxes outside bedrooms, meaningful resident roles and flexible support for couples living in care. 

Some homes also demonstrated effective use of technology and feedback systems, enabling managers to respond quickly to concerns raised by residents, relatives or visitors.

Common challenges

Although overall experiences were positive, several challenges were identified across all three homes:

• Some residents experienced loneliness and social isolation despite active programmes of activities. 
• Support for residents using digital technology was often informal and inconsistent. 
• Costs, transport limitations and staffing requirements sometimes restricted opportunities for outings and community activities. 
• Moving into a care home remained a significant adjustment, and not all homes had formal settling-in programmes. 
• Some residents were reluctant to raise concerns because they did not want to be seen as a burden, even when issues affected their comfort or wellbeing. 

Recommendations

The report recommends that the Strategic Quality Improvement Group (SQIG) strengthen its focus on residents’ experiences by:

• Routinely reviewing and analysing resident feedback. 
• Holding learning events to share good practice between care homes.
• Increasing independent visits focused on listening directly to residents. 
• Involving residents and families more closely in service design and commissioning decisions. 
• Creating a resident and family advisory group. 
• Improving feedback systems and encouraging homes to act quickly on concerns. 
• Addressing barriers to activities, transport and community engagement. 
• Supporting residents more effectively when they first move into care homes. 
• Promoting fair access to technology while ensuring it complements rather than replaces human contact.

Conclusion

The report concludes that residents generally enjoy positive experiences in Hertfordshire residential care homes and value the kindness of staff, their independence, meaningful activities and opportunities for social connection. However, further work is needed to address loneliness, improve support during transitions into care, strengthen opportunities for community engagement and ensure residents feel confident raising concerns. The report argues that continuous, independent engagement with residents is essential to improving care quality and keeping residents’ voices at the centre of decision-making.