Shining a spotlight on care homes: Healthwatch Greenwich's reflective review

In 2022 Healthwatch Greenwich visited 11 elderly/nursing care homes in the borough and made a series of recommendations for improvements . In 2023, they revisited them to review action taken in response to their recommendations. The volume of information, observations, and reports collated across the 21 visits offered the opportunity to carry out a reflective re-evaluation as a way of gaining deeper insights into the quality of care provided, highlighting good practice, and identifying areas for improvement.

The evaluation came up with five common themes:

• Healthwatch’s observations suggest that racially minoritised groups are under-represented in care homes in Greenwich, as compared to their representation in the general population of Greenwich. Differences in age profiles may explain part of the difference, but research suggests that systemic racism is also a contributing factor.
• Accessing NHS dental services for care home residents in Greenwich has become increasingly challenging with a significant percentage unable to access the dental treatment they need in a timely way. The transfer of responsibility for NHS dental services to integrated care boards (ICBs) offers an opportunity to improve access to NHS dental services in Greenwich care homes.
• Activity coordinators are essential in promoting the well-being of care home residents by providing tailored and engaging activities that foster social, physical, and mental health. Although variations in activity provision exist due to limited resources and (in some cases) expertise, ongoing training for activity coordinators should be considered in order to provide consistent, high-quality, personalised activities to all care home residents, regardless of care home.
• Family members play a crucial role in the care of their loved ones in care homes, offering ongoing emotional support and advocating for their needs. While all care homes operate an open-door policy and make efforts to involve relatives, maintaining relationships with family members can be challenging. Lack of accessibility and trust hinder engagement. Addressing these challenges requires creating accessible communication channels and fostering trust through open dialogue, responsiveness to concerns, and a culture of inclusivity and collaboration.
• Care homes have varying degrees of connections with the wider community. Engagement with the wider community provides opportunities to promote emotional and mental well-being. It also combats ageism and stereotypes while fostering inclusivity and shared responsibility. Greater community connection allows for volunteer involvement, bringing fresh perspectives and skills. Commissioners can support this process by providing guidance and resources.