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Better communication within care home services

Care home residents require support from many quarters but communication is often poor. The Care Homes Connect programme is working to improve this.



Sophie Cowley and Liz Ward are programme leads at the NHS Institute for Innovation and Improvement, Coventry.

Keywords: Care homes/Communication/Collaboration

  • This article has been double-blind peer reviewed
  • Figures and tables can be seen in the attached print-friendly PDF file of the complete article in the ‘Files’ section ofthis page


There are 376,250 older people living in 10,331 care homes in England (Care Quality Commission, 2010). Most care home residents have multiple health and social care needs, and an estimated two-thirds of them have dementia (Alzheimer’s Society, 2007).

The increasing dependency of people through ageing means that care homes will continue to be an important place in the health and care system for many very frail older people.

Collaborative working

During their time in a care home, older people can require support from a multitude of staff and organisations from the wider health and care system including GP surgeries, ambulance services, hospitals, community services and social care services. The interactions and communications between these are vitally important in providing holistic care for care home residents.

However, there are some common challenges to achieving this. An unpublished review by the NHS Institute for Innovation and Improvement and the Social Care Institute for Excellence this year found that, between organisations, there is often:

  • No shared or agreed aims;
  • Poor communication, including in sharing information and paperwork;
  • A lack of mutual respect and trust;
  • Little understanding of each other’s roles.

The Royal College of Nursing (2012) has also explored some of these issues and said that “a cultural divide between the different professional teams” existed and “that, compared with nursing staff in the NHS, care home nursing staff were not as highly respected or valued”.

All of these factors can make it difficult for organisations to build relationships with each other and can affect the quality of care for residents.

Residents have little interest in organisational priorities, and find the divisions of primary, secondary, community and social care relatively meaningless (National Voices, 2012). They care about organisations and services working together as a team around them to support their needs.

Care Home Connect programme

The NHS Institute for Innovation and Improvement’s care homes programme team has found that there is an appetite to improve relationships across the system for the benefit of residents and relatives and for the benefit of organisations.

One part of the programme - Care Homes Connect - focuses on capturing experiences to strengthen these relationships. Information has been gathered from many different perspectives, including those of residents and relatives, to understand examples of both excellent, collaborative working and challenges. Regardless of who or where you are in the system, communication has been found to be the top frustration and barrier.

Care Homes Connect is drawing on these experiences to develop mechanisms to improve communications and ensure reliable communication across all parts of the system.

One important stage of Care Homes Connect is to bring together residents, relatives and staff from across the system to understand their experiences of communication and interactions in a way that is relevant for everyone.

One care home manager said: “Everyone should be confident in communicating to anyone - whether a housekeeper or a nurse. Connect gives them the power to do this. I think it will bridge the gap on the blame culture.”

Using powerful, filmed storytelling, illustrating what it feels like for residents, relatives and staff, has provided an opportunity to develop a shared aim of improving care for residents.

This has been articulated by many as being previously very difficult to achieve. Listening to people’s views from other parts of the system can provide a platform to build open and honest communications leading to mutual trust and respect and a greater understanding of each other’s roles and responsibilities.

  • Care Homes Connect is being tested and developed with care homes and health and care organisations across England. It will be launched later this year. To find out more, visit, email and follow us on twitter @carehometeam

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