A study exploring alcohol policy and practice in care homes across England has been carried out by academics from the University of Bedfordshire in partnership with the Care Quality Commission (CQC).
The research, funded by the National Institute for Health and Care Research (NIHR) School for Social Care Research, found that residents, families, care home staff and care home inspectors felt strongly that people living in care homes should be able to continue drinking alcohol when they move into a home.
Drinking alcohol can create a sense of community for residents and staff, for example, by celebrating special occasions together. It can help create a homely environment for those who enjoy alcohol and ensure that people maintain continuity between their lives before and after moving into a home. However, there are potential risks associated with people drinking alcohol in care homes. These include medication interactions, confusion, falls and injuries.
The University of Bedfordshire’s research found that in most homes, alcohol was available regularly. For example, staff might serve it at meal times, or there may be a bar within the home or a drinks trolley. Residents were supported to decide for themselves whether the benefits of alcohol outweighed the risks. Where risks were identified, strategies were put in place to reduce them.
In contrast, the research found that some homes had a ‘blanket ban’ on drinking alcohol. In others, alcohol was rarely available. For example, a glass of sherry might be offered at Christmas. Some homes only gave the appearance of providing alcohol. In one care home, a bespoke ‘pub’ had been built, fitted with Velcro dart boards, fake fires, bar stools and optics, but the optics were full of coloured water and were just for show. In some homes, residents’ own alcohol was taken away to be served by staff, people weren’t able to drink in their rooms, alcohol use was routinely monitored and recorded, or everyone was restricted to one drink, regardless of their individual level of risk.
These policies were mostly motivated by concerns about health and safety. But care home inspectors who took part in the study thought that, with the best intentions, care staff had sometimes gone too far, becoming paternalistic or “wrapping people in cotton wool”. They were looking for care staff to achieve a balance between health, personal choice, risk, safety, human rights, and equality and diversity.
Dr Sarah Wadd is based at Bedfordshire’s Tilda Goldberg Centre for Social Work and Social Care and led the study. She said: “People living in care homes should be supported to have as much choice and control of their lives as possible. It is important to remember that just as health has value, so too does pleasure. The goal is to find a balance between minimising risk and maximising quality of life. Our research has shown that this isn’t always happening in practice. We have produced good practice guidance for care staff and a guide for care home residents and the general public.”
Speaking about this research, Amy Hopwood from the Care Quality Commission said: “This important research shines a light on the importance of care homes safely supporting their residents to continue drinking alcohol if they wish to, using their professional expertise to balance the risks alongside the individual’s preferences. Just like anything else in life that is a matter of taste and choice, how care homes manage alcohol is a strong indicator of how well they are delivering good, safe, personalised care to their residents.”