Eight themes

My Home Life’s vision of best practice is underpinned by an evidence base developed by more than 60 academic researchers from Universities across the UK. Its eight themes identify what best practice in care homes for older people looks like in the 21st century. They are grouped into three different areas:

Those best practices which seek to personalise and individualise in homes – tailoring care to each individual:

  • Maintaining Identity
  • Creating Community
  • Sharing Decision-making

Those which are concerned with what needs to be done to help resident, relatives and staff navigate their way through the journey of care:

  • Managing Transitions
  • Improving Health and Healthcare
  • Supporting Good End of Life

Those concerned with the issues of leadership and management required to transform care into best practice:

  • Keeping Workforce Fit for Purpose
  • Promoting a Positive Culture

Personalising & individualising care

Maintaining Identity

There is a need for a person-centred approach in care homes. Encouraging staff to learn more about residents’ lives helps them to tailor their care to each individual.

For more videos, please visit the My Home Life DVD site.

It also gives older people the opportunity to integrate their past and present life experience along with their priorities for the future. This approach works best if the same staff can continue to work with the residents they know.

‘It is important for people to realise that what may seem a small matter to the management of the organisation is of great importance to some people living in a place. Everyone has different standards and tastes, but knowing the individual and their ways is helpful.’

A variety of creative approaches

There are many approaches care homes can adopt to meet individual needs, including:

  • linking with communities;
  • thinking creatively about meeting communication needs; and
  • being open to meeting particular spiritual, cultural, social and sexual needs sensitively.

Staff education and support

Person-centred care can be emotionally demanding for staff. Your care home should provide outlets for addressing anxieties.

Resources on this theme

Issue 2 Care Home Staff Bulletin: Maintaining Identity (PDF, 495k)
Maintaining Identity poster (PDF, 305k)
Maintaining identity (PDF, 85k)

This document contains a short summary of a research review undertaken as part of the My Home Life programme. The full literature review, including research references, further tools and examples of ‘best practice’, is available in Resources.


Creating community

Communities are created through relationships between residents, family, friends, staff and the wider community.For more videos, please visit the My Home Life DVD site.

‘When I was not well one day, a lot of residents came up to see me as they missed me and visited me. It has helped. It is the other residents and staff together – everybody. I have more friends here.’

Creating a community involves

  • understanding and respecting the significance of relationships within the home;
  • recognising roles, rights and responsibilities; and
  • creating opportunities for giving and receiving, and for meaningful activity.

Relationship-centred care

Mike Nolan and a team at Sheffield University identified six dimensions that underpin ‘relationship-centred care’. These six ‘senses’ acknowledge the subjective and perceptual nature of the key determinants of care for older people, families and staff. They are:

  • a sense of security;
  • a sense of continuity;
  • a sense of belonging;
  • a sense of purpose;
  • a sense of fulfilment; and
  • a sense of significance.

The care home environment

The building and environment of your care home can support the community and relationships within it. For example:

  • a choice of communal areas close to each other;
  • individual rooms where residents and their guests can enjoy complete privacy;
  • gardens providing safe access to fresh air, plants and wildlife.

Relationships within the local community

These are important in maintaining quality of life for residents, fostering links with local organisations such as schools and voluntary groups. Easy access to transport, especially for relatives who are frail, is essential.

Resources on this theme

Issue 3 Care Home Staff Bulletin: Creating Communities (PDF, 1,167k)
Creating Communities poster (PDF, 689k)
Creating community (PDF, 76k)

This document contains a short summary of a research review undertaken as part of the My Home Life programme. The full literature review, including research references, further tools and examples of ‘best practice’, is available in Resources.


Sharing decision-making

Care homes can function as true communities if everyone’s contribution is recognised and valued. 

For more videos, please visit the My Home Life DVD site.

All residents (including those with cognitive impairment), their families and staff members need to have the opportunity to be involved in the decisions that affect them, to the extent that they wish to be involved.

Methods for disseminating information to all members of the care home community, such as a regular newsletter, have the potential to ensure that everyone feels involved and creates ownership of identified problems and solutions.

‘There is a lot of experience among us [residents] but the skills we have developed in our lives are completely wasted… There are a lot of things that residents could share if given an opportunity.’

Decisions to influence change

Feeding the views of residents and relatives into a change process should be a priority, and establishing a group for residents, relatives and staff should be encouraged.

Ongoing shared decision-making through negotiation

Some decisions, such as the fine balance between rights and risks, need to be continually re-assessed and negotiated between residents, relatives and staff to maintain quality of life.

Resources on this theme

Issue 4 Care Home Staff Bulletin: Sharing decision-making (PDF, 974k)
Sharing decision-making poster (PDF, 404k)
Sharing decision-making (PDF, 77k)

This document contains a short summary of a research review undertaken as part of the My Home Life programme. The full literature review, including research references, further tools and examples of ‘best practice’, is available in Resources.


The journey of care

Managing transitions

Moving into a care home is a major transition in life which may involve considerable losses but, with appropriate planning and support, it can bring benefits and improved quality of life for both older people and their families. 

For more videos, please visit the My Home Life DVD site.

‘I have lived in this care home for two years…I have now rebuilt my life, thanks to the proprietor and staff. I now want to put the past behind me and live in the present and live as active a life as possible.’

Easing the transition

The transition for residents and their relatives can be eased if pressure on them is minimised:

  • if they have access to all relevant information to help them play a full and active role in the life of the home and, for relatives, in the care of the older person;
  • if they are able to work with staff;
  • if they are able to maintain ownership of decisions about the future;
  • if they feel that others are aware of the consequences of the move for them and their loved ones; and
  • if information is available on how to choose a home and how to ease the transition of moving.

Care homes as a positive option

Care homes as a style of both housing and care, can be a positive option. Entering a home can offer new opportunities. Initiatives that promote a proactive approach to decision-making, such as facilitating trial visits, should be encouraged.

Resources on this theme

Issue 1 Care Home Staff Bulletin: Managing Transitions (PDF, 380k)
Managing transitions poster (PDF, 162k)
Managing Transitions research briefing (PDF, 75k)

This document contains a short summary of a research review undertaken as part of the My Home Life programme. The full literature review, including research references, further tools and examples of ‘best practice’, is available in Resources.


Improving health and healthcare

Health is fundamental to quality of life. Older people have substantial and complex healthcare needs which require the full range of services listed below.

For more videos, please visit the My Home Life DVD site.

‘It was useful to have access to a physiotherapist or occupational therapist when I needed it to help me with my mobility to enable me to be independent and keep my confidence.’

Ensuring adequate healthcare services

There is considerable evidence that older people in care homes are not receiving the healthcare services that are their right. Some are paying for services that should be provided under the NHS. Primary Care Organisations should review their provision to ensure that residents have access under the NHS to all services, including:

  • a General Practitioner;
  • specialist medical services;
  • specialist nursing care;
  • physiotherapy;
  • occupational therapy;
  • speech and language therapy;
  • chiropody;
  • all screening services; and
  • regular medication reviews.

Some areas have developed such services for care homes, including new roles, and there is potential to enhance professional rehabilitative input to care homes by developing intermediate care initiatives.

Health promotion

Health can be promoted by spending time in personally meaningful and enjoyable ways, socialising and sharing, physical activity and exercise, and learning.

Resources on this theme

Improving health and healthcare (PDF, 87k)
Issue 5 Care Home Staff Bulletin: Improving health and healthcare(PDF, 635k)
Improving health and healthcare poster (PDF, 239k)

This document contains a short summary of a research review undertaken as part of the My Home Life programme. The full literature review, including research references, further tools and examples of ‘best practice’, is available in Resources.


Supporting good end of life

Care homes are complex systems where people are both living and dying. Many are also experiencing multiple losses. 

For more videos, please visit the My Home Life DVD site.

There is a need to develop a culture of relationship-centred care, with the emphasis on personal need and dignity, through which residents, relatives and staff are supported. Encouraging an open approach to the awareness of dying is a key cultural shift – not just in care homes but in society.

‘Death is such a taboo subject. It’s a big problem because all of us are so near to death. By 90 you can’t get much nearer without knowing that it is around the corner, and we need to be able to express that sometimes if we want.’

A ‘good death’

It can be difficult to predict when someone will die, so promoting good end-of-life care should be integral to quality care in care homes. Practices and interventions rooted in palliative care, and support from specialist palliative services, are helpful. Existing standards, frameworks and tools can help support good palliative care.

Ongoing support

It is important that staff, family and other residents receive continuing support following a death. Opportunities to discuss their feelings and to ‘say goodbye’ can occur at the funeral or memorial service or through remembrance events.

Resources on this theme

Issue 6 Care Home Staff Bulletin: Supporting good end of life(PDF, 544k)
Supporting good end of life poster (PDF, 247k)
Supporting good end-of-life (PDF, 76k)

This document contains a short summary of a research review undertaken as part of the My Home Life programme. The full literature review, including research references, further tools and examples of ‘best practice’, is available in Resources.


Leadership & management

Keeping workforce fit for purpose

Keeping track of the education and training needs of the workforce in the care home sector requires ongoing research and the sharing of lessons learnt from attempts to improve practice through education.

For more videos, please visit the My Home Life DVD site.

‘The more training we’ve given the girls, the better it’s been. The better the care’s been… The place is starting to get a better reputation.’

Education and training as integral to practice

The following should be encouraged:

  • Creative learning initiatives, developed and supported to become part of mainstream practice.
  • Relationship-centred education and training, concerned with developing the whole of the care home workforce on site, rather than external educational inputs for personal and professional enhancement only.
  • Registered and non-registered workers learning together as a force for change, rather than a means of qualification.
  • Consideration of learning for residents.
  • Residents, relatives and staff need to be central to the education process by sharing their experiences of quality of life in care homes.

Care homes as learning environments

The potential of care homes as good learning environments for staff and students must be recognised. Through encouraging increased financial investment, teaching care homes can be an ideal for which to strive.

Resources on this theme

Keeping the workforce fit for purpose (PDF, 75k)

This document contains a short summary of a research review undertaken as part of the My Home Life programme. The full literature review, including research references, further tools and examples of ‘best practice’, is available in Resources.


Promoting a positive culture

In a positive culture, the ethos of care remains person-centred, relationship-centred, evidence-based and continually effective within a changing health and social care context. 

For more videos, please visit the My Home Life DVD site.

A ‘complete community’ is consistent with the most positive experiences of older people and ‘best care’.

‘With the help of staff I have begun to do things that I didn’t think I could. I help the staff to set the tables and wash dishes, things like that. And I enjoy it. I am not too great now but I am keeping up as best I can.’

Promoting a positive culture

Creating positive culture requires:

  • recognition of the complex and multidimensional nature of life and work in care homes;
  • promotion of enablement and partnership;
  • person-centred and relationship-centred care through biographical and developmental approaches;
  • staff working as an effective team with mutual appreciation and some blurring of roles;
  • relatives to be integrated within the effective team; and
  • close links maintained with the local community.

Leadership, management and expertise

Effective leadership, management and the availability of expert advice is paramount in the creation and maintainance of a positive culture.

Resources on this theme

Promoting positive culture (PDF, 75k)

This document contains a short summary of a research review undertaken as part of the My Home Life programme. The full literature review, including research references, further tools and examples of ‘best practice’, is available in Resources.