Why we should make care homes more visible – to social workers and to wider society (Blog 1/3)

Dr Sally Nieman is currently working with My Home Life England through a part-time fellowship with the North Thames Applied Research Collaboration (ARC), and has written a 3 part blog series.

In this first blog, Sally highlights how care homes deserve greater awareness and appreciation, and calls for social workers to have a greater role in care homes:

“With a background in local authority adult social work and a PhD focused on social work with older people in care homes, I was excited by the opportunity to gain practical research experience. I hadn’t expected to be paired with My Home Life England, part of City St George’s, University of London – but it has turned out to be the perfect match.

My Home Life England focuses on improving quality of life for people wherever they are supported – often in care homes – through professional development, research, and community engagement. If, at first sight, this does not seem like the obvious fit for a social worker, I have quickly come to see how closely our values align.

As a social worker committed to social justice, I am troubled by how ageism shapes society and is one of the most tolerated forms of discrimination [1]. The way we talk about ageing and older people still regularly emphasises stereotypes of dependency, failure and burden. This is especially true for care homes, but well-resourced care homes staffed by a respected, valued workforce are fundamental to our society.

Yet many people are still scared of ‘ending up’ in a care home – perhaps this is a defence against the fear of growing old, intensified by worries about the quality of care they might receive. The perception of care homes as a ‘last resort’ is further reinforced by health and social care policies which position staying at home as always best for everyone.

Independence is of course important, but this narrative can make moving to a care home seem like a failure. What I find striking is that this is at odds with strengths-based practice, which underpins adult social care in England, under the Care Act 2014, and focuses on supporting people to live well in ways that reflect their strengths and what matters to them. Indeed My Home Life England’s recent ‘Thriving in Residential Care’ research revealed countless powerful stories of older people now ‘thriving’ after moving into residential care, with notable improvements to their overall health.

Many care homes have really strong community connections, linking with local schools, groups and businesses, whereas others are less visible and not always acknowledged as part of the community. This lack of visibility may contribute to negative assumptions about care homes, particularly as research suggests that people with direct experience of care homes tend to view them more positively than those without. [2]

All this matters, because how society and the media talks about care homes influences how social workers think about them, and about the people living and working there. Social workers often have limited involvement with older people once they have moved to a care home. Yet my research, and that of others [3], suggests that social workers have a vital role to play. With their focus on rights, relationships and advocacy, social workers should have a greater role in care homes – helping to make older people more visible and supporting older people and care home staff in meaningful ways.

Of course, this is not always easy in the current context of adult social care. Social workers often work in systems that reduce what they do to a set of tasks – certainly, in my research, social workers spoke about the tension between their values and the demands of the system. They described drawing on both personal and professional experience to stay grounded in what matters: rights and relationships, which ultimately leads to better outcomes for people living in care homes.

This aligns with My Home Life England’s approach, which promotes the importance of relationships and a shift from simply providing care to creating environments where people feel valued, respected, and empowered. It speaks to the importance of connection, partnership, and seeing the person, not just the process, and a greater involvement of social workers in care homes would help to achieve this.

In my second blog next week, I will explore some of the barriers to building these relationships between care homes and social workers, and will introduce the idea of Transactional Analysis as a way to reshape these dynamics. I will also explore the emotional side of practice and what might build greater connection. My final blog will outline the need for a different narrative: a more appreciative lens which focuses on reciprocity and working together, and which suggests that social workers have a vital role to play in making sure older people in care homes are seen.”  

Written by Dr Sally Nieman