16 August 2017

Better care, better home Professor Gillian Leng, deputy chief executive at NICE

Gillian Leng discusses what people should expect from life in a care home.

A care home should be a place people call home - it should not feel like a hospital or institution. And the care people receive should reflect that sense of being in a home-like environment.

Local Healthwatch England staff and volunteers visited almost 200 care homes to see how services were being delivered and how people living in them felt about their care.

Their report showed that while most people received good care, this was not the picture everywhere.

In some places, staff went above and beyond the call of duty to connect with residents. In other places, especially where there was a high staff turnover, continuity of care was poor, making it hard for residents to develop relationships.

In some homes, residents were given limited choices, for examples about what clothes they could wear or how they could spend their day.

This variation in care across the country can be addressed with the help of NICE guidance and standards.

NICE advice is clear that people should have choice in a range matters if they are to receive the highest level of care.

We also set out how to make sure their mental wellbeing is always looked after.

This is to ensure they stay as well and independent possible in the place they call home.

From managing medicines in care homes to making sure residents’ teeth are kept healthy, our recommendations give care home managers and staff the tools they need to provide a better service.

A great example that demonstrates this is the work from Healthwatch Isle of Wight. Using NICE guidance, the team helped staff understand why it’s important to have clear care plans in place for people.

Their work won an Isle of Wight Care Award, and the NICE sponsored better care award at Healthwatch's annual conference.

More importantly, it helped local authorities realise the difference that improving care can make to people’s lives, and the family that support them.

And ultimately, that’s why NICE guidance exists. It exists to make a difference.


  • What about putting pressure on government to provide community dentistry services for people in care homes and particularly those with challenging behaviour eg dementia.
    My mother's teeth are rotting before my eyes as she sits all day with her teeth full of biscuits crumbs. She needs fillings in her teeth but the local dentist not really prepared to treat patients who cannot consent. She will soon loose teeth which will not only affect her appearance but reduce her ability to enjoy food and to communicate.
    It is very sad and demeaning.

  • Hello Liz. Very sorry to hear about this. We have published guidance for dental care in the community. You can read our news story here: https://www.nice.org.uk/news/article/nice-calls-on-care-homes-to-prioritise-the-oral-health-of-residents

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