A 'home for life' in residential homes for older people in England: exploring the enhancers and inhibitors

A three-year in-depth study has examined three models to improve care in residential homes for older people in England. The study showed that each aimed to provide a 'home for life' for residents. Using multi-source data gained from a range of qualitative and quantitative methods involving residential home managers, care staff and extensive review of documentation related to key care functions, inhibitors and enhancers to the achievement of this aim were identified. Inhibitors were lack of available top-up funding to meet increased care needs, care staff's inadequate knowledge of behaviour-disordered residents, workload, cross-sector barriers and environmental problems. Among the enhancers were flexible regulation, up-skilling of care staff, care staff's achievement in palliative care, perceived avoidance of hospital admission, and sound practice-led relationships with nurses. The implications for practice are of relevance to policy makers, educators, community health and social care professionals, and older residents, their relatives and representative organisations.