Nearly half of care homes in Wales have supported residents with alcohol dependence, according to a report from Alcohol Change UK. However, fewer than one in five staff had received any alcohol-related training, and less than half of the facilities had a written alcohol policy.
The findings are based on a snapshot study of participating facilities – ‘we cannot claim it represents the experiences of every care home in Wales,’ says the charity, ‘but it provides a window into the kinds of situations staff are navigating, and where more support may be needed.’
The study is based on an online questionnaire for care home professionals along with visits to seven facilities late last year, which included interviews and focus group sessions with managers, staff, residents and family members. External support ‘also appears limited’, the report says, with just over 63 per cent of respondents ‘rarely or never’ consulting external professionals about alcohol-related issues. ‘One detailed account described a crisis in which staff contacted 11 agencies over a weekend without securing support, leaving them feeling vulnerable and underprepared,’ it states.
All care homes should consider having specific alcohol policies, the report urges. While the charity’s research did not show that policies ‘automatically’ reduced harm, clear guidance could give staff confidence, increase transparency, and support consistent decision making, it states. Alcohol awareness training should also be improved, it says.
Another emerging challenge was the growing number of younger residents with alcohol-related brain damage, particularly Korsakoff’s syndrome. Managers anticipated that shifting generational drinking patterns would lead to ‘different expectations among future residents entering care’, says the report. ‘Staff recognised these shifts and expressed interest in training to prepare for a changing population.’
While residential care homes are regulated services with duties of care, they are also people’s homes, which means the issue of alcohol ‘raises tricky questions’, the charity acknowledges. ‘Moving into residential care does not mean losing your rights. Many residents still want to enjoy a drink. For some, it helps them feel normal and helps them to feel at home. How do we respect choice while keeping people safe?‘
A 2024 report from the University of Bedfordshire and the Care Quality Commission (CQC) concluded that there was an ‘urgent need to improve the quality of care in relation to alcohol, particularly for people with alcohol dependence’ – including inreach from community alcohol services. Policies varied widely across the sector, it said, ranging from blanket bans on alcohol to one facility that had an open bar.
While people’s drinking habits ‘do not disappear’ when they move into a care home, the ‘context changes significantly’, the Alcohol Concern report states. ‘Staff have responsibilities for residents’ health and safety. Other residents share communal spaces. Medication regimes may interact with alcohol. Cognitive changes may affect the capacity to make informed decisions.’ This meant that ‘care homes must find ways to respect residents’ choices, while fulfilling their duty of care.’
Understanding policy and practice on the use of alcohol in care homes for older people in Wales available here