A new research project looking at how people with drug and alcohol problems are supported in care homes has been launched by the University of Bedfordshire in partnership with the Care Quality Commission (CQC).
The number of over-50s receiving drug treatment has increased seven-fold over the last two decades, the researchers point out, alongside a four-fold increase in those receiving alcohol treatment. More than 1,700 care homes in England reported caring for at least one person with a substance dependency in 2022-23.
The project will be led by director of the university’s Substance Misuse and Aging Research Team (SMART) Dr Sarah Wadd and funded by the National Institute for Health and Care Research. The findings will help care homes to ‘balance the complex issues of person-centred care, health needs and legal responsibilities in caring for people with substance dependence’, said CQC policy manager Amy Hopwood.
The study follows the team’s earlier report on alcohol policy in care homes, the first of its kind in England, which was published last year. Launched in response to concerns from CQC about lack of good practice and based on interviews with residents, family members, staff and inspectors, the study found that policies across the sector varied widely, with some care homes imposing a blanket ban on alcohol while others even had their own bars. Some facilities had admitted residents without realising they were alcohol-dependent – with the associated withdrawal risks – while others had evicted anyone found to have a dependency. Staff frequently lacked appropriate training so ‘it really isn’t great for people with complex needs related to their substance dependence to be in one of these mainstream care homes’, Wadd told DDN at the time.
According to the most recent OHID figures 29 per cent of adults in substance misuse treatment in 2023-24 were aged 50 or older, compared to just 12 per cent in 2009-10. Of these, 12.5 per cent were in the 50-54 age group, 8.5 per cent were aged 55-59 and 7.6 per cent were aged 60 or above.
‘Caring for people with drug and alcohol dependence in care homes can present complex practical, ethical and legal issues, particularly if the person is unable or unwilling to stop drinking or using drugs,’ Wadd stated. ‘For example, should care staff acknowledge that some people will inject drugs in their rooms and provide them with a safe storage box for their drugs and sharps bins to reduce risk to others? Should care staff help residents space out alcoholic drinks to avoid potentially life-threatening withdrawal symptoms? Is there a need for more care homes for people with substance dependence who are not ready to stop drinking alcohol or using drugs?’
The team will carry out interviews and focus groups with residents, families, care home staff, inspectors and other professionals to prepare case studies on good practice and innovative care, she added. ‘When we have this evidence, we will bring together a group of experts, including people with lived experience, to agree the recommendations.’