arlier this year the University of Bedfordshire and Care Quality Commission ( CQC ) published a report on alcohol policy and practice in care homes . Funded by the NIHR School for Social Care Research ( NIHR SSCR ), it was the first study of its kind in England and the first internationally to include input from residents , families , care staff and inspectors .

Based on interviews with more than 220 people , the consensus was that while people should be allowed to drink in care homes , there was also 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 ’.

Alcohol was considered to be a source of pleasure for people who may not have many others , and who may be struggling with ‘ deteriorating physical function and cognition ’. It helped to foster a sense of community and allowed people to maintain some continuity with their life before entering the care home , the report says . Policies varied across the care homes surveyed , however , with some imposing a blanket ban and others only

giving the ‘ appearance ’ of allowing drinking – one inspector described a facility with its own ‘ pub ’, complete with bar stools , Velcro dart board and fake fire . The alcohol in the pub ’ s optics was also fake , however – coloured water that was ‘ just for show ’. At the other end of the spectrum was a care home with an open bar , and one with an unattended drinks trolley accessed by someone in recovery who was then admitted to hospital with alcohol poisoning .

SAFETY CONCERNS In some premises the residents ’ own alcohol was taken away to be served by staff , with its use ‘ routinely monitored and recorded ,’ says the report . While policies like this were the result of concerns over health and safety – the potential effects of combining alcohol with medications or liability for negligence – they also ‘ may conflict with a resident ’ s right to self-determination , privacy and to have care tailored to their preferences ’, it states .

‘ We were originally approached by CQC who said they were concerned that there was less than good practice around alcohol in care homes ,’ says director of the substance misuse and ageing research

team ( SMART ) at the University of Bedfordshire ’ s Tilda Goldberg Centre for Social Work and Social Care , Sarah Wadd . ‘ Most care staff were doing what they thought was best , and even those who were really prohibitive were doing it for the right reasons . They ’ d just gone a little bit too far .’

Some homes prohibited people with limited mental capacity or a diagnosis of dementia from drinking , while others admitted residents without realising they were alcohol-dependent – with the attendant risks of withdrawal . Others simply refused to admit – or evicted – people with an alcohol dependency , with managers saying that caring for residents with alcohol issues was a ‘ huge workload ’ or ‘ legal nightmare ’.

It ’ s hard to gauge exactly how many people are being evicted for alcohol issues , Wadd explains . ‘ We looked at CQC data on evictions , and it didn ’ t show up too much in there . But when we interviewed staff they often talked about people being evicted , so the two didn ’ t match up . The problem is that if people are evicted it ’ s really hard to get another care home to take them , so they end up getting stuck , and it ’ s obviously very traumatic to be

This is the first study of its kind in England and the first internationally to include input from residents , families , care staff and inspectors .

evicted or moved from one home to another .

‘ Most care home managers said they wouldn ’ t accept people who were dependent on alcohol , and in many cases that was right – for the other residents , staff and the individuals who are alcoholdependent ,’ she continues . ‘ Most care homes are caring for very frail and vulnerable people . Often they have dementia , and would get distressed if they saw someone intoxicated because they just couldn ’ t make sense of that behaviour . The staff often didn ’ t have sufficient 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 .’

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