Short-notice care home closures

Communication

The announcement of a home closure can be traumatic for residents, families and the workforce. Timely and well planned communication is extremely important in reducing distress and enhancing choice.

We need to build up trust and report with residents and families quickly - they'll hear all sorts of things in the press or from other sources and they won't necessarily want to believe what we're telling them

Commissioner

• OverviewOpen

  • Communication in general is the key to:
  • avoiding misunderstandings and establishing trust with residents and their families
  • enabling residents and families to exercise choice and control with regard to making alternative arrangements
  • allaying fears and maintaining confidence in care arrangements
  • protecting organisational reputation and demonstrating transparency.

  • There is a balance to be struck between providing information that is essential at the time and that which will raise anxieties
  • It is important to act in a timely fashion in order to minimise the incidence of rumour or speculation.

  • Communication should be both proactive (sharing information and keeping people informed) and responsive (dealing with queries and allaying people’s anxieties)
  • Partners in the system need to agree a policy on information sharing between themselves, and what to communicate more widely.

  • The person managing the closure project needs to develop a communications plan.

  • Specific communication relating to individuals must be timely and sensitive. Once the proposal to close is confirmed, all residents, families and the workforce should have an individual letter that gives an outline of what will happen. Make sure that instructions about when and how external mail is to go out are clear

  • Information needs to be shared with the Care Quality Commission (CQC) or other national equivalents throughout the process, particularly about the maintenance of standards of quality and safety during the closure, and future plans for residents.

  • Communication plans will need to address the what, when, how and with whom of communication.
  • A list of frequently asked questions and answers should be devised early on in the process as a way of reducing the number of individual queries that have to be answered.

  See examples and tips for more information.

• Working with residents and familiesOpen

  • Trust and rapport will be established by listening to concerns and providing honest answers to questions.
  • Every resident (together with families if possible) should have an initial one-to-one meeting with a senior member of the care team to explain exactly what will happen and how their personal needs will be met.
  • Depending on the circumstances of the closure, be ready for disbelief and or anger from some residents or carers.
  • Careful consideration should be given to how and when residents with cognitive impairments are informed. 
  • Special attention should be given to seeking out those relatives who are not in touch with the resident and/or who do not respond to initial contacts.

  See examples and tips for more information.

• Managing the mediaOpen

  • Agree a media handling plan with key partners to ensure factual reporting and positive media coverage wherever possible.
  • Include the home owner in the media handling plan to enlist their co-operation in avoiding negative messages
  • Agree consistent messages with colleagues about concern for primacy of quality and continuity of care, and the health and wellbeing of residents.
  • Use local radio and newspapers for disseminating information.
  • Make sure there is the capacity to respond to enquiries triggered by news bulletins or other forms of mass communication.

• Communicating with staffOpen

  • The role of existing staff in providing continuity of care to residents is crucial, so minimising their stress levels will enable them to be more effective at work. Harnessing their commitment at an early stage is vital.
  • Ensure regular and open communication with staff affected by the potential closure.
  • Agree early on the approach to communication with staff - for example face to face meetings, e-bulletins, individual letters or through nominated representatives - depending on the size of the home and whether it is part of a larger company
  • Involve the trade unions from the start; communication plans should say who will do this and timescales drawn up.
  • It is vital that information to staff is coordinated and that the same facts are being provided from management, trade unions and professional bodies.
  • Staff need to be given clear information about their options during and following the closure period.
  • Consultation with trade unions should include arrangements for identifying jobs that will be under threat and/or arrangements for transfer to a new employer.
  • Devise a list of FAQs for staff with information about where they can get further help and advice, e.g. external organisations such as Citizens Advice Bureaux.
  • Commissioners have no automatic access to the staff in a care home that they do not employ. To engage with staff requires the cooperation of their employer, their unions and the staff themselves. Provision in contracts to allow commissioners to 'step in' when there is an emergency may facilitate this.

  See examples and tips for more information.

Examples and tips

Examples of what others are doing plus materials they have developed and useful tips.

Communication - examples and tips sections

Key points from policy and research

• Direct communication with residents (particularly those with high support needs) is very important as their voices are often subdued and their views represented through staff, relatives or friends (Joseph Rowntree Foundation, Older People's Vision for Long Term Care, 2009).
• Attention to communication and information dissemination has been identified as a priority by senior managers surveyed to elicit good practice on home closures (Glasby et al (2011))
• Engagement with a variety of stakeholders at an early stage is essential - including service users themselves, their families, care staff, partner agencies and external advocacy agencies. (Glasby et al (2011))
• In unplanned closures there was a greater need to work closely with the adult safeguarding team than in planned closures, because the closures often happen suddenly as a result of concerns about the quality of care (Glasby et al (2011))
• The nature and quality of communication with residents, relatives and carers about proposed home closure varies considerably (Williams and Netten 2003).  The way in which residents were informed varied, some being told by their families and others by formal letter. Some first heard of imminent closure by rumour. A substantial number said that the responsibility to inform residents was left to family members.
• Relatives value openness and good communication from council staff prior to and during the closure.
• In the worst instances of practice researched, residents learned about the impending closure by gossip and rumour or from articles in the local press. (Glasby et al (2011))
• The differences in practice between councils do not generally appear to be affected by whether the individual was publicly or privately funded. (Glasby et al (2011))

What the regulator says

In the event of threatened or imminent emergency closure, commissioners should make contact with the Care Quality Commission (CQC) at the earliest opportunity. CQC will provide information under its information-sharing protocols indicating any action which it is taking