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Working with Care Home Leaders to Support Integration at Place

Steph Thompson, Deputy Director, My Home Life England


This short article describes how a group of care and health leaders have developed new ways of working together at place.


In February 2020 we started to get a glimpse of what COVID-19 might mean. By June 2020 we were understanding that the pandemic was having a profound impact on people living and working in care homes, those who loved them and those who work with them. (1)

During this time, My Home Life England (MHLE) started working with Sefton Metropolitan Borough Council to run a leadership support programme for care home leaders and, from there, to explore stronger integration between care homes and the wider health and care community.

Courage and Collaboration

While the programme was running, we worked with colleagues in the council and the wider system to find out what they hoped ‘integration’ might bring.

It’s worth remembering that people who work in public sector commissioning and delivery of care and health services may have different perspectives and priorities, but they spend a lot of time together in meetings.

However, care home leaders, often connected through a great local association or linked through a managers’ network, rarely have the time or opportunity to come together to share ideas and develop a connection as a team.

The reasons for this are complex, nuanced by local circumstance. However, a consistent factor is the breadth and depth in the role of a care home leader, often individually responsible for what public sector organisations have multiple departments to do. 

Commissioning systems for care homes, by definition, create competition, making it hard for people to share innovation and positive practice. So when care leaders do have to time to come together, they often focus on the problems they have in common.

For people participating in a My Home Life England programme, there is usually the natural creation of a supportive community of managers.’ (2)

In Sefton, the MHLE participants grabbed the opportunity to contribute to the developing agenda.

Care homes naturally form little hubs of integration. They connect the expertise of people living in the home and their friends and family, with the people working in care homes and a range of health and care practitioners.

The priority areas identified by Sefton care home leaders were:

  • Developing new ways of working together (a move from consultation to involvement)
  • The enhanced health in care homes framework
  • Discharge planning from hospital
  • Using data and information provided by or collected about care homes in a more integrated way for everyone’s benefit.

A ‘summit’ day was co-designed and on the day we jointly agreed ways of working well together. Participants actively listened to each other and a lot of assumptions came to light. The care home leaders were key note speakers and highlighted the opportunities they saw to work differently together.

Throughout the summit, participants focused on being curious, what was real and possible and what was working well that could be built on.

As a result, there has been an explicit and real change in the main forum that connects Local Authority/ NHS and care home leaders together. Renamed the ‘Care Home Strategic Partnership’, the terms of reference have changed substantially with a focus on collaboration, celebrating positive practice and sharing of information and experience. The partnership is co-chaired by one of the care home leaders who attended the summit and attendance from care homes is increasing again. Agendas are co-produced.

People often leave events, workshops or summits with sense that it was a nice day out, but nothing will really change. That’s not the case in Sefton. This summit led to a step change and the beginning of a new relationship between care homes and the wider system in Sefton. ‘It does feel different now’ (3)

So, what helped make this happen? It started with a commitment from the council and system partners to support quality of life for people who live, work in and visit care homes. Their investment in the MHLE leadership programme helped support care home leaders to gain confidence in their leadership and their capacity to engage and connect as a team. The Care Home Strategic Partnership continues to develop, supported as a collaborative structure with ideas and developments brought by care home managers as well as the wider system.

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