Creating inclusive care home environments for older LGBT+ people

Sexual orientation as a social and cultural dimension to older people's lives is often obscured within health and social care policy and practice settings. This situation is even more problematic for older lesbian, gay, bisexual and transgender (LGBT+) individuals.

Recent research studies indicate that care home staff in England and Wales receive little or no training on working with residents from sexual and gender diverse groups, despite increasing numbers of older LGBT+ adults.

In 2018 Dr Paul Willis won ESRC IAA funding for an online learning resource for care and nursing home staff and managers in England and Wales, to inform and improve care home practice with older residents identifying as LGBT+ and in turn foster more socially inclusive living environments for all residents.

Willis worked closely with Berkeley Wilde, founder and director of The Diversity Trust, and with the Therapeutic Media Company. An expert advisory group was established including representatives from Stonewall Cymru, Skills for Care, Curo Housing, LGBT Bristol, and Swansea University academics Dr Tracey Maegusuku-Hewett and Dr Michele Raithby.

The project set out to create two short films capturing LGB and trans older adults' perspectives, but produced a much more comprehensive, and comprehensively adopted, resource. An enthusiastic response from local care homes led to over 10 contributors, including frontline care staff, and training providers such as Brunel Care and AbleCare Homes.

The resulting four films present the perspectives of older LGBT+ members, a wide range of local care staff perspectives, and the story of Alan and Werner, two older men in a long-term relationship living together in a care home.

With input from their advisory group, the team also created five case studies about older LGBT+ residents' concerns and experiences in care homes. Each case study is accompanied by questions to facilitate small-group discussion and top tips to guide staff discussions.

Together the films, case studies, guidance on promoting LGBT+ inclusion in care homes, tips for staff and managers, and a legal timeline for training purposes, form the learning resource Care under the Rainbow.

The Bristol team also worked with new collaborators Opening Doors London. They subsequently incorporated the IAA-funded work into their own learning resource Pride in Care, targeted at a wide range of service providers including care homes. This further extended the project' reach and actively endorsed the practical value of the materials.

In May 2019 after a well-attended launch event, over 100 care homes in SW England and SE Wales were introduced to the online learning resource. They included Anchor Housing and HC-One in England and Pobl Group and Hafod Care in Wales, as well as the Social Care Institute for Excellence, Housing LIN, Social Care Wales and Research in Practice for Adults (RiPfA). The resource has also been of wider interest to care home providers across the country. Initial feedback from a care home provider in Yorkshire, England said "We have had a themed learning month with regards to LGBT residents and have used the resources to teach our staff as well as to make visual displays for our staff and service users".

Later that year, Wilde and Dr Wenjing Zhang also gave an invited presentation on the project at Fudan University in Shanghai, China, followed in 2019 by a Research Seminar on LGBT+ ageing, equality and social inclusion in collaboration with Age UK Bristol and Brunel Care.

To ensure sustainability, the Diversity Trust committed to maintaining the webpage for five years, including revising and updating content. The trust will also incorporate Care Under the Rainbow into its education, consultancy and training activity.

Paul Willis commeted "IAA funding allowed us to develop a new and original learning resource for directly informing practice, [something] that we would not have been able to do with standard research funding…".

Berkeley Wilde of the Diversity Trust reported that "The Diversity Trust has been delighted to be a partner on the Care Under the Rainbow project. The project has put us in direct contact with a range of new potential clients in the residential care sector. We have developed a new section of our website titled "Care Services" which we will use to market both the free online resources from the project as well as our training services to new clients. As well as all the new materials we have generated through the project and the collaboration with the team at the University of Bristol, we have been able to increase our social reach with more social media outputs. We have also gone on to form new relationships at an international level with colleagues at Fudan University in Shanghai, China, and with Dr Sue Westwood at York Law School, University of York. Both these contacts have enabled our Director Berkeley Wilde to speak about the work of the Diversity Trust and in particular our work with older LGBT+ people and communities".

Lead researcher


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