What do we want from the care home of the future? That is the question being addressed by the Commission on Residential Care which is due to report its findings on Wednesday (3 September).
Well I want somewhere that is first and foremost 'home' and somewhere that is caring, provides care, takes care, and cares for me and my fellow residents.
What do I mean by home? Home is where I live, eat, sleep, wash, watch TV, read books, listen to music, surf the net, garden, laugh, play, all when I want, with family and friends. I am surrounded by the things I like and reminders of my life so far.
If I can't continue to live independently for whatever reason - from severe dementia to neurological conditions or major accident - then I want my home to be a safe and enjoyable place where I am nursed and cared for. Caring is hard. It requires dedication, commitment, skill and experience. It requires listening, laughing, fun and enthusiasm. It requires love, passion, empathy and patience.
Caring and home are above all about people. I want to live with people I know and like. I want to be cared for by people who know about and respect me and whom I like and respect. I want to be part of a wider community, to mix with people of all ages and to get what I need locally from a good GP to accessible transport.
So a care home in the future might be much smaller than many of our large institutions. It might be much more flexible in terms of living space, both personal and communal, and it will be well designed. The focus will be on companionship as well as care. And it won't be hidden away.
The key thing to making this home work will be the people. Well trained, well respected and well paid staff who are well led and well managed.
With our ageing population and the growing number of older people with dementia, we have to make care homes work now. It's not just about the changing expectations of the baby boomers, however important they are as a driver. It's because too many older people, particularly with dementia and without a champion to speak up for them, experience poor residential care. Good Care Guide hears about shocking and sad experiences every day.
How can we change things?
First, we need a clear vision for care homes of the future, based on what older people and their families want.
Second, we need to properly fund care in this country. Public bodies are currently forcing down the fees they pay care homes and driving down quality as a result. A new system of care funding has to be based on what is needed to deliver the best care for our ageing population, joining up health and social care.
Third, we need to be clear that the quality of care is primarily determined by the quality of staff. We have to invest in their training, development, supervision and management and in their pay and conditions.
Fourth, the care system needs to be properly regulated to much higher standards. Just one example: why are there no minimum staffing ratios in care homes? The increasing number of care home residents with dementia and other challenging conditions requires more as well as better staff to deliver good care.
Finally, older people in care homes need champions, who will speak up when things aren't going right. Every older person should have a named advocate as well as a named care coordinator.
These five steps could help create care homes that we want to live in rather than care homes we all dread the prospect of. Instead of 'be nice to your kids, they'll choose your nursing home', let's create a future where we have shaped the care homes that we want for ourselves and for our parents.