Westminster City Council is taking a close look at the quality of care in older people's care homes and addressing the issue of residents being placed in facilities outside the borough. This is often due to limited local capacity and the need for specialist care. The council is taking steps to address this by exploring opportunities to expand local provision and reduce reliance on out-of-borough placements, including the expansion of extra care housing, such as the Carlton Dene extra care scheme.

The Vulnerable Adults, Health and Communities Policy and Scrutiny Committee met on Wednesday to review contract management and quality assurance. Here's what was discussed:

Care Home Quality and Out-of-Borough Placements

The committee reviewed the council's role in monitoring and improving the quality of care homes for older people. A report presented at the meeting highlighted several key points:

  • Community-Based Support: There's a move towards helping older people stay in their own homes through services like reablement and extra care housing, such as the Carlton Dene scheme. Tenants in Carlton Dene will be supported with leading-edge technology, utilising Wi-Fi-enabled smart hubs connected to door sensors, movement sensors, falls detectors, and smart plugs.
  • Investment in Facilities: The council is committed to high standards in care facilities, as seen with the Beachcroft House care home.
  • Out-of-Borough Placements: A significant number of older people are placed in care homes outside Westminster due to limited local capacity and the need for specialist care. The council has a system in place to monitor these placements.

As of April 2025, 307 Westminster residents aged 65 and over were living in care homes in neighbouring boroughs. To ensure the quality and continuity of care for residents in out-of-borough placements, the Council has implemented a robust monitoring and oversight framework. This includes:

  • Regular reviews of individual care plans by allocated social workers.
  • Scheduled visits to out-of-borough homes, particularly where concerns have been raised or where homes are not rated Good or Outstanding by the CQC.
  • Close collaboration with host local authorities to share intelligence and coordinate safeguarding responses where necessary.
  • Use of a centralised placement tracking system.
  • Engagement with residents and families, including feedback mechanisms.

The report also noted that the council encourages local care homes to sign up to the Veteran Friendly Framework for Care Homes.

Challenges remain, including workforce pressures, rising complexity of residents' needs, and financial sustainability. Workforce pressures impacting care homes in Westminster include recruitment and retention of care staff, driven by competition from other sectors, cost-of-living pressures, and limited access to affordable housing in central London.

Westminster supports providers in developing a skilled and resilient workforce through:

  • Access to training and development programmes, including dementia care, safeguarding, and leadership.
  • Promotion of digital innovation, such as electronic care planning and remote monitoring tools. Increased use of digital care planning, remote monitoring, and assistive technologies can enhance care quality and efficiency.
  • Support for recruitment and retention, including signposting to local employment initiatives and national campaigns.

Opportunities exist in expanding extra care housing and using digital innovation. The report also mentions a need to increase local provision of residential care and supported accommodation for residents with mental health conditions.