Care homes – new support arrangements: advice note

Letter and guidance setting out new arrangements for NHS Boards and local authorities in providing enhanced clinical and care support for care homes.

From: Chief Social Work Advisor, Chief Nursing Officer and Interim Director Social Care

To: Chief Social Work Officers, IJB Chief Officers, Executive Nurse Directors, Directors of Public Health, Medical Directors 

Cc: Local Authority Chief Executives and NHS Chief Executives

Subject: New arrangements for enhanced collaborative clinical and care support for care homes

We are writing to confirm new arrangements for providing enhanced collaborative clinical and care support for social care in Scotland. This follows a review undertaken by a Short Life Working Group (SLWG) comprising a range of stakeholders from across the health and social care sector.

We know that the social care workforce is continually and tirelessly providing exceptional care and innovating in the face of many challenges. We would like to build on this strong platform by ensuring that the sector is supported when needed and there is a continuous cycle of cross sector collaborative support to strengthen what is already in place.

As you know, arrangements for providing additional whole system, multidisciplinary support for adult care homes have evolved during the pandemic since the original request in May 2020 from the then Cabinet Secretary for Health and Social Care. Arrangements were subsequently widened to include adult social care. There has been considerable learning and examples of excellent partnership working during this time, and a recognition of the outstanding contribution and skills of so many care home staff and the teams that support them. That learning has very much been a two-way process. 

While there has been considerable value in the arrangements, it has been important to review them to ensure that they reflect the current context.  Based on the findings of the review and taking account of the current pressures facing the sector, we have developed a number of recommendations. Overall we recommend continued enhanced support for adult and older people’s care homes to support the sector as it emerges from the pandemic and as it deals with the current pressures. This note follows one from Caroline Lamb and Sally Louden on the 8th December on winter pressures and preparedness.

We note that such an approach outlined for care homes is also relevant for the wider social care sector, which many local systems have already adopted.

The recommendations are outlined in the advice note in Annex 1. They support a partnership approach, which recognises the experience of care home staff and the provision of support to care homes in the context of ensuring a homely environment in which people live and work. The note provides guiding principles and a framework which recommends that health and social care professionals continue to work together to identify ways to improve the health and wellbeing of people living in care homes, as described in My Health, My Care, My Home - healthcare framework for adults living in care homes published by SG in June 2022 and Health and Social Care Standards in Scotland.

We hope this will be helpful to you as you continue to work with and support care homes locally.  

Yours sincerely


Iona Colvin,  Chief Social Work Advisor

Professor Alex McMahon, Chief Nursing Officer

Angie Wood, Interim Director Social Care

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