My Health, My Care, My Home - healthcare framework for adults living in care homes: summary

About This Framework

People who live in care homes have a right to have their health and healthcare needs met in a person-centred, holistic, consistent and co-ordinated way. Their requirements go beyond physical health, and include social, psychological and spiritual care. People need consistent and timely access to good health and social care support to enable them to have joyful purposeful, fulfilled lives. However, healthcare services are not always configured with care homes in mind.

Through active engagement and participation, this framework and its recommendations has been developed in collaboration with various key stakeholders from across the sector. This includes people who live in care homes and their families, care home providers, representatives and staff, Health and Social Care Partnerships (HSCPs), our health and social care workforce, academics, and policymakers.

The recommendations draw on the diverse experience and feedback shared during the engagement and consultation process aiming to ensure consistent high-level healthcare for everyone who is living in a care home.

The wider determinants of health and wellbeing have also been examined and explored. This, coupled with our extensive programme of engagement, has helped to centre the framework around the following six core elements:

1. Nurturing environment

2. The multi-disciplinary team

3. Prevention

4. Anticipatory care, supporting self-management and early intervention

5. Urgent and emergency care

6. Palliative and end of life care

Importantly, the core elements are underpinned by both 'a sustainable and skilled workforce' and effective use of 'data, digital and technology'. These areas are seen as key enablers that will help the sector to implement the recommendations within this framework.

Other enablers are realistic medicine and ethical commissioning.

Practising and applying the six principles of Realistic Medicine will ensure decisions about healthcare are made in partnership with people and their families and will deliver care of greatest value to them. These six principles are:

• shared decision making
• personalised approach to care
• managing risk better
• reducing harm and waste
• reducing unwarranted variation
• innovating and improving

In March 2021, the Scottish Government and Convention of Scottish Local Authorities (COSLA) issued a joint statement of intent outlining how they would work together to deliver the key foundation pillars set out in the Independent Review of Adult Social Care in Scotland. This will lead to shared ethical commissioning principles and establishment of core requirements for ethical commissioning which will ensure that going forward, fair work requirements and principles are met and delivered consistently across Scotland.