A National Survey Exploring Dementia Care Provision in Social Care in England
- 1Queen Mary University of London
Abstract
Context: Dementia is associated with significant use of social care, yet we know little about how providers respond to increasing demand and policy ambitions to deliver more care in community settings. Objective: To examine dementia care provision, workforce training, service integration, and perceived challenges among care homes and home care agencies in England. Methods: We conducted a mixed methods co-designed survey of care home and home care agency managers across five geographically diverse English regions, exploring: training, service delivery, relationships with other services, and future priorities. We analysed data descriptively and free-text responses using qualitative content analysis. Findings: We received valid responses from 42 home care agencies and 47 care home managers, who estimated around one third of home care clients, and most care home residents, had significant cognitive impairment. Most care homes held regular multidisciplinary meetings (29/40, 72.5%). Home care managers described positive collaborations with health and other social care services, but also difficulties accessing support and concerns about undervaluation of care workforce skills within multidisciplinary care. Across both settings, frequently reported challenges included: increasing care complexity, behaviours that challenge, recruitment, retention and financial constraints. In home care settings, difficulties working in partnership with families were cited as reasons for care breakdown. Most organisations provided dementia-specific training, identifying communication, behavioural support, de-escalation, safeguarding, and working with families as unmet training needs. Limitations: Findings are probably limited by response and desirability bias; we did not triangulate findings with objective data. Implications: As policy shifts care to community settings, investment in social care workforce development, specialist support and integrated pathways are essential for sustainable high quality dementia care. Increased funding, improved training, stronger career pathways, and greater recognition of care workers were identified as priorities for improving dementia care.
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BibTeX
@misc{darby2026national,
title = {{A National Survey Exploring Dementia Care Provision in Social Care in England}},
author = {A. Darby and C. Durkin and H. Chapman and O. Kelsey and C. Kenten and S. Banerjee and Y. Birks and C. Cooper},
howpublished = {medRxiv},
year = {2026},
month = nov,
doi = {10.64898/2026.11.09.26367668},
url = {https://www.medrxiv.org/content/10.64898/2026.11.09.26367668v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - A National Survey Exploring Dementia Care Provision in Social Care in England
AU - A. Darby
AU - C. Durkin
AU - H. Chapman
AU - O. Kelsey
AU - C. Kenten
AU - S. Banerjee
AU - Y. Birks
AU - C. Cooper
PY - 2026
DA - 2026/11/09
PB - medRxiv
DO - 10.64898/2026.11.09.26367668
UR - https://www.medrxiv.org/content/10.64898/2026.11.09.26367668v1
AB - Context: Dementia is associated with significant use of social care, yet we know little about how providers respond to increasing demand and policy ambitions to deliver more care in community settings. Objective: To examine dementia care provision, workforce training, service integration, and perceived challenges among care homes and home care agencies in England. Methods: We conducted a mixed methods co-designed survey of care home and home care agency managers across five geographically diverse English regions, exploring: training, service delivery, relationships with other services, and future priorities. We analysed data descriptively and free-text responses using qualitative content analysis. Findings: We received valid responses from 42 home care agencies and 47 care home managers, who estimated around one third of home care clients, and most care home residents, had significant cognitive impairment. Most care homes held regular multidisciplinary meetings (29/40, 72.5%). Home care managers described positive collaborations with health and other social care services, but also difficulties accessing support and concerns about undervaluation of care workforce skills within multidisciplinary care. Across both settings, frequently reported challenges included: increasing care complexity, behaviours that challenge, recruitment, retention and financial constraints. In home care settings, difficulties working in partnership with families were cited as reasons for care breakdown. Most organisations provided dementia-specific training, identifying communication, behavioural support, de-escalation, safeguarding, and working with families as unmet training needs. Limitations: Findings are probably limited by response and desirability bias; we did not triangulate findings with objective data. Implications: As policy shifts care to community settings, investment in social care workforce development, specialist support and integrated pathways are essential for sustainable high quality dementia care. Increased funding, improved training, stronger career pathways, and greater recognition of care workers were identified as priorities for improving dementia care.
ER -