New report published: understanding policy and practice around alcohol use in care homes for older people in Wales
We are pleased to share the publication of our new research report, delivered in partnership with Age Cymru and commissioned by Alcohol Change UK.
Testimonial from Andrew Misell, Director for Wales, Alcohol Change UK:
“We were very pleased with the quality and professionalism of the work delivered by Practice Solutions. The report created was clear, well structured, and usable for sharing with stakeholders. Throughout the project, communication was open, consistent, and responsive, with all feedback incorporated thoughtfully into the final output.
What stood out most was Practice Solutions’ strong sector relationships, which supported engagement across the project and provided real value for money. This was a genuinely positive experience for us, and we look forward to the potential of working together again in the future.”
About the research
For many people, alcohol is part of everyday life. A glass of wine with dinner, a drink shared with friends, or a familiar routine at the end of the day. These moments carry meaning beyond the drink itself, connecting people to identity, memory, and social life. When someone moves into a care home, those habits do not simply disappear, but the context changes.
Care homes are both regulated services and people’s homes. Staff are responsible for safety, wellbeing, and clinical care, while also supporting personal choice, dignity, and independence. When a resident wishes to drink alcohol, these responsibilities can pull in different directions. This research explores how care homes across Wales navigate that tension between autonomy and risk, and what this means in practice for residents, staff, and the wider system.
Why this work matters
Despite the complexity of alcohol use in later life, there has been very limited research focused specifically on care home settings in Wales.
Alongside this, the context is changing:
- Alcohol-related harm among older adults is increasing
- More people are entering care with complex needs, including alcohol dependency and alcohol-related brain damage
- Care providers are being asked to balance rights-based care with increasing regulatory and clinical pressures
This creates a growing challenge for the sector, with no consistent guidance or shared framework to support decision-making. This research was commissioned to help address that gap, bringing together evidence from across Wales to better understand:
- How alcohol use is currently managed in care homes
- The values, attitudes and dilemmas faced by staff and leaders
- The lived experiences of residents and families
- Where further support, policy development and training are needed
What the research found
The research highlights a sector deeply committed to person-centred care, but often working without the tools it needs. Key findings include:
- A strong emphasis on supporting resident choice and autonomy, with many homes going to significant lengths to honour individual preferences
- Ongoing tension between personal freedom and duty of care, particularly around safety, medication and capacity
- Inconsistent policy and guidance, with over half of homes lacking clear or well-understood alcohol policies
- A significant training gap, particularly in supporting residents with alcohol dependency
- Limited access to external specialist support, leaving staff to manage complex situations alone
- Emerging challenges, including increasing numbers of residents with alcohol-related brain damage and changing generational expectations
The findings point to a system where good, values-driven practice exists, but is not consistently supported by policy, training or infrastructure.
Impact and next steps
This report provides one of the first detailed insights into alcohol use in care homes in Wales. It offers a clear evidence base to support:
- Care providers to strengthen policy and practice
- Commissioners and partners to improve system support
- National bodies to develop clearer guidance and frameworks
- Future research to build on emerging challenges
The report concludes with a set of practical recommendations aimed at strengthening the foundations of care, while protecting the rights, dignity and quality of life of older people.
Our role
Practice Solutions worked in partnership with Age Cymru to design and deliver this research, combining:
- Sector expertise in social care and system improvement
- Engagement with care home staff, residents and families
- A mixed-methods approach to capture both data and lived experience
This work reflects our ongoing commitment to supporting person-centred, rights-based care, and to bringing forward insight that helps the sector respond to complex, real-world challenges.
Read the full report: