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We spoke to 13 care home managers across East Kent between October 2024 and January 2026 to understand how services are working from their perspective. This included nine residential homes and four nursing homes, all supporting people living with dementia.
Managers shared their experiences of working with hospitals, out-of-hours services, and primary and community care. While many talked about strong day-to-day relationships, they also highlighted some persistent issues that can make it harder to deliver safe, joined-up care.
This is one part of a wider project looking at care home experiences. We’ve also published a separate report focusing on support and training needs in East Kent care homes.
Challenges around hospital discharge
Hospital discharge came up again and again as a pressure point.
11 out of 13 managers said they had experienced at least one issue
More than half said they had dealt with several issues at once
The most common problems were:
No electronic discharge notification (EDN)
Residents returning without medication
Changes to medication that were unclear or not recorded properly
Many managers felt these issues were linked. Where EDNs weren’t provided, medication errors were far more likely to happen. In practice, this can mean staff having to chase missing information or urgently arrange prescriptions, sometimes late in the day or over a weekend.
Communication and continuity of care
Only two managers said they were completely happy with how hospital admissions and discharges work. Most felt there was room for improvement, particularly around communication.
Managers described:
Incomplete or missing handover information
Uncertainty around residents’ needs when they return
Feeling pressure to accept residents before they’re fully prepared
Several also pointed out that information can vary depending on who is on shift in the hospital, which increases the chance of things being missed.
Out-of-hours care
Most managers were broadly positive about out-of-hours support.
10 managers said current arrangements work well
They spoke about confident staff teams and appropriate use of services like NHS 111.
That said, a few areas came up where things could improve:
Better working relationships with ambulance services
More consistent use of tools like Restore2
Greater recognition of care home staff knowledge
Working with primary and community services
Many managers described good relationships with GPs, district nurses and other community teams. But access isn’t always straightforward.
GP services
Some managers reported:
Long waits—even for urgent concerns
A shift away from face-to-face visits, which they found harder to manage for residents
Dental care
Access to dentistry was a major issue:
8 managers raised concerns about NHS dental services
Common problems included long waiting times and lack of home visits
Wider community services
While generally positive, managers said support could be inconsistent at times, often due to staffing pressures.
In summary
Care home managers in East Kent are working hard to support people with increasingly complex needs. Strong relationships across services are making a difference—but gaps in communication, access and coordination are still creating challenges day to day.
Related report
This report is part of a wider project. You can also read our report on support and training needs in care homes, which explores the workforce pressures behind many of the issues raised here.
