How LGBT+ inclusive are your services?


Alice Wallace, Director, Opening Doors London

In recent years there has been far greater acknowledgement of the needs and experience of older people from LGBT+[1] communities – but research continually shows that social care services are not responding effectively.

Whilst most social care staff want to deliver the best possible care, many older LGBT+ people fail to access necessary services due to fear about being open about their sexuality or gender identify. This is often with just cause: 15% of those completing the Pride in Care survey said that they heard negative comments directed at LGBT+ people – and over 50% said that they did nothing about it, leaving older LGBT+ people feeling vulnerable, isolated and alone.

Older LGBT+ people are less likely to have support from their family than their heterosexual peers and therefore have higher levels of need – but they are likely to have much lower levels of trust of social care staff, higher levels of dissatisfaction and poorer communication experiences than with the heterosexual population. Often discrimination is systemic and results from social care structures designed for a mainly heterosexual and cis-gendered[2] population. Here at Opening Doors London [ODL] many of our members have experienced this type of discrimination.

Despite the 2014 Care Act requiring all health and social care staff to address the health and care support of LGBT+ people by tailoring services to their individual needs, many front-line staff say they lack the knowledge, skills and experience to do this effectively.   In response, ODL has developed several training courses led by older LGBT+ people themselves whose professional knowledge of LGBT+ health and care is informed by their own lived and experience – and that of ODL’s 2000+ membership. The workshops explore relevant practice issues and help staff implement inclusive care and support plans.

A recurring theme often raised in these sessions by participants is ‘We treat everyone equally and therefore do not need to consider sexual orientation and gender identity, as it is irrelevant to a person’s care.’ Of course, treating everybody the same misses the point, people need to be treated equally, but not identically to other groups. LGBT+ people might have specific needs and may therefore need require different support and interventions.

ODL’s ‘Pride in Care’ national quality standard is for any organisation that wants to evidence that they are providing inclusive services. Accreditation is through a step-by-step process which includes policy reviews, staff surveys, management briefings and on-going support. Pride in Care is championed Care England and with accompanying training endorsed by Skills for Care.

Recently the Care Quality Commission (CQC) has increased attention on LGBT+ inclusivity during inspections and many care providers have taken up the challenge of improving their practice. This work has received more impetus recently with the publication of the report by the House of Commons Women and Equalities Committee, ‘Health and Social Care and LGBT Communities’ to which ODL provided written and verbal evidence. The report recommends that the CQC should conduct a thematic review of social care services for LGBT+ people which should include examples of best practice and guidance to social care providers around how to create LGBT+ inclusive care services. This would be a positive move forward, and in the meantime, ODL will continue to work with individuals, organisations and policy makers to influence change and improve health and care services for the benefit of all older LGBT+ people.


Opening Doors London (ODL) is the leading provider of services for LGBT+ people over 50 in the UK. More information can be found at www.openingdoorslondon.org.uk or by contacting prideincare@openingdoorslondon.org.uk




“Older LGBT+ people are less likely to have support from their family.”

[1] LGBT+ refers to people who identify as lesbian, gay, bi and/or trans.

[2] Denoting or relating to a person whose sense of personal identity and gender corresponds with their assigned at birth sex [i.e. not non-binary or trans]

Edel Harris





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