LGBTQ+ Inclusive Care: Training for Care Staff

Older LGBTQ+ people moving into residential care often carry decades of experience of discrimination that shapes how safe they feel being open about who they are, sometimes leading them to conceal a partner's true relationship, a chosen name, or simply their own history once they enter a care setting. Inclusive care training exists to close that gap between a service's good intentions and a resident's lived experience.

What the Evidence Shows

The 2017 National LGBT Survey, with over 108,000 respondents, found that among care home residents who identified as LGBT+, 72% had been open about their identity with staff or fellow residents — but 50% said they had avoided being open specifically out of fear of a negative reaction. Of those who had disclosed, 35% reported it had no effect on the care they received, 28% reported a positive effect, but 23% reported a negative one. A 2019 report from the Women and Equalities Committee put the underlying issue plainly: "Access to the same services as others is ineffective if that service is structured for a heterosexual and cisgender default."

Research consistently shows that most care professionals are not intentionally discriminatory — the more common problem is that staff feel under-equipped to meet LGBT+ people's specific needs, which can show up as avoidance, assumption, or simply not knowing what to ask.

What Good Inclusive Practice Looks Like

A University of Kent-led guide, co-designed with older LGBTQ+ people and care providers, was developed specifically to give care homes practical, everyday tips for inclusive practice — designed to be used in day-to-day care, in supervision conversations, and in staff training, rather than sitting as a one-off policy document. Core good practice includes never assuming a resident's sexual orientation or gender identity based on appearance, using the language and pronouns a resident chooses for themselves, recognising long-term same-sex partners with the same respect and involvement in care decisions given to opposite-sex spouses, and being alert to the possibility that a resident may have concealed part of their identity or history for decades and may not be ready to be fully open even now.

Building This Into Person-Centred Care

This connects directly to the same principles covered in cultural competence and religious needs training — asking rather than assuming, recording what matters to the individual, and reviewing that regularly rather than treating an initial assessment as fixed. Skills for Care published a dedicated LGBT+ learning framework in February 2023, reflecting a wider sector recognition that this needs the same structured, integral training investment as any other core competency, not an optional add-on module.

Practical Steps for Care Teams

Training should cover using open, non-assumptive language during admission assessments (for example, asking about a person's "partner" rather than assuming a husband or wife), ensuring paperwork and care plans reflect a resident's chosen name and pronouns consistently across the whole team, and actively welcoming and involving partners and chosen family in care decisions and visits in the same way as any other spouse or next of kin. Recognition schemes such as the "Pride in Care" quality standard, awarded by Opening Doors to assessed organisations, give services a way to demonstrate this commitment is genuine and ongoing rather than a one-off statement.

The Regulatory Backdrop

This is not just good practice guidance sitting outside any formal framework — the CQC's fundamental standards require providers to deliver person-centred care and to uphold dignity and respect, and providers must not discriminate against people using their service on the basis of protected characteristics under the Equality Act 2010, which explicitly includes sexual orientation and gender reassignment. CQC has published specific guidance on relationships and sexuality in care services precisely because this has been identified as an area where practice consistently lags behind policy. Embedding LGBTQ+ inclusive practice alongside broader equality and diversity training gives staff both the legal grounding and the practical, day-to-day skills this specific resident group needs.

Choosing an inclusive care home is also something prospective residents and their families are increasingly asking about directly, and services that can point to genuine training, visible policy, and staff confidence on this topic — rather than a generic non-discrimination statement — are better placed to answer those questions honestly.

Frequently Asked Questions

Why might an LGBTQ+ resident not disclose their identity to care staff?
Many older LGBTQ+ people have lived through decades where being open carried real social, legal, or professional risk, and that history can make disclosure in a new care setting feel unsafe even when a service genuinely intends to be welcoming.

Does LGBTQ+ inclusive care require a separate policy from general equality and diversity training?
Not necessarily a separate policy, but it does need specific, dedicated training content — general equality and diversity training alone often does not equip staff with the practical knowledge this survey evidence shows is missing.

How should staff refer to a resident's same-sex partner?
With the same language, respect, and involvement in care decisions given to any other long-term partner or spouse, following the terms the resident and their partner themselves use.

Inclusive care training for LGBTQ+ residents is ultimately about closing the gap between a service's stated values and what a resident actually experiences day to day — and the evidence is clear that most of the barrier is a lack of confident knowledge, which is exactly what focused training can fix.