Blood Tests in Care Homes: A Guide for Managers and Families

The Blood Testing Challenge in Care Homes

Care homes in England accommodate approximately 400,000 residents, the vast majority of whom are aged 75 and over with multiple chronic conditions. Routine blood monitoring is a fundamental part of their care, yet arranging blood tests for care home residents is one of the most common operational headaches for managers.

Sending a resident to hospital or a GP surgery for a blood test requires staff escort, transport arrangements, and risk assessments. For residents with dementia, leaving the familiar care home environment can trigger confusion, agitation, and distress that may last hours or even days after the outing. A single blood test appointment can consume half a day of staff time.

Routine Blood Monitoring for Residents

The most common reasons care home residents need blood tests include:

• Medication monitoring — many drugs prescribed to care home residents require regular blood checks to ensure they are working safely. This includes warfarin (INR), lithium (lithium levels and renal function), methotrexate (FBC and LFTs), disease-modifying anti-rheumatic drugs (DMARDs), and anti-epileptic medications.
• Chronic disease management — diabetes (HbA1c), chronic kidney disease (U&E, eGFR), thyroid disorders (TFTs), and heart failure all require periodic blood monitoring.
• Nutritional status — vitamin D, B12, folate, and iron studies are commonly checked in care home populations where nutritional intake may be suboptimal.
• Infection investigation — when a resident presents with signs of infection, blood tests including FBC, CRP, and blood cultures help determine the cause and guide treatment.
• Pre-operative assessment — residents requiring surgery (e.g. hip fracture repair) need baseline blood tests including FBC, U&E, clotting, and group and save.

Coordinating With GPs

Care home residents are typically registered with a local GP practice, and blood test requests come from the GP. Effective coordination between the care home, the GP practice, and the phlebotomy service is essential to ensure the right tests are done at the right time.

Best practice involves the care home maintaining a blood test tracker — a spreadsheet or digital record showing each resident’s required tests and their due dates. This allows the care home manager to batch requests and arrange a single phlebotomy visit that covers multiple residents, rather than booking individual appointments.

Bulk Booking Efficiency

Mobile phlebotomy services like Lola Dispatch can visit care homes on a regular schedule — weekly, fortnightly, or monthly — to take blood from all residents who are due for testing. A single visit can cover 10–20 residents in 1–2 hours, which is dramatically more efficient than sending residents individually to hospital.

The cost savings are substantial: no transport costs, no staff escort time, no risk assessment paperwork for each trip, and no disruption to the care home routine. For residents, the experience is far less stressful — they remain in their own room or a familiar communal area.

Reducing Hospital Transfers

Every unnecessary hospital transfer carries risk for a frail elderly person: falls, hospital-acquired infections, delirium, and medication errors during transitions of care. NHS England data shows that a significant proportion of ambulance call-outs from care homes could be avoided with better community-based healthcare.

Regular on-site blood monitoring helps care homes detect deterioration early — catching a rising creatinine before it becomes an acute kidney injury, or identifying a dropping haemoglobin before it causes a fall. This proactive approach keeps residents safer and reduces the burden on emergency services.

Consent for Residents With Dementia

Taking blood from a resident who lacks capacity to consent requires careful adherence to the Mental Capacity Act 2005. The key principles are:

• Assume capacity — every resident should be assumed to have capacity unless assessed otherwise. Many residents with mild to moderate dementia can understand and consent to a blood test with appropriate support.
• Support decision-making — use simple language, visual aids, and allow extra time. Explain what will happen in short, clear sentences.
• Best interests decision — if a resident lacks capacity, the blood test can proceed if it is in their best interests. This decision should be documented, involving the care team and, where possible, family members or the appointed lasting power of attorney for health and welfare.
• Least restrictive option — if a resident becomes distressed and resists the blood draw, it may be appropriate to pause and try again later rather than proceed against their will. Document the attempt and the outcome.

CQC Requirements

The Care Quality Commission (CQC) expects care homes to demonstrate that residents have timely access to healthcare services. Under the “Safe” and “Effective” key lines of enquiry, inspectors will look at how the care home ensures that prescribed blood monitoring is carried out on schedule.

A robust blood test tracking system, evidence of regular phlebotomy visits, and clear documentation of consent and results all contribute positively to CQC inspection outcomes. Conversely, evidence of missed or significantly delayed blood tests — particularly for high-risk medications like warfarin or methotrexate — is a red flag that inspectors will pursue.

Setting Up a Mobile Phlebotomy Service for Your Care Home

If you manage a care home and want to establish a regular mobile phlebotomy service, the process is straightforward:

• Contact Lola Dispatch to discuss your requirements, including the number of residents, typical test volumes, and preferred visit frequency.
• Agree a schedule (e.g. every Tuesday morning) so that GP practices can time their blood test requests accordingly.
• Designate a quiet, well-lit room for the phlebotomy visits with a comfortable chair and a flat surface for equipment.
• Ensure blood test request forms are collated and ready before each visit.
• Confirm the laboratory arrangements for sample dispatch and results return.

For families with a relative in a care home, it is worth asking the home manager what arrangements are in place for blood tests. If the current system involves regular hospital trips, suggest that the home explores mobile phlebotomy as a less disruptive alternative.