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Nurses call for post-reg specialist qualification in care of older people


“Neglected” care home nurses are failing to receive adequate preparation for the role and are unable to access the same career development opportunities as NHS nurses, according to a survey.

Around 70% of survey respondents said undergraduate pre-registration nurse education did not prepare the future workforce with the skills, knowledge, competencies and experience to deliver high quality care to older residents.

This was despite the vast majority, 87%, of respondents – which included nurses, managers and community registrants working in care homes – reporting that a particular set of specialist competencies were required to do the job.

A post-registration specialist qualification for care of older people – including care home nursing – was suggested by many people taking part in the research project, which was carried out by academics at the University of York and funded by the Royal College of Nursing Foundation.

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Such a qualification would ensure the nursing care home workforce was “fit for purpose” and able to meet the increasingly complex care needs of residents, said the report on the study – called Supporting Nursing in Care Homes.

“There was consensus among participants that undergraduate pre-registration nursing programmes are not adequately preparing the future nursing workforce,” noted the report.

“These programmes were viewed as focusing predominantly on acute care nursing and having insufficient focus on care for older people, frailty, co-morbidities, complex long term conditions, dementia, end of life care, health and social care partnerships, and the political landscape of care homes,” it said.

Personal care – including nutrition, bowel and catheter care – was the highest ranked priority for continuing professional development of care home nurses, according to the 352 people taking part in the survey. They were followed by dementia care and managing long term conditions.

The most frequently cited barriers to CPD for care home nurses were a lack of staff cover, limited access to NHS training opportunities, and a requirement for staff to take courses in their own time and unpaid.

When asked how to ensure the nursing profession attracted the best candidates for care homes, survey respondents said nurses in this setting should receive the same learning and development opportunities offered to NHS nurses.

The report said: “Participants recommended the development of a career pathway for nurses in care homes by national bodies – such as the RCN and NHS England – care home leaders and nurse education.

“This would constitute an important step in raising the profile of the sector to attract and retain nurses, support them towards clinical leadership in the sector, as well as increase the value and visibility of the role in society,” it stated.

The report’s authors concluded: “As the populations ages, the role of the care home and the care home nurse will become increasingly important in future years and our report findings provide a platform for stakeholders in the sector – including commissioners, providers, care home managers, care home nurses, educators and researchers – to consider what needs to happen next.

“After years of neglect, it appears that the role of the care home nurse is making its way on to political, practice, education and research agendas,” they added.


Readers' comments (20)

  • I would like to agree that we need more training in the care home working as a nurse. I have to deal with residents with complex needs amongst those with chronic conditions and end of life care, which I have not been trained in. I would like the RCN to push forward this agenda for nurses working in the care home settings.

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  • There is a desperate need for better training for nurses in care homes, both for patient safety and job satisfaction. It's no wonder nurses leave the profession. They need more support. It is a fantastically important role they have in care homes.

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  • I LOVE working in a care home setting as I love working with older people and strive to contribute to a real quality of life for them in many different ways.I really feel the need for more educational input and would welcome the chance to have access to NHS courses and train alongside NHS colleagues to update my clinical skills.
    I really want to do an NHS course in wound care/tissue viability, blood taking, male catheterisation and end of life care.
    The only 'training' I get in the care home is Health and Safety (same thing,year in year out!) SOVA and Fire Training plus medication.That's pretty much it!!
    I would love to do a specialist training course,maybe similar to ENB 998 but there just doesn't seem to be the opportunity.
    I can't afford to pay for this stuff myself and the Care Home sector is mainly private owners who are in it for profit not to educate nurses!!
    As long as you have a PIN number (even if it's a rusty old one!!) they are covered and they will keep avoiding the issue of further training in care homes until forced to by Government.
    Nurses in Care Homes should be able to access one course (paid for by their employer) every year to update wherever they feel they need to.
    If it's down to Care Home owners it will be a non-starter!!!

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  • Working in a care home I am committed to providing the best evidenced based care I can to my patients who often have very complex, life limiting conditions. I agree a specialist training course in care of the older person would be of great benefit.
    At present I spend a lot of my free time and money on continuing professional development even though my employer is very receptive to our training needs and organises frequent training, but understandably their resources are not infinite either. Access to Trust training would be a huge bonus.

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  • I am an owner of Care Homes and I have been advocating not only extra training but also designating a specialist category to this very specialised field of Nursing. Apart from my own staff, I have found no support whatsoever from anyone in the Nursing Community to support me.
    I am very proud of my staff and all of the thousands of Nurses working in Nursing Homes and during my thirty years in this job all I have seen is them denegrated , the Public , bye the way, sing their praises on a daily basis but no one listens do they.

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  • I totally agree - ever since I did my PhD looking at death and dying in nursing homes I have been thinking exactly the same. Nurses and formal carers do an amazing job in care homes. However, more recently, I see an increased need for a care home qualification for social and health care assistants - something on the lines of the old SEN qualification.

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  • HCSW

    Recently I have done few shifts in a local nursing homes. Shocking! Nurses do not have to use gloves there: as they simply do not touch the patients (except the night staff RGN, which has to wash one person). Registred, qualified staff do only medication and paperwork. Lotsa paperwork! As in old Russian saying: "more paper you use, cleaner bum you will have!". My fellow CAs were friendly, but many did not understand that feeding a patient that lies flat on the bed is terribly wrong! Conclusion? I love NHS!

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  • HCSW | 21-Apr-2015 9:22 am

    very helpful "constructive" feedback from you as usual. I am sure all of Britain's care homes will welcome it and be falling over themselves to use it to inform future improvements! no wonder a nursing degree and training, registered qualification and regulation is so essential to the professions and to safe and high standard patient care and to teach its members to express themselves as well as learning and developing the skills of intelligent reflective practice and offering and taking constructive criticism and feedback!!!!

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  • Jo Hockley | 20-Apr-2015 1:33 pm

    Thank you for your support, much appreciated.
    SEN's can already be used in the "Registered Nurse" role believe it or not the active words being "Registered" and Nurse, suprisingly this has been confirmed by our Area Health Authoriity when they were in control,I actually got an SEN accepted as Matron just before CQC took over.
    I wonder how many know this fact

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  • HCSW

    @ Anonymous | 21-Apr-2015 9:44 am

    Why are you afraid to provide us with your nickname? Your sarcastic comments ad personam are as pleasant as a fart in the bus.

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