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Review backs value of Admiral nurses in care home settings

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Specialist dementia nurses working in care homes have helped improve support and care for elderly residents and their families, and boosted the skills and confidence of other staff, an evaluation has found.

Researchers from the Association for Dementia Studies at the University of Worcester explored the role of Admiral nurses employed by the Orders of St John Care Trust – one of the first organisations to deploy specialist dementia nurses within care settings.

The trust developed the in-house role with the charity Dementia UK and the My Home Life initiative, which promotes good practice in care homes, and currently has four such nurses working across its 68 care homes.

Researchers found the nurses – who do direct work within settings as well as providing phone and email advice – offered a wide range of both practical and emotional support to staff, residents and relatives.

“This research demonstrates the value of Admiral nursing in care homes”

Simon Evans

The nurses not only helped with individual problems and queries but had a positive impact on the wider policy, practice and culture of settings.

Around 90% of care home staff and managers surveyed rated Admiral nurses’ input as “important” or “very important” when it came to key areas like supporting relatives, resident care, care quality and staff training and support.

Sixty-eight per cent of staff said working with the nurses had made them better able to deal with residents in distress, while 46% said it had reduced the number of residents with dementia receiving anti-psychotic medication.

Sixty-seven per cent of staff reported their knowledge and skills had improved because of working with the Admiral nurses and around 64% said they were now able to provide better care for residents with dementia.

More than 58% said they felt more support in their job and around the same percentage said they felt more confident. More than half said they could identify changes that needed to be made in their setting.

Crucially nearly half of staff and managers said the nurses’ input had helped prevent elderly residents having to move to other settings. This increased to 54% among operations staff – senior managers at the trust who – agreed the role had enabled residents to stay in their care for longer.

“This is significant because it can improve the quality of the resident experience by reducing transitions that are often traumatic,” said a report on the review’s findings.

“This suggests a strong business case for such a role as it appears to help ensure changing resident needs can be met for longer and that care homes supported by the My Home Life Admiral Nurse can provide care for people whose needs are not met by other providers,” it added.

The research was commissioned by the Orders of St John Care Trust and funded with a grant from the Burdett Trust for Nursing.

It included a survey of more than 100 care home staff and managers and 24 operations staff, in-depth interviews with staff, research in four care homes and discussion groups with nurses.

“This research demonstrates the value of Admiral nursing in care homes and the potential it has to improve support for residents, families and staff,” said Simon Evans, head of research at the Association for Dementia Studies.

“This is important at a time when increasing numbers of residents have dementia,” he added.

The report makes recommendations for other organisations who may want to employ specialist dementia nurses, including looking at caseloads.

The researchers concluded it was reasonable for one such nurse to work with 15 to 20 care homes, visiting each bi-monthly and providing a flexible response to individual issues and cases.

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