Nurses in Care Homes: what to look for when choosing residential care for your loved one

Nurses are not in all care homes – it depends on the type of care provided. However, if your loved one needs higher level care, provided by nurses in care homes, then it’s important that you understand which type of homes are appropriate. Furthermore, it’s important to identify how you can be sure the nurses in the care homes you look at are suitably qualified and a good fit for your loved one.

Here we look in more detail at nurses in care homes and include a list of questions that you can ask about nursing care when visiting a home.

Which types of care homes use nurses?

Residential care for older people is split into some broad categories:

Residential care

In residential care you won’t find nurses in care homes, rather trained care staff. The care provided here supports personal care, as well as providing things such as meals and social activity.

Nursing care

In nursing care, this is where you will find nurses in care homes. There are care staff, as with residential care, but there are also nurses providing a higher level of care which we detail below.

Dementia care

Dementia care is a specialist form of residential care for those living with dementia. There is usually a combination of nursing care for complex care needs as well as knowledgeable and dedicated dementia care staff.

What do nurses in care homes do?

Nurses in care homes are responsible for the more complex care needs of residents.

It’s usually within the broad remit of care staff to undertake tasks such as assistance with washing and dressing residents, helping them mobilise, managing continence, providing and supporting with nutrition, and engaging with social activity.

Nurses in care homes may also do some of these tasks at times but their primary responsibility is to meet the round-the-clock nursing care needs of residents. These will vary from resident to resident but typically include things such as medication management, dressing changes, stoma bag changes, undertaking assessments etc. In certain cases, the nurses in care homes specialise in certain conditions. For example, in our dementia care homes, our nurses specialise in dementia care.

In a nursing home, you can expect qualified nurses to be available 24 hours a day. You can also expect your loved one to have a bespoke care plan that is devised to specify and cater for their individual care needs. For example, a resident with dysphagia and at risk of aspiration will require different nursing support to a resident requiring stoma care.

The nurses employed in nursing care will be a mix of nurses who are training on the job and working towards their qualifications and experienced qualified registered nurses. There will always be at least one qualified and registered nurse on site 24 hours a day. Typically qualified nurses will hold a Level 3 Diploma, but usually much higher. They will be registered with the Nursing and Midwifery Council. They will have completed mandatory training across a range of core skills including patient handling and moving, infection prevention and control and safeguarding. They will be required to renew and refresh these skills regularly.

Senior nurses in care homes typically oversee teams of nurses and care staff. They are responsible for individual care plans but also liaising with other healthcare professionals involved in your loved one’s care. As such, they will coordinate their care with that of GPs, physiotherapists and other specialists. This ensures your loved one’s care is best managed so that their needs are met.

Nurses in care homes report to the care home manager who has overall responsibility for the home.

How do I know if my loved one needs nursing care?

Specialised nursing care understandably costs more to provide, typically around £150-£200 more per week than residential care. As it’s more expensive, it’s important to know what your loved one needs. There is some provision for non-means tested NHS-funded nursing care which may cover the nursing-only element of care home costs. This process is usually started for someone within hospital, before they are discharged to a care home, but it’s worth asking the healthcare teams involved with your loved one.

Generally speaking, if your loved one needs any support beyond basic medicine administration, then they probably need nursing care. If they have a specific diagnosis, such as dementia or Parkinson’s disease, then they will probably need nursing care. It is possible to transition from residential care to nursing care but this can be difficult and distressing, so nursing care if often the first step and then scaled up as needed.

If you are unsure whether your loved one needs residential care or nursing care, where there are nurses in care homes, then a care needs assessment is recommended. This can be provided by your local adult social care team.

How to determine if a nursing home is the right one for your loved one?

There is enormous variation when it comes to choosing the right nursing home for your loved one with complex needs such as dementia. Much of the decision will rest on the qualifications, manner and experiences of the nurses in the care home. So, what should you look for? This list of questions will help you determine if the nursing home is the right choice:

How many qualified nurses are available at any one point during the day? What level qualifications do they have?

Questions to Ask a Care Home

  • Can I meet some of the nurses in the care home?
  • Is specialist nursing care provided? For example, do you offer specialist dementia nursing care?
  • How does nursing care change as the disease progresses?
  • Are your nurses experienced in managing multiple conditions? For example, can they care for someone with both Parkinson’s disease and dementia?
  • Do you complete an assessment of potential residents before accepting them? What does this involve?
  • Will my loved one have a named nurse or care worker responsible for their overall care?
  • How are families and loved ones involved in the care and decision about the care?
  • What is the range in care needs between residents?
  • If care needs change over time, or increase, can they be met within the same setting?
  • Can I see a bedroom and bathroom set-up?
  • How is the home accessible? Will my loved ones mobility needs be met?
  • Can I see relevant policies? E.g. Continence policies, catheter policies.
  • Which GP surgery are you linked to? How do residents see the GP? Does a GP visit the home regularly, and if so, when?
  • How often are resident’s needs reassessed?
  • Are travel arrangements organised and provided for hospital and clinic visits? Do staff accompany residents to appointments? Is there an additional charge for this?

How do you communicate with loved ones?

When visiting a home, look at the facilities for things such as handrails, raised toilet seats and mobility aids. If your loved one has dementia, particularly look to see that the facilities are designed with this in mind with appropriate facilities, furnishings and lighting – there should be specific amenities catering for sensory needs. But also ask to speak to some of the staff. Talking to the staff will help you get a feel for whether the care is right for your loved one.

Get high quality nursing care at Eastleigh

At Eastleigh Care Homes in North Devon and Somerset we are proud to be a leading provider of high-class nursing care in the area. The nurses in our care homes are amongst the best and a hugely valuable part of our care teams. We’d love you to come and meet them for yourself.

Get in touch on 01769 573166 to arrange a visit to meet the nurses in our care homes.