Listening to the voices that need to be heard

Earlier this year, Scottish Care, a membership organisation and the representative body for independent social care services in Scotland, published a report called Voices from the Nursing Front Line. Through the voices of nurses themselves, it tells the story of what nurses love about working in care homes and the challenges. In other words, why they choose to enter, stay and leave.

It was particularly important for us to know this information given that nursing recruitment and retention challenges have reached a critical point in care homes in Scotland. Scottish Care’s research has shown that current nurse vacancy levels in care homes are around 28%. That is almost one third of posts unfilled, which has a significant effect on care home residents, other nurses and carers in those services and the entire health and social care sector.

Full understanding

But by only focusing on statistics, we risked not fully understanding the reasons behind them and of devaluing the experiences of more than 5,000 nurses who do work in care homes across Scotland. Given Scottish Care’s commitment to front line staff involvement and representation in all areas of our work, we therefore undertook interviews with 28 nurses working in the independent care home sector.

The results of these interviews form the basis of the report, and can be summarised as:

• Nurses enjoy their jobs in care homes because of the level of person-centred care they are able to deliver and the relationships they can build with residents and families.
• Nurses in care homes have a breadth and depth to their knowledge – clinical skills, relationship building, leadership, communication, coping with pressure, confidence – but many people (professionals and public) don’t realise this.
• A misguided, negative perception of nursing in care homes presents challenges for recruitment and retention.
• Nurses feel undervalued, in terms of recognition, pay and terms and conditions – especially in comparison with NHS nurses.
• The role of care homes and of nursing in care homes is changing – with the increased dependency and complexity of needs of people living in care homes, and the delivery of more palliative and end of life care. More training and support is required to enable nurses to best look after themselves, and the people they care for.

The report also makes a number of recommendations about what can be done to either further develop or improve the realities outlined above.

Since the report was published, positive progress has been made in relation to these recommendations and there has been commitment from the Scottish Government, the RCN and universities to undertake focused work with Scottish Care on nursing in care homes.

Level pay discussions

Among other developments, Scottish Care has been invited to speak about social care nursing with nursing students and has been involved in discussions about levelling pay, terms, conditions and career development opportunities between nurses working in care homes and in the NHS.

But more than anything, we need nurses to continue telling their stories – warts and all – about why they choose to work in care homes. It is the voices of those with real experience that influence change – and you can be part of that.

If you are a nurse working in a care home and would like to be part of the improvement journey with Scottish Care, get in touch. While the direction of travel is positive, there is still much more to do to ensure nurses in care homes feel engaged, valued and supported in their work – and we can’t do it without you.

About the author

Becca Gatherum, policy and research manager at Scottish Care