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The specialist care home making placements a priority

Opening its doors to more students has helped Hilltop House enhance learning and recruitment

Opening its doors to more students has helped Hilltop House enhance learning and recruitment


Nurse manager Becky Cowell, right, says Hilltop House offers so many learning opportunities
for those in training, such as nurse apprentice Tracy O’Sullivan, left. Picture: Tim George

A placement in a specialist care home is not always top of the list for nursing students looking for wide-ranging experience.

But nurse manager Becky Cowell says the approach to learning at her workplace is helping to change perceptions. ‘In this kind of environment, you come across so many different scenarios,’ says Ms Cowell, who works at Hilltop House in Northampton, a care home that provides a range of services for men with brain injuries.

‘There may be physical health emergencies, alongside challenging behaviour. This mixed bag of needs gives our students such good opportunities, putting them in good stead for qualifying, as they are exposed to issues they might not see in a psychiatric unit or an acute hospital ward.’

Stronger links with universities

Hilltop House, which is part of the Oakleaf Care Group, offers acute assessment and rehabilitation for more than 50 men aged 18 and over with an acquired brain injury, including those caused by accidents, strokes or cardiac arrest.

Although the home has been accepting students on placement for several years, numbers have risen significantly in that time – from one or two a year to around 20 in the first eight months of this year. They come for between five and 11 weeks. Most are based at the University of Northampton, but can also come from universities in Bedfordshire, Leicester or Milton Keynes.

‘Over the past couple of years our links with local universities have become much stronger,’ says Ms Cowell, who qualified as a mental health nurse in 2012 and joined the home in 2016.

‘Students are our future nurses, and you only get back what you put in. As the organisation has grown, it’s become apparent we have so many learning opportunities. It would be a shame for them to miss out.’

‘We have so many learning opportunities. It would be a shame for them to miss out’

Becky Cowell, nurse manager

Hilltop House clients have an initial assessment to see if the service is suitable for their needs, then an individual programme is drawn up based on their interests and abilities. This incorporates different forms of rehabilitation, including speech and language, occupational, horticultural and physiotherapy.

The service also has five community houses that provide varying levels of support for residents to either maintain their skills or try to increase them, so they can live more independently. A palliative care unit serves those approaching the end of life. At its most recent inspection, the Care Quality Commission (CQC) described the service as outstanding.

Challenging but rewarding

‘It’s challenging work, but very rewarding too,’ says Ms Cowell, who manages 20 registered nurses. ‘We have the privilege of watching the men gain their independence, building their skills. A lot of the time we see them going back to live at home, which is fantastic.’

‘We’ve had students who have lacked confidence, so we’ve invested time in them and they’ve left with a lot more’

Becky Cowell

In the past, placements were only offered to learning disability and mental health students, but the service now accepts adult nursing students too. ‘Our students were going back to their universities and talking about how much physical health experience they were gaining here,’ says Ms Cowell, who is also a mentor.


Ms Cowell: ‘We’re creative, so students
get more out of their placement.’
Picture: Tim George

‘We decided to trial adult nursing students too and it’s been a great success, so now we take all three branches. I’m delighted at how many students we’re getting through the doors.’

Structured around the individual

Placements are structured around the individual student. ‘For example, if we have someone who needs to learn more about giving injections, diabetes or epilepsy, we can move them for a shift so they can gain that experience,’ says Ms Cowell. ‘We’re creative and look for the opportunities, so they get as much out of their placement as possible.’

Being part of a small nursing team such as theirs can be beneficial, Ms Cowell believes. ‘We’ve had students who have lacked confidence, so we’ve invested time in them and they’ve left with a lot more,’ says Ms Cowell. ‘We give ownership to them and say, “Let’s work together”.’

Another advantage is being able to work closely with the home’s extensive team of therapists. ‘Students work very collaboratively,’ she says. ‘It means that when they leave us they have a good understanding of everyone’s role within the multidisciplinary team.’

Developing existing staff

So successful is their approach that several former students have applied to work at Hilltop once qualified, including one of two new nurses who started in September. ‘We take them through preceptorship, with a programme that includes all the skills they need for their practice portfolio, but focused on what we do here,’ says Ms Cowell.


Ms Cowell, right, supervises as Ms O'Sullivan practises her clinical skills. Picture: Tim George

They also develop their existing staff. Therapy assistant Tracy O’Sullivan was offered a nurse apprenticeship, which she began in September.

‘It’s a massive opportunity for me,’ she says. ‘I’ve been working in care for more than 20 years and first came here in 2007. Four years from now I’ll be a mental health nurse.’

Strong working relationships

The home is one of five taking part in the second phase of the Teaching Care Homes project, which began in 2016. Led by Care England and supported by the Foundation of Nursing Studies, with funding from the Burdett Trust for Nursing, the project aims to develop a network of homes that will become centres for learning, practice development and research.

Each is developing strong working relationships with education providers, alongside being a resource for other care homes.

‘It’s a good fit with what we’re trying to do,’ says Ms Cowell. ‘We’re delighted to have been accepted and have got a lot out of it so far. We’ve become more well-known, with the chance to visit other homes and get ideas about how we can improve our own practice. We want to promote care work, making sure everyone has a positive experience.’


After a successful placement at Hilltop House as a student, Karen Eastwood is now
unit manager. Picture: Tim George

‘I always wanted to come back’

‘Students can sign off on their whole portfolio here, if they’re proactive,’ says Hilltop House unit manager Karen Eastwood, who qualified in 2012.

‘All our students enjoy their time here. It’s a good learning opportunity for them, both in terms of theory and practice. There are few placements where you can achieve so much.’

Ms Eastwood is one of seven nurses who have joined the home’s nursing staff after being at Hilltop House as a student. ‘It was always my desire to come back,’ says Ms Eastwood, who also worked at Hilltop as a support worker before she began her nursing degree.

‘Whether the men are here for a short or long period of time, you can make a massive difference to their lives. They may arrive immobile and with significant deficits, but over time you can see the impact we make. When they leave here to go home to their families, I can’t tell you how rewarding it feels.’


Ms Eastwood helps student Haydn Davies prepare a pump-fed PEG feed. Picture: Tim George

‘We’re all mentors because we want to be’

Having done her mentorship training, Ms Eastwood is among the staff members who guide students on their placements. ‘I wouldn’t be here today without the amazing mentors I had, so I felt I wanted to give something back to the profession and our future nurses,’ she says. ‘Here we’re all mentors because we want to be. We’re not forced to do it, and that plays a big part.’

‘Whether the men are here for a short or long period of time, you can make a massive difference to their lives’

Karen Eastwood, care home unit manager

Being able to follow a patient’s whole journey of care over several weeks provides students with a unique experience, she believes. ‘My last student was able to do an initial assessment, admitting the person and caring for them right through to discharge. It was really satisfying for her,’ says Ms Eastwood.

‘There was a good chunk of time, so she could get her teeth into making a real difference, with care plans and projects. If she had been on a hospital ward, the person may only have been there for a couple of weeks.’


Lynne Pearce is a freelance health journalist


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