By Dr  Agnes Fanning  MA MSc BSc RN DN RNT, Queen’s Nurse, Queens Nursing Institute (QNI), and Dr Jane Wray, Senior Lecturer in Nursing (University of Hull), and Senior Clinical Nurse Advisor to the National Preceptorship Project

Nurses working in social care settings have unique knowledge, skills and expertise¹. They are delivering high quality, individualised care, supporting people to live independently at home and in community settings².  RNs in adult social care are “systems” leaders¹, navigating  a complex organisational, regulatory, practice, and professional landscape to deliver high quality evidence based care. As we move to a more integrated health and social care system in the UK³, social care nurses have a pivotal role to play and are ideally placed to lead and implement change specifically within the nursing/care home sector.

The role of the registered nurse working in a care, residential or nursing home is a highly skilled one, requiring an in-depth knowledge of long-term conditions associated with ageing, managing complex multiple morbidities and frailty⁴. Social care nurses have high levels of autonomy; their role is diverse, complex and relationship-based, focused on an individual’s health condition and how this impacts their social and community life^1,5. Practising as an accountable health professional, social care nurses are responsible for care assessment, evaluation and review of individual health and social care needs, evidence-based clinical decision making, and liaising with a wide range of external stakeholders to plan and co-ordinate care. Adults in social care may have several co-morbidities and may also be living with dementia or a physical disability and the recent ‘Hearing the nursing voice:  Listening to Independent Sector Social Care Nurses’⁶  highlighted key ‘Principles of Practice’ for social care nurses. These were; Building relationships with residents and relatives, supporting wellness, being a visible and compassionate leader and sharing knowledge and empowering others.  Their role and contribution is critical to safe, effective, evidence based practice and recent evidence from the Kings Fund⁵ reported better outcomes for residents in care homes when there are higher nursing staffing levels.

There are an estimated 40,000 Registered Nurses working in adult social care in England⁵. Given the importance of nursing and nurses to the delivery of high quality social care, it is of concern that since 2012, the number of nurses working in this sector have decreased. The recruitment and retention challenges facing the entire nursing workforce mean that social care is recruiting from an already depleted workforce. However, in November 2021 the DHSC published their Adult Social Care Winter Plan⁷ committing to providing funding to address local workforce capacity pressures to support recruitment and retention activity.

The Covid pandemic has placed social care under the spotlight and has showcased the critical role of nurses working in these settings. However, long term sustainable workforce planning is needed to meet the increased demand for social care services and to facilitate health and social care integration. More nurses are needed with the skills and expertise to work in social care and Skills for Health, RCN, QNI and NHSEI have been promoting  opportunities available to nurses at all stages of their career. More organisations are providing student nurses with opportunities to enhance their knowledge, skills and experience of social care nursing through placement opportunities⁸. These experiences will inform their decisions as to future careers, jobs and roles in nursing within the social care sector.  In addition, out-dated stereotypes and negative perceptions associated with working in social care as a ‘low status career choice’ are also being challenged^5,6.

Social Care nursing offers a long rewarding career option. With more student nurses having placements in social care settings it is expected to attract more newly qualified as well as very experienced nurses who may be moving from the acute or community sector. Nursing in the social care sector has both rewards and challenges, and recognition of the value, role and contribution of RNs working in the adult social care sector is long overdue.

To find out more about the ‘Care Home Nurses Network’ see the website Care Home Nurses Network – The Queen’s Nursing Institute (qni.org.uk). This is a jointly funded initiative by the Chief Nursing Officer England, the Queen’s Nursing Institute and the RCN Foundation.

References

1. Skills for Care (2019) Recognising the skills and responsibilities of registered nurses within social care. Available at: Recognising the responsibilities and contribution of registered nurses within social care (skillsforcare.org.uk)
2. Mitchel, G (2019) social care nursing is much more than giving out medication. Nursing Times, 22nd May 2019. Available at: https://www.nursingtimes.net/news/community-news/social-care-nursing-is-much-more-than-giving-out-medication-22-05-2019/
3. Health and social care integration: joining up care for people, places and populations – GOV.UK (www.gov.uk)
4. The Queen’s Nursing Institute (2021) Care Home Nurse. Available at: qni.org.uk/carehomenurses
5. Cornes M, Manthorpe, J. (2022) The role and contribution of Registered Nurses in Social care: A rapid evidence review. NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, Kings College London. Available at: The role and contribution of Registered Nurses in social care: A rapid evidence review
6. Douglas J (2022) Hearing the Nursing Voice: Listening to Independent Sector Social Care Nurses. Scottish Care Nursing Insight – May 22 (scottishcare.org)
7. Department of Health & Social Care (2022) Workforce Recruitment and Retention Fund for adult social care. Available at: Workforce Recruitment and Retention Fund for adult social care – GOV.UK (www.gov.uk)
8. Skills for Care (2021) How to make the most of student nurse placements in social care settings – for the person who needs care and support, employer, student and education provider. Available at: How to make the most of student nurse placements in social care settings (skillsforcare.org.uk