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Clinical Updates

Why Work In A Care Home?

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It is well documented that the UK is on the brink of a Social Care crisis. There is a lack of healthcare workers and nurses wanting to work in residential settings, with people seeming to favour the acute hospital environment.

Sharon Allen, chief executive of Skills for Care, the employer-led workforce development body for adult social care in England, agrees that recruitment and retention is “the number one issue for the sector”.

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There are 60,000 vacancies in adult social care on any one day.

Contrary to the popular belief that this type of job is not rewarding and job satisfaction is low, I would like to talk about why I loved working in a care home.

Why I Loved Working in a Care Home

I worked as a Carer, a Registered Nurse and Home Manager in a busy nursing and residential home for many years. The main reason I loved working in a care home was that the residents became our extended family. 

Some of our residents had lived in the home for years and with that, we were able to get to know people really well. Some residents did not have loved ones or even visitors, and as staff we filled that role.

I enjoyed coming to work to see familiar faces and had a genuine bond with our residents; working in a hospital with a fast turnover of patients makes it difficult to get to know people as well.

Furthermore, I used to enjoy building a relationship with the families of our residents too.

I understand how hard it is for them to leave their loved ones in our care. Knowing that family members trusted us to look after them made us feel valued and appreciated. 

Special Occasions with our Residents

Working in a care home is very sociable. We are effectively working in people’s homes and it is important to ensure that we maintain a homely feel that is less formal than that of acute environments.

Care home staff are able to share special occasions such as Birthdays and Christmas with their residents and make these events meaningful.

I can recall many Christmas mornings when we would sit with the residents in the day room and open presents together in the same way that families sit together and open gifts.

We cared for one lady who had lived with us for many years who did not have any family. Several of the staff members used to buy her a gift so that she had presents to open on Christmas morning.

I can recall many trips and events I was involved in at the Care Home. Some of the favourites being a trip to the Zoo, going to Blackpool Illuminations and the Christmas Church services.

Critical Clinical Skills Required

Older people often have a range of medical conditions. Working in a care home means that staff need to have excellent clinical skills to be able to look after people with frequently complex care needs. 

Many older people do not want to go into hospital and want to stay in the care home for their treatment. This dispels the myth that care home nurses lose their clinical skills. I believe that they need them more than ever.

Finally, working in a care home means that sadly sometimes we have to say goodbye to our residents. Having looked after somebody whether for a short time or a long time makes it hard for staff when a resident passes away. When someone is dying, I consider it a privilege to be able to sit and hold their hand and support them and their loved ones through such a difficult time in their lives.

For all of these reasons, I found working in a care home to be the most rewarding role I have had.

It can be tough. There are many pressures facing social care, but if you can go to work and make a difference to your resident’s lives there is nothing more rewarding than that.


Written by Claire Bailey, Registered Nurse and Clinical Operations Manager at AutumnCare.

Clinical Care

Hourly rounding ‘may not be the best way for nurses to deliver care’, finds study

Hourly rounding places an emphasis on ‘tick box’ care.

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Hourly rounding made a minor contribution, if at all, to the way nurses engage with patients.

A new report by researchers at King’s College London has found that the widespread practice of hourly or intentional rounding, may not be the best way for nurses to deliver care to patients.

The report also found that rounding makes a minor contribution, if at all, to the way nurses engage with patients.

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Hourly or intentional rounding involves standardised regular checks with individual patients at set intervals and was introduced in hospitals in England in 2013, with 97% of NHS acute Trusts in England implementing it in some way.

The majority of NHS trusts adopted the ‘4Ps’ (Position, Pain, Personal needs, Placement of items) model of rounding.

The research was commissioned and funded by the National Institute for Health Research (NIHR) and was led by Professor Ruth Harris in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care.

Hourly rounding places an emphasis on ‘tick box’ care.

The NIHR report – Intentional rounding in hospital wards to improve regular interaction and engagement between nurses and patients: a realist evaluation – is the first study of its kind in the world.

The study found that rounding placed an emphasis on transactional ‘tick box’ care delivery, rather than individualised care. However, patients were found to value their interactions with nursing staff, which the study argues could be delivered during other care activities and rather than through intentional rounding.

The report also found that rounding was implemented without consultation, careful planning and piloting in the interests of political expediency following the Francis Inquiry Report into care failures in the NHS.

Ruth Harris, Professor of Health Care for Older Adults at King’s College London, said; “Checking patients regularly to make sure that they are OK is really important but intentional rounding tends to prompt nurses to focus on completion of the rounding documentation rather than on the relational aspects of care delivery.

“Few frontline nursing staff or senior nursing staff felt intentional rounding improved either the quality or the frequency of their interactions with patients and their family.”

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Clinical Updates

Nurses’ ‘worry’ better than most early warning scores, finds study

Nurses were asked to grade patients between ‘no concern’ and ‘extreme concern’. 

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A sense of worry can provide important information for the detection of acute physiological deterioration.

Nurses’ worry has a “higher accuracy” than most published early warning scores (EWS) at predicting if a patient is becoming more unwell, according to a recent study.

The study looked at 31,159 patient-shifts for 3185 patients during 3551 hospitalisations across two surgical and two medical wards. Researchers compared if the nurses were worried about a patients potential for deterioration using ‘the Worry Factor’ with early warning score indicators.

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Nurses were asked to grade each patient between “no concern” and “extreme concern”.

The Worry Score

Out of 492 potential deterioration events identified, researchers found that when nurses had an increasing worry factor the patient was more likely to require emergency medical treatment – 7 cardiac arrest calls, 86 medical emergency calls and 76 transfers to the intensive care unit.

The study also revealed that accuracy rates were significantly higher in nurses with over a year of experience.

The researchers concluded that “nurses’ pattern recognition and sense of worry can provide important information for the detection of acute physiological deterioration” and was often more reliable than traditional early warning systems.

They also noted that the worry score could be used alone or easily incorporated into existing EWS to potentially improve their performance.

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