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Winter work

Care home nurses need every INCH of our support

Outside the workplace, care home nurses lack recognised leaders and a collective voice. They need to be heard.

In January, a cross-party parliamentary health select committee on the nursing workforce heard evidence from the independent nursing and care home (INCH) sector.

All too often these residential homes, outside the NHS, are unfairly marginalised. Yet they care for more than half a million of our most complex and dependant population who are too frail to remain in their own homes.

It is worth highlighting the role of our nursing colleagues working in the INCH sector. Their working environment and employment culture can be challenging, and is outlined in a recent National Audit Office report.1

There are currently 43,000 nurses working in the INCH sector, and one in five has a zero-hours contract. Staffing levels are lower in this sector than in the NHS, and remuneration is more than £3,000 below the NHS average pay for nurses, with little opportunity to increase it through career progression. This can deter nurses from working in care homes, especially younger and newly-qualified ones. 

Care home nurses often experience isolation from their NHS colleagues by virtue of structures and employers. With few exceptions, they are excluded from NHS educational opportunities, professional development funding and clinical commissioning group community projects by virtue of their private business status. Safeguarding reporting and whistleblowing are made more challenging without the rigid protocols and advice from the NHS.

CQC reports and stories of poor care have instilled fear and reputational damage in a service that needs support. Outside the workplace, care home nurses lack recognised leaders and a collective voice. They need to be heard. 

How has this happened? Major long-term failures in healthcare policy and planning have hindered close working between health and social care to share data and develop the workforce. And nurses have lost out.

NHS Scotland has launched a campaign to highlight the importance of nursing in social care, outlining it as a valued and rewarding career. A UK study to look at the relationship between quality of care, skills and staffing in care homes reports in 2019. And Jeremy Hunt will launch a consultation paper this summer on the care and support of the elderly. 

Nurses are a lynchpin for working partnerships and should make their views known. Nurses working in this sector are experts on our aging population. We must heed them: aging is inevitable for us all.

Marilyn Eveleigh is a nurse adviser and independent trainer in East Sussex


1 National Audit Office. The Adult Social Care Workforce in England. London;NAO:2018