On average, nursing homes receive poorer grading on their performance than residential homes. It is thought that this is caused by staff shortages: the CQC State of Care report showed that 20% of nursing homes do not have enough staff on duty to ensure good and safe care. Poorer staff conditions and prospects compared with the working environment in the NHS, has resulted in recruitment difficulties for nursing homes.
Reduction in training opportunities
Staff shortage and a higher proportion of agency staff reduces the continuity of care, without the close working relationships that are vital. Additionally, nurse training places appear not to be sufficient: the Registered Nursing Home Association recently stated that there are now fewer nurses trained than there were in 2010 due to a reduction in places. While 50,000 applied for training last year, only 21,000 places were available.
There are also staffing issues in the residential care sector. A report from the UK Commission for Employment and Skills stated that increasing the supply of staff for residential care is vital, since the average age of carers is becoming closer to retirement age. They forecast that over the next seven years, half a million more residential care workers will be needed to maintain satisfactory standards.
There are clearly major challenges ahead
Firstly, there is a perceived gap in career prospects in the care home sector when compared with prospects in the NHS. This makes it more attractive for a health care assistant to work in a more secure and higher paid job but doing similar work.
Secondly, there is a perception that residential and nursing care homes are of lower quality than the NHS.
Thirdly, residential care homes are – like other services – beginning to shoulder the burden of more complex care, and a shift towards primary care in the community. This makes the workload more complex, in a context of austerity and decreased funding.
A solution of integration
The integration of health and social care is hoped in the long run to reduce any inequalities and this has already begun with a common care certificate for all sectors. This was an outcome of the Francis Inquiry into the Mid Staffordshire NHS Foundation Trust.
There is also the basic attraction that in residential and nursing homes generally, the working relationship with service users is more longer term, less episodic, and likely to lead to greater work related rewards and job satisfaction.
It is hoped that factors like these will lead to a more equal balance across all sectors of care as staff face challenging times ahead.
Tony Clarke – QCS Expert Scottish Care Contributor
