Nursing in Practice Winter 2021 (issue 122 | Page 15

Wales . ‘ Finding a [ social care ] nurse is like finding gold dust ’. QNI chief executive Dr Crystal Oldman echoes this , saying nursing students often do not see a care home placement as ‘ valuable ’ to their learning . She explains that , during her 18 years in higher-education roles , ‘ we would constantly hear students objecting to being placed in a care home , saying “ I ’ m not going to learn anything ”’.

The lack of appeal of care home nursing is not a new problem . Member support manager at Scottish Care Swaran Rakhra says working in geriatrics is not perceived as ‘ sexy ’. Ms Harris adds that social care is ‘ normally seen as a lesser sibling of hospital care ’.

Senior social care fellow at The King ’ s Fund Simon Bottery says that although social care has ‘ pretty good membership organisations [ they are ] fragmented ’ and there is no ‘ overall body that represents social care more broadly ’. The RCN ’ s transformational lead for independent health and social care sector Mark Bird echoes this , saying individual bodies ‘ do a lot of good work , but we still work in isolation ’. ‘ We don ’ t sit together , we don ’ t vocalise it , and we don ’ t commit as one strength ,’ he says .

On the importance of pay , a variety of opinions emerge . Nurses are usually paid more than other care home staff . But Louise Brady , clinical development lead at the Royal British Legion , says : ‘ Pay has to reflect the complexity of the skills .’ Ms Harris points out she has lost nurses to hospitals and other organisations that offer higher pay or better training .

A lack of training opportunities certainly seems to be causing problems . Southern Healthcare director Margot Whittaker explains : ‘ At the moment , we ’ ve got nurses who are doing very ad hoc training and I feel very strongly we need to have a [ national ] training programme .’

Are current factors making the situation worse ? The pandemic has clearly taken its toll . Senior policy officer at Care England Louis Holmes says the recent pressures on homes – which have been severely impacted by Covid-19 , particularly at the start of the pandemic – have seen ‘ nurses leave the care sector at a very speedy rate ’.

Mr Bottery points out nursing homes have lower CQC ratings compared with domiciliary , residential and community care providers . ‘ A lack of nurses is impacting on the system ’ s capacity ,’ he warns . ‘ There ’ s a clear link between an inability to recruit [ social care nurses ] and a lack of quality in the system .’

The panel agree the mandating of Covid jabs is likely to worsen the level of vacancies . The Government ’ s own statement of impact ² , released in July this year , estimated 40,000 of the current workers in the sector in England might not take up the vaccine by the deadline , which would mean care homes losing that number of employees . Care home owner George Coxon , although in favour of mandatory vaccination , says : ‘ The NHS is soaking up a lot of people who are refusing to be safe and do the right thing .’

Policy director at the National Care Forum Liz Jones asks : ‘ Was this practically and logistically the best way to achieve vaccination ? It would seem at the moment it probably wasn ’ t .

Social care workers are needed more than ever as our population ages – and registered nurses are an integral part of this

It is likely we will see members who will lose staff .’ ( At the time of this roundtable , no decision had been made on making vaccination compulsory for NHS staff , but on 9 November , the Government announced the mandate would be extended to the NHS in England , with a deadline to have both doses by April 2022 .)

Is the situation different in Scotland and Wales ? Covid vaccination is not compulsory in Scotland and Wales . Suzy Webster tells us there was ‘ a real concern care staff would leave the sector , which we have suffered very badly from , particularly in West Wales and our seaside resorts – a lot of our staff came over from tourism and hospitality , but sadly people seem to be going back to their old jobs ’. Mr Rakhra adds : ‘ I think if we were to go down the route of mandatory vaccinations in Scotland , we would lose a lot more staff .’ ( The 9 November decision in England has not been mirrored in Scotland or Wales .)

The devolved nations also face high vacancy rates but are tackling them in slightly different ways . The RCN ’ s national officer for independent health and social care Clare Jacobs says Wales has started work on a partnership forum , which she says is at an ‘ embryonic stage ’. The forum will focus on workforce , with representatives from trade unions , senior NHS management and the Welsh Government .

In August the Scottish Government released its consultation for a National Care Service ³ , to change the way social care is delivered in the country . It touches on recruitment and retention , suggesting a national body could oversee this as well as staff training and development . Mr Rakhra says more detail is needed and its effectiveness would depend on funding from the Scottish Government .

Is the English Government doing enough ? A Health and Social Care committee report last October ⁴ said the budget for social care in England should be increased by £ 7bn a year ‘ as a starting point ’ – much more the £ 5.4bn being pledged . ‘ We stand with the health select committee ,’ Mr Holmes says . He says the Health and Care Bill , currently going through Parliament and expected to come into effect in April 2022 , ‘ has some good gestures but is lacking in detail ’. Ms Jones is glad there is some investment but says the money from the health and social care levy ‘ is not enough ’. ‘ Social care brings incredible economic value to the country . Social care is a local business .’

Mr Bottery points out the pandemic forced ministers to recognise they ‘ actually didn ’ t really know what was going on [ with social care ]’. They are now working out the ‘ right level of oversight and involvement between national government and local providers ’, he says . He tells the roundtable panel this means they now have an ‘ opportunity for influence ’.

What needs to be done ? There is no dispute that the image of a social care nurse needs to improve and the perception of care homes being the poor relation to hospitals debunked . ‘ We really need to

Winter 2021 nursinginpractice . com