Care Home Open Week: The community role of care homes

To celebrate Care Home Open Week 2022, Machala Evans, a nurse at our Tŷ Penrhos Care Home, spoke to The Royal College of Nursing about the necessity of holistic care and the prominent community role care homes can have.

Read the article on the RCN website or read on below.


What made you realise that care home nursing was where you wanted to be?

I previously worked as a community carer for eight and a half years, predominantly in dementia care. What I quickly realised is that I didn’t want to be a hospital nurse. The in-depth care that care home nursing allows means you really get to know your patients, which is what I’m so passionate about in a care home setting.

I interviewed for 14 roles in a week before working at a care home and Tŷ Penrhos was the first one I interviewed for. I knew straight away from the dynamics between the carers, the cooks, the maintenance, and the patients that I had to work here.

I won’t lie about the fact that the first six weeks were scary! Suddenly, I’m a qualified nurse and everyone is looking at me, but it’s the best thing I have ever done. I’ve gained so much confidence and couldn’t imagine doing anything else.


What are the main misconceptions about working in a care home?

The main one, which couldn’t be further from the truth, is that we aren’t real nurses and that we are deskilled, meaning, we don’t get to use all the skills we have learned. Whatever area of nursing you go into, you will learn specialised skills. I am a registered general nurse but the personalised holistic care we give to every single resident means the treatment I administer is different for everyone, from the care planning, to risk assessments, to nutrition and hydration and a variety of chronic physical problems as well as emotional and wellbeing support.

I’ve become the resident expert in wound care, which I never would have thought! This is entirely different on elderly skin. We had a patient who came to us with a prognosis of three months to live and they are still there three years later! All down to the correct wound care, pressure relief and not to mention the expensive specialised mattress I talked the manager into getting! That’s where I’ve really had the opportunity to develop my influencing and advocacy skills and my manager trusts my best judgement for our patients.

There are endless opportunities for you to develop the skills you want. We have an excellent training department who fund courses as well as free training through local authorities. I have completed management training to become a clinical unit lead where I get the best of both worlds between managerial and clinical skills and being a nurse, which is what I genuinely love. After completing the manual handling training, I also became a qualified trainer in this myself! I think the holistic care we provide as well as the chance to become specialised in certain disciplines is unique in this environment.


How important is continuity of care to family members and what opportunities are there for them to get involved?

Tŷ Penrhos is a very family-oriented care home, relationships with the families and continuity of care are essential to what we do. They trust you; they know you have their family members best interest at heart especially in end-of-life care which is a massive responsibility. I have never understood the term ‘nice death,’ but now I do. A pain free and comfortable end of life is equally important for the family members as for the patient.

We run lots of day trips that the family can come along to. We visit farms, beaches, cafes, local parks which has amazing effects on the residents’ wellbeing. Families can also visit during mealtimes, which works better for us sometimes if the residents are not taking food from us. We have total transparency and understand that these elements are an integral part of care and our residents’ overall health.


Care home open week encourages the public to visit and break down barriers in the community. How would you say Tŷ Penrhos participates in community life?

At Tŷ Penrhos we have a brilliant relationship with the local school. During the Queen’s Jubilee week, we visited the school and had a tea party. Prior to covid and with more opportunities now we routinely invite school choirs and local artists, hold pet therapy sessions, we even have chick incubators every year and the kids come in to see them being hatched. We have 15- and 16-year-olds in on work placements where they can sit with residents and assist the activity co-ordinators. All this helps build and strengthen intergenerational relationships and develop understanding of the older adults a valid and present group in society.

The care home is ultimately the best place for them, where they are most comfortable and at home. We provide the highest level of care we can ensure they are not sent to hospital unnecessarily to take pressures off other services.


If you had to give one piece of advice to someone thinking about becoming a care home nurse, what would you say?

Just do it! I’ve gone from thinking ‘I can’t to this’ to feeling completely empowered and proud of the job we do. I have a lot of say in my role. If you’re the kind of person who wants your voice to be heard and to have meaningful influence and advocacy for your patients, this is the place for you. We have had numerous students on placements coming back to us after their studies, so having that opportunity at university really changes the game in opening students’ eyes to the possibilities this rewarding and dynamic role can provide. I would say make the most of your placements, come in with an open mind after reading this Q&A and get stuck in!


To read more from RCN, click here.