Nursing or Residential Care?

Halwill Manor provides Nursing and Residential Care, specialising in dementia care.

The difference between Nursing and Residential Care is the subject of many discussions and confusion. The main difficulty people come across when defining the two, is determining whether a particular condition or disability warrants ‘Nursing Care’.  In order to get a better understanding of the difference between Nursing and Residential, it makes sense to establish clear definitions of the two.

Residential Care

Below is a definition taken from the Alzheimer’s Society Factsheets:

“Most residential homes provide personal care for the residents who need it. This might include help with dressing, washing, going to the toilet and taking medicine. If you are considering a residential home, find out whether suitable care can still be offered if the person with dementia becomes more confused and dependent, as a move to another home can be very upsetting.”

In its most basic form, Residential Care involves assisting people with washing, dressing using the toilet, walking, taking medication and eating and drinking. These are known as Activities of Daily Living (ADLs). Someone who can no longer physically care for these basic needs will require support under the residential category.

Residential care can also mean providing care for someone that has lost all mobility, and requires moving and handling with assistive equipment. This does not mean that only physical disability can inhibit someone from caring for themselves. Because there are many neurological conditions that can stop this function of self-care whilst the body may still be physically able. We will cover Neurological conditions and Dementia later in this article.

Residential Homes will be able to provide accommodation and staff supervision 24hrs a day, and will provide support for all aspects of personal care and emotional needs, as well as communication, social activities. Each resident in a Residential Home will have a comprehensive care plan specifically tailored to the individual.

Before an individual is admitted into the home, a document (called the pre-admission assessment) will be carried out. This document lays the basis for the building of the care plan, but more importantly establishes whether the Home can provide all of the necessary support for the person.

Nursing Care

Definition again taken from the Alzheimer society Factsheets:

“Nursing homes always have a trained nurse on duty and can offer 24-hour nursing care in addition to personal care. Nursing care may need to be considered in certain circumstances – for example, if the person with dementia is very confused and frail, has difficulties walking, has other illnesses or disabilities, or continence problems.”

The key aspect here is that nursing care requires trained nurses whom are able to deal with more complex health needs. This range of needs is extremely broad which is why all trained nurses must study for at least 2 years at degree level, whilst working in acute hospital placements. A fully trained registered nurse will be able to treat and understand many complex needs including:

  • Managing and treating wounds and sores
  • Intravenous medication (IV Lines)
  • Taking blood samples (venepuncture)
  • Catheterisation
  • Promoting bowel function
  • Identifying medication side-effects
  • Renal failure

A Nursing Home will be able to provide all of the aspects of Residential care as described above, as well as 24-hour Nursing support.

An important point to remember is that some homes will employ Registered Mental Nurses (RMNs) as well as Registered General Nurses (RGNs); this is particularly helpful in dementia care homes, where an in-depth knowledge of neurological conditions will be valuable.

When providing support for someone that presents a degree of complex needs, a Registered Nurse will have the expertise to identify small changes in a person that could be a signal to indicate a health complication.

In these scenarios, the nurse will be able to intervene immediately, either by themselves or by consulting a GP. This quick reaction can save valuable minutes, compared to an environment where external professional assistance is required which can inevitably take much longer.

‘Dementia Care’ Homes

This is where the decision-making process for someone looking for a care home placement can become difficult. Especially when there are out dated terms being used to describe types of support, such as EMI (Elderly and mentally infirm). Which by today’s standards simply means someone elderly with cognitive impairment such as dementia.

Nowadays many homes are dementia care homes or dementia specialists. A dementia care home can be either a Residential Home or a Nursing Home.

At Halwill Manor we provide Residential support, Nursing Support and specialise in dementia care.

The independent regulator of care services (CQC) does not have a specific registration requirement for services to provide Dementia Care. So how do you know if a Care Home is genuinely able to provide dementia support? A good way to find out is by looking at the quality of staff, i.e. staff training and numbers.

All care homes should be able to give you a detailed explanation of their training programme. An effective dementia care home will provide training such as Mental Capacity Act training, managing challenging behaviour, and Dementia awareness.

A care home should also be able to demonstrate good staff levels at all times.

It’s worth your while to observe staff interacting with dementia sufferers, looking at the type of language and tone used, and see what approach is taken.

The environment is another factor with an important role to play in dementia care. Does the environment look and feel calm? Is it warm and comfortable, or cold and clinical? is it quiet and calming? Are there social activities taking place to engage people’s awareness?

Our observations and discussions with people and visitors showed there were sufficient numbers of staff on duty to keep people safe. Staff appeared to have time to meet people’s individual needs. During our visits call bells were answered in a timely way. People said staff responded quickly to call bells.” (2017 Halwill Manor CQC Report)