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Nursing home care: Who provides care in an aged care home?

Submitted by Emma Hamilton on Wed, 09/09/2009 - 1:28pm

Many health care professionals will be involved in the care of a resident in a nursing home. Understanding how the aged care home operates, who provides care and who to go to when you have a problem are important in ensuring your relative gets quality care.

Aged care homes are classified as low- level care or high- level care. The nursing staff employed in an aged care home will have various levels of nursing experience.

In some low- level aged care homes a registered nurse will be 'on call' in case of an emergency. Always ask the aged care home how many qualified nursing staff actually work on the floor as opposed to being 'on call'.

Personal care workers who work in low-level care need easy access to qualified nursing staff either an endorsed enrolled nurse or preferably a registered nurse at all times.

Keeping up to date on your loved one's health will be much easier if you understand the roles and experience of key nursing home staff.

 

Personal care workers

Out of all care staff Personal Care Workers (PCW's) or Assistants in Nursing (AIN's) spend the most time with your loved one. Nursing home staff should preferably have their Certificate 111 in Aged Care Work. 

PCW's assist your loved one on a daily basis with personal hygiene, mobility, meals and social interaction. In some nursing homes PCW's can assist older people with self medication (Taking medication from a Webster Pack).

PCW's can vary in nursing experience and skills. A good aged care home will organise its staff into nursing teams taking into account every staff member's knowledge and capabilities.

On occasions nursing home staff will be replaced by agency nurses. Don't expect agency nurses to know a great deal about your loved one's care routine or medical history.

If a nursing home is having to rely on agency staff on a regular basis it is generally not a good indicator of continuation of care.

 

Enrolled Nurses

Enrolled nurses (EN's) play a vital role in aged care homes and hostels. To be an enrolled nurse you need to complete 18 months of study at TAFE and a Health Facility to achieve a Diploma in Enrolled Nursing.

An enrolled nurse may assist a registered nurse in an aged care home to manage the resident's care or they may manage care in a low level care home.

An enrolled nurse will help a resident with activities of daily living such as feeding, mobility and personal hygiene. They may also will assist with taking general observations, dressing wounds and diabetes care.

An endorsed enrolled nurse can administer some medications in an aged care home.

 

Registered nurses (RN)

Registered nurses (RN's) working in residential care are generally university trained with special skills in geriatric, palliative and dementia care.

The number of registered nurses on duty at any time in an aged care home can vary. A registered nurse will direct and supervise PCW's and ensure a resident is receiving proper care according to their nursing care plan.

On a daily basis a registered nurse will assess your family member's health, provide physical and technical nursing care and manage medications.

The registered nurse will make sure your loved one receives treatment as prescribed by a doctor. They may also organise other health care professionals to be involved in the care of your family member. 

If you are concerned about your family member's health or you have a problem with nursing home staff, the registered nurse in charge is the person to speak to.

Family should be kept up to date regularly by the registered nurse and informed of any changes in a family member's health. This includes information such as changes to medication, problems with mobility, nutrition and any recent falls or skin tears.

 

Director of Nursing (DON)

The Director of Nursing or DON is in charge of the day to day management and administration of a residential care facility.

All aged care homes must be accredited in order to receive government funding. The DON ensures the aged care home meets a set of 44 expected outcomes relating to the care provided to its residents.

You can ask a DON about the aged care homes current accreditation status. An aged care home with three years accreditation shows compliance with the 44 expected standards aged care homes are expected to meet.

An aged care home that focuses on quality assurance and a culture of continuous improvement will be more responsive to the care needs of its residents and more likely to deliver a quality service.

The DON largely drives this culture and will strive to deliver quality care to its residents on an ongoing basis.

When choosing an aged care home ensure you arrange a meeting with the DON. Is the DON approachable? How does the DON interact with residents and staff?

Ask the DON about the nursing homes current accreditation status and how the aged care home handles complaints. Is the DON open to discussing your concerns?

Question the DON about staff turnover. How does the aged care home look after the needs of its staff? What levels of experience do they have? Do you provide opportunities for ongoing education and promotion? How do you reward your staff?

If you are choosing an aged care home take the time to observe the nursing care staff. Nursing staff that are happy and respected will work hard to ensure your family member receives the care they deserve.

 

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