One of the main considerations in deciding on care for an older relative is whether they will receive the level of medical support which is appropriate for them. Skilled nursing care, care that is more than just assistance with everyday living and provides continuous clinical care from a registered nurse, is the solution for many families.
This guide will describe what a skilled nursing home is, how it’s different from a residential care home and what to consider when comparing nursing homes.
What Does Skilled Nursing Care Actually Involve?
Skilled nursing care includes medical care that is provided by registered nurses in a care home. It is for people who need a bit more health care than those who do not. It’s for people who have more complex health needs, whether it’s a long-term condition, recovering from a hospital stay, or a health diagnosis like dementia that requires close attention.
What Skilled Nursing Care Facilities Typically Provide
- Handling and giving medicines
- Bandaging and change of dressings
- Chronic condition monitoring such as diabetes or heart disease monitoring
- Mobility and continence support
- A good relationship with GPs, district nurses and hospital teams.
- Palliative/end of life pain management
A nursing home that is skilled at providing nursing care will have trained individuals working around the clock as opposed to a home caregiver, who will typically only be present for a designated amount of time. For families whose relative’s needs are beyond the safe capacity of home care, that constant presence is key!
A Typical Day of Skilled Nursing Care in a Care Home
Morning
Health check: Blood pressure, medication and review of sleep patterns; followed by support with feeding and mobility.
Afternoon
Insulin injections or wound reviews as scheduled (if part of the resident’s care plan) or physiotherapy, GP visit or rest, depending on the resident’s care plan.
Evening
Another dose of drugs and a second health check before residents go to bed at night and nursing care staff present at all times for any unusual occurrences.
This means that families will feel more assured that care is not merely reactive. It is planned, recorded, and reviewed as the needs of the residents develop.
When Do Families Need to Consider Skilled Nursing Care?
There’s rarely one single moment that triggers this decision. More often, it’s a combination of signs building up over weeks or months.
What Are The Common Triggers?
- Lots of hospitalisations or falls
- A new diagnosis that needs to be monitored on a regular basis.
- Medications that are too complicated to take safely at home.
- A Caregiver who is experiencing burnout at home.
- Moving to a hospital with a continued nursing requirement.
Home care is typically not enough to care for someone if the GP or hospital discharge team stated that they would require “nursing care” instead of “residential care.
Skilled Nursing Care vs Residential Care: What’s the Difference?
| Factors | Residential Care | Skilled Nursing Care |
| Staff on site | Trained care assistants | Registered nurses, 24 hours a day |
| Suited to | Help with daily tasks (washing, dressing, meals) | Ongoing medical or clinical needs |
| Medication | Support with taking medication | Full medication management |
| Health monitoring | Basic wellbeing checks | Regular clinical monitoring and intervention |
Some care homes provide both, meaning that a person could be admitted to nursing care when their needs change, without the need to move. This continuity is important, especially for those with dementia, as they are very important to their familiar environment and the consistent staff. It also relieves the family of the stress they may experience when they are looking for another home when everyone is already stressed.
Top 5 Questions to Ask When Choosing a Skilled Nursing Care Home
A good place to begin is with the home’s most recent Care Quality Commission (CQC) inspection report, which outlines ratings for the following areas: safety, effectiveness and leadership.
Questions Worth Asking
- How many registered nurses are on duty at any one time?
- What to do if a resident’s health suddenly changes?
- Who reviews and who does the reviewing of medication?
- Are families able to obtain a copy of a sample care plan?
- What training do nurses/carers receive for any specific condition (e.g. dementia/diabetes)?
Visiting at different times of the day, and preferably in person, will give you more information than a brochure will.
Getting the Right Support in Place
Long-term care is not about going to the “next level”. It is about customising the support a person receives to meet their real health needs, safely and reliably. A nursing home in Sutton Coldfield that provides residential care, dementia care and nursing care will enable residents to transition between levels of care when they require it without having to move. A little time spent comparing, asking direct questions and reading the CQC ratings can make the difference for families to make that decision with confidence.
