Nursing homes call for nurse subsidy

By Elin Mymadi

Health Editor, BBC News

Mr Cameron insisted there were early signs of success in “lacking cash” for major improvements Video: Nursing home progress The Conservative Party has led criticism of the slow roll-out of the national voluntary registered nurse (PRRN) scheme to nursing homes across England. Many nursing homes have simply done nothing and so their patients have been denied the necessary “critical care”. David Cameron warned in his party conference speech in 2008 that thousands of patients could die because of a lack of a registered nurse. Two years later, the government is struggling to get 300 nursing homes to sign up to the scheme. Lord Darzi, the Government’s health architect and who pioneered the PRRN scheme in the NHS, first launched the scheme in 1998. This was backed up with the government subsidy of £180 a week to cover the added cost of employing a PRRN to work at home. But ever since it was introduced in the NHS, this subsidy was abolished and money has gone towards charging social care home owners for services, so their costs have been rising sharply. Most nursing homes have not signed up to the scheme; many are worried about the impact on the bottom line. We have to make sure they are delivering safe care for people with dementia

Lord Darzi On average, home owners pay £1,400 to £1,600 a week to care for each registered nurse. They are struggling to pay for non-staff costs such as linen, curtains and a heating system. Many are simply not profitable, so they simply continue to provide care but without the extra PRRN staff. The result is often a drop in the quality of care which relies on patient involvement, giving patients the opportunity to express wishes and find out about their treatment. Many nursing homes struggle to offer dedicated activity periods away from the ward, which can be crucial for keeping dementia patients sociable. To challenge the problem, the care sector group NSPCC is running its own pilot scheme in 12 of the worst performing home owners. The results have been inconclusive. In isolation… It’s very hard to measure when it’s a one-off – you can only judge it when you can look at it again and again

Caitlin Barry, Nursing Homes NSPCC says the scheme is not working because it is too difficult to assess the quality of care and find out what is working and what is not. The scheme is too complex for anyone to undertake without specialist training. “The funding is not available for training people,” said Carmel Ziter, a board member of nursing homes group Your Villages. “The cost of an entry point to complete the training is the equivalent of £120 for a nurse or midwife, and this is something that has yet to be worked out. “There is something wrong here and it’s very difficult to measure when it’s a one-off – you can only judge it when you can look at it again and again.” Social care allocation plans were adopted in February, but they are different for nursing homes, although a number have been rolled out in areas including Hampshire and the Vale of Glamorgan. This means a nursing home is not automatically allocated a duty to offer the PRRN, but needs to seek approval first from the social care assessment task force. At least three nursing homes have tried to sign up, but either did not receive permission, or have not yet had to reapply. ‘Why not?’ Today there are 12 nursing homes using the scheme, with another 900 – about a quarter of the entire network – running a pilot. They range from hostels for lone parents to retirement villages and privately run homes. While some argue the government needs to spend more cash to convince more nursing homes to sign up, others say there are simply not enough staff to offer the service, so the money is not an issue. “It’s a great thing but I don’t see any point in paying it unless there is a viable business,” said Carmel Ziter. “And because so many nursing homes already have a PRRN – it’s a huge difference, and that has always been the problem.”

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