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Status consciousness

By guest blogger JEF SMITH

It is good news that the Department of Health has appointed Professor Deborah Sturdy as it first strategic advisor for social care nursing. Overdue, one might say, as the quality of nursing in social care settings has long been a cause of concern. In 2018/19 only 72% of nursing homes achieved a ‘Good’ rating from the Care Quality Commission, compared with 82% of residential care homes, and the calibre of the nursing care provided must have played an important role in this judgement. Although, in fairness, some nurses are employed in domiciliary care and community services where the ratings were somewhat better, there is clearly considerable room for improvement. Deborah Sturdy will have her work cut out.

But has she got her priorities right? The press release from Care England which welcomed her appointment contained quotes from three people, all of them in my view wide of the mark. Professor Sturdy herself said, ‘This is a significant opportunity to shine a light on the important work of nurses across the system. This role affords them a platform for their voice to be heard …’ Professor Martin Green, Care England’s chief executive, expressed the opinion that ‘Care home nurses are often under valued and do not have a sufficient voice. I hope that this appointment will correct this anomaly…’. And General Sir Adrian Bradshaw, Governor Royal Hospital Chelsea where Deborah Sturdy currently works, spoke of ‘this very important role supporting the Chief Nurse for England to recognise the important work nurses do in social care’.

I readily acknowledge that the status of nurses working in social care needs raising and that their voices should be heard more powerfully, but are these really the priorities? What about the quality of the nursing care itself? What about the residents, not least those with mental health problems or learning disabilities who are living in homes where the nursing care has been and continues to be poor, even abusive? Surely improving nursing care for service users should be at the top of the to do list, not nurses’ social and professional status.

Incidentally – but perhaps not coincidentally – all three of the people quoted in the press release chose to attach titles and honours to their names. A bit too status conscious?

  • The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.

3 Replies to “Status consciousness”

  1. Jef, you need to be careful about interpreting the lower CQC ratings for nursing as demonstrating that nursing care isn’t as good as residential care. Nursing care by its nature is hugely more involved and requires a considerable amount of extra paperwork. My experience is that the CQC inspection process is good at picking up ‘issues’ with paperwork rather than identifying the genuine quality of care so I’d expect the results for nursing homes to be lower.

  2. Yes, Jef. As with authority and respect, status can be sought, bought, stolen and grabbed and held on to, or it can be earned and given (and taken away) by peers (no, not the “Lords”) and those who know you and your work.
    A nurse working in a hospice has a relatively high status in the eyes of the public, whereas a nurse in a care home has a relatively low status. However, a brilliant nurse working in a brilliant care home will have authority, respect and status with their colleagues, residents, relatives, friends and probably in the neighbourhood.
    In 1982, people who worked in the large local authority care home I managed were ashamed to work there. They denied they worked there. Their clothes smelled and their lives were tainted by the gross institutionalised cruelty and deprivation of the place. Four years later, they were proud to work there because they had transformed the place, their own lives and the lives of the residents. It was a valued part of its neighbourhood. Oh, and we had a brilliant nurse.
    Many local care homes are the pride of their neighbourhood and many others are simply part of the low status care home “industry”. I don’t think that national initiatives make much difference either way. They may only serve to draw attention to – and thereby reinforce – the low status of nurses, managers, care workers, and give new status (and high salaries) to a few high profile “industry leaders”.

  3. I agree that we need to be careful about making statements on the quality of nursing You will remember a conference in Manchester Jef, as I do many years ago. When Counsel and Care launched its report on sexuality in care services that there was very little support or quality control in Care Home Nursing and whilst we have a long way to go we have come a long way since then and Professor Sturdy’s appointment is to be greatly welcomed

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