Care homes have very much been in the spotlight over the last year, with increased awareness of how vital their care services are to our loved ones. 

A community nurse's role in a residential care environment is critical to upholding the continued standards of care we expect.

Here we'll explore what a community nurse does, the diversity of this position, and how care homes use community nursing teams to deliver outstanding services, therefore enhancing the lives of care home residents throughout the UK.

With so many career opportunities within communities, many nurses are considering returning to the workforce, upskilling, or looking at vacancies in their local area. 

This guide runs through what that post might look like in practice.

What is community nursing?

If you have ever received support through an occupational health service, required medication to be administered, needed rehabilitation support or helped a relative through end of life care, you have likely met a community nurse without realising it.

This role is extraordinarily varied, with nurses sometimes working in small localised teams or sometimes alone. 

In short, a community nurse is tasked with providing care across a broad range of venues and facilities, helping patients to stay well and manage health conditions, so that they can ultimately avoid an unnecessary hospital stay.

Each area will have its own community nursing team which could include:

• Nurses who take blood, provide medication support or help with changing catheters or continence care
• Home visits for vulnerable people including helping with end of life care and support with rehabilitation
• Community mental health nurses provide support, guidance, advice, medication and can signpost people to appropriate services where required

Community nurses are specialist practitioners delivering an exceptionally vast range of help for numerous health conditions, directly impacting primary care services and rolling out new initiatives and support programmes on the front line.

What is the job of a community nurse?

The NHS treats over one million patients every 36 hours and is the 5th largest global employer. 

Hospital admissions exceed 16 million a year, and over 23 million people attend an accident and emergency department per annum.

Community nurses work in their local area and ensure that people receive professional nursing support, avoiding unnecessary hospital admissions. 

These nurses regularly visit people in their own homes to ensure their patients retain independence and get help to cope with long-term health conditions and recovery.

District nurses and community nurses are very similar roles:

• A district nurse is a registered general nurse who manages community care. They often work away from GP surgeries and clinics, which might mean working in residential homes, or through healthcare centres
• Community nurses also work primarily in homes or health centres and are trained as specialists. Each nurse works with disabled, elderly and vulnerable patients in their area who cannot travel to a hospital or need ongoing care and support to maintain a good quality of life

In some cases, both types of nurse work under the other's guidance, but these roles are generally very similar and may both work as part of the same team.

Why are community nurses so essential to care homes?

Registered nurses bring high skill levels to care home settings and are experienced in a range of disciplines, such as:

• Managing complex care issues
• Dealing with frail and vulnerable patients
• Knowledge of long-term conditions associated with ageing

When it comes to a residential care home nursing demands can be diverse, often delivered autonomously, involving family liaison and developing personal relationships with each patient.

Care homes take many forms - they might be privately owned, run by a charity, or managed by the local authority. 

Therefore, the staffing can also vary, with some care homes having full-time RNs, others relying on agency nurses, and yet more working with registered nurses from community nursing teams.

A nurse may visit a care home regularly, be present for specific hours of the day, or visit as and when needed, with 24-hour round-the-clock availability for urgent care needs.

In many cases, the nurse may be the only qualified medical professional on a shift, requiring leadership skills, exceptional time management and the ability to prioritise and deliver outstanding nursing support to patients with a high level of dependency.

What is community nursing's relevance to residential care homes?

As we've explored, care homes might not always have a registered nurse on their staff. 

Facilities offering only residential care often rely on primary health services and NHS nursing teams to support them with medical care for their residents.

The contribution of these nurses to the care home sector cannot be underestimated.

A survey by the National Library of Medicine found that:

• Community nurses are the most frequent NHS professional to visit a care home
• Care home managers depend on a good working relationship with nursing teams to deliver high medical support standards
• Nursing contributions vary depending on the services offered by the care facility

In summary, community nurses are vital for elderly or vulnerable patients who require ongoing help throughout their time in a care home.

Their professional duties might include:

• Providing care or administering medication as directed by the patient's doctor
• Record keeping to show the care given and medication administered
• Identifying care planning needs and risk assessing a patient's health
• Managing less experienced nursing staff or care assistants
• Re-evaluating and assessing the care needs of each patient
• Taking vital signs and consulting with other healthcare professionals
• Liaising with patients and their families to discuss treatments, examinations or any surgical interventions required
• Helping care home residents with health, diet and exercise

This list of duties is not exhaustive, and so the role of a community nurse in a care home facility can be extremely diverse, multi-faceted and complex. 

Community-based nursing is an invaluable service - it helps older people receive all the care, compassion and practical assistance they should receive. 

Moreover, healthcare standards are equivalent to those available through community nursing services to older people who live independently.

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