Follow a resident’s care home journey, through from pre-admission to end of life care. Find out more about risk assessments, short stays, discharge, acute admission, and the role of nursing staff when supporting residents, families and nursing colleagues.

• Care Home Journey
• Introduction to characters
• John and Graham
• Seema
• Jane and Eileen
• Sue
• Danilo
• Rachel

Prior to admission to a care home the nurse's role is key in the assessment of the person's needs, support for the family and subsequent care planning.

• Pre-admission
• The needs of the individual
• John - moving into Red Cedars
• John and Graham - addressing concerns
• Sue, Melanie and Dave - making arrangements
• Further resources
• The needs of family and friends
• The needs of nursing colleagues
• Sue - carer responsibilities
• Practice interventions (resources)

During admission to a care home the nurse plays the pivotal role in supporting the transition process for the person and their family. The nurse’s role will include practical interventions such as assessment of the new resident’s needs, care planning and medicines management.

• Admission
• The needs of the resident
• Seema - respite care at Red Cedars
• The needs of family and friends
• The needs of nursing colleagues
• Sue - Supporting Seema's wellbeing
• Sue - clinical supervision
• Practice interventions (resources)

This section looks at the role of nursing when providing long term care.

• Ongoing assessment Care planning Risk assessment
• The needs of the resident
• The needs of family and friends
• The needs of nursing colleagues
• Practice interventions (resources)

When a patient enters a care home for a short stay it is the nurse’s role to know the reason for the stay so that appropriate plans can be put in place.

• Short stay
• The needs of the resident
• Danilo - clinical scenario
• The needs of family and friends
• Sue - gaining feedback
• Seeking feedback from residents and families - the role of the nurse
• The needs of nursing colleagues
• Practice interventions (resources)

The role of the nurse in the process of discharge includes both a coordinating and educative activity. The registered nurse teaches self-care, organises services and arranges medicines and follow up interventions.

• Discharge
• The needs of the resident
• Seema returns home
• The needs of family and friends
• The needs of nursing colleagues
• Danilo - advancing career
• Practice interventions (resources)

The RCN promotes the role of registered nursing in care homes to ensure that high quality care and optimal outcomes are sustained. The right staff in the right place at the right time is required in order to ensure safe, effective, good quality care is delivered.

• Fundamental essential care
• The needs of the resident
• John and Rachel
• The needs of family and friends
• Caring in changing circumstances
• The needs of nursing colleagues
• Practice interventions (resources)

The nurse’s role in an acute admission situation is primarily to act quickly and in accordance with the residents wishes.

• Acute admission
• The needs of the resident
• Clinical scenario: emergency situation
• The needs of family and friends
• Key points for sensitive communication
• The needs of nursing colleagues
• Eileen, living with frailty
• Practice interventions (resources)

Sometimes residents need to be transferred to other permanent residences, this might be the residents own choice for example to be closer to family members, on other occasions residents have needs that cannot be met by the home they are currently living in. Occasionally residents need to be transferred to other residences as the home they are living in needs to close.

• Other transfer
• The needs of the resident
• Jane and Eileen
• The needs of family and friends
• The needs of nursing colleagues
• Practice interventions (resources)

Whilst some deaths occur suddenly, the majority of people die after a period of chronic illness, with three quarters of all deaths being expected. Many people entering a care home with nursing will be at the end of their lives.

• End of life care
• The needs of the resident
• Situation, Background, Assessment and Recommendation
• The needs of family and friends
• The needs of nursing colleagues
• Practice interventions (resources)
• The end and rebirth of Red Cedars