Clinical career pathway

Care assistants provide the highest possible standards of care and service to all the residents, under the direction of a team leader of manager, whether working individually or as part of a team.

The role is busy and varied. During a typical day, the care assistant will help residents with activities that they would usually perform (or have in the past performed) themselves but cannot now do so without assistance. These include washing, dressing and eating, all the while promoting and encouraging as much independence as possible while maintaining residents’ dignity and self-esteem. Care assistants contribute to care plans, alongside residents themselves and/or their representatives, and also support residents to participate in wellbeing activities, both inside and outside the home. There are lots of opportunities to develop positive, helpful and caring relationships with residents and their families in the role.

The senior care assistant (SCA) provides the highest possible standard of person-centred care and service to residents, in addition to performing a supervisory role. He or she takes charge of a shift of carers and is responsible for the smooth running of the service while on duty. They also respond to emergencies, providing guidance and support to care assistants under the supervision of qualified nursing staff.

The caring side of the role involves helping residents with personal care such as washing, dressing and eating, while encouraging their independence and maintaining their dignity and self-esteem. SCAs contribute to care plans, involving residents and/or their representatives in this process, and supporting to participate in wellbeing activities. The role offers plenty of opportunities to develop positive and meaningful relationships with residents and their families. As part of their managerial duties, the SCA acts as a role model to care assistants, organises the keyworker system for the unit and supports the training and supervision of new and junior staff members.

The SCA/med tech’s role is the same but they are trained to administer prescribed drugs and treatments.

The assistant practitioner (AP) provides a high standard of nursing care within their scope of practice. In the absence of the nurse, he or she manages the unit, organises the care staff for the shift and delegates care based on residents’ needs.

APs support the nursing staff by undertaking a range of specialised clinical tasks, including phlebotomy, urine testing, wound care, blood glucose/blood pressure monitoring, administering drugs and treatments after completing the required training. Other responsibilities include writing and updating care plans, maintaining accurate records, liaising with the wider multi-disciplinary team and acting as the residents’ advocate, helping them to facilitate their own choices regarding personal care. APs act as a role model to care assistants, lead and develop the home’s keyworker system and undertake supervisions, return-to-work interviews, shift rotas, annual leave and other necessary support.

Trainee assistant practitioners (TAPs) train for 12 to 18 months while working under the supervision of a nurse, nurse – team leader or a member of the home’s management team. They must also submit written assignments and undergo observations by assessors.

Nurses adopt a ‘hands on’ approach to all situations and offer the highest possible standards of physical and psychological nursing care when on shift.

A key part of the nurse’s role is to administer prescribed drugs and treatments, helping residents to achieve optimum independence while maintaining their dignity and self-esteem. Nurses contribute towards the writing of care plans and reports, implementing changes when outcomes do not meet care plan goals. They also assist in palliative care for terminally ill residents, ensuring that everything is right for both the person at end of life and their family.

In addition to the above duties, the nurse – team leader supervises/mentors the nurses and care staff, demonstrating clinical and managerial leadership. He or she conducts staff supervisions and appraisals and works with the home management team to ensure that all staff have the appropriate skills and knowledge to deliver first-rate care. They also help with admission assessments and arrangements, evaluate the effectiveness of care plans and are responsible for the ordering and safe administration/storage of drugs and treatments.

As a member of the home’s management team, the clinical manager plays a full part in providing the highest possible standard of person-centred care to residents. He or she adopts a ‘hands on’ approach, working with and taking responsibility for the nursing and care assistant teams, and ensuring that the home’s policies and procedures are followed, in accordance with relevant legislation. He or she also manages the home in the absence of the home manager.

The clinical manager is responsible for ensuring that the home’s clinical care is safe and meets the required fundamental standards. He or she demonstrates clinical care and managerial leadership to other staff, supporting nurse – team leaders to provide care that meets residents’ needs at all times. They evaluate the effectiveness of care plans and take responsibility for auditing care delivery, developing action plans to rectify areas of weakness, and monitoring and reporting these to the home manager. Other duties include conducting supervision and appraisals, dealing with staff rotas, assisting with recruitment and onboarding, ensuring that staff have the relevant skills and training, dealing with complaints, facilitating the safe administration/storage of drugs and treatments and helping the home manager to carry out pre-admission assessments.

The home manager is responsible for the smooth running of the home. Registered with the Care Quality Commission, he or she is ultimately responsible for the health, safety and wellbeing of residents, in accordance with the organisation’s policies, procedures and core values.

The home manager leads the staff team, working with the deputy/clinical manager and the heads of department to ensure that residents receive the best possible person-centred care. He or she conducts staff supervision and appraisals, oversees training, ensures that the home is fully staffed, helps recruit new employees, upholds budgetary control and occupancy levels, attends management meetings, carries out pre-admission assessments and maintains good working relationships with staff, residents, families, social workers, professionals and other external agencies. The home manager also builds up strong relationships with residents, ensuring that their care plans cover all their needs. The home manager also involves residents in the running of the home, regularly seeking their opinions and those of their families/representatives.