Jayne Easterbrook, Training and Development Director at Care First 24, and Marisa Spice, Head of Learning and Development at Nellsar, reveal their motivations behind the creation of the Social Care Nursing Preceptorship.

Across health and care, the preceptorship’s aims are one: to support newly registered nurses and nursing associates to gain confidence, develop critical thinking, improve decision-making, integrate with teams and feel comfortable in their roles and in the workplace. Independently, Marisa and I reviewed the preceptorships available at the time and reached the same conclusion: that having a social care preceptorship would be invaluable for the sector’s professionalisation, and its attraction, recruitment and retention of staff.

Core similarities

We began working on a social care preceptorship for our respective organisations. We also began to connect with health preceptor groups, which is when we came across each other and decided to collaborate. Although we worked in completely different parts of the sector, we felt that the core of the preceptorship would be the same, and we could adapt additional details for the differences by following slightly different pathways.

I was very fortunate to be included in regular meetings with the NHS East of England preceptorship network, which were helpful in identifying new research, guidance and plans. Marisa was also involved in external meetings and research. We used this as a starting point for our discussion, and began to plan the policies, procedures and documentation that would be required for best practice.

Changing perceptions

At Care First 24, we had nurse apprentices about to qualify who we felt would greatly benefit from the support that a preceptorship could offer. When our first cohort of nurses began in 2020, they were not allowed to do any placements with Care First 24 because our organisation was classed as ‘homecare’, despite the fact that we provided complex care to adults and children in the community. We spoke to the university at the time, but it could not see the value in placements with us, allowing only some placement hours within care homes themselves. This meant that we saw very little of our apprentices for the four years of their course.

Thankfully, this has now changed, and the value of social care placement has been recognised by universities, nursing organisations and other stakeholders. Skills for Care (SFC), the Outstanding Society and the Queen’s Institute of Community Nursing (QiCN) have worked hard to change the perception of social care nursing, and we have been involved in many SFC projects, including its national preceptorship working group, We Are Social Care Nursing.

Solving problems through collaboration

I began writing guidance and an overview of what we would require and shared this with Marisa. In turn, Marisa shared what she had produced, and this was the beginning of our project. One challenge was the health preceptorship’s language, which made translation to social care very difficult. We discussed how each part could change, without losing the meaning of the standards.

Together, we adjusted the original paperwork to make a basis for a care preceptorship, including adaptions for different areas of the sector; for example, in homecare, the preceptee would sometimes be working alone in the community, with telephone support if required.

Nursing focus

Now, we have trained preceptors within our nursing teams who are allocated one or two preceptees to support. The preceptees find building a relationship with this named person to support them makes it easier to seek help if needed, especially around how they are feeling and their wellbeing.

Preceptees have an initial meeting with their preceptor to identify the support required and regular meetings to discuss progress throughout the preceptorship. This is clearly recorded, so that any areas of progress or concern can be addressed. In addition, the preceptee status identifies the newly registered nurse as being in the first stages of their chosen career, and all members of the team are made aware; this helps the team to understand the support that may be required.

Some new nurses and nursing associates (particularly our own apprentices who worked for the organisation prior to starting their training) may need a shorter preceptorship. Other new-to-social care nurses may take longer to feel comfortable in the new environment, so the preceptorship may run for a longer period. We have made the length flexible between six months and a year, with the onus on the preceptee and preceptor to decide the length of the programme during their reviews.

Developing key skills

One of our objectives was to increase recruitment and retention, and the preceptorship provides confidence to those who are feeling unsure about a nursing career. It also provides support for our in-house newly qualified nurses and nursing associates who achieve their degree through the apprenticeship scheme. This has been successful and we have found that retention has increased. Similarly, for Nellsar’s newly registered international nurses who have passed their Objective Structured Clinical Examination (OSCE) with the Nursing and Midwifery Council (NMC), the post-registration support has been essential for retention and developing the nursing teams.

In addition to supporting newly qualified nurses, who may not have had a social care placement, or where their placement was in a very different social care specialty, our preceptorships have been created to help them understand the role and feel confident to practice. Some have found that social care is not for them and move on, taking with them ‘valuable lessons in people’s care to take on their journey’. But most staff that join enjoy the autonomy of the role and get job satisfaction from working with people receiving support holistically and meeting individual needs.

From clinical to care

Preceptorship is also a useful tool for supporting more experienced nurses from other specialties to transition into their new role in social care, as it is very different from working in a hospital, and support during their settling in period is vital. At Care First 24, we have staff that have worked in highly skilled clinical areas. They still use their clinical skills regularly, attend clinical training and are provided with support for revalidation.

When people first come to work in social care, they often have a very different perception to the reality. In social care, you frequently need to make decisions based on your own knowledge and experience, versus in a hospital, where you have the support of many experienced staff and a range of equipment available.

It can be daunting, not having a medical support network around you. With the additional support of a preceptorship, alongside a good induction, staff can flourish in the role. Without it, nurses may feel that it is too difficult and return to a health setting. Once the preceptorship is complete, nurses find that social care is a great place to work, with lots of opportunities to learn, develop and discover a great future with career progression.

Sector-wide support

Once Marisa and I had completed and verified the care preceptorship, we sent it to SFC, the Royal College of Nursing (RCN), NMC, Department of Health and Social Care (DHSC), NHS England and local workforce development managers. We wanted to share it to support other providers and highlight how preceptorships can support the recruitment and retention of nurses and nursing associates within social care. We were delighted to find that SFC was also working on the care preceptorship, and we were invited to take part in several working groups.

There is a lot of work going on to promote social care nursing, driven primarily by policy changes and the lack of jobs available in the NHS, especially for newly qualified staff. All care providers can get involved, by promoting social care as a viable career choice, supporting apprenticeships, or having student placements from local universities. There are also often speaking opportunities at local colleges or universities, which allow providers to showcase social care roles. It is so important that we champion the value of social care nursing and challenge myths about the sector.

Continuous development

Our project will continue to move forward with regular progress reviews to ensure our objectives are being met. Marisa has had more newly registered staff since the implementation of our preceptorship and has now run her pilot project, which has allowed us to reflect on progress. Nellsar’s programme has continued to add further guidance and support based on more extensive feedback, that Care First 24 can apply where appropriate.

I have had fewer preceptees complete the preceptorship, but feedback from preceptees and the preceptor has been vital for informing the next stage for homecare. One main issue for us in the community is ensuring the preceptor has the time and support to meet the needs of the role and differentiating this from the everyday support and mentoring that the senior team provides for new staff. It is important that we standardise the support for all new learners.

Following its national working groups, SFC has published resources and advice for the Social Care Nursing Preceptorship to help organisations become preceptorship ready. SFC holds regular meetings and has free training resources to support providers to develop their own preceptorships. Marisa and I are also both now a part of SFC’s Preceptorship Leads Community of Practice Group and we look forward to continuing to develop and support others.

Is your organisation preceptorship ready? Visit the CMM website and comment on this feature or join the conversation to share your thoughts.

Jayne Easterbrook is Training and Development Director at Care First 24.
Email: jayne@carefirst24.co.uk
LinkedIn: @Jayne-Easterbrook

Marisa Spice is Head of Learning and Development at Nellsar.
Email: marisa.spice@nellsar.com
LinkedIn: @Marisa-Spice