Fundamental essential care

Last quality assured: 27/08/2025

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Last reviewed: 27/08/2025

Fundamental essential care

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.

Care staff working with nurses in care homes are a significant part of the delivery of quality care and their contribution must be valued and recognised within care home teams. The RCN encourages membership from non-registered care staff where duties are delegated by a registered nurse.

This section uses a number of stories relating to Jane, John and Seema and our care home team at Red Cedars to demonstrate aspects of the RCN principles of nursing practice.

The needs of the resident

Principle A states that nurses and nursing staff must treat everyone in their care with dignity and humanity - they understand their individual needs, show compassion and sensitivity, and provide care in a way that respects all people equally.

Principle A

Brenda at Weavers

Here we see a care home leader in conversation explaining the need for staff to develop their skills to provide high quality resident care.

Principle F

Principle F states that nurses and nursing staff have up-to-date knowledge and skills, and use these with intelligence, insight and understanding in line with the needs of each individual in their care.

Principle F

John and Rachel

John has started to enjoy life at Red Cedars and sees Graham on a regular basis. Rachel provides a lot of care for John and has started to understand a lot more about dementia. Rachel is keen to develop her knowledge and wants to put this to good effect within the care home. She recognises the number of people with dementia is increasing and represents a significant number of residents in care homes. She knows it is vital that all nurses who support people living with dementia have a sound understanding of dementia and the impact the condition has on the individual and their families. For example, staff can deliver public health messages that can minimise or prevent vascular dementia through a healthy lifestyle.

Nurses can lead the development of dementia friendly environments and ensure care is tailored to meet residents' needs.

The RCN has supported a range of care homes across the UK to implement its SPACE dementia principles to improve care.

The needs of family and friends

Principle D

Principle D states that nurses and nursing staff must provide and promote care that puts people at the centre, involves patients, service users, their families and their carers in decisions and helps them make informed choices about their treatment and care.

Many care homes are finding ingenious ways of ensuring families and carers remain involved in their loved ones care which include using carer's expertise in care planning and delivery, and enabling relatives remote access to residents notes.

Principle D

Caring in changing circumstances

Eileen has been undertaking a caring role for Jane for some years now, Eileen would never describe herself as a carer but provides significant personal care and prompting for Jane. Eileen has also helped Jane manage her diabetes and takes urgent action if Jane becomes hypoglycaemic.

Since Jane has joined Red Cedars, Eileen has remained engaged in Jane's care. To assist staff in promoting partnership in caring, the RCN has published the Triangle of Care in conjunction with The Carers Trust.

The Triangle of Care is a guide to improve the relationship between the patient, staff member and carer by promoting safety, supporting communication and sustained wellbeing. The original document is designed for hospital wards but the principles are highly relevant to a care home.

The Triangle of Care is made up of six key standards which aim to improve collaboration between carers and health care workers.

Six key standards

Carers and their essential role are identified as soon as possible.
Staff are carer aware and trained to engage with and understand carers' needs.
Policy and practice regarding confidentiality and sharing information are in place.
Defined posts responsible for carers are in place.
A carer introduction to the service and staff is available.
A range of carer support services are available.

The needs of nursing colleagues

Principle B

Principle B states that nurses and nursing staff take responsibility for the care they provide and answer for their own judgments and actions -they carry out these actions in a way that is agreed with their patients, and the families and carers of their patients, and in a way that meets the requirements of their professional bodies and the law.