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15 April 2024

How being a L&D Nurse in social care offers a different approach to nursing within mental health

Tinisha is a qualified Mental Health Nurse – she studied in Teesside and is now a Service Manager.

She played rugby for England between 2003-2007 and always thought she’d work with Rugby or the Army but a back injury, laid rest to those plans.

With her family’s background in health and social care and with some experience of mental health within her family, it seemed logical Tinisha would find her way into working within health and social care. She moved to Teesside in 2007 and met her wife which was the reason she did not return to Northamptonshire.


Tinisha thanks for your time! Can you tell me how you ended up working for Cygnet?

I’ve always done some sort of caring role. Aged 15 I began my career as a companion to older ladies and would sit and keep them company on the weekends.

Support work was always a part time job whilst studying for my first degree and masters and I enjoyed it, but never thought it would come my career as I was so heavy into my rugby. But due to government cuts to grass root sports and Rugby not being a big sport in the North East, I ended up taking a support role full time in 2009. I have worked across many different clientele such as preparing young juveniles for the community, supporting  people with an LD and sense impaired conditions to be involved with sports and the Special Olympics (2012) as well as ABI and Secure mental health services. I love helping people with additional care needs especially through sport.

In 2012 I felt I needed more direction in my life and due to working in the NHS the view was that the good Support Workers go into Nursing. That’s exactly what I did.

I worked in High – Medium forensic female units – it was one of the best jobs I ever had!

However after some time, during a safety intervention of a patient, I got a knee injury. The knee injury affected had a deep impact on my personal life and changed by ability to be involved in sport. The trust was not so compassionate and I felt I wanted to work for an organisation that doesn’t just see you as a number.

My friend Victoria Wisniewski who I’d studied with, and she was working at Cambian (which became Cygnet) and she told me about a role at Appletree – a female rehab unit.


How was it working at Appletree and with an independent healthcare provider for the first time?

It was great! We had more resources and more time to spend with patients. As a Nurse, we also had more of a voice, within the Multi-Disciplinary Team (MDT) than I did within the NHS. I could have a say over my patients care. I became a Senior Nurse and in 2019 promoted to Head of Care.

After 4 years and then during COVID there needed to be changes to the service and some maternity leaves, all of which coincided with me experiencing burnout.

My Mentor from Cygnet supported me to look for other roles. Carla Brown, someone I’d worked under, who was Ops Director at a hospital I worked at in Northampton, told me about a role at Hope House – a social care service that was going through a bit of a tough time. Something different but a chance to prove myself as a Manager.


How was it moving from health care to social care at Hope House?

In healthcare it’s far more structured. Everyone has a vision of the service and everyone within the MDT know what they’re achieving and what service they want to build.

Its different in social care. Although it’s a nurse-led service, because we don’t offer clinical support, I needed to upskill in other areas and park the clinical side for the time, which did feel weird at first! But was able to upskill in the HR and corporate side of the role. After 18 months of working here, I was asked to support and then consider a role at Hollyhurst as a Manager and I’ve now been here for 2 years.


What is your role like at Hollyhurst?

We wanted to make a service with direction and a vision. Not to be service that was a seen as a service that could manage the more complex individuals no matter the variety. We wanted to become intentional with what we can help our service users to achieve.

I didn’t have any Nursing skills in Learning Disabilities and autism but in social care we’re here to empower people to live more fulfilled lives and I had a lot of transferable skills from working in high secure environments. The ability to observe, wait and listen is key whichever service line you work within.

In High Secure I needed to be stiff, structured and vigilant. Working in social care, there is still risk but not in the same way. In LD, the risks are more calculated and we let our service users decide whether they are ready to make their own decisions.

Because of my experience in secure, I’d say I’m now more risk positive in Learning Disabilities and this is a good thing. I give people the ability to make their decisions and understand their own risks, to help develop them. My service users and LD nurse have also taught me to be less hyper vigilant and not focus on risk as much, which has made  me less stressed as an individual.


Is it flexible and supported at Hollyhurst?

Yes – far more so than in healthcare. I’ve got a young family and I can go home to them and not worry. Our Operational Director is so supportive and has the time to know our residents and staff and that isn’t always possible in other settings.


What did you love about Female PD and what are the difference in skills you need for that versus social care?

I loved female PD as I had life experience and found there was nothing more humbling – than understanding my patients.

It was like peeling an onion of our service user’s traumas, it took time, empathy and understanding.

You have to have deep-rooted empathy not surface empathy and be able to build trust with people and see past their behaviors – as their behaviors are there for a reason.

I had some difficulties in childhood so could relate to some of their issues.

In PD you need to be able to gain trust but be firm. You need to be firm and fair (which I’m told I am by my patients!) and be able to maintain boundaries and continue with best practice, even if service users were trying to ‘manipulate’ you – for want of a better word!

It’s a skill to be able to get that balance and one I think only someone with practical experience and life experience, can do.

In social care there are many crossover skills – like being a natural problem solver, being comfortable listening to service users and allowing long silences and knowing you can’t fix everything. You need your Service users to know they need to engage with you to move forwards on their life journey.


What age groups are best suited to the different types of Nursing, in your experience to date?

In my view, In PD – the older generation are probably actually more suited to it.

A lot of the Service Users didn’t have parental figures, so having older and female staff would be really beneficial. You need some experience to be able to go into a tough environment and people with no long work and life experience may find working in this field traumatizing themselves if they haven’t experienced difficult circumstances.

In social care, it can be any age – we’ve got a diverse team but I’d say younger people may be more suited. This is because there are so many changes coming through in social care and less restrictions and younger people may find this transition easier to understand and see change for the better.


Why do you love your career social care and what gets you excited for the future?

In social care and at Hollyhurst – we have the time to get to know the people we support. All nurses go into the profession to help people but in social care you really do get to help people! You walk side by side with your services users to get them back into the community.

I love being a pain in the side of our Social Workers! I advocate for my service users to get them what they need – I love doing that!

We have to think outside the box and be innovative and creative.

I work with my Team on everything.

We look at service user referrals together and  we complete service specific training with our MDT in house, such as talking mats and Makaton. It’s really hands on experience and collaborative.

I think in social care, you also get the opportunity to learn a lot about yourself, as much as your residents! In the most positive way… and your residents make you smile every day too.


Tinisha – thank you so much! Your energy is inspiring and I’d love to work in your Team!

If you are interested in working at Hollyhurst in Tinisha’s team or within social care anywhere else at Cygnet please explore our vacancies

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