Who works in a care home in Spain

Care worker

They spend more time with residents than anyone else: they help them get up, wash, dress, eat and move around, keep them company during the day and tell the nursing team about any change they notice.

Qualifications: Intermediate vocational qualification (FP de grado medio) in Care for Dependent People (Técnico en Atención a Personas en Situación de Dependencia), or the professional certificate in social and healthcare support for dependent people in care settings (certificado de profesionalidad de atención sociosanitaria a personas dependientes en instituciones sociales).

Ask on your visit: This is the most important staffing ratio: ask how many care workers there are on each shift, especially at night and at weekends, and whether staff turnover is high.

Health and social care assistant

This is what many care homes call staff who hold the social and healthcare support certificate. They do the same job as care workers: hands-on help with personal hygiene, meals, mobility and companionship.

Qualifications: Professional certificate in social and healthcare support for dependent people in care settings (certificado de profesionalidad de atención sociosanitaria a personas dependientes en instituciones sociales).

Ask on your visit: Ask whether all hands-on care staff hold the qualification required by the rules of the autonomous community (Spain’s regional government) where the home is located.

Nurse

Prepares and gives medication, dresses wounds, checks vital signs and blood sugar, monitors how each resident is doing and coordinates the work of nursing assistants and care workers.

Qualifications: Degree in Nursing.

Ask on your visit: Is there nursing cover 24 hours a day or only during the day? What happens if there is an emergency at night?

Doctor

Assesses each resident’s health on admission, opens their medical record, adjusts treatments and monitors chronic conditions. Works with the resident’s GP (primary care doctor) and the hospital.

Qualifications: Degree in Medicine; a specialty in Geriatrics or in Family and Community Medicine is common.

Ask on your visit: How many hours a week is a doctor on site? In many care homes the doctor is not there every day, and part of the medical care depends on the local health centre.

Nursing assistant (TCAE)

Supports the nursing team with basic care (hygiene, meals, moving and dressing) and with simple healthcare tasks such as taking vital signs.

Qualifications: Intermediate vocational qualification (FP de grado medio) in Auxiliary Nursing Care (Técnico en Cuidados Auxiliares de Enfermería).

Ask on your visit: How many people does each nursing assistant look after on each shift?

Physiotherapist

Designs and delivers individual rehabilitation plans, works on mobility, balance and walking to prevent falls, and treats pain and the after-effects of fractures or strokes.

Qualifications: Degree in Physiotherapy.

Ask on your visit: How many physiotherapy sessions a week does each resident get? Are they included in the fee?

Occupational therapist

Helps residents stay independent in everyday activities (eating, dressing, washing), adapts assistive products and the surroundings, and runs cognitive stimulation workshops.

Qualifications: Degree in Occupational Therapy.

Ask on your visit: What workshops are there each week? Are they adapted to each person’s abilities, or does everyone do the same thing?

Speech and language therapist

Treats communication, language and voice problems and, above all, swallowing difficulties (dysphagia), which are very common in older people: advises on food textures and how to eat safely.

Qualifications: Degree in Speech and Language Therapy.

Ask on your visit: Not every care home has a speech and language therapist. If your relative has trouble swallowing or has had a stroke, ask who assesses dysphagia.

Psychologist

Supports residents as they settle in, assesses and stimulates memory, attention and orientation, treats problems such as anxiety or depression, and advises families.

Qualifications: Degree in Psychology.

Ask on your visit: How do they support residents during the first weeks of settling in? Is there psychological follow-up afterwards?

Social worker

Manages admission, keeps the family informed, handles applications for support such as recognition of dependency status or the service-linked benefit (prestación vinculada al servicio), and acts as the link between the resident, the family and the care home.

Qualifications: Degree in Social Work.

Ask on your visit: Ask them for help with the paperwork under the Dependency Act (Ley de Dependencia): the benefits can cover part of the cost of a place.

Social educator

Designs programmes to maintain each resident’s social relationships, participation and interests, and encourages contact with their family and the local community.

Qualifications: Degree in Social Education.

Ask on your visit: Are there activities outside the home and links with the local area, such as outings, volunteers or visits from schools?

Activities coordinator

Organises leisure: games, music, celebrations, outings and workshops that give the week a rhythm and help residents get to know each other.

Qualifications: Higher vocational qualification in Sociocultural and Tourist Activities (Técnico Superior en Animación Sociocultural y Turística).

Ask on your visit: Ask for a month’s activity calendar and check whether there are also activities in the afternoons and at weekends.

Care home manager

Is responsible for how the whole home runs: organises teams and shifts, manages the budget, makes sure regulations are met and deals with families on important matters.

Qualifications: A university degree is usually required and, in many autonomous communities, specific training in managing social services centres or in gerontology.

Ask on your visit: Ask to speak to the manager during your visit: how they welcome you and how well they know each resident says a lot about the home.

Administrative staff

Handles billing, the admission contract, receipts and each resident’s paperwork, and deals with suppliers and public authorities.

Qualifications: Vocational qualification (FP) in Administrative Management or in Administration and Finance.

Ask on your visit: Ask for written details of what the monthly fee includes and what is charged as an extra: hairdressing, chiropody, accompanying residents to appointments, incontinence pads…

Receptionist

Answers the phone and greets visitors, keeps track of who comes in and goes out, and receives residents’ post and parcels.

Qualifications: No specific qualification is required.

Ask on your visit: What are the visiting hours? Can you call at any time to ask how your relative is?

Cook

Prepares the menus following the guidelines of the nursing team and the doctor: diets for diabetes or low-salt diets, texture-modified and puréed food, and allergy control.

Qualifications: Vocational qualification in Cookery and Gastronomy (Técnico en Cocina y Gastronomía) or equivalent experience, plus food handling training.

Ask on your visit: Is the food cooked on site or brought in by a catering company? Ask to see the week’s menu.

Kitchen assistant

Prepares ingredients, plates up meals, washes up and keeps the kitchen clean under the cook’s supervision.

Qualifications: Food handling training.

Ask on your visit: Is there an alternative if your relative doesn’t like the dish of the day? Are their tastes taken into account?

Cleaning staff

Keeps rooms, bathrooms and communal areas clean and disinfected, which is key to preventing infections in frail people.

Qualifications: No qualification is required, but training in hygiene protocols is.

Ask on your visit: During your visit, notice how the bathrooms and communal areas smell and how clean they are: it says a lot about the home.

Laundry staff

Washes, irons and mends residents’ own clothes and bed linen, and returns them to each room.

Qualifications: No specific qualification is required.

Ask on your visit: Is washing of personal clothing included? Do clothes need name labels?

Maintenance technician

Makes sure the heating, hot water, lifts, call bells and adjustable beds work properly and are regularly checked.

Qualifications: Vocational qualification (FP) in installation and maintenance, or equivalent experience.

Ask on your visit: Do all rooms have a call bell and heating and air conditioning?

Maintenance assistant

Helps the maintenance technician with day-to-day repairs: light bulbs, doors, furniture, grab rails and handholds.

Qualifications: No specific qualification is required.

Ask on your visit: How long does it take them to fix a fault in a room?

Driver

Takes residents to appointments, errands and outings in adapted vehicles. At day centres, they usually run the pick-up route.

Qualifications: A driving licence for the type of vehicle (category D1 or D for minibuses).

Ask on your visit: Does the home accompany residents to medical appointments? Is there a charge? At a day centre, is there transport from home?

Gardener

Looks after the garden and outdoor areas so that they are safe and pleasant for walks.

Qualifications: No specific qualification is required.

Ask on your visit: Is there a wheelchair-accessible garden or terrace? Do residents go outside every day?