Continuity Of Care In Care Homes: Supporting Changing Needs Over Time
Choosing a care home is a significant decision for any family. It often comes at a point when caring for someone at home has become more difficult or when their health has changed following an illness or hospital stay.
An older person's care needs may not stay the same, for example, someone might initially need help with personal care and everyday tasks but later require more specialist support. They may develop dementia, experience reduced mobility or need additional nursing care as their health changes.
For families, this can raise an important question: what happens when a person's care needs change? Continuity of care is one way of approaching this, as it recognises that care should adapt around the individual rather than expecting the individual to fit a fixed level of support.
What Does Continuity of Care Mean?
Continuity of care means providing consistent, coordinated support while allowing that support to change when a person's circumstances change.
For someone living in a care home, this could mean their care plan is regularly reviewed and adjusted as their health, abilities or preferences develop. The people involved in their care should have a clear understanding of their needs and communicate appropriately when something changes.
The purpose is not necessarily to keep everything exactly as it was, but more about maintaining an understanding of the person while their care evolves. Their routines, preferences, relationships and individual circumstances remain important even when the practical support they receive becomes different.
The Care Quality Commission (CQC) describes person-centred care as care that is tailored to an individual's needs and preferences. Its guidance also explains that care should be reviewed when a person's needs change and a good care home will be adhering to this.
Why Can Continuity Matter In Later Life?
Moving into a care home can be a major transition, not only for the person recieving care but for their family too. There is a new environment to become familiar with, new routines to understand and new relationships to develop. Over time, however, a care home can become a familiar and comfortable part of someone's life.
A resident may become accustomed to the people caring for them and develop friendships with other residents. Their room may contain photographs, treasured belongings and familiar objects from home. These details are important as it can help create a sense of familiarity. If someone's care needs increase, being able to remain in surroundings they know may be reassuring, provided the care home can continue to meet those needs safely.
For families looking at care homes in Perth, it can therefore be useful to ask how a provider approaches changing care needs before making a decision.
Care Needs Can Change Over Time
A person's needs when they first move into a care home may be very different from their needs several years later. An older person may initially need assistance with washing, dressing or preparing for the day. As their mobility changes, they might require more support getting around the home. Changes in health could also mean they need additional help with medication or other aspects of their daily routine.
This is why care planning needs to be an ongoing process and needs to be reviewed often. A care plan should provide an accurate picture of the person's current needs while recognising their preferences and abilities. When something changes, their support can then be reviewed.
The CQC emphasises the importance of understanding the individual rather than simply focusing on a diagnosis or condition. Person-centred care should take account of a person's physical, emotional and social needs alongside their preferences and quality of life. This approach can help ensure that changes in care remain connected to the person's everyday life.
When Residential Care Needs Become More Complex
Some people enter a care home because they need support with everyday living but do not initially require nursing care, but over time, their circumstances may change. An illness, deterioration in health or the progression of a long-term condition can result in more complex needs. In some circumstances, a person may then require nursing care or additional clinical support. Whether those needs can continue to be met within the same care home will depend on the individual and the services the provider is able to offer.
Supporting Independence As Care Needs Increase
Needing more care does not mean a person has to lose their independence. In a good care home, support should be provided in a way that allows residents to remain involved in decisions about their daily lives wherever possible. Someone may need assistance getting dressed but still want to choose their own clothes. They may require help moving around the home while continuing to decide which activities they would like to take part in.
Maintaining independence is not necessarily about doing everything without assistance. It can be about having control over the things that remain possible and receiving the right support with the things that have become more difficult. This is an important part of person-centred care and can help ensure that increasing care needs do not overshadow the individual's personality, preferences or sense of identity.
Continuity of Care & Dementia
Continuity can also have particular importance for someone living with dementia, as it can affect memory, communication and a person's understanding of their surroundings. Changes to familiar environments or routines may therefore be difficult for some people.
A care team that gets to know a resident over time can develop an understanding of their personality, routines, preferences and ways of communicating. That familiarity can help staff provide more personalised support. It can also help them recognise changes in behaviour or wellbeing that might otherwise be difficult to identify.
However, dementia affects people differently. There is no single approach that will be appropriate for everyone living with the condition. Care should therefore be adapted to the individual and reviewed as their needs develop.
Familiar routines can remain important too. Something as simple as knowing how a person likes to start their morning or which activities they enjoy can help staff provide care that feels personal and respectful.
Frequently Asked Questions
What does continuity of care mean in a care home?
Continuity of care means providing consistent support while adapting that support as a person's needs change. It involves keeping the resident's preferences, routines and individual circumstances at the centre of their care.
Can care needs change after moving into a care home?
Yes, a person's health, mobility or abilities can change after they move into care. Their care plan should be reviewed when their circumstances change so that the support they receive remains appropriate.
Can someone stay in the same care home if their needs increase?
This depends on the person's needs and what the care home can safely provide. Some homes can accommodate changing levels of support while others may need to involve another service or recommend a different setting if needs become too complex.
How does continuity of care help someone living with dementia?
Familiar surroundings, routines and care staff can help provide consistency for some people living with dementia. Understanding a person's history, preferences and communication style can also help staff provide personalised support.
Can families be involved in care planning?
Yes they can, residents should be involved in decisions about their care as far as they are able and willing to be. Families can also contribute information and take part in discussions where appropriate and with consideration for the resident's wishes.
What happens if an older person returns from hospital?
Their care needs may have changed following an illness, injury or hospital stay. The NHS recommends appropriate discharge planning so that support is in place when someone leaves hospital. This may involve the care home, healthcare professionals and family members where appropriate.
Looking For Care In Perth?
Whether you require nursing, residential, or specialist dementia care, our experienced team is dedicated to delivering compassionate, person-centred support in a warm and welcoming environment. Contact us today to book a tour, we would love to show you around and answer any question you have.
