Short-notice care home closures

Continuity of care: Examples and tips

With careful planning, residents should experience as little disruption or unevenness as possible in the quality and quantity of care that they receive before, during and after any transition that has to take place. The aim should be to minimise anxiety and promote reassurance. The following are examples of what others are doing plus materials they have developed and useful tips.

• Changes to services - policy statementOpen

  Northamptonshire County Council Health and Adult Social Services (HASS) Directorate are committed to the following principles:

  • Ensure that the dignity and welfare of HASS customers is considered at all times.
  • Embed a culture of engagement by promoting the involvement of HASS staff, customers and other stakeholders in decision making about the future of services.
  • Communicate decision making in a timely, effective and transparent manner to all stakeholders.
  • Minimise disruption and distress to customers, promoting familiarity and consistency of care wherever possible.
  • Where relocation of residents is required, assess the needs of all care home residents irrespective of funding arrangements.
  • Where decision making results in the need to close a home, ensure timescales are appropriate to residents.
  • Work collaboratively with other organisations and partners to promote effective communication, timely processes and effective use of shared resources.
  • Ensure that any individual assessments or decision making meet the requirements of the Mental Capacity Act 2005; particularly the need to assess mental capacity during the closure process and to make decisions on behalf of those lacking mental capacity in their best interests.
  • Consider equality and diversity issues throughout the closure process, respecting the cultural needs of customers and using advocates and interpreters wherever necessary.
  • Develop good practice by monitoring and reviewing the processes used as part of the organisation's governance structure.
  • Staff will work in accordance with the principles of the Data Protection Act 1998.

  
  (Source: Northamptonshire County Council - Changes to Services Procedure and Practice Guidance)

• Good record keepingOpen

  Good record keeping is important during the closure and relocation process to promote effective communication between staff and organisations, to promote transparency of decision making and to promote the transfer of information to the new home. For a care home closure, staff will need to:

  • Ensure any care plans are photocopied and information relevant to the resident moves to the new home with the resident. Robust care plans should be in place to ensure continuity of care and to encourage the maintenance of residents' preferred lifestyles.
  • Keep a record of all assessments, decision making and movements of residents.
  • Keep a log of medicines and ensure these are moved with the residents.
  • Keep a log of change of GP if this is necessary.
  • Keep a log of residents finances and ensure these are moved with the resident.
  • Keep an inventory of residents' belongings, to be signed by the resident.
  • Information should be available for each resident on the following:
    • registration category of residents and identify any change of category
    • details of relatives
    • medical history
    • whether there is a requirement for advocacy to support the resident
    • details of residents' needs including those that may require exceptional arrangements or health care provision. Also identify if there are any relatives of residents who may have factors to consider such as own health, whether they are out of county, etc.
    • The resident's life history book is particularly important for people with dementia.
      
      

  Not all of this information may be essential for a care home closure.
  (Source: Northamptonshire County Council - 'Changes to services procedure and practice guidance')
  

• Involve existing care staffOpen

  • Existing care staff should be utilised during the closure and relocation process to pass on knowledge of customers to new services, handover care plans and summaries, etc. and verbally discuss residents' care needs.
  • Wherever possible, and with the agreement of the person themselves, details of the person's likes, dislikes, routines, aspirations, diet, abilities, risks, preferred lifestyle and support needs etc. should be passed on. This will promote continuity of care and support.
  • Care staff should be encouraged to support residents at their new home or services for an initial settling-in period if possible. This promotes familiarity and consistency of care.
  • Care staff should be consulted and encouraged to be involved in the closure and relocation process.
  • Care staff should be kept informed of progress and customers' moving dates as well as how residents are settling in to new homes when this applies.
  • It is acknowledged that closures can be distressing for existing care staff as well as residents and that they may need support.

  (Source: Northamptonshire County Council - 'Changes to services procedure and practice guidance')