What are the criteria for someone to be requiring full time care either at home or in a care home?

Answered by Hannah Kelly

This is very dependent on the specific situation of the individual and needs to be considered on a case-by-case basis. There are no ‘set’ criteria as such. Ultimately, the decision to move to full-time care often comes because of concerns regarding safety, wellbeing, and loneliness. From a safety perspective, it needs to be considered if a person is safe to be left alone for any length of time. Some people can manage at home by receiving 2 – 4 care visits each day for years without risk progressing. Most often, it is night time that results in being problematic as well as longer periods in the day between visits. Many people find that they require support to go to the bathroom and wake frequently during the night. If solutions cannot be found, then more support is the safest solution.

Once the length of time between 4 visits a day becomes too long, then full-time care should start to be considered, either in their own home or a care home. This could be due to a physical need or due to living with dementia and that dementia progressing. Often this decision comes from a gradual increase in care provision at home, either from paid carers, an agency or family members no longer being able to cope with the increased need for assistance throughout the day and night.

Sometimes there is not a physical need for full-time care but an emotional one. If the person suffers with loneliness, then full-time companionship is likely to promote good wellbeing.

In terms of funding, the Local Authority will be able to complete a financial assessment of the individual’s case and a social worker will assess the level of care and support needed. If the person is paying for their own care without any financial assistance, the care home or live-in care provider will complete a needs assessment. There are occasions where multidisciplinary teams work in partnership to assess how much support and care a person requires to remain safe.

On a personal level, I have cared for many service users who have lived in their own homes for years with multiple visits a day including 6- hour sits, so the bulk of a 12-hour day was covered with carers, and the service user was low risk at night. There was never a requirement to move to 24-hour care. I have also experienced individuals whose needs altered rapidly and required full-time support very quickly. It really does come down to the individual’s case, so knowing the individual, their anxiety levels and capabilities is a huge factor in this sort of decision.

In terms of whether a care home or live-in care is appropriate, that really comes down to the individual, their current living accommodation and their preferences for where they would like to spend their days.