I'm Toni Rowbotham, a Care Quality Lead at our Trowbridge branch. People often ask what a care assessment actually involves, so here is a look at my day, from the first phone call to the moment care starts.
How I got here
I have worked in care for over 15 years. I started off as a care and support worker out on the area, then became a reablement worker, followed by senior carer. I then moved up to area manager and then team manager. I have been with Spire Homecare for nearly three years at the Trowbridge branch, running the area until we started to grow. We gained more hours and then needed more office staff. I am now in the role of a Care Quality Lead and love it.
I love looking after my clients and completing person-centred care plans to suit each individual, and working with different agencies to get the best possible outcome for the client so they can remain at home.
I have NVQ 2 and 3 and specialised in dementia care as a trainer.
What a typical day looks like
I check the inbox on Birdie to see if anything urgent has come in during the night, then check Teams, emails and WhatsApp for any messages. I update any support plans and talk to families, GPs, adult social care, nurses and occupational therapists if required during the day. I hold reviews with clients and families, deal with any emergencies that may arise, and see if the team need any support with anything.
How many assessments I do depends on how many packages of care come in. It can be up to five a week.
What is always in my bag or car when I go out to an assessment: folders with all the information from Spire Homecare, business cards, the needs assessment or hospital discharge notes, a notepad and pens, and information on private rates if required.
Before the visit
I contact the family to see if they want to attend the assessment, especially if the client has dementia or special needs. I read the assessment of needs to gain a bit of background on the client we are going to see.
I phone the client to make the appointment with them, and call the family if the client has agreed to have them there. I check GP Connect to add any medication if the assessment states we are to administer medication.
It is usually just the client and maybe a family member who are there on the day.
Before I arrive, families often worry about how their loved one is going to react to having someone enter their home each day, what times the calls are and if they will suit the client, and whether we can give medication.
The assessment itself
I always introduce myself and explain why I am there, and offer to make a cup of tea.
On a daily basis I cover health, medication, mobility, personal care, eating and drinking, the home environment, routines, likes and dislikes, and what matters most to the person.
Risk assessments need to cover everything from personal care, making meals and administering medication, to a home risk assessment including any stairs or stairlift, the bathroom and outside areas, COSHH and manual handling. Basically absolutely everything that can cause harm or be a risk to the client and carers.
An assessment can take up to two hours, depending on the care needs and the complexity of the package of care.
I always ask the client directly. I ask the client if they want to involve the family in the discussion, however the client is my priority and their needs.
The most important question I ask is what we can do to help you and make your day more comfortable, so you are able to stay at home. The question needs to be person-centred and the client needs to feel they are being heard.
Birdie and Smart Plans
I record the assessment with the consent of the client and any family member who may be present. The care plan is then put on the system by the Care Quality Lead.
Compared with paper care plans, it captures a lot more of the conversation and takes more detail. It makes the information more person-centred, because you capture everything the client requires. Families are able to have their input, and families can sometimes give us a really good insight into the client that we may not be aware of. We can give the carers more information to support them to look after the client and give them the support they need each day. I can look over the recording and capture everything that has been said, and make sure I haven't missed anything.
Families can see information and get updates through the system too. We can give them an access code.
After the visit
The package of care will usually have started the day the assessment is held.
Care plans are reviewed every three and six months. However, if there are any changes, this can be done as needs change.
To match the right carers to a client, we make sure that the client will accept both male and female carers, and then put carers in. If for any reason the client does not get on with the carer, or the other way around, we would remove them from the call. It can take some time to establish a good relationship between carers and clients.
The moment that stayed with me
I visited a lady and gentleman who are both in their nineties and living quite independently. We are supporting the wife now, as her husband was finding it difficult to support her with her personal care. It was heartwarming to see the love and support they had for one another, and that they are still trying to be as independent as possible in their nineties.
The most rewarding part of my job is making sure you have done all you can so that the person you are looking after has the care and support they want, and making sure that if there is something else you can do better for them, you explain it to them, as it may be of more use.
The hardest part is explaining to families with loved ones who have dementia that the person is still inside, and it is the disease that is making them different in the way they are acting. Families find it really hard to understand why their loved one can be so different.
What people often misunderstand
Often people think the care plan is set in stone, and that no changes are to be made or it can't be updated. This is not the case. We can adjust, change and review care plans at any time during the time we are providing the care and support. It is also important that the family do have some input if their loved one lacks capacity, or needs any help with explaining what they would like.
If you are nervous about care at home
I will do everything I can to support your loved one and make sure they have everything they need. This may mean liaising with other professionals to achieve it. We hold regular reviews, and we keep the family informed of any concerns.
What I would like you to take away
More of an insight into the day-to-day activities of a Care Quality Lead, and the amount of knowledge we have to retain for each and every customer we are supporting, as well as supporting the whole team to have a smooth passage.
Last reviewed by Toni Rowbotham, Care Quality Lead.