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What is a nursing home care plan and why is it important?

The transition of moving your loved one into a care home can be a very difficult time. As part of this transition process, the care home staff will prepare an appropriate care plan by gathering details of health information and a review of the new resident’s health condition. The next of kin has the right to take part in planning the care of the resident with the care home staff to ensure it is suitable and meets their specific needs.

What is a care plan?

Care home care plans are a vital part of the nursing process. The plan is a centralised document of the residents’ health condition, the level of support they require, how the support will be given and what the aims and goals of the care are. In a basic care plan, health assessments will be completed at least every 90 days. The finalised care plan will be made available to the carers so they have a clear understanding of the resident’s specific needs and can tailor their care methods to that resident.

Why are care plans so important?

A care home plan determines the level of care a resident will require, for example, people living with dementia require the highest standard of care. Care home plans give residents individual goals, aims and structure for their care. They are designed so if possible, the resident does not have to lose their full independence. A care plan will help the resident retain as much control over their life as possible and enable them to continue to do the things they love.

A care plan is also very important to the resident’s family, so that they can be reassured that the care home is meeting the needs of their loved one and they are receiving the best care possible.

Finally, a care home plan ensures consistency of care. If a robust care plan is in place, staff on differing rotas or visits can use the same information and mirror the same quality of care and support. This will result in a higher standard of care and a better quality of life for the resident.

What does a care plan include?

A care plan involves a systematic review of a person’s needs by conducting a health assessment. The care home staff will also discuss and explore information with the resident’s family to establish what is most important for the resident to ensure they can have as much of their independence as possible. This type of information can include the care seeker’s hobbies, likes, dislikes and preferences on meals or daily routines. Next, goal setting and action planning relating to what the family would like the care home to achieve will be conducted. The care plan will be continuously reviewed to ensure the best care possible. Care plans are an essential aspect to providing optimal standard quality care.

How is a care plan developed?

Step 1: Care needs assessment

Firstly, an assessment will be conducted which includes a thorough evaluation of subjective and objective symptoms and vital signs. This is done to ensure the care home gains a holistic understanding of the resident’s needs and risk factors. Nurses within the care home are responsible for collecting and maintaining this data. Certified nursing assistants may be required to collect vital signs, such as pulse rate, respiration rate and blood pressure.

Step 2: Making a diagnosis

A diagnosis is identified using the subjective and objective data collected during the resident’s assessment, resident input and clinical judgement from the nurse’s diagnosis. Through diagnosing the resident’s specific requirements and needs, the care home can tailor their care to make the new resident comfortable in their new environment.

Step 3: Setting goals

This step in the care home care plan describes the goals for the resident so that they are receiving the best possible care and feel comfortable in the care home. The goals are commonly short-term goals such as reduction of pain, improvement in vital signs, recovery, or adapting to their new home environment. The goals will be directly related to their diagnosis.

Step 4: Implementing the plan

Implementation describes how the care home staff will tailor their care to achieve these goals. Specific nursing interventions will be applied based on the executed goals to make sure the resident is receiving the highest quality of care. Unlike hospitals, care homes are not clinical environments, so it is important for care home staff to communicate a warm and welcoming ‘home from home’ feel while ensuring the residents’ needs are met so the resident feels comfortable in their new environment.

Step 5: Evaluating the plan

A care home care plan will be evaluated on a continuous basis. An evaluation will describe how well the resident’s condition responded to the nursing interventions and if the identified goals were met or not. If the goals were not achieved, the nursing care staff will revise the plan with their families and make adjustments where necessary. 

Making the decision to move a loved one from the family home into a care home can be an emotional time for everyone concerned. By designing a care plan, the family can be assured that their loved one is being supported to ensure the resident feels at home as quickly as possible. At The Fremantle Trust, we are committed to ensuring everyone is given as much choice and independence as possible, enabling them to live as full and as active a life as they can. 

If you want to put people at the heart of your job, become a volunteer at The Fremantle Trust, view our career vacancies, or contact us today.

We have several nursing homes in Buckinghamshire county. Learn more about care homes nearest to you:

Care home in Aylesbury
Care homes in Princes Risborough
Nursing home in Chalfont St Peter
Care homes in Amersham
Care homes in Slough
Care homes in Chesham
Care homes in Stoke
Care homes in Burnham
Care homes in High Wycombe
Care homes in Marlow