What do we mean by complex care?

Complex care is person-centred support at home for someone whose health or care needs are more involved, perhaps because they are living with a long-term condition, the effects of an injury or stroke, or several health conditions at the same time.

They may need support with mobility and transfers, personal care, medication, catheter or stoma care, or the use of moving and handling equipment. Some people need two care workers for certain parts of their care or several visits throughout the day.

There can also be an element of unpredictability. Someone's strength, mobility or ability to carry out everyday tasks may fluctuate, and what works safely one day may need to be adapted on another.

With some conditions, a person's abilities can vary from day to day, or even at different times of the same day.

Someone may be able to transfer with a standing aid in the morning but need more support later when they are tired. Sometimes the answer can be as practical as arranging an evening visit a little earlier, when they have more energy.

For some clients, different moving and handling equipment may already be available depending on their abilities at the time. Equipment may also be put in place in anticipation of their needs changing, so there is another safe option available if they need it.

If a care worker arrives and finds that someone can no longer complete their usual transfer safely, they won't simply carry on and hope for the best. They make sure the person is safe and contact the office so that we can find out more about what has changed and decide what needs to happen next. Where needed, somebody from the office team can go out to assist.

We also consider whether there may be a reason for the change that needs further attention. Depending on the situation, this might mean contacting the GP or working with an occupational therapist, physiotherapist, specialist nurse or another professional involved in the person's care.

For example, a change in mobility may mean that different equipment needs to be considered. Changes for someone living with Parkinson's may need to be discussed with their specialist nurse or other healthcare professional to consider whether their medication or other aspects of their treatment need reviewing.

If unfamiliar or less standard equipment is introduced, a Manager or one of our Care Coordinators can meet with the occupational therapist or physiotherapist to trial it and understand how it should be used. We complete a moving and handling risk assessment, update the person's care plan and communicate the change to the care workers supporting them.

Where care workers need to learn how to use the equipment, we show them what to do and make sure they understand how to use it safely before it becomes part of the person's usual care.

Our care workers also feed back what they are seeing during visits. Because they get to know the person and their usual abilities, they may be the first to notice that something has changed.

Sometimes the solution is a change to the care we provide. At other times, the person may need assessment, treatment, different equipment or advice from one of the professionals involved in their care.

A transfer will only be carried out when it can be done safely for both the client and the care worker.

Some people need two care workers for particular parts of their care.

This may be because of the way they need to be moved or transferred, the equipment being used, or the amount of physical support they need at that time.

It doesn't necessarily mean that every visit needs two care workers. Someone might need two people to help them get up in the morning or settle into bed at night, but only one care worker for other visits during the day.

What is needed is considered as part of the person's assessment and care planning, taking into account their abilities, the equipment being used and how the care can be provided safely.

If their abilities change, we can review those arrangements rather than assuming the same level of support will always be needed.

Some people have a live-in carer but need two people for parts of their personal care, such as washing and dressing, repositioning or transfers.

In these situations, one of our care workers can visit to provide that second pair of hands, working alongside the live-in carer. Visits are arranged for the times when double-handed support is needed, for example four times a day.

This means someone can keep the live-in care arrangement that works for them, while the parts of their care that need two people are carried out safely.

We don't provide live-in care ourselves, but we're happy to work alongside a live-in carer who has been arranged privately or through another agency.