For families
When what you have arranged stops working.
Arrangements rarely fail suddenly. They erode. The hard part is telling the difference between a bad week and a package that no longer fits.
Signs the arrangement has stopped fitting
- The visits are being used to catch up rather than to do what was planned.
- You are topping up the gaps yourself, more each month, and it has stopped being sustainable.
- Nights are the problem — waking, wandering, calling out — and the daytime package does not touch it.
- Two people are needed for moving and handling, and only one comes.
- Hospital admissions are becoming a pattern rather than an event.
- The person is safe but not really living — clean, fed and profoundly bored.
- You are frightened to go away for a weekend.
Things worth trying before a care home
A lot of arrangements are declared failed when what actually failed was the shape of them.
- Longer visits rather than more of them. Two long visits often achieve more than four rushed ones.
- Move the timings. A great deal of distress is a mismatch between the rota and the person’s day.
- Change the provider, not the setting. If continuity is the problem, that is a provider problem.
- Reassess. If needs have changed, the council assessment should change with them.
- Equipment and adaptations. An OT assessment is free and sometimes solves what looked like a staffing problem.
- Overnight support — a sleep-in or waking night — where nights are the specific issue.
- Respite, so the decision is made rested rather than exhausted.
When a care home is the right answer
Sometimes it is, and saying so is not a failure. It tends to be the right answer when needs are genuinely around the clock and unpredictable, when nursing care is required, when the house cannot be made safe, or when the person is isolated at home and would have more of a life somewhere with people in it.
That last one gets missed. Home is not automatically better. For some people, home has become a place they are alone in all day.
Deciding honestly
Involve the person as fully as they can be involved, even when it is difficult. Someone able to make the decision is entitled to make it, including unwisely. Write down what you are actually worried about — it is often more specific than it feels, and specific problems sometimes have solutions.
And be honest about the carer’s position. “I cannot keep doing this” is a legitimate reason, not a shameful one. A carer’s assessment exists precisely for that.
What we will tell you
If you ask us to take on a package we do not think we can do well, we will say so and try to point you somewhere better. We would rather decline than be the fourth agency that did not last. Where we think a different shape of support would work, we will say that too — including when it is not a service we sell.
What our visiting support involves · how to choose a provider · talk it through with us.
Written by Care Horizons, an independent care provider in Yate, South Gloucestershire. General information, not financial, legal or medical advice. For benefits and funding decisions, your local council’s adult social care team and Age UK are the authoritative sources.
Nothing here is a sales pitch. If it is useful and you never call us, that is a good outcome.
If you would like to talk0117 405 4320 Send an enquiry
What we will tell you
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Choosing a care providerPaying for care at homeOur care for older people
Start with a conversation.
No forms to fill in first, no commitment, and no pressure. Tell us what is going on and we will tell you what we think.
0117 405 4320 [email protected] Enquiries are handled by our Service Manager and Deputy Manager, with Director Vierka Hiscock overseeing every case. We normally respond within one working day.