When a loved one first moves into a care facility, every family hopes that they’ve chosen a centre where their relative will be safe, comfortable and fully supported for as long as they continue to need care. That also means that when this arrangement doesn’t work out, it can be deeply distressing for families trying to find a quick solution while protecting their loved one from upheaval.
One of the first pieces of advice we’d offer is that, when placements in residential care centres break down, this usually isn’t random. There is almost always an identifiable reason, such as how the person’s needs were assessed, or how well the centre can adapt as care needs change.
Understanding why care home placements fail can help families make more confident decisions going forward and put them in a better position to find a centre where their loved one will receive the compassionate support they expect.
What Does a Care Home Placement Breakdown Mean?
The terminology care professionals use is unfamiliar to many families, but a placement breakdown simply means that the home isn’t able to meet the person’s needs any longer, or that it feels the services and skills it offers aren’t suitable.
Families may receive a request to move a resident to another setting or find themselves in the challenging situation of needing to find alternative care urgently. This can become a real emergency if, for example, your loved one is upset or has experienced declines in their well-being or quality of life.
The wording can sound abrupt, and it’s important to reiterate that this doesn’t mean a family chose ‘badly’; rather, in most cases, there is an underlying mismatch between what the individual needs and what the facility can provide.
Common Causes of Care Home Placements Failing
Every situation is unique, but most placement breakdowns can be linked to a limited number of fundamental aspects of residential care delivery, which we’ve summarised below.
Underestimating Care Needs
Care assessments might have underestimated the individual’s needs, for example, by not identifying mobility challenges that require more support than expected.
No Reablement or Rehabilitation Capacity
A lack of focus on reablement or rehabilitation care can mean that residents who might have been able to recover skills and confidence find they are losing independence unnecessarily, becoming more reliant on care, or are experiencing reduced physical or mental well-being.
Inflexible Staffing Models
These issues can arise where, for example, a resident has increasing one-to-one support needs that cannot be met, or where there are insufficient qualified nurses to provide complex care support.
Poor Clinical Oversight
Inadequate medical supervision can pose issues around medication management, the monitoring of symptoms or an inability to intervene early when a person’s health deteriorates. It can also be linked to hospital admissions that should have been avoidable.
Rapidly Changing Care Needs
Care needs might change faster than the centre can adapt to, especially when a person is living with a progressive condition such as dementia.
While the care home should be able to provide detailed information about why the placement has failed, it is neither the fault of the family nor of the resident. Understanding what has gone wrong is important to ensure loved ones can secure a more suitable and stable placement elsewhere.
What Are the Early Warning Signs That a Care Placement Isn’t Working?
Families often notice that ‘something isn’t quite right’ but can’t put their finger on a specific problem. Our advice is to trust your instincts and ask questions if you have any suspicion that a loved one isn’t happy or isn’t receiving the level of care they need.
Some of the indications of an issue might include:
- Changes in mood, such as a loved one becoming more anxious, agitated, quiet or withdrawn
- Differences in physical health or personal care, such as a loved one’s hair not being done properly or not having changed into a fresh outfit from one day to the next.
- Variations in how a loved one interacts in social occasions or activities, or showing little interest in hobbies and days out they usually enjoy.
- Lack of communication between staff and families, or finding that care centres aren’t mentioning things that a loved one is worried about.
In some cases, care home staff might raise a concern about whether they have the right complex-needs management resources to provide adequate care or request a reassessment, but it’s also possible for families to identify a problem before it becomes more apparent.
How Does Reablement Reduce the Risk of a Placement Breakdown?
Reablement is another of those phrases used in the care sector, and it means that care centres concentrate on helping residents regain or maintain their independence. That could be following a stroke or illness, a hospital stay, an injury or a period of time when the person’s mental or physical health has started to decline.
This approach is all about encouraging autonomy and giving care home residents the support they need to feel confident and capable, rather than becoming more dependent on care to manage everyday tasks. Reablement care could include:
- Supporting a resident’s physical recovery through regular movement and exercise
- Helping to build confidence and self-belief through routines and decision-making
- Setting progressive, but achievable goals around motor functions, mobility or other skills
- Creating activity schedules and plans, and ensuring residents are encouraged to participate
Reablement can play a significant role in reducing the risk of a breakdown in care home placements by stabilising or improving the person’s condition, reducing the amount of care they need over time, and contributing to their well-being and quality of life.
What To Ask Before Choosing a New Placement for Your Loved One
If you’ve dealt with the stress of a placement breakdown, the next steps are all about asking questions and being assured that, whichever centre you choose, you won’t find yourself in a similar situation in the future.
Going back to the reasons behind most breakdowns is a great steer on the topics we’d suggest asking, such as:
- How does the care centre assess and review needs? Homes that provide initial assessments and regular reassessments are ideal for individuals whose needs may vary or progress over time.
- What experience do you have with complex or changing needs? Families want to know that a home has expertise in complex care and is well-equipped to adapt as needed.
- Do you offer reablement or rehabilitation care? Look at whether the facility promotes independence and whether they create long-term plans to help residents maintain or maximise their well-being.
- How flexible is your staffing? It’s wise to check how a centre will respond when a resident requires more intensive or personalised care, and whether it’s equipped to provide it.
- What clinical support is available? If your loved one has medical needs, you may require a nursing care facility with 24/7 medical oversight rather than a residential care centre.
- How do you communicate with families? Clear, open dialogues and collaborative care planning are the gold standard, building trust and ensuring that any concerns from either side are addressed as soon as they arise.
While experiencing a placement breakdown is often challenging, it also provides insights into what your loved one really needs from their care environment. Concentrating on these areas and ensuring your relative is as involved as possible in all discussions will give you the information you need to make the choice that is in their best interests.
If you’re managing a placement failure and need more advice, you are welcome to get in touch with your nearest Forest Healthcare centre, and our friendly teams will do all they can to help you navigate this.