Provision of Residential and Nursing Care for Older People (Aged 65+)

Residential Care provides support with daily living tasks such as bathing, dressing, eating, and mobility. It is suitable for individuals who do not require regular medical attention but need assistance with their overall wellbeing and safety. Residential care homes aim to create a homelike environment, offering communal living spaces, meals, and recreational activities to foster social interaction and a sense of community. The individual has been assessed as having care and support needs that cannot be met in their own home environment or other suitable alternative (such as Extra Care Housing or Supported Living). The individual will have some or many of the following needs, which are expected to be met in a residential care environment. The individual may be physically active with a level of predictability around day-to-day needs. Changes in needs are likely to be minimal and when they do change, needs will be expected to return to their usual pattern with standard care and support. The individual does not meet the criteria for Funded Nursing Care (FNC) and does not have Nursing needs that require the daily onsite supervision and oversight of a registered Nurse. The individual may have health needs that require support and supervision of external specialist services from the NHS, Integrated Care Board, or other agencies, such as community nursing support. These needs should be met and funded by the NHS. Any clinical nursing need is to be met by NHS services and not solely designated to care staff. Needs Profiles are intended to identify key characteristics of the type and level of support required for an individual who requires a care home placement. The needs profiles are not exhaustive and not everybody will require support in every level of need noted within them. Temporary fluctuations may occur within bands, for example a resident may have a care and support need from a higher needs profile for a temporary period. In the event this happens, and where the Provider feels able to safely meet the short-term higher care and support need, there may not be the need for the resident to be re-banded (i.e. there may be instances where temporary fluctuations can be managed within the same needs profile). Please see specification of requirement for full details.

The individual has been assessed as having care and support needs that cannot be met in their own home environment or other suitable alternative (such as Extra Care Housing or Supported Living). The individual will have some or many of the following needs, which are expected to be met in a residential care environment. These needs generally require a higher level of residential care due to a significant and ongoing progression or deterioration in an existing condition, which is ordinarily manageable within a residential care environment, and usually follows an expected pattern. The individual may require a higher frequency of interventions and possibly increased risk management support. The individual has needs which require a range of care and support due to their variability. They may require the ongoing input of a staff team with a broad range of skills and training to manage risks. The individual does not meet the criteria for Funded Nursing Care (FNC) and does not have Nursing needs that require the daily onsite supervision and oversight of a registered Nurse. The individual may have health needs that require support and supervision of external specialist services from the NHS, Integrated Care Board, or other agencies, such as community nursing support. These needs should be met and funded by the NHS. Any clinical nursing need is to be met by NHS services and not solely designated to care staff. Residential enhanced is need specific, not diagnosis-led, and requires specialist interventions due to the intensity of care needs. A diagnosis of dementia does not automatically mean the person needs this level of care. Needs Profiles are intended to identify key characteristics of the type and level of support required for an individual who requires a care home placement. The needs profiles are not exhaustive and not everybody will require support in every level of need noted within them. Temporary fluctuations may occur within bands, for example a resident may have a care and support need from a higher needs profile for a temporary period. In the event this happens, and where the Provider feels able to safely meet the short-term higher care and support need, there may not be the need for the resident to be re-banded (i.e. there may be instances where temporary fluctuations can be managed within the same needs profile). Please see specification of requirement for full details.

The individual has been assessed as having care and support needs that cannot be met in their own home environment or other suitable alternative (such as Extra Care Housing or Supported Living). The individual will have some or many of the following needs, which are expected to be met in a Nursing home environment. The individual has needs which can only be met with the on-site supervision of a registered Nurse. This care is required in a home registered to provide care with Nursing. Health needs may be able to be commissioned by the Local Authority (LA) under the incidental and ancillary rule or be met by Funded Nursing Care (FNC), however these could be needs that are stand alone. If the needs are multiple, then this cumulative effect may be outside of the rules or FNC coverage and mean that the individual services outside those that should be met by the LA. In these situations, Continuing Healthcare (CHC) must be considered and, if appropriate, assessed for. Prior to funding request, social care staff should have considered CHC. If nursing care is required, when applying for FNC, an NHS CHC checklist must be completed and submitted to the Integrated Care Board (ICB). Needs Profiles are intended to identify key characteristics of the type and level of support required for an individual who requires a care home placement. The needs profiles are not exhaustive and not everybody will require support in every level of need noted within them. Temporary fluctuations may occur within bands, for example a resident may have a care and support need from a higher needs profile for a temporary period. In the event this happens, and where the Provider feels able to safely meet the short-term higher care and support need, there may not be the need for the resident to be re-banded (i.e. there may be instances where temporary fluctuations can be managed within the same needs profile). Please see specification of requirement for full details.

The individual has been assessed as having care and support needs that cannot be met in their own home environment or other suitable alternative (such as Extra Care Housing or Supported Living). The individual will have some or many of the following needs, which are expected to be met in a Nursing home environment. The individual has needs which can only be met with the on-site supervision of a registered Nurse. This care is required in a home registered to provide care with Nursing. Health needs may be able to be commissioned by the Local Authority (LA) under the incidental and ancillary rule or be met by Funded Nursing Care (FNC), however these could be needs that are stand alone. If the needs are multiple, then this cumulative effect may be outside of the rules or FNC coverage and mean that the individual services outside those that should be met by the LA. In these situations, Continuing Healthcare (CHC) must be considered and, if appropriate, assessed for. Prior to funding request, social care staff should have considered CHC. If nursing care is required, when applying for FNC, an NHS CHC checklist must be completed and submitted to the Integrated Care Board (ICB). Needs Profiles are intended to identify key characteristics of the type and level of support required for an individual who requires a care home placement. The needs profiles are not exhaustive and not everybody will require support in every level of need noted within them. Temporary fluctuations may occur within bands, for example a resident may have a care and support need from a higher needs profile for a temporary period. In the event this happens, and where the Provider feels able to safely meet the short-term higher care and support need, there may not be the need for the resident to be re-banded (i.e. there may be instances where temporary fluctuations can be managed within the same needs profile). Please see specification of requirement for full details.

The individual has been assessed as having care and support needs that cannot be met in their own home environment or other suitable alternative (such as Extra Care Housing or Supported Living). The individual has needs which may be able to be met either in a specialist residential home or in a home registered to provide care with nursing. The individual requires a highly specialist level of social care due to the complete and unpredictability of their needs or the impact of interacting health and social care needs. The individual will have some or many of the following needs. Health needs may be able to be commissioned by the Local Authority (LA) under the incidental and ancillary rule or be met by Funded Nursing Care (FNC), however these could be needs that are stand alone. If the needs are multiple, then this cumulative effect may be outside of the above rules or FNC coverage and mean that the individual services are outside those that should be met by the LA. In these situations, Continuing Healthcare (CHC) must be considered and, if appropriate, assessed for. This profile is not intended for those individuals who require interim placements. The individual will have been assessed under a Care Act Assessment (2014) and accepted as having eligible Care Act needs. The individual may a require a CHC Assessment and receive CHC funding. Any cost differential incurred by a nursing home for nursing needs should be met through FNC. Prior to funding request, Social Care staff should have considered CHC. If nursing care is required, when applying for FNC, an NHS CHC checklist must be completed and submitted to the Integrated Care Board (ICB). Individuals with a psychiatric diagnosis that is managed, and their assessed needs meet social care eligibility criteria under the Care Act (2014) would be considered under the Medway Council needs profiles, a diagnosis alone is not indicative of the need to proceed under a specialist profile.