Keeping the same carers with the same people

"Who's coming today?" is a question asked from the inside of the front door, by the person who has to let a carer into their home and their morning. This page is about how a service can make the answer a name the person already knows. It gathers what published guidance, from England, Ireland and Canada, says about continuity of carers; how a service puts it into practice differs by where it operates.

Build small, steady teams around each person

For a rota built around continuity, the starting point is the priority NICE's home care guidance in England asks providers to give continuity of care: each person seeing a consistent worker or small team they can get to know. The same NICE guideline for England suggests a way to do it: building a team of workers around the person and their unpaid carer. In Canada, the Canadian Home Care Association's principles for home care call for care that is responsive and consistent among providers, and for health and social care to work together with a focus on continuity for the person receiving care.

Plan rotas from the person outward

NICE guidance in England asks services to match care workers to people through a process that is open about how it works, weighing the person's care and support needs, the workers' skills and, where possible and appropriate, the interests and preferences of both. HIQA's evidence review for home care standards in Ireland says consistent, continuous care for each person depends on providers planning and organising their resources, their workforce included, in a way that takes account of the needs of the people they support. Starting from the person is the order this guide suggests.

Hand over what matters to the person, not only the tasks

To keep continuity, NICE's adult social care guidance for England asks managers to see that every member of staff supporting a person has learned the way that person prefers to be supported, to keep the same people with them where possible, and to arrange a good handover for the times their usual staff cannot come. HIQA's evidence review for Ireland found that collaboration and good communication can support continuity of care when the right processes are in place.

Introduce new carers to the person

NICE's quality standard on home care for older people in England says providers should make sure older people get their care from a consistent team of workers who know their needs, and should always tell them beforehand if new staff will be visiting. Among the ways NICE's home care guideline for England gives for supporting continuity is introducing people to the workers who are new to them.

Plan for holidays and leaving before they happen

When a regular carer's leave is booked, or their leaving date is known, that is the time to act on NICE's adult social care guidance for England, which asks providers and managers to tell people in advance when their regular staff are going to change, and to agree any change to their care and support with the person, for example to visit times. NICE's home care guideline for England recommends telling people the reasons when their staff will change, not only telling them in advance.

Check your approach against your own policies, your regulator and professional advice where you operate

NICE writes for England, HIQA's review for Ireland and the Canadian Home Care Association for Canada, and each speaks for its own place. For how families see continuity from their side, there is What good care at home can look like. How your service arranges it is for your own policies, your regulator and professional advice where you operate.