It’s Tuesday afternoon and the phone rings. The home manager is for the first time using the word “nursing care.”
You thought this was settled. Mum knew the carers by name. She’d stopped asking to go home. Now someone’s telling you her needs have changed and your first thought isn’t clinical at all. It’s: I promised her she’d never have to move again.
So, can it happen? Yes, and it happens more than most families would expect. It’s what you do about it that’s more important than when it occurs.
Why Would a Home Raise Nursing Care?
Because a residential care homes near me doesn’t have a registered nurse on duty, once someone’s needs become clinical, the home may not be able to meet them safely.
That isn’t a verdict on you or on how well your relative has settled. Their health has shifted. Common signs:
- Weight loss or trouble swallowing
- Breakdown of skin or wound not healing.
- District nurses visiting most days.
- Needing a hoist or two carers, to move.
- A fall or hospital stay they haven’t bounced back from.
Who Decides and What Happens First?
It should be a discussion, not a proclamation. Typically, it’s along these lines:
- The home reviews the care plan and talks to you and your relatives.
- The GP and community nurses give their view.
- The council can carry out a free care needs assessment, even if you pay for care yourself.
- The NHS may check eligibility for continuing healthcare
The question they’re asking is very basic. Has your relative become so dependent on a registered nurse for 24 hours a day or do they still need assistance with the things they need to do?
If you’re not sure that a move is required, state as such. The reasons can be requested in writing and a review can be requested of the assessor. If you are in Sutton Coldfield, this would be Birmingham City Council’s adult social care team.
Can They Stay in the Same Home?
Sometimes, yes. A dual-registered home is registered with the CQC for both residential and nursing care, so a resident whose needs rise can stay where they are.
If the home has no nurses on site, the move will be to another home registered for nursing. Check its CQC report before you visit. Whether your relative keeps their room depends on the home, so ask.
On any visit to residential care homes in Sutton Coldfield, or residential care homes in Birmingham more widely, ask this first: Are you registered for nursing as well? If her needs change, what happens? A home that says “we’d help you find somewhere else” is telling you something.
Marian House looks after residential, nursing, dementia and respite residents in one building. A change of needs does not necessarily equal a change of address; it typically means a new care plan and a discussion with you.
What Changes Day to Day?
The routine around your relatives stays familiar. What changes is the clinical side.
- A registered nurse visits regularly to perform wound care, medications and health monitoring.
- The care plan is rewritten around the new needs.
- Familiar carers stay involved where possible.
- You hear from a nurse when something changes.
To see nursing care hour by hour, read A Day in Nursing Care at Marian House: What Families Can Expect.
How Do You Talk to Someone About It?
Keep it plain and on the topic of what will help, not what they’ve lost. Consider replacing “You need nursing care now” with “The nurses are going to help your legs a little bit more. When talking to your relative if they have dementia, use short sentences and say it more than once. Maintain their pictures, their chair and visiting time as normal. Explain to the nurses what they drink to settle their tea and go to bed at night.
And go easy on yourself. Guilt at a moment like this usually means you care a great deal. It doesn’t mean you’ve chosen wrong.
Will the Fees Change?
Usually, yes. Nursing is more expensive as registered nurses work at the home and the NHS might contribute if they qualify. Inquire about any possible changes in fees from the home and document it. Our care home fees page explains how we work.
A Residential Home That Doesn’t Ask You to Start Again
Marian House provides residential care in Sutton Coldfield; there is a 24-hour presence of skilled nurses on site. Day to day, this translates into assistance with washing, meals and company, which is already included in the building if needs are heightened.
We work with Birmingham City Council and we get to know the person behind the plan: how they take their tea, which chair is theirs, who they’re waiting to hear from. When a resident’s needs change, those details don’t get lost. They go straight into the new care plan.
Making a selection of a residential care home which Sutton Coldfield families will reside within for the foreseeable future is worth making an additional telephone call or booking a visit and asking us the questions.
If they need some help with a daily task, let alone a registered nurse’s judgement. Signs are: weight loss, swallowing difficulties, wounds that do not heal, frequent visits from the District Nurse and the need for a hoist and/or two carers. Together with the GP, a decision is made about making changes to the home.
No single person. The home reviews the care plan; the GP and community nurses can add their opinion and the council and NHS can evaluate. You and your relative will have a voice and you will be able to request in writing the reasons.
If a house is not registered to meet a person’s safe needs, they may make a recommendation to move, usually following a review and discussion with the family. It’s important to ask early if a home is dual registered if you want to go into either a home for care or a home for yourself.
Yes, if there has been a change in needs. It helps to remain in the same house since it can be disorienting to start a new building. Discuss with staff how they respond to the change and explain their plans ahead of time.
Not necessarily. Plans for care are reviewed on a regular basis and needs may change following an illness or hospitalisation. Inquire at the home about the frequency of reviews and who informs you about the results.
