Glossary

Clinical Commissioning Group – see Integrated Care Board

Continuing Healthcare

Cardiopulmonary resuscitation

Discharge to assess

Do not attempt cardiopulmonary resuscitation

Deprivation of Liberty Safeguards

Elderly Mental Infirm

End-of-life care

Funded Nursing Care

Integrated care board

Key lines of enquiry – see CQC

Lasting Power of Attorney

Liberty Protection Safeguards

Mental Capacity Act

Mobile Care Monitoring

Next of Kin

Office of the Public Guardian

Safeguarding Adults Board

Speech and language therapy

Safeguarding Adults Review

Tissue Viability Specialist Nurse

The process of determining what help or support you may need because of your age, illness or disability. It also helps the local authority to decide if you qualify for council-funded care and support. You can request a care needs assessment via your local council’s adult social services department or online. Care homes will also perform their own needs assessments prior to admission.

Where patients are supported and funded to leave hospital when it is safe and appropriate to do so. The guiding principle is not to keep people in hospital for any longer than they need to be. They may go home or be moved to a new ward or facility, such as a care home – whichever is the best for them while they are assessed for longer-term care and support needs. This can also be called ‘home first’, ‘safely home’ or ‘step down’ or referred as ‘pathway 3’, which denotes a residential or nursing care setting (as one of several ‘pathways’ according to where hospital patients are discharged).

A comprehensive evaluation that is done before admission to a care or nursing home to identify someone’s needs and ascertain if these can be satisfactorily met by that particular care facility.

When you are in residential or nursing care, your needs and finances are re-assessed on a regular basis. You, your family, the home (maybe including outside professionals who are also involved in your care) look at whether the services you are receiving are still meeting your needs and helping you achieve your chosen outcomes. Changes can be made if necessary.

Any product or service designed to enhance someone’s quality of life or help them achieve greater independence. These may include a mobile phone, memory prompt or remote control and pendant alarm as well as equipment (such as sensor mats) that can detect potential hazards in your home or alert a carer/the emergency services if you have a fall or seizure.

Behaviour that may cause harm to the person or those around them such as aggression, self-harm and disruptive or destructive behaviour. Such behaviour can be caused by a difficulty in communicating needs, perhaps because someone is living with autism, dementia, a learning disability or mental health problem, and they may need specialist support.

A plan that sets out someone’s care and support needs, how these will be met, what services they will receive and their own priorities and aspirations. This is compiled by health professionals in the community or in a residential care or nursing home following a care needs assessment, with input from the patient/client and their family, who have a say in the management of their care. If you are in residential or nursing care, your daily routine may also be called a care plan and should be accessible to you, your family, carers and the emergency services. It includes basic personal details, information about your health, ability to carry out activities of daily living, and what has been agreed about you care and support. Residents have the right to see their own records and receive a copy of all assessments and care plans.

A person who provides unpaid help to a partner, family member, friend or neighbour who is ill, struggling or disabled and could not otherwise manage.

A disorder of the mental processes caused by brain disease or injury. It is a persistent and progressive condition that it gets worse over time and eventually affects every aspect of a person’s life. The term ‘dementia’ describes several different conditions affecting the brain, including Alzheimer’s disease, frontotemporal dementia and vascular dementia.

Someone who acts as a single point of contact for you, often in a residential care home. They help co-ordinate your care and can also provide information and advice.

Person-centred digital software that records details of every care action with residents using a special mobile hand-held device. The efficiency of its streamlined care plans and care evidence records frees up carers to spend more time with residents. Within Canford Healthcare, this information feeds directly into our Relatives Gateway. This is a two-way portal that allows families (with Power of Attorney) access to a resident’s day-to-day notes and information about any aspect of their care including meals, wellbeing and daily activities. As it’s two-way, families can comment, send messages, ask questions and upload photos.

Care and support that is based around the needs, preferences and priorities of the person receiving it. They are an equal partner in their care, according to the principle of ‘no decision about me without me’.

Help with getting up, washing, dressing, going to the toilet, eating, drinking, going to bed, taking medicines and other personal activities.

A person who is in day-to-day charge of regulated services provided at a residential care home or home care agency. They must be registered with the Care Quality Commission. At our home we refer to them as the home manager.

Having good physical and mental health, control over your day-to-day life, protection from abuse and neglect, fulfilling relationships, sufficient money, and the opportunity to take part in the activities and hobbies that interest you. These are designed to keep people physically and mentally active, engaged and fulfilled, with a sense of purpose and self-worth. Every residential care setting has a regulatory requirement to organise activities, which must be recorded in a resident’s care notes.

Voluntarily planning your future treatment, care and what you wish to happen at the end of your life. You may involve family and friends in the process, and it can be documented and communicated to everyone involved in your care.

A legally binding decision (in England and Wales) that you make about the medical treatment you would or would not wish to have in future, if you could not make decisions yourself because of illness or because you lack the capacity to consent.

A (non-legally binding) written document about your wishes, feelings and preferences regarding your future care and support, in case you become unable to tell others. It can cover any aspect of your care, such as where you want to live and how you like to do things. You can write it yourself, with support from family, friends and your GP.

Other people should act in your ‘best interests’ if you are unable to make decisions for yourself (for example, about your health or your finances). Best interests are not defined in law but there are guidelines for what people must consider when they decide what is best for you. These include your wishes, feelings and beliefs, personal circumstances and the views of your family and friends.

An independent person who considers whether someone (without a Power of Attorney or Deputyship in place) who lacks capacity and is in hospital or a care home is there for the right reasons, and whether it is in their best interests to remain there.

You understand what you are being asked to agree to, and you can let people know whether you agree. See also informed consent.

A law passed in England that sets out what care and support you are entitled to and how health and social care professionals should work with you. Councils must consider your wellbeing, assess your needs and help you get independent financial advice on paying for care and support. The Act puts people and their carers in control of their care and support.

The team – comprising psychiatrists, psychologists, nurses, social workers and occupational therapists – organises the treatment and care of people with complex or serious mental health problems. They work with other care providers, such as GPs, hospitals, care agenciess, hospices and voluntary organisations.

An English court that makes decisions about the health, welfare, property and finances of those who lack the mental capacity to make decisions for themselves. The court can appoint a ‘deputy’ to make ongoing decisions on behalf of someone who lacks capacity and grant power of attorney.

DoLS is an amendment to the Mental Capacity Act 2005 and ensures that people who are unable to make decisions about their own care, support, property and finances are protected and that their care arrangements (in a hospital or care home) are in their best interests. DoLS is due to be replaced by Liberty Protection Safeguards (LPS) but there is as yet no due date for this. See Liberty Protection Safeguards

Someone appointed by the Court of Protection to make decisions on your behalf about your property and financial affairs or your health and welfare, or both, if you lack capacity to make them yourself and have not already given someone power of attorney. This can be family or friends or a professional, such as a solicitor.

This medical order written by a doctor instructs health care providers not to perform cardiopulmonary resuscitation (CPR) if a patient’s heart or breathing stops. It can also be known as DNR (do not resuscitate) or DNAR (do not attempt resuscitation).

EMI care is the provision of care for older people with mental frailty, often living with the advanced stages of dementia.

When you are not specifically asked if you understand and agree to something being done to you, but you behave as if you do. For example, extending your arm so that a medical professional can take a blood sample suggests you have given ‘implied consent’. Implied consent also applies in an emergency if you are unconscious, as medical staff may assume that you would agree to life-saving treatment.

When you receive information that enables you to decide whether to allow someone to do something to or for you. You should only give consent if you understand what you are being asked to agree to, what the benefits and risks might be, and what the alternatives are if you do not agree. See capacity to consent.

An integrated care board (ICB) is an NHS organisation that develops plans to meet people’s health needs and provides services in a particular region or area. ICBs were established in July 2022 and replaced the former Clinical Commissioning Groups (CCGs).

A legal decision you make to allow a specific person to act or make decisions on your behalf about your property and finances and/or health and welfare, if the time comes when you are unable to make these decisions for yourself. All LPAs must be registered with the Office of the Public Guardian. See Lasting Power of Attorney (finance).

This scheme is due to replace DoLS, although implementation has been delayed and there is as yet no fixed date for the change. LPS extends legal protection to everyone over the age of 16 who needs to be deprived of their liberty to enable care or treatment and lack the mental capacity to consent to such arrangements. This now covers people living in their own home or supported living, as well as in a hospital, hospice or residential care home. LPS puts their rights and wishes at the centre of all decision-making. See Deprivation of Liberty Safeguards.

The ability to make your own choices and decisions, about key aspects of your life, such as your care, support, property and finances, for example, as defined by the Mental Capacity Act. To do this, you must be able to understand and remember information and communicate clearly – either verbally or non-verbally – what you have decided. Someone may lack capacity because of dementia, a mental health problem or learning disability.

Your closest relative by marriage or blood. They have no automatic legal rights to make decisions for you or manage your financial affairs. If you wish to give someone the power to do this, you need to give them ‘power of attorney’. See Lasting Power of Attorney.

A service that supports adults with acquired communication and swallowing difficulties as a result of stroke, dementia, brain injury, voice disorders and other medical or neurological conditions. Following an assessment, the SALT team gives advice and therapy that is targeted to the person’s individual needs to help them with, for example, language, communication, memory, swallowing, eating and drinking. The SALT team works closely with carers and other health professionals.

The nurse-led Tissue Viability Service provides specialist advice and care to patients with, or at risk of developing, wounds.

If you are considering a deferred payment agreement with your local council to pay for your care, the council must ensure that there is ‘adequate security’ and that you can afford to repay them eventually. This security may be the value of your house, a valuable possession or someone who can guarantee that payment will be made. See Deferred payments

This is charged if a resident who has been in our care for more than six months passes away while in our care. It is equivalent to seven days’ fees and holds the room while we can clear it of personal belongings and prepare it for a new resident.

A money-managing service that may be offered by your council. The council can receive benefit payments on your behalf and arrange payment of your living costs. There may be a fee to pay. If you have no next of kin, the council can apply for deputyship instead.

Things you have that can include possessions (such as a house, car or savings accounts), equipment, particular knowledge and skills or relationships.

This helps pay for personal care if you have a physical or mental disability that requires you to be looked after by someone else, or if you are elderly. It is paid at two separate rates, depending on your requirements. Being in receipt of Attendance Allowance can also mean any other benefits you may receive are paid at a higher rate. You can claim this even if you don’t have someone looking after you.

Ongoing care outside hospital, arranged and funded by the NHS following a care needs assessment, for someone who is ill or disabled, whose need for daily support arises mainly for health rather than social care reasons. It may also cover care in a nursing home.

If you need residential care, the council will assess your needs and decide if you can afford to pay for a care home. This may mean selling your house, so the council may help pay the fees while you wait for your house to be sold, and then you will have to repay the council.

A discussion between you and your council or local authority to work out how much you can afford to pay towards any care and support that you need. It involves looking at your income, savings and individual circumstances and takes place after an assessment of your care and support needs. See means test.

If you are eligible to receive financial help during your first 12 weeks in a care home, the amount that the local authority may be prepared to pay may not cover the total care home fees. As a result you may be asked to pay the shortfall, and this is called a ‘first party top-up’ (also referred to in conjunction with the twelve-week property disregard).

A flat-rate sum paid by the NHS for the nursing care component of your nursing home fees, regardless of whether your care is paid for by yourself or your local council. It is paid directly to the care home. You will usually be assessed for NHS continuing healthcare before a decision is made about whether your eligibility for NHS-funded nursing care.

A legal decision you make to allow a specific person to act or make decisions on your behalf about your health and financial affairs if you later become unable to do so. See Lasting Power of Attorney (LPA)

The council or local authority looks at how much money you have and works out what it will pay towards the cost of your care. Currently, if you have savings of less than £23,250, you will generally receive help, although the more money you have, the more you will need to pay. See financial assessment

If you intend to pay for your care yourself, you will need to provide evidence that you have a minimum of two years’ worth of funding for nursing care or three years if you are going into a residential home.

If you are in residential care and receiving savings credit, some of this will be disregarded, or not considered when the council assesses how much you can afford to pay towards your care.

If you are moving into council-funded residential care that costs more than the council believes is necessary to meet your needs, a third party (such as a relative, friend, charity) must agree to pay the difference. They must enter into a contract with the council confirming the arrangement. The key aspect is that this is your choice: a top-up fee should only be charged if you have requested a more expensive care home, not because the council is unwilling to pay what a care home costs.

If you go to live in a care home and a local authority undertakes a financial assessment to check if you are eligible to receive financial assistance, it will not take into account the value of your property for the first 12 weeks.

An organisation that carries out regular inspections to check that hospitals, care homes, dentists, GPs and home care agencies in England provide high-quality care that meets the needs of those using the services. The CQC does this by assessing the quality of care against its five standards – safe, caring, effective, responsive and well led. These standards were until recently referred to as ‘key lines of enquiry’ or KLOEs.

A system through which healthcare organisations are accountable for sustaining high standards of patient care and seeking continuous improvements. Organisations have a duty to their communities and must show evidence that standards are being upheld.

This is care given to someone with symptoms of dementia to meet their needs safely and help them enjoy the best possible quality of life and wellbeing.

Advance and palliative care in residential or nursing homes, hospitals, primary care and hospices for adults with terminal, progressive illness. At this stage, you may also wish to consider whether you wish to have the following in place:

This is a period of residence in a care home that is usually longer than two weeks. For Canford Healthcare homes, this is a period of 31 days or more.

Provides 24/7 care and support, including personal care (washing, dressing or going to the toilet) in a residential setting. Nursing home residents receive round-the clock medical support from qualified nursing staff for ongoing illnesses, as well as treatments including injections. They will have specialist nursing equipment on hand.

Care given to people with an advanced and incurable progressive illness in a care home, hospital, hospice or their own home. The primary aim is to manage pain and other symptoms and help the person achieve their best possible quality of life.

Accommodation where frail or older people, or those with disabilities, receive 24-hour care and support with or without nursing care. Trained staff provide help with personal care (such as washing and dressing), eating, giving medication and mobility, for example. Homes may be registered to supply specific types of care need, such as palliative, end-of-life or dementia.

Short-term (or respite) care for someone in their own home or in a residential setting. This can be to cover a carer’s holiday or convalescence in a residential care or nursing home following a hospital stay if you are not ready to return to your own home, especially if adaptations are needed for you to live safely and independently.