Clarify the tasks
Identify which activities need assistance and which require nursing or other clinical input.
Home / Care in practice
Care in practice
What a support pathway
can look like.
Illustrative planning scenarios across complex physical support, acquired brain injury and functional neurological disorder. These examples explain the planning process. They are not stories about actual clients.
ILLUSTRATIVE SCENARIO · COMPLEX PHYSICAL SUPPORTSeveral support needs.
01 02 03
Several support needs.
One practical daily plan.
A person needs help with personal routines and household tasks, alongside nursing visits. Their support coordinator is looking for clear roles, suitable worker skills and practical communication between providers.
Agree on responsibilities
Discuss timing, current care instructions, contact people and the boundaries of each service.
Plan for changes
Agree how questions about the daily arrangements will be raised and reviewed.
An illustrative example. Each person’s support needs and arrangements are different.
ILLUSTRATIVE SCENARIO · ABI01 02 03
Returning home after an acquired brain injury.
A person is preparing to leave rehabilitation. They need assistance with personal routines, support to organise daily activities and a clear handover of the strategies their rehabilitation team has recommended.
Understand the person
Discuss their priorities, communication preferences, current abilities and the tasks requiring help.
Plan the support
Clarify agreed routines, required worker skills, service availability and the roles of existing professionals.
Agree on review
Identify who to contact, how changes will be communicated and which goals should guide later discussions.
An illustrative example. Each person’s support needs and arrangements are different.
ILLUSTRATIVE SCENARIO · FND01 02 03
Bringing daily support into a rehabilitation plan.
A person living with FND has fluctuating movement difficulties. Their treating team has set functional goals, and they are seeking practical help at home that fits with that plan.
Clarify the guidance
Discuss the current treating plan, daily goals and any individual response instructions.
Define useful assistance
Identify tasks that need support and activities the person is working towards doing more independently.
Keep communication clear
Agree which people to involve and how questions or changes in support needs should be raised.
An illustrative example. Each person’s support needs and arrangements are different.
Discuss a real referral with the team.
Use the person’s own goals and support needs to guide the conversation.