Your typical day record sheet for an NHS Continuing Healthcare assessment

An NHS Continuing Healthcare assessment turns on a description of care needs, and the assessment itself sees one hour of one day. This sheet records the rest. Keep it for seven days, note the ordinary detail rather than the strong adjectives, and you will have most of what the assessment asks about. Frequency, duration, how many people, and what has happened when help was late are the things that carry.

How to fill this in

  • Write what happened, not what you think it proves. Description beats argument.
  • Use numbers. Four times a night, twenty five minutes, two people, three days out of seven.
  • Date everything. A dated example is worth a page of adjectives.
  • Record the range. The best hour and the worst hour of the same day, and say which is which.
  • Include what happens without help, and what happens when help arrives late or not at all.
  • Do not tidy it up. The tidied version is the one that gets underestimated.

The seven day record

Day 1

Date
 
Overnight: what was needed, how many times, how long
 
Morning: what was needed, and how many people
 
Through the day: what changed, and when
 
Evening and bedtime
 
Equipment used, and who checks it
 
Anything that went wrong, or nearly did, and what was done about it
 
Was this a typical day, a good day or a bad day?
 

Day 2

Date
 
Overnight: what was needed, how many times, how long
 
Morning: what was needed, and how many people
 
Through the day: what changed, and when
 
Evening and bedtime
 
Equipment used, and who checks it
 
Anything that went wrong, or nearly did, and what was done about it
 
Was this a typical day, a good day or a bad day?
 

Day 3

Date
 
Overnight: what was needed, how many times, how long
 
Morning: what was needed, and how many people
 
Through the day: what changed, and when
 
Evening and bedtime
 
Equipment used, and who checks it
 
Anything that went wrong, or nearly did, and what was done about it
 
Was this a typical day, a good day or a bad day?
 

Day 4

Date
 
Overnight: what was needed, how many times, how long
 
Morning: what was needed, and how many people
 
Through the day: what changed, and when
 
Evening and bedtime
 
Equipment used, and who checks it
 
Anything that went wrong, or nearly did, and what was done about it
 
Was this a typical day, a good day or a bad day?
 

Day 5

Date
 
Overnight: what was needed, how many times, how long
 
Morning: what was needed, and how many people
 
Through the day: what changed, and when
 
Evening and bedtime
 
Equipment used, and who checks it
 
Anything that went wrong, or nearly did, and what was done about it
 
Was this a typical day, a good day or a bad day?
 

Day 6

Date
 
Overnight: what was needed, how many times, how long
 
Morning: what was needed, and how many people
 
Through the day: what changed, and when
 
Evening and bedtime
 
Equipment used, and who checks it
 
Anything that went wrong, or nearly did, and what was done about it
 
Was this a typical day, a good day or a bad day?
 

Day 7

Date
 
Overnight: what was needed, how many times, how long
 
Morning: what was needed, and how many people
 
Through the day: what changed, and when
 
Evening and bedtime
 
Equipment used, and who checks it
 
Anything that went wrong, or nearly did, and what was done about it
 
Was this a typical day, a good day or a bad day?
 

One prompt for each of the 12 care domains

These are the subject areas the assessment covers. No levels or scores appear here, and nothing you write in this list decides anything. Answer in your own words, or leave a domain blank if it does not apply.

  1. Breathing

    Describe breathing on an ordinary day. When is it worse, and what happens then?

     

  2. Nutrition: food and drink

    Walk through meals and drinks on an ordinary day. Who does what, and how long does each take?

     

  3. Continence

    Describe an ordinary day and night for the toilet. How many times, and who helps?

     

  4. Skin and tissue viability

    Describe the skin as it is now, and what is done for it each day.

     

  5. Mobility

    Describe every move on an ordinary day, from waking to bed. Who helps with each one?

     

  6. Communication

    How do they let someone know what they need? Describe how it actually happens.

     

  7. Psychological and emotional needs

    Describe mood across an ordinary week. What is a good day, and what is a bad one?

     

  8. Cognition

    Describe what memory is like now, with something that actually happened.

     

  9. Behaviour

    Describe what happens, in plain terms, using a recent example.

     

  10. Drug therapies and medication: symptom control

    List what is given on an ordinary day, at what times, and who gives it.

     

  11. Altered states of consciousness

    Describe an episode from start to finish, using the most recent one.

     

  12. Other significant care needs

    Is there anything you do, or watch for, that none of the questions so far have asked about?

     

Who decides, and what happens next

A Checklist may be completed first to decide whether a full assessment happens. If it goes forward, a multidisciplinary team completes the Decision Support Tool and the integrated care board makes the eligibility decision. Your record is information for that process, and the guidance expects the views and knowledge of family members and representatives to be taken into account where consent to share information has been given. Source: Department of Health and Social Care, NHS continuing healthcare decision support tool guidance, last updated 27 October 2022.

General information to help you organise your own record. Not legal, clinical or benefits advice, and we are not connected to the NHS or any integrated care board. Eligibility for NHS Continuing Healthcare is decided by the integrated care board, informed by a multidisciplinary team assessment we are not part of, and nothing here predicts a decision. For the official process see the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, last updated 27 October 2022, and the NHS website. Free help is available from Age UK, Carers UK and Citizens Advice.

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