Level of Care with Vayyar Care: Are we really seeing what someone needs?

When we talk about Level of Care (LOC), it can be easy to think of it as a number, category or assessment that tells us how much support someone needs. This is a point of particular interest at Vayyar Care.

Care needs aren’t static. They can change gradually, sometimes without anyone noticing immediately. And by the time a formal review takes place, the person may already need a different level of support.

So, what does Level of Care really mean, and could we be doing more to recognise when someone’s needs change?

Put simply, Level of Care is the amount of support a person needs to stay safe, well and as independent as possible.

In practice, a person’s level of care is typically established at admission, documented within their care plan and then reviewed on a regular cycle. That plan becomes the basis for how the home supports the individual day to day. From staffing and moving and handling to night checks and wider care planning.

But there is an important distinction to make.

A care plan reflects an assessment of someone’s needs at a particular point in time. What happens in the weeks and months between those reviews can look very different.

This is where having a clearer picture of day-to-day activity can be valuable.

A Level of Care report can group rooms according to the level of support that observed activity is consistent with for example, activity consistent with a largely independent resident, activity consistent with one caregiver providing support, or activity consistent with two caregivers providing support.

Importantly, the report is describing observed activity, not assessed need. It doesn’t score an individual, set a staffing requirement or determine what care someone should receive.

Instead, it can highlight where the pattern of activity in a room looks different from the plan the team is currently working to. Giving care professionals a reason to take a closer look.

Not at all. Care needs can change constantly, and those changes don’t always happen in obvious ways.

Some changes announce themselves. A fall, a hospital admission or an infection can immediately prompt a response from the care team.

The more difficult changes can be much quieter.

Someone might become a little less steady on their feet. They might spend longer in bed in the morning. They might start getting up twice during the night instead of once. Perhaps a carer starts giving them a little more help with something they previously managed independently.

Each individual change can seem insignificant.

But collectively, they can represent a meaningful change in someone’s level of need.

And often, those changes appear in a person’s behaviour for weeks before they become apparent during a formal review.

Care teams already have a wealth of information available to them.

There are assessments and care plans, daily notes, handovers, incident and accident records, dependency tools, feedback from families and, importantly, the professional instinct of people who know their residents well.

But there are gaps in that picture Vayyar Care can help providers address.

Assessments are snapshots. Someone may present differently depending on the time of day, their environment or how they happen to be feeling at that particular moment. The person seen at two in the afternoon isn’t necessarily the person at three in the morning.

Then there are the hours when fewer staff are present. Nights and early mornings can be some of the least observed parts of the day, yet they can contain important signals about changes in behaviour and routine.

And gradual change can easily become absorbed into everyday care.

A team naturally adapts to the people they look after. A little extra help here, a little more support there. Because these adjustments happen naturally during a shift, they aren’t always recognised as a change in care needs.

This is where a continuous view can add another layer of information.

By looking across the full 24 hours, including periods when fewer staff are present, activity patterns can help highlight changes that may otherwise be difficult to spot.

For example, trends in second-person presence can provide an observable signal that support may be happening more often than it used to.

It doesn’t tell a care professional that someone’s needs have changed.

It gives them a reason to ask the question backed by objective information while there is still time to act.

It can go wrong in both directions.

The first is under-supporting someone.

If a care plan says one carer is required, but the reality has moved beyond that, there may be increased risk of falls or moving and handling injuries for both the resident and staff. The team may be working to a plan that no longer reflects the person in front of them.

But there is another side to the conversation we noticed at Vayyar Care is discussed less often: over-supporting someone.

A resident who could still do something for themselves may begin to receive help with it routinely. Over time, that ability can quietly disappear.

It’s a loss of independence and dignity caused by kindness.

It also means staff time may be being used where it isn’t needed, while somewhere else in the home a genuine change in need could be going unnoticed.

The goal, therefore, isn’t simply to provide more care. It’s to provide the right care, at the right time, based on where someone is.

Technology can help fill in some of the hours when nobody is specifically watching.

Passive sensing can provide information about presence and movement, time spent in bed or in a room, getting out of bed, bathroom activity, room occupancy, changes in routine, second-person presence trends, and falls and fall patterns.

And because it is passive, there is no wearable for a resident to remember to put on and nothing for staff to manually log.

But technology also has limitations and those are important.

It can’t tell us why something has changed.

It doesn’t know whether someone spending more time in bed is because they’re unwell, experiencing low mood, sleeping better than they have in months or adjusting to a new medication. Similarly, it doesn’t know about the conversation a carer had with them over breakfast.

It’s one source of information, and a specific one.

The value is in reducing the amount of change that has to be spotted in the moment by a busy person during a shift.

That means noticing change doesn’t have to depend entirely on who happened to be working that day.

Vayyar Care’s sensing technology sits within the room, providing continuous, contact-free and camera-free sensing.

From this, the Level of Care report can build a picture of activity within each room and highlight where current activity is consistent with more or less support than the existing plan assumes.

But the important part isn’t simply generating the report. It’s what happens afterwards.

The report becomes a routine piece of information, rather than another alert for staff to react to.

A deputy or registered manager can review the information alongside the care plans and identify rooms where the two don’t appear to line up.

Those rooms can then be looked at properly through the existing care processes whether that’s a resident-of-the-day review, a care plan review, a dependency review, or a conversation with the resident and their family.

The outcome can then be recorded in the care record. Perhaps the care plan needs to change. Perhaps a referral is appropriate. Or perhaps, after looking into it, the decision is that nothing needs to change.

And that last point matters too.

A reviewed decision that the care plan should remain unchanged is still evidence of good oversight.

The technology isn’t making the care decision. It’s helping make the review more consistent and prompted, rather than relying on someone happening to notice a change and raise it.

The same sensing can also support real-time fall detection, meaning prevention and care planning can draw on the same source of information.

No, and it’s important to be precise about why.

Technology can show that something in a room has changed. It can’t tell you what that change means.

A resident spending more time in bed might be unwell. They might be experiencing low mood. They might simply be sleeping better than they have in months. There could be a change in medication settling in.

Only someone who knows that resident can put those observations into context.

What technology can contribute is a consistent, objective record of activity over time.

The judgement, assessment, care planning and decision about what support an individual needs remain with the care professionals responsible for them.

It’s a prompt to look, not a conclusion about a person.

The right care, at the right time

Level of Care shouldn’t be a label set when someone arrives and only revisited when something goes wrong.

Care needs change. The challenge is recognising those changes early enough to respond appropriately.

The aim isn’t to provide more care for the sake of it. It’s to provide the right care, matched to where someone is increasing support when they need it, and stepping it back when they become stronger or more independent.

Independence can be easy to lose by accident and difficult to give back.

Better visibility can help shorten the gap between a change starting and someone noticing it. That creates an opportunity to intervene gently, look for the underlying cause and have important conversations with residents and their families before a small change becomes a much bigger one.

Ultimately, the relationship between a resident and the people caring for them is what makes good care possible. Technology doesn’t change that.

It simply gives care teams a fuller picture of the days and nights they can’t all be present for helping them make more informed decisions about the care and support each person needs.

Learn more about Nourish Care’s partners and our Partnership Programme here.