Assessment and Admission Process for an EMI Nursing Home

The assessment and admission process within an Elderly Mentally Infirm (EMI) Nursing Home is designed to ensure that the service can safely and effectively meet the individual's physical, mental health, nursing, and social care needs while promoting person-centred care from the outset.
 

1. Referral and Initial Enquiry

Referrals may be received from hospitals, community mental health teams, social workers, discharge coordinators, Integrated Care Boards (ICBs), local authorities, GPs, families, or other care providers. Information is gathered regarding the individual's medical history, diagnosis, current care needs, risks, behaviours, mobility, communication, and funding arrangements.
 

2. Pre-Admission Assessment

A comprehensive pre-admission assessment is undertaken by a Registered Nurse, Registered Manager, or appropriately trained senior member of staff. The assessment may be completed in the person's current residence, hospital, care setting, or virtually where appropriate.

The assessment considers:

• Dementia diagnosis and cognitive functioning.

• Mental health needs and history.

• Nursing requirements and clinical complexity.

• Physical health conditions and long-term illnesses.

• Medication requirements.

• Mobility and falls risk.

• Nutritional and hydration needs.

• Continence needs.

• Communication abilities.

• Behavioural and psychological symptoms of dementia (BPSD).

• Risks to self or others.

• Safeguarding concerns.

• End-of-life care requirements.

• Social, cultural, religious, and personal preferences.

• Mental Capacity Act considerations and legal status.

The assessment aims to establish whether the home can safely meet the individual's needs and whether admission would be beneficial for the person and existing residents.
 

3. Review of Documentation

Relevant documentation is reviewed to support the assessment process, including:

• Hospital discharge summaries.

• Care plans and risk assessments.

• GP and specialist reports.

• Mental health assessments.

• Medication records.

• Deprivation of Liberty Safeguards (DoLS) information.

• Advance care plans and DNACPR documentation.

• Funding approvals and placement agreements.
   

4. Multidisciplinary Decision Making

Where required, discussions take place with healthcare professionals, family members, advocates, commissioners, and mental health teams to ensure a full understanding of the individual's needs. The Registered Manager and clinical team determine whether the placement is suitable and whether the home has the necessary resources, staffing, and expertise to provide safe and effective care.
 

5. Admission Planning

Once the placement is agreed, an admission date is arranged. Staff work with the individual, family members, and professionals to gather detailed information about the person's life history, routines, preferences, interests, and wishes.

Preparations include:

• Allocating an appropriate bedroom.

• Developing initial care plans.

• Completing medication arrangements.

• Organising specialist equipment if required.

• Informing relevant healthcare professionals.

• Planning support for a smooth transition.
   

6. Admission to the Home

On arrival, the resident and family are welcomed by staff and introduced to the environment. Initial observations and nursing assessments are completed, including:

• Baseline clinical observations.

• Skin integrity assessment.

• Falls assessment.

• Nutritional screening.

• Dependency assessment.

• Medication reconciliation.

• Infection prevention screening.

The resident is supported to settle into their new surroundings with reassurance, orientation, and emotional support.
 

7. Development of Person-Centred Care Plans

Within the first 24–72 hours, detailed care plans and risk assessments are developed based on information gathered during the assessment process and initial observations. Care plans focus on promoting independence, managing risks, maintaining wellbeing, and achieving positive outcomes.
 

8. Ongoing Review

The admission process continues beyond the first day, with regular reviews undertaken during the initial weeks. Staff monitor how the resident is settling, assess changing needs, and update care plans accordingly. Family members and relevant professionals are involved in review meetings to ensure the placement remains appropriate and that the resident receives high-quality, person-centred care.

This robust assessment and admission process ensures that individuals entering the EMI Nursing Home receive safe, effective, compassionate, and responsive care tailored to their unique needs while supporting a smooth
transition into residential nursing care.