Care planning and domiciliary call rounds

Most home care services run a repeating daily pattern. Setting these up as call purposes once — rather than as times on individual visits — is what makes the round maintainable when clients join and leave.

Morning call — 07:00 to 11:00

The heaviest and least flexible part of the day. Getting people up, washed, dressed and given breakfast and morning medication. Everyone wants it early, which is why it is the round that most often fails to fit.

Lunch call — 11:30 to 14:00

Usually shorter. Meal preparation, a check-in, sometimes a second medication round. The window is tight because a lunch call at 15:00 is not a lunch call.

Tea call — 16:00 to 19:00

Evening meal and a check. Often overlaps with the start of the bed round for a different set of clients, which is where double-booking creeps in when rounds are planned by hand.

Bed call — 19:00 to 22:00

Settling people for the night. The window matters more than the exact time, and putting someone to bed at 18:30 because it suited the route is the classic complaint about badly planned rounds.

The exact windows will differ by service. What matters is that they are defined once as purposes and then applied by tagging, so changing your morning round means changing one window rather than a hundred visits.

A care package usually reads as something like: four calls a day, two carers at the morning and bed calls, 45 minutes in the morning and 30 minutes for the rest, medication at the morning call. That translates directly.

Visits required becomes 4. Staff required becomes 2 on the calls that need a double-up. Duration is set per call rather than averaged across the package. The minimum gap stops calls bunching, and the call purposes place each one in the right part of the day. Nothing about this requires you to decide the order or the times — that is what the scheduler is for.

Setting a service up is a one-off. Running it is a routine, and the routine is what most people actually need help with. This is the shape a working day takes once the initial setup is done.

1. 01

   The evening before: confirm who is working

   Almost every failed round traces back to staff availability being wrong at the point the schedule was built. Before you generate anything, check tomorrow's carers against the rota: who is on, what hours, and whether anyone is starting from a different place than usual. A carer marked as working 07:00 to 15:00 who is actually on until 13:00 produces a round that looks fine on screen and collapses at lunchtime.

2. 02

   Set the planning day and check what is due

   Set the date at the top of the scheduler. Recurring packages appear automatically for that day, so what you are looking at is the caseload as it actually stands — including anything moved onto this date from elsewhere. Read the count before you go further: if it is higher or lower than you expected, something has been moved or skipped and it is far cheaper to find out now.

3. 03

   Add today's exceptions

   Hospital admissions, respite, a client away with family, a one-off extra call after a discharge. Skip the visits that are not happening and add the ones that are. This is the only part of the day that genuinely needs judgement, and it is worth doing carefully — a call left in for someone in hospital costs a carer a wasted journey.

4. 04

   Generate, then read the warnings before the schedule

   The temptation is to look straight at the rounds. Read the warnings first. They name the specific visits that could not be placed and why — no one with the right skill available, a window too narrow to fit, a double-up where two diaries would not align. A schedule with three unplaced calls is not a finished schedule, and finding that out at 07:00 tomorrow is the expensive version.

5. 05

   Resolve what could not be placed

   Each warning has a small number of honest fixes: widen the window, extend someone's hours, move the call to another day, split a double-up across two times, or accept it needs agency cover. Change the input and generate again. What you should not do is quietly drop the visit — the whole point of the warning is that someone has to decide, and it should be a decision rather than an omission.

6. 06

   Check the map before you send anything

   The timings can be perfectly valid and the day still be wrong. Look at each carer's route on the map: a round that crosses the patch twice usually means a window is tighter than it needs to be, or a call is pinned to a strict time that only needs a window. Thirty seconds here often saves an hour of driving.

7. 07

   Share each round with the carer

   Send each staff member their own round as a link. They see their stops in order with arrival times and can open the whole day as a multi-stop route in Google Maps, Apple Maps or Waze rather than typing postcodes one at a time. Links are read-only and expire, so a round that has been superseded stops working rather than sending someone to yesterday's calls.

No round survives contact with a Tuesday. These are the four disruptions that come up most, and the quickest way through each.

A carer calls in sick

Reduce that carer's hours to nothing or remove them for the day, then regenerate. The scheduler redistributes their calls across whoever is left and tells you plainly which ones will not fit — which is the number you need when deciding whether to call in agency cover. Reassigning by hand hides the shortfall until someone is standing outside a door.

A client goes into hospital

Skip the visits rather than deleting the client. Skipping removes them from the days affected while keeping the package intact, so when they come home you unskip rather than rebuilding the whole care package from memory.

A new package starts mid-week

Add the client with the full pattern — visits required, gap, purposes, durations — and set the recurrence to start from the right date. Do not add today's calls as one-offs and mean to set up the pattern later; that is how a package ends up existing only in someone's head.

The round is consistently overrunning

This is a capacity problem wearing a scheduling costume. Check the durations against how long calls genuinely take, including getting in and out of the property. Fifteen minutes of optimism per call across a thirty-call round is seven and a half hours that does not exist, and no amount of routing recovers it.

The common thread is that each one is a change to an input — who is working, who needs visiting, how long for — rather than a change to the schedule itself. Express the change, regenerate, reissue. That loop is the whole operating model.

It is worth being direct about the boundary. GeoRoutes plans and routes visits. It does not hold care plans, medication administration records, risk assessments or daily notes, and it is not a care management or rostering system in the regulatory sense. Services normally keep whatever records system they already use and use this to build the rounds.

If you are looking for the mechanics of double-ups, repeat calls and gaps in more detail, the guide on appointments, double-ups and repeat visits covers each field in turn.