L is a woman in her early seventies who lives alone in her own home. She has autism, obsessive compulsive disorder and reduced mobility and has been supported by Trinity Homecare for approximately ten years. Throughout this time, her care has focused on personal care and companionship, with a strong emphasis on routine, familiarity and maintaining her independence.
Access to the community has always been central to L’s well-being. Regular outings gave structure to her week, supported her emotional regulation and helped her remain socially connected. One activity in particular, visiting her preferred garden centre, was especially meaningful to her. The familiarity, predictability and calm of this environment provided comfort and played an important role in maintaining her emotional stability.
As L’s mobility declined, new risks emerged. Transferring into a standard vehicle became unsafe, significantly limiting how she could travel. An independent case manager explored alternative transport arrangements, including the use of a minibus service. While this option addressed immediate safety concerns, it also introduced new restrictions. The service operated only to selected destinations, meaning L could no longer visit the garden centre that had been such an important and established part of her routine.
The impact on L was both noticeable and concerning. She became increasingly distressed and withdrawn and her engagement with the community reduced. Carers observed changes in her mood and confidence and it became clear that the loss of choice, routine and familiarity was negatively affecting her emotional wellbeing.
Rather than accepting this as an unavoidable consequence of declining mobility, the care team took a proactive approach. They recognised that safety alone was not enough and that L’s quality of life, identity and emotional needs needed to remain central to her care. The team worked collaboratively with an external transport provider to develop a more personalised solution that balanced effective risk management with choice, dignity and independence.
Through careful planning and shared risk assessment, a new arrangement was introduced. This enabled L to travel safely and comfortably with her carer, while continuing to access the places and routines that mattered most to her. The approach was flexible, well-considered and fully aligned with L’s individual needs, preferences and abilities.
The impact of this change was significant and sustained. L’s mood improved and her confidence increased. She re-engaged with activities she enjoys and returned to familiar routines that gave her a sense of control over her life. Carers consistently noted that she appeared calmer, more settled and more engaged following outings, with these improvements clearly recorded in care notes and reviews over time.
This case demonstrates how truly person-centred care goes beyond meeting basic needs. It highlights the importance of partnership working, creative problem-solving and a commitment to individual choice, even where risks and complexity increase. By focusing on what mattered to L, the team preserved her independence, protected her emotional well-being and ensured her support remained safe, flexible and deeply respectful.
CQC KLOEs demonstrated:
- Safe
- Caring
- Responsive
- Well-led
