The scope of home care services is key to minimizing risk and ensuring the safety of your employees and their clients. But clients and their families sometimes ask employees to perform tasks not covered in the program’s scope of services or that are beyond the competency of employees.

To ensure the integrity of care, employees need to communicate properly with clients and their families, including what they can, cannot do and how to respond if asked to exceed the scope of care services.

Home Care Communication

It’s important for every home healthcare provider to document in writing the organization’s scope of services. The proper communication of this plan can lessen the chance of misunderstanding and clarify expectations.

If clients or family members ask for tasks beyond the scope of services, have employees refer to this document and to utilize the SBAR communication technique to manage the request and communicate concerns to their supervisors.

SBAR Communication Technique

SBAR stands for Situation-Background-Assessment-Recommendation. The following is an example of SBAR Technique:

S – Situation: What is the client or family request?

“Mrs. Jones has asked me to cut one of her pills in half because she is afraid she will choke if she takes it whole. I am not sure I should do this.”

B – Background: What were the prior circumstances?

“The client’s daughter puts the pills in the daily medication box. The client has never previously voiced any similar concerns to me.”

A – Assessment: How have the client’s needs changed?

“The client isn’t eating well and needs a reminder to take her medications. At times, she gets short of breath just walking across the room. Mrs. Jones’s condition has worsened, and she needs more help.”

R – Recommendation: What course of action is indicated?

“I request that you reassess this client and her current level of services and advise me on how to respond to her request.”

The format of the technique is very flexible and can be adapted to suit the specific needs, procedures and scope of services for your own organization. For more information about the SBAR Technique, see “SBAR Technique for Communication: A Situational Briefing Model,” from the Institute for Healthcare Improvement at the Institute for Healthcare Improvement.


The scope of home care services is an important element of your organization’s business. With the proper communication techniques and procedures such as SBAR, you can help ensure safe and effective care for clients while reducing the risk of liability exposures.