Home comfort: Reducing unnecessarily long hospital stays

The Home First scheme in Somerset is giving hospital patients who are healthy enough the chance to return home to finish their treatment. 

In the past, people – including those with diagnosed or suspected dementia – would have stayed in hospital for assessments and to plan for their rehabilitation. This can now take place at home or during a temporary stay at a specialist reablement unit, care home or community hospital. 

Covering four hospitals in the county, Home First enables nurses and occupational therapists to liaise with patients, families, social workers and other professionals to ensure that the person can leave hospital safely. 

‘It’s not about hurrying people out of hospital, it’s about getting them home as soon as they don’t need hospital intervention,’ says Tim Baverstock, Strategic Manager for Commissioning in Adult Social Care at Somerset County Council. 

People still get the assessments and support they need, but in an environment where these can be more effective. 

‘You get a much better idea of people’s ability out of hospital,’ says Tim. 

Once a person returns home, they are supported by visiting homecare staff to become more able. 

‘It means people are less likely to come back into hospital,’ says Iona Brimson, Senior Commissioning Officer at the council. 

‘Our priority is, “How can we help you be at home and also keep you there?”’

Joined-up support 

Lorna Brown is Home First and Discharge Lead for Musgrove Park Hospital in Taunton, overseeing and co-ordinating people who leave hospital under the scheme. 

‘We know people with dementia do better in their home environment, so if we can support them at home then we should be,’ she says. 

A detailed assessment of a person at their home is vital. 

‘It’s really key to involve the family,’ says Lorna. ‘When we’re assessing a person’s care needs, we’ll include carer support in that.’ 

A person remains supported by Home First until their needs are met or further support is sourced. 

‘We track and maintain them through the system – it’s joined up and is better for the person,’ says Lorna. 

For people with dementia or delirium, a more specialist range of staff and community support services can also help. This could include the Intensive Dementia Support Service (IDSS) – a crisis team that supports people with dementia whose behaviour is challenging. 

‘We aim to stabilise and prevent admission into mental health in-patient beds, while Home First and its care providers continue to support the individual,’ says Emma Norton, IDSS Service Manager.

First class care 

One of the reablement units in which patients can stay before returning home is Woodlands Farmhouse, a respite home run by homecare provider Ruby Care. Specially trained staff consider a person’s capability and work closely with them on a daily basis to help them regain skills and independence. 

‘We provide reasonable goals to ensure that people are supported to take risks, but won’t set unachievable tasks that may hinder their reablement,’ says Julie Lawrence, Care Manager at Ruby Care. 

‘They gave my wife the care she needed and they even looked after me,’ says Stanley.

Stanley, whose wife recently had a short stay at Woodlands after spending a month at Musgrove Park Hospital, says it provided a better environment for her recovery. 

‘It was first class – very good. They gave her the care she needed and they even looked after me,’ he says. 

His wife speaks equally highly of her stay. 

‘The food was nice and the staff were brilliant – they would do anything for you,’ she says.
 

In charge 

Ruby Care also provide a short-term homecare service for people returning home. They meet the person at home for a safety assessment and produce a detailed report of their care needs. This means a smoother handover process if long-term homecare is required from another provider. 

‘We believe that the support we are providing will reduce, or at a minimum delay, the need for long-term residential or nursing care,’ says Emma Purvis, Registered Manager at Ruby Care. 

Helen, who is 93, spent 10 days at a short-stay home before receiving support at home from Ruby Care. 

Her niece Jo says, ‘My aunt was going downhill but Ruby Care ensured she was drinking plenty of fluid, getting proper meals and taking her medication. They have been absolutely phenomenal – they’ve gone above and beyond on so many levels.’ 

‘My aunt feels like she’s in charge of her life because she’s in her own home,’ says Jo.

Luckily, Helen didn’t need a hospital stay, and Jo says her aunt has appreciated the opportunity to remain at home. 

‘Helen can still do so much for herself. Rather than taking that away from her, they’ve given it back to her,’ she says. 

‘She feels like she’s in charge of her life because she’s in her own home.’