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Waverley Borough Council Committee System - Committee Document

Meeting of the Community Overview and Scrutiny Committee held on 10/09/2001
DELAYED DISCHARGES FROM HOSPITAL - SUPPORTED REHABILITATION


The purpose of this report is to draw members’ attention to the issue of hospital discharges being held up due to a lack of suitable support facilities in the community. It puts forward a proposal for consideration whereby the Council, in its Housing Landlord role, could assist its partner organisations to address the issue.

There are no resource, environmental or community safety implications at this stage. There are “opportunities for all” implications which are referred to in the report.
APPENDIX F

WAVERLEY BOROUGH COUNCIL

COMMUNITY OVERVIEW AND SCRUTINY COMMITTEE
10TH SEPTEMBER 2001



Title:
DELAYED DISCHARGES FROM HOSPITAL – SUPPORTED
REHABILITATION
[Wards Affected: All]


Summary and Purpose

The purpose of this report is to draw members’ attention to the issue of hospital discharges being held up due to a lack of suitable support facilities in the community. It puts forward a proposal for consideration whereby the Council, in its Housing Landlord role, could assist its partner organisations to address the issue.

There are no resource, environmental or community safety implications at this stage. There are “opportunities for all” implications which are referred to in the report.



Introduction

1. Members will be aware of the need for hospitals to discharge their patients as soon as possible after their medical treatment has been concluded. Achieving a regular turnover of beds is essential in order to be able to treat as many patients as possible. However, it does not necessarily follow that a person who has reached the end of their medical treatment has, at that time, the full capabilities necessary to live independently without some help - particularly in the case of an older person. Creative ideas for facilitating the discharge of older people from hospital are being sought and this report suggests a proposal for members’ consideration.

Background

2. The issue of supporting older people returning home after a stay in hospital is not new. However, pressure on bed spaces is increasing year on year and ways need to be found to avoid blocking bed spaces by people who no longer require to be hospitalised for medical reasons. It is important for the health and well being of the community as a whole and indeed for those older people who are ready to leave hospital that their discharge is facilitated.

3. In past years, this problem would have been addressed by periods of convalescence or rehabilitation in Nursing and Residential Homes. However, the current level of provision of these facilities both in the private and public sector is insufficient to meet the demands and, locally, a number of homes have closed recently. It is unlikely that this provision will increase due to the very high capital costs involved in developing such facilities in this area.

4. Additionally, high employment levels in the Borough, together with the prosperity of the area, generally means that there is often difficulty in both the independent and public sector in recruiting sufficient numbers of care staff for domiciliary care. The lack of availability of community resources is one of the major reasons for the high numbers of people who are delayed in their transfer home from hospital.

5. Within its role in Community Welfare the Council has a responsibility to enable, encourage and support partner agencies wherever possible. The Council’s Sheltered Housing and Community Schemes are an important example of how Waverley is helping to support older people to live independently in the community. The Council also works closely with Social Services, Health Authorities and Voluntary Organisations on a range of projects aimed at promoting independent living. It is within this context that this proposal is being put forward for consideration.

PROPOSAL TO REDUCE DELAYED DISCHARGES FROM HOSPITAL

Outline Details of the Scheme

6. Officers have been in discussion with colleagues from Social Services, the Health Authority and Primary Care Group and there is broad support for the initiative described below.

7. It is proposed that a flat/bed-sit in a Sheltered Housing Scheme is made available for use by the Health Service as a unit of accommodation to be used for rehabilitation purposes. The Health Service would move a person out of hospital into the flat for a period of up to six weeks with Social Services and the local Health Trust providing care and support services. The aim of the initiative would be to assist the person to establish or re-establish a level of confidence and independence prior to returning to their permanent home.

8. It is proposed that suitably furnished flats/bed-sits in a number of sheltered housing schemes could be used for this purpose. This would aid the spread of this resource throughout the geographic area of Waverley and would assist the Council in being flexible about the availability of units of accommodation for the purposes of this initiative.

Eligibility for the Scheme

9. It is anticipated that the scheme would be for those aged 55 and over and the eligibility criteria could include such things as:

a permanent residence in the Waverley Borough Council area which they are able to return to at the end of the brief rehabilitation period;

there is written agreement to participate in the initiative;

they are assessed as being medically fit with the potential to return to their own home within the six week period.

Resource/environmental Implications

10. It would be intended to focus, where possible, on the use of flats/bed-sits in sheltered housing schemes which prove more difficult to let – thereby generating an income from a property which might otherwise be vacant, for example, the Dorlcote Sheltered Housing Scheme at Witley currently has 7 vacant bed-sits. It is anticipated

that, at worst, there would be no financial disbenefit to this Council, and at best a rental scheme to cover all related costs, the cost of the proposal being met by the Health Service and Social Services both in terms of rental on the property and the provision of support services.

11. As this initiative would be on a purely experimental basis, it is considered that it would not have a major impact on the staff at the Scheme.

"Opportunities for All" Implications

12. This proposal would provide individuals with the opportunity to leave hospital and move to a short term supported environment before returning to their own home, thereby allowing access to hospital services to others. The knock-on effect is that the released “blocked beds” mean that other cases can be treated/operated upon.

Community Safety Implications

13. There are no community safety/Crime and Disorder implications.

Conclusion

14. This initiative has been introduced in other parts of the country including Guildford and Hampshire. It is also known as a “Step Down” Scheme. It gives the Council the opportunity to fully participate in its role in the Care and the Community, working in partnership with other agencies for the benefit of the Community as a whole and, in particular, for those individuals ready to be discharged from hospital. Your officers would welcome Members’ comments on the proposal. Subject to the Committee’s support being forthcoming, the particulars of the scheme could be explored further with our partner organisations and a detailed report submitted for approval in due course.

Recommendation

That the Committee recommends the Executive Committee that the details of a “Waverley Step Down” Scheme be developed, in partnership with other agencies, and a further detailed report be submitted for Members’ consideration in due course.



Background Papers (DoH)

There are no background papers (as defined by Section 100D(5) of the Local Government Act 1972) relating to this report.



CONTACT OFFICER:

Name: Mr J Swanton Telephone: 01483 869375
E-mail: jswanton@waverley.gov.uk