For many years Reading Council has successfully championed ‘going home' for people discharged from hospital as the best solution and providing the best outcomes for patients.
The strengths of Home First are the number of options available. Residents can be safely discharged from hospital at the point where they are ready to leave, rather than being admitted, or facing a lengthy wait while care home placements are arranged. As a council we explore and deploy a range of local solutions, including:
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Discharge to home with a course of reablement – designed to help residents regain their independence.
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‘Discharge to Assess' – residents spend up to six weeks in a more intensive reablement-focused extra care environment – designed to support those who aren't yet ready to return home.
- A wrap-around package of domiciliary care and support from voluntary partners, reflecting the resident's needs.
We know many people are well enough not to be in hospital, but still have care needs, preventing them from returning home straight away. Now, more than ever, it's vital we work with our partners in the NHS to enable people who are well enough to leave hospital as soon as possible.
In the context of the pandemic Home First is our embedded approach for those leaving hospital or needing more support. It's not acceptable to ask care homes to take new admissions where residents have tested positive for COVID-19, and who are potentially infectious. This is based on our experiences earlier in the pandemic, which left many care settings worn down with the impact this had for residents and their families, some suffering significantly. Many of our local care homes would have struggled to convert their premises to accommodate safely patients who had tested positive for COVID-19 without affecting others – despite the measures many put in place to manage risks.
During the first COVID-19 lockdown, Reading proactively sought out new ways and new partners to enable us to achieve additional care resource at such a crucial time.
We partnered with the Holiday Inn Reading South, to help residents leave hospital as quickly as possible, creating new care facilities from April to June with the aim of freeing up as many NHS beds as possible and help ease the pressure on the healthcare system. The hotel was not specifically for COVID-19 patients, however in the light of the outbreak safety measures were put in place at the hotel and care staff resourced with appropriate personal protective equipment.
Working closely with the hotel manager the council converted 30 of the hotel's rooms into short-term care beds and partnered with care agency Care 1st Homecare to help deliver the service, our adult social care team was on-site seven days a week and newly discharged hospital patients supported by carers 24/7.
Council hospital-based social workers referred people into the service at the hotel and at the height of the pandemic in early May, 14 beds were freed up at the Royal Berkshire Hospital and local community hospitals and 14 people were being supported at the hotel as a direct result.
The hotel was the second new discharge service commissioned by the council in response to the COVID-19 crisis, also partnering with River View Care Centre in West Reading for people who were well enough to leave hospital but had residential or nursing needs.
COVID-19 has had a significant impact on adult social care with people requiring hospital admittance and experiencing quicker hospital discharges back into the home or requiring a package of social care to minimise the risk of exposure to COVID. We know the outcomes for residents are greatly improved if they're supported to go home from hospital rather than into alternative accommodation.
Cllr Tony Jones is lead member for adult social care at Reading Council
