Coming out of hospital
Hospital discharges are conducted in accordance with the Care Act 2014. The hospital staff will tell us if you need an assessment of your care needs to start or continue with care services on your return home.
Acute hospital discharges
Once the hospital has contacted us, we then have between 3 and 5 days to complete an assessment of what social care eligible needs you may have and whether a package of care is required in line with the Care Act.
This process also applies to those who may be in need of residential or nursing care and would meet the criteria for local authority funding.
Community hospital discharges
Sometimes you may be admitted to a local, community hospital or residential care home rather than an acute hospital.
You may also be transferred to a community hospital or care home for rehabilitation following an acute hospital stay.
On occasion it may be necessary for you to be given temporary support to continue your recuperation. This can be in your own home or a short stay in a care home.
We also provide short term services that can give you support in your own home to regain lost skills and independence. The service can be offered for up to 6 weeks, but this will depend upon your needs and may only be provided for a week or 2.
Intermediate care is a service provided to help you recover from illness sooner. It involves a range of professionals including occupational therapists, social workers, physiotherapy and nursing staff working closely together. Support is usually provided in your own home and normally lasts no longer than 6 weeks.
Intermediate Care is available to all adults over 18. It can be accessed via a referral from your GP or another social care or health professional. You can self-refer, or have a referral made on your behalf by a carer or family member, by contacting Call Derbyshire, tel: 01629 533190.
All referrals will be assessed using the intermediate care eligibility criteria. In general you need:
- to be medically stable and supported by your GP in the community
- to be able to benefit from time-limited rehabilitation in order to improve your level of independence
- consent - if the referral is made by a professional or your carer, they need to have your consent
If it's considered that you're not suitable for intermediate care, you'll be given the reasons for the decision. You may also be given details of more appropriate services.
Derbyshire home from hospital support service
The Derbyshire Home from Hospital Service provides practical support for vulnerable people leaving hospital, or those living at home but at risk of being admitted.
You can use the service if you live in Derbyshire, or are registered with a Derbyshire GP, and need more support than is available from family or friends.
The Home from Hospital service is provided by a combination of staff and volunteers from the South Derbyshire CVS consortium, which includes Amber Valley CVS, Chesterfield Volunteer Centre, Erewash Voluntary Action CVS, and Connex Community Support.
The service can provide the following types of support for up to a maximum of 6 weeks:
- fetching shopping and ensuring you have a plan in place to manage shopping after the service ends.
- making sure your home environment is warm, comfortable and clean.
- arranging for key safes to be fitted and community alarm or telecare systems to be provided, if needed
- supporting you to pay bills and make appointments
- collecting medication prescriptions
- supporting you to maintain and improve your social networks
- supporting you to understand care options and plan future support
- signposting to other statutory, voluntary sector and community organisations
At the end of the 6 week period you will either:
- be able to manage day to day tasks independently, or with the same or a decreased level of support you had before your hospital admission
- choose to continue to have ongoing support from other universal services
- have been assessed by adult social care for an ongoing care package
To make a referral to this service contact South Derbyshire CVS Consortium email: firstname.lastname@example.org or tel: 01283 817417.
Information and advice
We'll offer advice and information to help you regain your independence after a hospital stay. This is available even if you're assessed as not eligible for other support services, or are a self-funder.
You can use our brokerage service help you to find any care services you need in your local area, tel: 01629 537763. You don't need an adult social care assessment in order to use this.
It's important that your family carers are involved in the plans for your hospital discharge if you want them to be.
With your consent we'll discuss your discharge arrangements with them and make sure they're willing and able to give you any support you need.
If you have any concerns about this please ask to speak to an adult social care worker or Call Derbyshire tel: 01629 533190.