Home First

What is home first?

When your hospital treatment is finished, the best place for you to recover is at home. This is known as the home first approach.

The home first approach helps you to maintain your independence as much as possible as you recover from illness or injury at home, after a hospital stay.

Home first also means that ongoing care assessments happen at home, because this is the best place to understand your longer term care and support needs.

“Home” could be in a care home, your own home or that of a friend or family member.

What are the risks of staying in hospital when you’re well enough to go home?

Staying in hospital when you’re medically well enough to go home can result in deconditioning. This can mean you lose the ability to do everyday tasks. It’s often caused by inactivity and extended periods of time in bed.

Deconditioning can:

reduce your independence
reduce your confidence
reduce your muscle strength
increase the risk of you having poor mental health and wellbeing

Staying in hospital longer than you need to can also increase your risk of getting a new infection.

These risks could mean you need more care and support when you finally do go home. By recovering at home, these risks are reduced. Being at home can get you back to your usual routine, helping you get stronger quicker.

How does home first work in practice?

Discharge planning

Planning for your discharge starts as soon as you are admitted to hospital. The aim is to discharge you once your medical or care needs can be met at home or in the community.

The ward team will work with you and let you know when you’re ready to leave hospital. The ward team may include:

nurses
social workers
occupational therapists
other specialists like physiotherapists and dieticians
doctors
discharge liaison officers

Your discharge plan will cover any immediate support you will need to go home. Your longer term care or support assessments will be carried out at home, once you have been able to recover further.

Don’t be afraid to ask staff about the plan to get you home. They will ensure any care you need is in place by the time you go home. Having a discharge plan is to help you get better and support you to leave hospital when the time is right.

This helps to reduce the:

length of hospital stays
risk of further deconditioning or frailty
risk of infections

The plan needs to include what matters to you, and this will help staff plan well. Let the ward team know if there are any issues at home that need to be resolved so there’s no delay to your discharge.

You, as well as your family members or carers, are entitled to be involved in this planning process so you know:

what will happen at home
who to contact if you need any help

Discharge options

When you are ready to go home, some discharge options are considered:

immediate discharge with little or no ongoing care needs,
immediate discharge to your normal package of care (the care you were receiving before your hospital stay)
discharge with short term help to recover
discharge with stable long term care needs, which will involve creating a plan to provide your care and support at home or at residential or care home
discharge to a different short term location to a service called a ‘step down’ or ‘intermediate care’ placement, to prepare you to go home

Preparing to go home

There are lots of things you can do in hospital to keep moving and get ready to go home, including:

getting dressed each day
being as mobile as possible
using things you would usually have at home like your glasses, hearing-aid, watch and diary

Your family or friends (carers or unpaid carers) can help you while you’re in hospital. They can help you with eating, dressing and walking, if necessary. Hospital staff can show you them how do this correctly. This will help you and your carer feel more prepared when you go home.

Useful information

PAVO Community Connectors Service:

01597 828649 / community.connectors@pavo.org.uk

Your local Community Connector will be present on the unit on set days.

They can:

Listen to you and understand ‘what matters’
Help you to access local services and make sense of what is available
Connect you with groups and activities in your area
Work with you and your family
Put you in contact with many 3rd sector organisations including British Red Cross: Powys Support at Home, Age Cymru Powys, Credu (Carers), Care & Repair Powys, Citizen Advice Powys, Powys Befriending Service and many more

Ask to speak with the Community Connector when they are on the units.

The Money Advice Team:

For assistance, contact 01597 826618 or via wrteam@powys.gov.uk

The Money Advice Team provides guidance on budgeting, debt management, benefits maximisation and financial support options.

Citizens Advice Powys:

0345 6018421

Citizens Advice Powys is open to callers from Powys, on Tuesday, Wednesday and Thursday from 9am until 3pm. If you leave your details and a short message they will return your call. For text relay service please use 18001 08082 505720

You can also use their online form at www.powyscitizensadvice.org.uk or visit your local outreach session.

They provide free, confidential, impartial and independent information and advice on a range of matters including:

Benefits
Debt advice
Energy advice
Work
Consumer advice and more