A Pathway 1 patient was medically ready to go home; however, safeguarding concerns meant that the ward wanted to wait until a social worker had completed safeguarding investigations before arranging discharge.

The challenge

With the patient’s consent, the ward discharge coordinator asked our Hospital Discharge Care Connector, Jo, to speak to the patient to offer signposting around what might be available to them once home. Jo was informed that there might be a need for replacement furniture and white goods, as the patient shared that they had been sleeping on the sofa due to broken mattress springs. There was no working fridge-freezer at the property so the broken appliance needed to be disposed of. The patient was living in social housing and had no money to replace the broken goods with new items, and said that they would like to access support to replace them, giving Jo consent to liaise with third parties to make this happen.

The solution

Jo first contacted charity Changing Lives Together, who redirected her back to apply online through the Help Scheme. Jo was unable to complete the online application as she did not have all the necessary information, such as NI number and the amount in bank accounts, so she contacted the patient’s allocated social worker and together they made a joint visit to the patient on the ward.

Jo then supported the patient with the purchase of a mattress and bedding ready for discharge. She discussed the benefits of being referred to a Social Prescriber within the GP surgery to support the patient once home, and the patient gave their consent for this.

Further arising safeguarding concerns meant that it was not possible for the patient to be discharged directly home, so it was agreed that accessing the Cheshire West and Chester (CWaC) Help scheme would be more appropriate to obtain the required white goods. Following this patient referral, Jo pursued the potential of having a direct referral process into the Help Scheme with Changing Lives Together, specifically to assist with delayed discharges from hospital. As a result, the proposed protocol is now in place and is working well, regularly contributing to discharges without further unnecessary delay.

Visit our Hospital Discharge Care Connector service page.

Feedback on our service

Here’s just some of the positive feedback that professionals and relatives of patients have shared.

“Thanks for the update and for all your support with Mr X over the past couple of days.”
Social Worker

“My parents are set to meet Liz from Vivo next Monday and it turns out the Opel group meet in the church 20 metres away, where I’ve discovered there is also a men’s group on a Monday morning.
Thank you so much. I’ve driven back to Brighton with a lighter heart. “
Relative of patient

“Thank you for all of your assistance with this one.” Social Worker

“Thanks, Jo, for the support.” IDT Nurse

“Thank you Jo. Been great meeting you and good luck, I have had good feedback from wards about your input.” Interim Head of Operations

“Thank you Jo. It was so good to talk to you and receive all the information, including today’s, so clearly.
Many thanks indeed. I will look into these today.” Relative of patient

“Thank you very much for your help and support, much appreciated.” Relative of patient

“Hi Joanne, there is a lot of really useful information here and I will work my way through all the attachments. Thank you ever so much for the conversation and the information.” Relative of patient