Options Liverpool - Autumn 2014

Autumn 2014 | 2nd Edition

The Royal Liverpool and Broadgreen University Hospitals NHS Trust

Liverpool

WORKING IN PARTNERSHIP

A guide to care and independent living

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Contents Welcome and introduction............ P4 The right place for your care...... P4-5 Leaving hospital.............................. P6 Your hospital team......................... P6 The assessment process................... P7 Continuing NHS Care...................... P7 Therapies......................................... P7 Dementia Practitioner.................... P7 Intermediate Care........................... P8 Liverpool Intermediate Care – Aiming to get you home........... P9-11

Intermediate Care at Home: Liverpool Out of Hospitals Service ....................................................... P12 REACT Service – Reablement at Home Service................................. P13 Our commitment to you............... P14 When you leave hospital.............. P15 Useful contacts.............................. P15 The Friends and Family Test.... P16-17 Age Concern – LIverpool & Sefton .................................................. P18-19 3

Welcome and Introduction Welcome to the Royal Liverpool and Broadgreen University Hospital.

This guide is intended to help you, your carer and your relatives and friends understand how your discharge or transfer from hospital takes place. We hope that you can help us so that this happens as efficiently and smoothly as possible.

The right place

for your care

Your local hospital in partnership with other hospitals in the region, and your local authorities recognise and support each patient to receive the right treatment, at the right place and by the right professional.

An acute hospital Trust is a hospital that provides consultant led health services within the National Health Service. Acute care is for patients who require emergency, medical or surgical services within a hospital environment.

The Royal Liverpool and Broadgreen Hospitals Acute Trust provide care for patients who require this level of care.

Hospitals are the right place to be when you are in need of specific medical or surgical treatment.

However, when

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your treatment has been completed, it is important that your stay is not delayed for the following reasons: ■

eds are needed for people who are very B unwell, and who may be waiting in the Accident and Emergency department for a bed to become available.

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P eople awaiting surgery, both urgent and non-urgent, may have their operations cancelled if a bed is unavailable.

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T here is a risk of acquiring infections in hospital, so leaving at the earliest opportunity means this is less likely.

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Some people find it harder to return home the longer they stay in hospital.

It is good practice to start planning for your discharge as soon as you come into hospital or even before you arrive. This means that we can begin to: ■

ssess what your A needs are likely to be when you are ready to leave.

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I nvolve relevant staff who can help in meeting those needs (e.g. social worker, occupational therapist, physiotherapist, district nurse)

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ake arrangements for equipment or M services which need to be in place when you are medically ready to leave.

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ake sure that your carer is given any M information, help or advice that is needed to aid your recovery.

All staff will work with you and your carer or relatives, as a team, in order to discuss your discharge with you.

for the next patient.

The Hospitality suite is a comfortable and safe place to wait and is staffed by nurses.

A supply of your current medication will be ordered from the Hospital Pharmacy and delivered to you in the Hospitality Suite.

This may take up to four hours. If you have any questions or concerns about your medication please ask to speak to your pharmacist or a member of the nursing team. Relatives or carers coming to collect you can meet you in the Lounge or a nurse can escort you to the main reception area.

We need to discuss any concerns you have Finally, we understand that any hospital stay at the earliest opportunity, e.g. your safety can be stressful and we need to support at home, managing your personal care or you and your carer during your time here. domestic arrangements, your ability to You can also help us by moving from move around and any equipment hospital when you no longer need you may need.

The our services. We will discuss You will be given an expected date for discharge based on when it is expected that your treatment will be completed. It is important that everyone involved is aware of this date so that we can all work towards it, and so that the necessary arrangements can be made.

Hospitality suite with you the sort of help you and your carer may need is a comfortable when you return home, to and safe place make the transition as easy to wait and as possible. is staffed Your Hospital Case by nurses.

Manager is the member of

These may include: ■

T ransport home. Patients are normally expected to arrange their own transport.

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S uitable clothing and footwear if you are not already using them in hospital.

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Access to a key to your property.

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Adequate basic food stocks.

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Adequate heating in your home.

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dequate support for your carer or A family members.

We aim for patients to be discharged before 10am but if this is not possible, it is likely that you will move to the Hospitality suite which enables us to prepare the bed

the team who will meet you on the ward and, along with the ward staff will begin planning your discharge from hospital.

For most patients, being discharged from hospital to their home is straightforward.

Some may need information and advice or may need the support of social services.

Some people have ongoing health and social care needs which require a more detailed assessment. Staff from health and social care will work together to plan and deliver services to support such people after discharge.

This guide explains some of these processes and explains the role of the hospital and Social Care team in the hospital discharge process.

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Leaving

hospital

You will be transferred from hospital when your consultant led team decide that you are clinically ready to leave hospital and that you no longer require an acute hospital bed.

We fully support your transfer out of hospital for the following reasons:

For the majority of patients, you will go home from hospital with no additional support required. In some cases you may require some extra support to regain your independence. Your hospital team will help you, your family and carers to access these services if you need them.

3. A cute beds are needed for people who are very unwell, and delays in transfer may result in patients waiting in the Emergency department for a bed to become available.

Your safe and timely transfer from hospital will also allow new patients who need acute hospital treatment to be admitted without delay.

1. T o support you to regain your independence 2. S ome people find it harder to return home the longer they stay in hospital

4. A lthough we work hard to ensure the highest standards of care there is a risk of acquiring infections in hospital. Leaving hospital as soon as you are medically fit means this is less likely and reduces the risk of any complication.

Your Hospital Team A Multi – disciplinary team including your Hospital Case Manager, Consultant team, Matron and ward nurses, Occupational Therapists, Physiotherapists and Social Workers will begin to plan your transfer from hospital as soon as you are admitted.

This team of clinical experts will explain their key roles to you if they are involved in your hospital care.

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The Assessment Process Your assessment begins as you are admitted to the ward area and is a way of working out what your needs are and which ones might be putting you at risk.

The assessment process will start with discussions with your Hospital Case Manager, with you and your family / carers. This process of information gathering and clarification of the situation will indicate which members

of the multi disciplinary team need to be involved in your assessment.

Your Hospital Case Manager will work alongside you to: ■ Identify your needs ■ Establish which members of the Multi disciplinary team may need to be involved in your care and assessment ■ Provide you with information about services that could support you as you are discharged from hospital

Continuing NHS Care If you have complex, ongoing health care needs, the team involved in your care, must first consider whether you meet the eligibility criteria for continuing NHS Care, although this assessment is completed fully once you return to your home environment.

Therapies You may be referred to a therapist to assist in planning for your discharge from hospital.

This could be someone from a number of different professions; a dietician, occupational therapist , physiotherapist or a speech and language therapist. They will discuss with you and assess what you

are able to do; and what you might need more help with. They will then discuss with you what treatment, help or support is available to improve your independence.

The therapists will discuss with the other members of the hospital team their findings and together with you and your family make a plan for your discharge from hospital.

Dementia Practitioner During your hospital stay we have a dementia practitioner who is available to provide support for patient’s relatives and carers.

patient admitted to the hospitals or their carers will also receive information as to relevant advice in order to support them following their hospital stay.

Dementia patients will receive a ‘This Is Me’ document in order to deliver specific care needs along with the opportunity to take part in bedside activities. Every dementia

Shaun Lever – Dementia Practitioner, Royal Liverpool and Broadgreen University Hospitals 0151 7062000 bleep 5111; 0151 7064727

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Intermediate

Care

Here in Liverpool, Intermediate Care can support people as they are discharged from the acute hospital who are not quite ready to return home.

This period of intermediate care can provide rehabilitation from Therapy staff or a period of reablement prior to returning home. Your hospital Team will work with you to assess your level of need and which intermediate care service which would suit your needs should you require it.

All patients who no longer need acute care but cannot return home and do not require specialist care are eligible to enter the intermediate care pathway if they meet the following criteria:

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Over the age of 18

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Resident of Liverpool or

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Registered with a Liverpool GP

Intermediate care is provided under Health and Social Care joint Commissioning arrangements and is free of charge whilst you are on the intermediate care pathway.

People may enter onto the intermediate care pathway following an episode of acute care for a further short period of recovery and or reablement. This can benefit patients and enables a more accurate assessment of your ongoing care needs prior to returning home or before long term care is considered.

Intermediate Care Aiming to get you home The aim is to help you to relearn daily living skills so you do not need long-term support or go back into hospital.

You need to know what you want to achieve and how this will be done in hospital to establish your reasons for going into Intermediate Care through your multi disciplinary team assessment.

First route out of hospital should always be your own home. If this is not possible, then the Intermediate Care aims to get you home and to eliminate dependency on long term support.

General Practitioner, Access coordinator (social care) and appropriate attendees related to your care programme.

Sedgemooor (30 beds) 41 Sedgemoor Road, Norris Green, Liverpool L11 3BR Tel: 0151 256 1810 â–

Liverpool City Council provides a model of health and social care support through community bed based centres. The model creates a circle of health and social care support for adults.

The Model of care: Each facility supports intensive short-term community bed based services under the umbrella of re-ablement services.

Re-ablement services help to ensure people receive the right level of support at the right time.

We aim to support patients as they are discharged from hospital to reduce the length of time you stay in hospital and can offer a more realistic assessment of your future support needs.

We operate a Multi Disciplinary Team approach which comprises of Social Worker, Community Matron, Therapists,

rovides a service to support hospital p discharges, admissions and respite specialising in care and support for people with dementia. A new purpose built integral day facility has been attached to the main building and will be operational in July 2013. The new build provides carer support, drop-in facilities, cafĂŠ, day support, community outreach work, advocacy, crisis intervention, health and well being advice and support.

Venmore (25 beds) Hartnup Street, Liverpool L5 1UW Tel: 0151 263 2888 â–

P rovides a service to support hospital discharges and admissions for people who have had a stroke. Service delivery is supported by the acute trust through Physiotherapist, Occupational Therapists, Speech and Language specialists and a range of social and health support services for individuals and their carers.

A new integral day facility has been commissioned for 2013. This will provide a unique opportunity to support people who have poor or limited mobility, are prone to falls.

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Intermediate Care Aiming to get you home contd.

Granby (30 beds) 50 Selborne Street, Liverpool L8 1YQ Tel: 0151 709 3988 â–

rovides a generic re-ablement service for p people, supporting hospital discharges and admissions for people recovering from a period of medical intervention. Granby works closely with the local community groups, schools and wider neighbourhood networks to ensure inclusive holistic approaches to providing and delivering localised services.

Rowan Garth 219 Lower Breck Road, Liverpool L6 OAE Tel: 0151 263 9111 â–

i s a specialist intermediate care unit, designed specifically to help you regain mobility and confidence, in order to live independently again.

Once admitted to Rowan Garth, you will be assessed by a qualified team of a Physiotherapist, Occupational Therapist and Social Worker, who will develop an individual therapy programme specifically to meet your needs.

The unit is staffed by fully qualified nurses and care staff who have worked within the intermediate care setting for many years and have been trained to assist your individual therapy needs.

Intermediate Care bed based services provide assessment, care and treatment for you and discuss with you and your family or carer what care and support you need. During your stay, you may move from one part of our service to another depending upon your assessed needs. This may include transfer to an alternative care setting.

Rowan Garth is located in Anfield, Liverpool and has been carefully designed to create a pleasant, well equipped care home. The home has a large landscaped garden and patio area.

During your admission you will be assessed by our therapy team who will discuss any treatment plans, goals and frequency of interventions with you.

Therapy treatment may be delivered on

This may involve staff working with you on a daily basis to complete exercises to improve your mobility and to ensure that all support you may need is in place.

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Intermediate care beds are provided by Liverpool community Health on the Royal Liverpool Hospital site (Ward 2A ) at Broadgreen Hospital (Wards 9 and 11) and at University Hospital, Aintree (Ward 35).

Intermediate Care Aiming to get you home contd. the ward or in the gym and will consist of chair based exercises, walking practice and functional activities, treatments will be carried out by a member of the multi disciplinary team where it is deemed appropriate to do so. It may be necessary to carry out a home assessment prior to your discharge and if so we will ask you to provide access to your home and ensure that you have appropriate outdoor clothing for the assessment.

Whilst every care has been taken to make sure the information in this publication is up to date it is not intended to be a complete and authoritative statement of the Law on the issues covered.

The publishers and the promoters cannot accept responsibility for any loss arising from the use of information contained in this publication.

Designed and published by Octagon Marketing Company Ltd Š2014 Britannic Chambers, 8a Carlton Road, Worksop, Notts S80 1PH. Tel: 01909 478822

If the Multi disciplinary team deems that you are medically fit for discharge but you are not ready for discharge home, you may move to another part of the service dependent upon your assessed needs.

This may include transfer to an alternative care setting.

If required you will be assessed by a Social Worker or community care assessor to find out if you require ongoing support at home.

Whilst we have taken every care in compiling this booklet, the publishers and promoters cannot accept responsibility for any inaccuracies. The inclusion of any advertisement in no way endorses the services or products sold.

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Intermediate Care

At Home:

Liverpool Out of Hospitals Service Liverpool Out of Hospital Service (LOOHS) is a multidisciplinary team of Health and Social Care professionals including Nurses, Occupational Therapists, Physiotherapists, Podiatrists, Social Workers and Support Workers.

LOOHS supports people and their carers when they are in health and / or social care crisis. The aim is to prevent people from being admitted to hospital if possible, support people to return home after a recent hospital admission, and enable people to live at home rather than in a care home, if they choose.

The rehab and reablement elements of the service aim to enable people to recover from recent loss of function, due to an

illness, or fall, for example. Therapists work in partnership with the local authority to develop a plan of care and rehab to enable people to regain their independence.

LOOHS tends to provide lots of support in the beginning and gradually reduces this support as people become more independent, but identifies that some people will need that care and support for the long term, and arranges that for them.

If you are assessed as requiring support from LOOHS you will be referred by a health or social care professional in the hospital.

Contact details For more information please contact Liverpool Out of Hospitals Services.

Tel: 0151 285 3715

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REACT Service – Reablement at Home Service Reablement assessment care team is a service delivered as a partnership between Liverpool City Council and Royal Liverpool and Broadgreen university Hospital NHS Trust.

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Advice on how to reduce the risk of falls

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oping with practical tasks such as laundry C and cooking

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Getting around your home

■ Practice using equipment provided The REACT service is for people who ■ Supporting you in taking need some help to manage as they are prescribed medication discharged from hospital. This is set up by a Care assessor who will talk Will I be charged for this service? through the type of help you There is no charge for this service, might need when you leave The REACT hospital to stay independent at service will work however, if you require ongoing support after the reablement home. The assessor will agree with you for at period, you may, following a a plan with you to help you least 4 weeks to achieve your goals, financial assessment have to but can be which will start when you contribute towards the cost return home. of any service provided. extended if you

need it.

The REACT service will work More information about our with you for at least 4 weeks but charging policy can be found at: will be extended up to 6 weeks if you www.liverpool.gov.uk/fairercharging need it. The team will monitor your progress and if you need further support at the end of More information: the REACT involvement this will be discussed If you have any questions or require further with you and a care plan agreed to meet any information please contact the Social Work long term needs. team on 0151 706 2840 How can the team help?

The team will work with you, looking at how you did things at home before and what things you can do to stay independent. This could include: ■

Increasing your confidence

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Finding new ways for you to do things

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Offering practical help and encouragement

Your programme of reablement will focus on every day issues such as: ■

Other Services: Lifeline (See separate leaflet) VNC Lifeline is an Emergency alarm system which provides a 24 hour emergency pendant / alarm for people who wish to remain living independently at home. Having an alarm can provide peace of mind knowing that it can be used day or night from anywhere in the home.

Washing and dressing

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Our commitment to you ■

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P atients should receive the right treatment, at the right place and by the right professional

appropriate services and facilities available to you ■

e will aim to transfer you from W hospital before 10am on your day of transfer and if you require transport, we will arrange this for you

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e place a high priority on keeping W your stay in an acute hospital bed to a minimum

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nce your consultant led tea assesses O that you are medically fit for transfer, we will aim to transfer you from hospital on the same day

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I f there is a delay in your transfer, the hospital provides Discharge Suites where you will be looked after until you leave the hospital

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ou will be transferred from the Royal Y Liverpool and Broadgreen University Hospitals Trust when you are ready to leave hospital as there are more

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T he suites are a comfortable area where you can watch television, read papers and be provided with refreshments (Including breakfast and light lunch)

When you leave Hospital It is important to know that the majority of patients will be transferred home directly from hospital.

If you no longer require consultant led care and there is a delay in the start of your care package or preferred community based placement, you

cannot choose to remain in an acute hospital bed.

You will be transferred to a bed within a non hospital setting (within 48 hours) whilst this is arranged We will only transfer you when the appropriate placement has been identified and confirmed.

Useful contacts; Alzheimer Society

rooms, downloads, memory games, telephone support, and a dementia café for people with dementia, their carers and health / social care professionals.

Alzheimer's Society staff and volunteers provide both local information and over 2,000 services across England, Wales and Northern Ireland to people affected 18-24 Seel Street, by dementia in their communities.

Liverpool, Merseyside Our local services include day care and L1 4BE. 0151 702 5555 home care for people with dementia, Age UK as well as support and befriending services to help Age UK is the UK’s largest Age UK partners and families cope charity working with and aims to improve with the demands of for older people. later life for caring. From Alzheimer's everyone by providing Age UK aims to Café's and innovative improve later life 'singing for the brain' information and for everyone. We sessions to memoryadvice, life-enhancing want to make a book projects and group services and vital difference to the lives outings, our services support. of older people – here provide both practical and in more than 40 support and an essential point other countries – by providing of human contact. information and advice, life-enhancing Glaxo Neurological Centre services and vital support. We develop Norton Street, Liverpool, products that are specifically designed Merseyside L3 8LR. 0151 298 2444 for people in later life, and fund pioneering research into aspects of PSS getting older. Age UK will campaign.

Provide information on dementia 5 Bold Street L1 4DJ. 0151 7077020 including news, training, forums, chat

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The Friends and Family Test What is the Friends and Family Test?

The NHS wants to ensure that you have the best possible experience of care. The Friends and Family Test is a way of gathering your feedback about this experience and helping to drive improvement in hospital services.

When you receive care as an inpatient or in an Accident and Emergency (A&E) department, you will be given the opportunity to give your feedback by answering a simple question about your experience.

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The results will provide a way for you to easily compare NHS hospitals so that you know where you and your family can get the best possible care.

The information will also give the NHS invaluable information on what patients think of services, which can be used to help make improvements if required.

How will it work?

When you are discharged, or within the 48 hours that follow, you will be asked to answer the following question:

“How likely are you to recommend our ward/A&E department to friends and family if they needed similar care or treatment?”

You will be invited to respond to the question by choosing one of six options, ranging from ‘extremely likely’ to ‘extremely unlikely’.

It is really important to us that you tell us why you gave your answer, so please answer any follow-up questions.

Your answer will not be traced back to you, and your details will not be passed on to anyone, so please tell us exactly what you think. A member of your family or a friend is welcome to help you give your feedback to the question if you are unable to.

How will the results be used?

Your hospital will gather the results and analyse them rapidly to see if any action is required. It will publish the results and you will also be able to see results for other hospitals to see how they compare.

Where will the results be published?

The results will be published on the NHS Choices website (www.nhs.uk).

Hospitals may also publish their results in their annual reports and Your feedback quality accounts. is extremely

important and will help to continually improve our services.

Do you have to respond to the question?

Your feedback is extremely important and will help to continually improve our services however you do not have to respond to the question. You can opt out by informing the hospital staff before your discharge. This may take up to 72 hours to set up on the system so you may still receive a text.

You can respond to the text message ‘STOP’. This will normally ensure you are no longer contacted in this way but if you do experience any problems please contact our customer relations team who will ensure that this is addressed.

You can contact the team on

0151 706 2000 or by email at complaints@rlbuht.nhs.uk

Does this replace the existing compliments or complaints procedure, or other forms of feedback used by the hospital?

No, you can still pass your compliments or complaints to your hospital in the normal way. Hospitals can continue to use existing ways of gathering feedback, in addition to the Friends and Family Test.

Where can I get more information?

For more information on the Friends and Family Test, please visit www.nhs.uk/friendsandfamily.

For information about how the test will be carried out in your hospital, please contact its Patient and Public Involvement (PPI) team or customer relations team.

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Going home from hospital?

Age Concern Liverpool & Sefton are here to help When you’re ready to go home, if you are over 50 and a Liverpool or Sefton resident then we are here to help and support you.

Please note that services marked with a ▲ are free of charge.

Help with personal care and daily living tasks After a spell in hospital you may find that the every day living tasks you used

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to take for granted are now a bit more challenging. Our Homecare Service can help. It provides personal care and support with things such as getting up and going to bed, washing, dressing, grooming, cooking a meal, going to the toilet; in fact all of the things we tend to take for granted and need to do every day. The homecare service can also escort you, including, to follow up appointments if you are feeling a bit anxious about going out on your own. We can also provide a shopping service and collect your pension if needed.

Information & Advice ▲ Often after a spell in hospital it is more

difficult to cope with every day tasks. If you find that this is true, you may qualify for extra financial help. Our team of advisors are there to provide expert advice and information including welfare benefit calculations, and help to complete forms.

They also have the ability to answer an extremely wide range of queries; from where can I get a tip-up-kettle to how can I get my house adapted to suit me.

Whenever you want to find anything out from a trustworthy source – give us a call.

ongoing befriending if you would benefit from a regular visitor thereafter.

The Counselling Service ▲ provides person centred counselling to help you to deal with anxieties, depression and worries and to help you to cope with the stress of life.

Services specific to Liverpool

Essential Shopping Service Do you have difficulty travelling to the Products to make life easier shops or carrying heavy bags? Would When you come out of hospital we can you benefit from friendly, reliable and arrange products designed to make it trustworthy support every week easier for you to get around your to help with your essential home such as rollators. We shopping needs? If so, Many older are able to arrange stair then take advantage of people worry lifts, which will make our new service. all parts of your home about summoning accessible again.

Liverpool Information help in an & Advice Service ▲ in emergency, so we Many older people addition to telephone worry about summoning now can arrange advice, and office help in an emergency, a personal based advice, the staff so we now can arrange alarm. in Liverpool also undertake a personal alarm. If you are home visiting if you find it hard in trouble, are feeling unwell to get out and about. or have a fall, you just push the button on a pendant or simple wrist watch type device and help can be on its way in moments. These alarms are perfect to provide peace of mind both for you and your family; who will know that you can summon help whenever you need it 24/7.

Services specific to Sefton The Befriending and Reablement Service ▲ can support you to regain daily living skills and re-engage with your local community for up to 6 weeks after discharge from hospital and it can provide

Social Clubs When you are settled back at home, if you find that you are bored or lonely and want to get out, make friends and enjoy a wide range of activities then why not try one of our social clubs. We can arrange door to door transport for you and you’ll be sure of a warm welcome at your nearest club.

For further information about our Sefton Services call – 01704 542993 For further information about our Liverpool Services call – 0151 330 5678

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