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The need

We know that older people returning home from hospital without enough support are more than twice as likely to be readmitted within three months. But this can be avoided. With the right support, improvements in cognition and physical function can be achieved. Our Home from Hospital service targets and prioritises at-risk people who are 75 years of age or over, living alone, with a carer or co-caring, with limited or no social support or social care.

What we do

Our service helps Trusts meet NICE guidelines on safe patient discharge from hospital, providing practical and social support for people returning home from hospital after illness, surgery or accident. Friendly, encouraging support from a volunteer at this time can make all the difference to restoring essential self-confidence, leading to improved health and wellbeing and reducing readmissions.

The service includes:

  • Welcome home packs including all key contact information in one place. It's reassuring to know it's there, and makes it easier for them to call their GP, Royal Voluntary Service or other support if needed. We also include a food hamper, with recipe cards and information on nutrition and hydration.
  • Safe and Well checks to assess any risks in the home like cold, damp or danger of falls.
  • Active signposting, where we liaise with local partner organisations to help get adaptations made, benefits sorted and so on.
  • Individual resilience packages where we will make a plan together and agree on a goal, such as 'walk around the block' for example. Then support could include assisted shopping, help getting back to visiting social clubs or friends, group or one-to-one Move it or Lose it! exercise sessions, and encouragement on good nutrition and hydration.

How it makes a difference

Those benefitting from the Home from Hospital service feel more confident, with improved levels of social contact and better health. They feel generally happier. In terms of cost benefit, 30 day readmission rates have been reduced in pilots. Only 9% of the vulnerable group aged 85 or over were readmitted, compared to the national average of 15% for over 75s.

Working with Leicester City Care Commissioning Group

Many residents within Leicestershire are over 65 years of age, living alone, with limited or no social support locally, rendering them vulnerable and in a greater need of health and social care. Increasing hospital strain and social isolation are issues that particularly impact the county, and have been recognised by Leicester City Clinical Commissioning Group.

Talk to us

We're always happy to share our experiences and discuss new ways we could work together in partnership in the NHS and in the community.