Provision of a Supported Hospital Discharge Service

The first strand Service is a short term rehabilitation, reablement and assessment service for Service Users at risk of requiring long term residential/nursing care or to prevent hospitalisation. The second strand is to promptly facilitate the discharge from hospital of in-patients or those presenting for emergency care who have been assessed as clinically fit for discharge but who may, following a further home based assessment, be found to have a need for reablement or rehabilitation and a requirement for short term or longer term support in order to remain at home. In both cases the Provider will work closely with the Service User, family carers, Occupational Therapists, Physiotherapists, other health professionals and known community networks to facilitate a support plan that allows Service Users to remain within their homes.