Occupational Therapy News OTnews February 2019_Joomag | Page 30

FEATURE INTERMEDIATE CARE
Promoting independence while
relieving pressure on services
I
Mark Coates and Pippa Dodsworth reflect of
the development of intermediate care beds, based
on partnership working between the local council,
health services and a privately-run care home
ntermediate care
is not a new
idea. Promoting
independence and
shifting care away from
discharge is a success, especially as older people
are particularly vulnerable at transition points in
care, so services need to work together and share
responsibility for meeting older people’s needs through
access to appropriate care, in the right place, and at
hospitals and residential
homes has been a policy
objective for over 30
years. It was developed
as part of the NHS Plan
in 2000 and was one of
the national standards in
the 2001 National Service
Framework for Older People.
As a result, the
government has stated its
belief that intermediate care
is an important approach
that will help to promote
independence for older
people and at the
same time relieve
pressures on
health and social care services.
The development of intermediate care has
generally been intended to promote safe and early
transitions out of acute hospitals (early discharge
to avoid unnecessarily prolonged inpatient care),
prevent inappropriate admissions to these facilities
and foster independence in community settings
(delay institutionalisation in long-term residential
care).
Hospital discharges are a challenging process
for health and social care professionals, individuals, the right time.
While intermediate care aims to keep people at
home, there are times when a person’s level of need
means they require intermediate care in a setting other
than home, for example a bed-based intermediate
care centre.
People are referred to bed-based intermediate care
either as a ‘step up’ from home for assessment and
rehabilitation – as an alternative to hospital admission
– or as a ‘step down’ from the acute hospital for a
period of assessment and/or rehabilitation before they
return home.
There is a need to share good practice and the
contributing factors that underlie effective and person-
centred intermediate care delivery in bed-based
settings.
While some people might read this article and
think, ‘so what, we have one of those’, it is worthwhile
reflecting on the journey we have been on, from just
12 beds (the pilot in one care home) to our current
state of 23 beds (the consolidation in two care
homes), to the planned future of a 40-bed intermediate
care centre (the final model) that will be operational in
September 2019.
The purpose of these intermediate care beds
in these care homes is to provide a structured
programme of therapy-led supportive and enabling
care to individuals in a care home setting.
This will assist and enable the person to achieve
family members and carers, with at least 80 per cent
of patients discharged from hospital returning home
without any complications or ongoing care needs.
However, some individuals will require input from
a number of different healthcare professionals, such
as social workers and therapists, to ensure that their and maintain an optimum level of health and
independence at home or in another community
setting, and enable a full assessment of the person’s
needs and future care requirements to be carried out
in a non-acute environment, where the focus is on
promoting independence and a return home.
30 OTnews February 2019