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Checking out - and Checking in

27 October 2017

Vic Rayner
Executive Director
National Care Forum

Headline news this week picked up an initiative in Essex which adapts the popular Air BnB model – where people essentially utilise part of their accommodation – to offer an alternative to remaining in hospital. The suggestion that hospitals might transfer people into the spare room of a local resident to meet the short term care needs of individuals has been floated via a trial offering of a service dubbed by the media as  Care BnB’. The trial was offered by a company called Care Rooms.

In the wake of negative backlash there is a suggestion that the rise of Care BnB as a viable alternative in Essex may have been shortlived. I think that what it represents – a critical need to look and think differently about how discharge is managed, will not and indeed – should not – go away.

From within the care sector there have rightly been vociferous objections to this approach, with a particular emphasis on how the care in those settings would be regulated. Although as ever with these stories – the devil will be in the detail – and there is a clear talk of partnership with regulated partners. Of course, these and other challenges raise serious questions for those who are trying to look for an imaginative solution to a major and escalating problem. However, we know that there are more ‘innovative’ solutions out there, but clearly the wholescale adoption of them has floundered and needs a fresh look; potentially a fresh feel.

Getting people out of acute settings into a ‘step down’ setting is not new  and there are some excellent examples of this around the country. For example, the work that is going on through Somerset Care and their partnership with Yeovil District Hospital. For a great opportunity to see this in action you can watch here.

Outside of residential care provision, there have been some innovative models developed to look at how sheltered housing can be used to support people who are ready to leave hospital, but unable yet to manage within their own homes. For example, work in this sphere has been carried out by Hanover Housing. Or indeed the development of onsite wards managed by housing providers, such as the Cedarwood ward, developed by Midland Heart and located within the Heart of England Trust.

Indeed, the whole idea of supporting people within a home outside of the family is very much in operation through the notion of Shared Lives Plus schemes. There is a growing emphasis on supporting older people as well as the more traditional application of the model to support people with learning disabilities.

And let’s look outside of the UK for other alternatives. I recently visited a number of Care Hotels in the Netherlands, where there is a clear focus on rapid discharge to Care Hotel settings, enabling people to embark on a rapid rehabilitation pathway to get people home. We are bringing highlights of these models to the care sector at the end of November in an open session on how it could operate in the UK – so please do contact me if you would like more details.

So whilst the notion of Care BnB as a solution to addressing hospital discharge may not be broadly welcomed, I do welcome the focus on the need for a fresh new model. I was taken by one of the responses on twitter which very loudly advocated – ‘invest the money in social care’ – and I wholeheartedly agree, but into what in social care is part of the question. We have a growing older population, a housing strategy that does little to prioritise older peoples provision, limited numbers of accessible properties and an ongoing shift towards a predominance of renting over home ownership. All of this means that however much we tighten up our integrated health, housing and social care connections, the number who need somewhere to ‘check in’ after they have checked out of hospital is only going to grow. Whilst Care BnB is unlikely to be the answer, a scalable resolution which has social care providers in partnership should not be far from grasp.

Follow Vic on Twitter @vicrayner
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