LIVINGSTONE ASHFORD UNIT BECCLES & DISTRICT WAR MEMORIAL HOSPITAL

LIVINGSTONE ASHFORD UNITBECCLES & DISTRICT WAR MEMORIAL HOSPITAL

KAREN THOMSON TD RGN

SERVICE MANAGER

WAVENEY PRIMARY CARE TRUST

Livingstone Ashford UnitLivingstone Ashford UnitBeccles War Memorial Hospital

July 2002 Produced by Eileen Whiting Innovation & Best Practice

BECCLES

Beccles & District War Memorial Hospital

BUNGAY

HALESWORTH

Patrick Stead HospitalB1123

A12

A146

A144KESSINGLAND

WALBERSWICK

SOUTHWOLD

Southwold Hospital

LOWESTOFT

James Paget Hospital



In the three South Waveney Community Hospitals, during the financial year April 2000:

Majority of which result from insufficient,

suitable residential or nursing home vacancies

A monthly average of fourteen delayed

discharges



‘Step Down’ Beds for patients who:-

Identified as fit for discharge

No longer required specialist health care

input of medical staff, nurses or therapists

Awaiting discharge to a residential home or

their own home environment





Enable and facilitate the resident to maximise their

independence with day to day living skills and personal care

What did we hope to achieve?

A reduction in numbers of delayed discharges

Length of stay would be 7 - 28 days

Residents final choice of destination made by forward planning

in consultation with resident, family members and Community

Social Care Assessor



A proposal between Local Health Partnerships NHS Trust and Suffolk Social Services

Resources were established

How did we go about it?

Staff recruitment commenced Nov/Dec 2000 Ward prepared for admissions Nov 2000

Plans for closure of unit 31.03.01 Nov 2000

Joint Health / Social Services specification Nov 2000



Prior to the first admission staff had three days induction

involving Moving and Handling, Health & Safety, Health &

Hygiene

Service specifications communicated

to all Stakeholders Dec 2000

‘Step Down’ Facility Opens Jan 2001

Monitoring of service Jan - Mar 2001 Formal evaluation Feb - Mar 2001 Closure of facility 31st March 2001



Established Practices

What helped?

Team Working


July 2002Produced by Eileen Whiting Innovation & Best Practice

Funding initially for three months over the winter period

Staff had to be recruited and selected for this period only

Extension of service short term

Implications for forward planning and specifying clear, set,

timely objectives and goals for the unit

Permanent funding

What hindered?



Single sex occupancy, as it is a Nightingale style ward

What does the service offer? Social care, physical and mental stimulation in a homely

environment Reduction in number of delayed discharges in acute and

intermediate care beds Enhancement of joint working between James Paget

Hospital, Community Hospital and Social Services





Time for reflection

What does the service offer?

Social care with health care

Medical care provided through general medical services.

Admissions through the Co-ordinator working in

partnership Removal from an ill health environment to a relaxed

homely environment



Colourful murals throughout bathroom / toilet areas.

Self determination & choice regarding day to day living

A safe, non-rigid environment where resident is

empowered to participate in their days structure

A model which is furnished and decorated towards a

residential setting





Key worker visits resident at home one month after discharge

A personal Key worker to monitor, review and consult

on ongoing care needs and development.

The opportunity to change pre made decisions

Families and carers encouraged to work alongside staff

Identification of adaptations and equipment that enables

maintaining independence with day to day living skills

The opportunity for planned trial periods within their

home environment, prior to discharge


July 2002Produced by Eileen Whiting Innovation & Best Practice

Proven evidence that staff who are encouraged and supported

develop rapidly as individuals and groups when empowered

Benefits to the organisation:

Releases beds hospitals for those who have nursing needs

Cost effective

User led service

A social model that sits well within a health setting

Promotes / maintains joint working and multi-disciplinary teams



Formal evaluation completed 22nd - 31st

March 2002 - positive outcomes which

resulted in recurring of funds

What methods are used to evaluate?



Questionnaires devised for both resident and immediate carer or family member

Question % Yes

% No % Unsure

Were you consulted on your discharge from hospital to the LAU? 70

30

-

Were you clear about the reason for your discharge from hospital to the LAU?

90

10

-

Were there any difficulties encountered in your discharge from hospital to the LAU?

-

100

-

Did you feel welcome and comfortable on arrival in the LAU? 90

-

10

Was the food service, choice and quality of food good? 78

2

20

Were you actively encouraged to participate in activities whilst a resident in the LAU

98

-

2

Were you consulted about the activities?

100

-

-

Did you feel like a (hospital) patient whilst in the LAU? -

90

10

Were you fully prepared for discharge from the LAU? 100

-

-

Were you consulted and informed on any decision about your stay or discharge plans?

100

-

-

Would you be prepared to become part of a residents group? (Focus Group)

22

48

40



Future Plans

To train and develop staff skills in rehabilitation and

re-ablement

NVQ qualifications in Health & Social Care

Maintain current high standards, strengthen joint working

and multi-disciplinary team approach to the Unit



What lessons are there for others? Forward Planning with adequate time scales

Situation of the Unit

Transition from Health Environment



Documents

LIVINGSTONE ASHFORD UNIT BECCLES & DISTRICT WAR MEMORIAL HOSPITAL