Warning over home care amidst changes to community bed provision

Health bosses have been warned to ensure people who need intermediary beds are given them as the health body looking after mid Essex seeks to make changes to community bed provision.

Community hospital inpatient beds – of which there are around 115 across six towns – provide short ­term rehabilitation services to care for people who are either too unwell to stay at home or who are being discharged from hospital but require additional support.

Very often, these are frail older members of the community who have been admitted to a main acute hospitals or are people who have suffered a stroke and who, following a short stay in a main acute hospital, require specialist bed-­based rehabilitation.

Mid and South Essex Health and Care Partnership has been looking at the possible future number and location of community beds across its region to decide whether to make some of the urgent changes made during COVID permanent given an increased need for intermediary beds, frailty beds and stroke recovery.

It is considering whether two frailty care wards in Brentwood community hospital should be made permanent to support wider hospital pressures.

Additionally, it is likely to increase the number of community based stroke-recovery beds to meet future demand.

It was its home-based recovery service that instigated a major concern – especially given that as part of the response to COVID, it replaced the community beds In Halstead with an intensive home recovery service – with the teams who were previously based on the ward providing intensive support to people in their own homes.

It was on this that Health and Health Overview Policy and Scrutiny Committee member Councillor Mike Mackrory made a plea at its meeting on November 4,  using evidence of his own mother, to ensure home-based care should be used only when appropriate.

He said: “My mother was in intermediate care after discharge and she benefited enormously from that.

“So I see that the plan is that it’s care at home instead of that previous method of support.

“There was no way that that the individual I was speaking about could have possibly been looked after in the same way at home not least the fact of getting her walking.

“So i’m worried that people being treated at home are not getting the same sort of care that they had at the intermediate level.

“What happened was that when she eventually went home it wasn’t long before she had to go back into the hospital.”

Stephanie Dawe, group chief nurse and chief operating officer at Provide, which helps deliver community health care, said: “We are a delivering a recovery at home service and I have to say that the evidence so far suggests that the improvements people make are better than when they’re in a hospital bed but there is always the occasion where people do need to be in a bed.

“The discussion we are beginning to open with you does not predetermine where any of those beds will be.

“We know we need beds. It is absolutely important for the reasons you say but there are people who do better by going home.

“We are making sure we are balancing those needs accordingly.”

Piers Meyler

Local Democracy Reporter