Live in care following hospital discharge
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East Kent Health and Care Partnership commissioned Healthwatch Kent to gather and analyse insights from five patients and their carers (relatives or friends) about their experiences of live-in care. Healthwatch Kent also spoke with the Multi-Disciplinary Team (MDT) Leads responsible for working with each patient and overseeing their live-in care planning and discharge from hospital alongside Carer Support Coordinators from Carers’ Support East Kent.
Through semi-structured interviews, developed into five case studies, this study explores how the live-in care model affected patient outcomes, discharge experiences and carers (relatives or friends) involvements. With these experiences coming from the first few people to go through the pathway, some of the issues being shared were picked up as part of the refinement and development of the pilot.
Positive impact on patient recovery: Across all five cases, live-in care was instrumental in enabling safe, more supported hospital discharges. Patients reported regaining confidence, some reported regaining independence, with carers (relatives or friends) describing the arrangement as reassuring and effective.
Inconsistent communication: A significant concern across the cases was inconsistent or poor communication between hospitals, carers (relatives or friends) and care providers. Some carers (relatives or friends) were unaware of care arrangements until the last minute or learned of them informally, contributing to confusion and distress. Feedback in this area concerned the overall journey of patients and not just what was in the Live in Care pathway scope.
Variable carer (relatives or friends) involvement: The involvement of carers (relatives or friends) in discharge planning varied widely. While some were deeply engaged, others were marginalised or uninformed altogether. This variability influenced overall satisfaction with the discharge process from patients and their carers (relatives or friends). Again, reflections in this area were often wider than just the Live in Care pathway.
Challenges with live-in care worker matching: Though many patients developed positive relationships with their care workers, mismatches in expectations, training levels and communication skills sometimes hindered the experience. The opportunity for the patient to meet with their live-in care worker prior to discharge was found to be severely lacking.
Support for live-in care: Despite the challenges, all participants recommended the live-in care programme for other patients. The programme’s perceived value lay in offering the opportunity for patients to return to their home with a humane, patient-centred approach to care.
Conclusion
The live-in care programme demonstrates strong potential to support a smoother, safer and more dignified return home for patients following hospital discharge. However, its long-term success hinges upon improvements to communication, patient and carer (relatives or friends) involvement, pre-discharge introductions between patients and livein care workers and addressing the gaps in information-sharing between hospital teams, patients, carers (relatives or friends) and care providers. With refinement, the live-in care programme could improve outcomes and satisfaction for patients during their critical transition from hospital to home.