Experiences of discharge to assess pathways in Coventry

We looked at the care of those after hospital discharge provided under three programmes (pathways) of care and support aimed at either enabling individuals to regain their ability to live independently or to have their ongoing care needs assessed once they are discharged from hospital.

We did this work due to  concerns related to the home support element of the Discharge to Assess identified through our  2017-18 work gathering user feedback on home support/care

This report presents the experiences of 47 people. The people we spoke to were some of the frailest and most vulnerable, who sometimes do not have their voice heard. We also spoke to service managers and workers.

We looked at discharge to a person's home and the home care/support put in place; discharge to a bedded facility either in a care home bed or in a housing with care flat and discharge to a nursing home bed for assessment. We made visits to care homes and interviewed people in their homes.

We identified cross cutting themes and areas for development. Found good practice in multi agency working at a worker level. We made 14 recommendation.

A comprehensive action plan co-ordinated by Coventry City Council is included as response. In addition we have followed up by convening an information task group across agencies to improve information provision to patients.