The Home First Report: an evaluation of the Home First Service in East Kent

This report by Healthwatch Kent, captures feedback from both patients families and and staff of the Home First service, which provides home care to support individuals discharged from hospital in regaining independence. The project aimed tounderstand the effectiveness of the service and identify areas for improvement. 

It involved interviews and surveys with 14 people, 6 who were Home First patients and 8 who were a family member/supporter of a Home First patient. 21 staff members also completed the survey with the surveys covering aspects of patient preparedness, care planning, involvement in discharge processes, and the support received at home. 

 By listening to the perspectives of both people experiencing the service and the Home First team, this report aims to provide valuable insights that can inform the ongoing development and refinement of the Home first service in East Kent and more widely across Kent and Medway. 

Key Findings

Most people (86%) felt prepared to leave hospital with care plans in place, but 40% said they were not fully involved in discharge planning. Improving patient involvement could strengthen communication and understanding, although this responsibility mainly sits with the hospital discharge team rather than Home First.

People valued the support from the Home First team, with 86% feeling the service helped maximise their abilities. Having a single point of contact was important, though 14% felt their concerns were not fully addressed.

Challenges were identified around communication in care planning (21% of people), short notice of discharge (21%), and limited practical support at home (14%). A significant number of people (64%) felt poorly connected to ongoing support services after leaving Home First, which may affect their long-term independence.

Staff felt that teamwork and problem-solving within Home First were strong, with 90% rating collaboration as excellent. However, 20% of staff reported not receiving an induction, and 60% expressed a desire for further training, particularly in administration, handovers, and leadership skills.

Recommendations

1. Ensure all new staff understand and are aware of the induction process, especially those recruited internally, to avoid perceptions of an informal start.

2. Consult with staff to identify desired training opportunities and support them to develop their skills further, helping more staff feel they can contribute fully to the team.

3. Improve signposting for patients leaving the service, ensuring they are connected to appropriate support services, with consideration of a follow-up check after discharge.

4. As the Home First service grows, ensure that the quality of care and patient empowerment continues to meet current high standards.