Sheffield E&V Beech Hill Unit

The aim of the visit was to explore the quality of intermediate care in the community provided by Sheffield Teaching Hospitals Foundation NHS Trust. Healthwatch Sheffield wanted to identify examples of best practice that could be shared with other intermediate care providers in the city, and highlight any areas for improvement needed. Healthwatch Sheffield especially wanted to find out whether the care provided met people’s needs and find out what patients and their families thought about the service provided.

This was an announced Enter and View visit. Management gave Healthwatch Sheffield a tour of the building, introducing us to clinical and non-clinical staff along the way. Healthwatch Sheffield met domestic staff, administration staff and members of the multi-disciplinary team. Healthwatch Sheffield spoke with members of management and members of staff working in various roles at the unit. Healthwatch Sheffield did not get the opportunity to speak to patients staying at Beech Hill during our first visit, as there was no opportunity to do so without disturbing patients or interrupting them during their lunch. Healthwatch Sheffield therefore returned on a separate occasion during visiting hours to speak with patients and their visitors. Healthwatch Sheffield spoke with seven patients and one relative at this time.

Beech Hill is an NHS community rehabilitation unit based in the Norfolk Park area of Sheffield, providing intermediate care for patients following a stay in hospital. It is an NHS unit with 31 beds, located in a Grade ll listed building which has been renovated to make it fit for purpose. The property is currently rented from the Shrewsbury Trust. Patients often stay on the orthopaedic ward because they have had surgery following a fall and most commonly are admitted with fractures to the neck of femur (the hip joint) and may have had a hip replacement. They also tend to have long term health conditions such as diabetes or heart failure and may have a cognitive impairment or be affected by post-operative delirium.

Patients that are admitted into intermediate care usually have complex co-morbidities that require a team of specialist staff intervention in order to plan rehabilitation/intervention. There are two wards, the Shrewsbury Ward on the first floor cares for patients experiencing orthopaedic problems and the Norfolk Ward on the ground floor is for patients who are recovering from a stroke. A multi-disciplinary team (MDT) works with patients to develop a rehabilitative care plan which involves setting and achieving realistic goals for improvement during their stay. Many patients stay at Beech Hill for around 4-6 weeks. If they deteriorate medically during their stay they may go back to hospital.

Goal planning is done with all patients so that they can manage the activities of daily living that are needed for their return home. These goals are reviewed weekly, and once a patients potential in this has been realised, discussions take place with regards to returning home. The whole team, including the patient is involved in discharge planning. Patients may also have a home visit from an Occupational Therapist to determine what services and/or equipment will be required to enable a safe discharge home. Patients sometimes go on to have long term 24 hour care following a stay at the unit. The Transfer of Care Placement Team, are hospital based but they meet with patients and their families to help them look for a care home that suits the patient’s needs. Before patients leave they have a care assessment to establish whether their needs can be met in a residential or a nursing home.