Home First Dorset brings together Dorset’s hospitals and the community health and social care teams to help people out of hospital more quickly to recover in their own home, or in another care setting such as a local care home or community hospital. NHS guidelines specify that family members and carers should be involved in assessing and planning any care or support that is needed after discharge from hospital.
NHS Dorset is currently redesigning the Home First service. They want it to work better for the people who deliver it and for those who are supported by it, including families and carers, patients, and staff.
Earlier in the year, Healthwatch Dorset volunteers carried out 45 in-depth feedback interviews with unpaid carers who had recently supported a loved one through the Home First process. They identified common issues and areas for improvement which they have shared with Dorset’s health and care leaders.
- Half of the carers who shared their views (22) rated the overall service they received in hospital as ‘poor’, largely due to poor communications, lack of information, poor treatment of the patient, and dissatisfaction with the process, including time taken and lack of attention and support.
“No notice given that my mother-in-law was being discharged.”
“Given two hours to collect my dad with no discussion or offers of help. He was sent home with just meds, no support, and no one asked how my dad would be looked after. I had to take emergency time off work.”
“Looking after Dad after discharge (from hospital) with pneumonia, I felt alone and vulnerable as a carer.”
- Ten people rated the service as ‘very good’, seven said it was ‘OK’ and six said it was ‘adequate’. The positive feedback received was focused on the kindness, professionalism and support of the medical staff and the clinical care.
“Staff were fantastic, but the organisation was lacking.”
“Extra support was already put in place for when my mother was discharged.”
- Thirty seven of the 45 people interviewed offered suggestions for improvement to the Home First service. The most common themes raised were:
– More support for carers
– Better information and communication
– An improved process of leaving hospital
– Better training for staff
– Person centred care.
Louise Bate, Healthwatch Dorset Manager said: “The NHS is required to assess and discharge patients from hospital as soon as they are ready to leave, and there is evidence that people recover more quickly in a home setting. Unpaid carers have been telling us for some time about the challenges they face while supporting loved ones through this process. Our report highlights the issues they have raised, and we will now work with the Home First project team to explore ways to improve the service in Dorset.”
The project was funded by NHS England as part of its Commitment to Carers Programme which aims to build a better understanding of carers experience of hospital discharge. Healthwatch Dorset worked in partnership with Dorset HealthCare, the Home First team, and Dorset Community Action.
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