A scheme to smooth the path from hospital to care home for south west Londoners who may display challenging or distressing behaviour has been awarded £286,000 to develop the pilot.
Behaviours that are challenging or distressing are often seen in people with health problems that affect communication and the brain such as dementia or learning difficulties. People may need specialist support to help them have a good quality of life and reduce any risk their behaviour causes them, and those caring for them.
Sometimes that makes it difficult to find the right specialist residential care for them to move to from hospital and as a result can stay in hospital longer than necessary, which is not good for their wellbeing and also reduces the number of hospital beds available for other unwell patients.
A grant of £286,000 from the local NHS has enabled the trial to be set up by the South West London Integrated Care System – led by the enhanced care in care homes team that worked hard to launch it quickly and overseen by Associate Director of Transformation Viccie Nelson.
During the pilot, patients across Croydon, Kingston, Merton, Richmond, Sutton and Wandsworth receive an assessment of their behaviour and needs. This review aims to understand the factors that contribute to the individual’s behaviour and identify their specific needs.
That understanding is used to develop personalised support that helps to minimise their behavioural issues in the care home, improves their quality of life and reduces any risk their behaviour causes them while also reducing the chances of the placement failing.
In addition, care homes receive tailored training and support to help them care confidently for residents with complex behaviour.
Dave Williams, Clinical Programme Lead for the Intensive Support Service, said: “I will go out as a behavioural analyst, review the individual’s case history and look at the behaviour they’re presenting in hospital.
“I will then understand whether it is just because of the environment – people can be unsettled, unwell or frustrated and that’s what’s coming out in their behaviour – or whether this is a long-standing issue and how that can be managed.
“For example, an individual had periodic stays at St George’s Hospital and had got to the point where the previous placement had broken down. We managed to find a new place and he’s moved there officially now – he’d been in hospital since the beginning of December.”
Mr Williams (pictured with his team from left Kim Ellis, project manager, Jill Tabuteau, project support officer, and Bernadette Hewitson, community support worker) points out that sometimes people swear, such as in this case but it is not meant to be directed towards care home staff.
“Obviously that’s not ideal but getting people to realise that and look at it in a different way and a different context has been really important and enabled his move out of hospital,” Mr Williams said.
“Training is around changing people’s perspectives on behaviour and seeing the person rather than the behavioural challenge, because once a service has got to know that individual they’re able to manage them a lot better.”
To help ensure care home moves remain successful – there have been 12 placements in around a month – intensive support is offered for up to four weeks following discharge from hospital.
Mr Williams said: “A support worker will go in once a week, check with the staff to see whether everything is okay and provide any help that’s needed such as assistance with any support plans, any documentation we’ve provided – check it’s still relevant moving forward – have there been any issues, have there been any concerns?”
If there are concerns or issues, they are fed back to the team, which also works closely with borough-based behavioural support teams, for action.
The pilot is due to run until the end of March 2023.
