Your Wellbeing

Short-term support

Sometimes we need a little extra help and care. This can be because of falling or tripping, going into hospital or because of a general decrease in our mobility and wellbeing. When this happens, there are some short-term solutions which can help you to regain as much independence as possible.

Leaving hospital

Patients, their families and Carers may be offered various services to help make discharge from hospital quicker and safer. Patients and/or their Carers may request a referral to the Hospital Social Work team for a Care Act Assessment to be completed. Staff on the ward can arrange a referral for you to the Integrated Transfer of Care Hub. This is a multidisciplinary group of professionals working together to support conversations with you and your relatives to understand your care and support needs. If someone has an existing social worker that knows them well then where possible they would remain involved to support the hospital discharge journey. Some of the services that may be provided are listed below.

Reablement

The reablement service is up to six weeks free care where the Reablement Team will work intensively with you to regain the skills and achieve the goals that have been jointly agreed with you. The level of support provided will be adjusted as your independence and confidence increases and circumstances change.

What we do

• increase independence and enable you to stay in your own home
• increase participation in the local community
• improve quality of life
• assist you to manage health conditions and promote healthy lifestyle
• work closely with you and where appropriate carers and family members
• provide a professional service with respect and dignity at the core

Our commitments

• provide individual assessment based on achievable goals.
• trained staff to support individual needs.
• support between the hours of 7am – 2pm & 4pm-10pm
• Occupational Therapist Advice

Telephone: 0300 123 7742

If you have sensory loss, contact the Deafness Support Network

• Telephone: 0333 220 5050

Rapid Response Service

The Rapid Response Team is based at the Countess of Chester Hospital and is a team of Community Support Workers, Nurses, Physiotherapists and Occupational Therapists. The service aims to facilitate prompt and early supported discharges from hospital to reduce the length of your stay and to prevent unnecessary hospital admissions from the accident and emergency department.

These aims are met through specialist nursing and therapy assessments. If necessary, a team can provide care and rehabilitation within your home for up to a maximum of six weeks.

Your individual needs will be continually assessed in your home and the level of support will be adjusted as your independence and confidence increases. If it is identified that ongoing care is required, a referral to Adult Social Care will be completed.

For more information, contact the Rapid Response Team

• Telephone: 01244 365240

Community Response Hubs 

Community Response Hubs are local multi agency teams of integrated health and social care professionals working in the community post discharge.

How do the hubs work?

The multi-disciplinary hubs are made up of social workers, nurses, therapists and rehabilitation and reablement workers that make sure that any support you require on discharge, is coordinated to give you the right amount support at the right time by the right services. Where-ever possible this will be arranged to support once you are home but where required, this can be in short stay placement. The hubs promote and facilitate short term rehabilitation and reablement to maximise your independence. If longer term support is required, you will be offered an assessment under the Care Act 2014 to determine your needs and your longer-term support plan to meet your identified outcomes.

Short term rehabilitation and reablement services are free for a maximum of six weeks whilst you work towards maximum independence. Where you require ongoing support and would like an assessment under the Care Act, your abilities during this period of rehabilitation and reablement can help inform this assessment and a determination of whether you are eligible for care and support to be arranged by the local authority. Find out more about the Care Act on our Key Legislation page. If you are eligible for support with funded services, you will have a financial assessment which will determine how much of your ongoing care package you will contribute towards. Find out more about how social care funding works on our Charges for Care and Support page.

Snow Angels – Hospital Discharge Support

Wherever possible, Snow Angels will visit the patient whilst they are still in hospital (Countess of Chester and Ellesmere Port) to arrange for appropriate support on returning home. Support can also be offered up to six weeks post-discharge.

Home visits and / or telephone calls will be conducted within two working days, providing the individual with reassurance and practical support. Support can include shopping, prescription collections, dog walking and lending an ear as we understand that returning home from a hospital stay can be difficult. To benefit from this service patients must be over 65 years old and live in the Cheshire West and Chester district. The service is open to new and existing Snow Angels users.

To make a referral:

• Online: Snow Angels
• Phone: 0300 666 0003

Monday to Friday 9am to 5pm (last referral at 3pm)