CH340. Transfer to, Stay in and Discharge from Hospital in Care Homes
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Transfer to, Stay in and Discharge from Hospital in Care Homes (England) Policy
Policy Statement
This policy shows the procedures followed when people who live in care homes are admitted to hospital and the arrangements made during their stay and on discharge. It is written in line with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 particularly the following.
- Regulation 9: Person-centred care, requires service providers to ensure that the care and treatment of people who use services must be appropriate, must meet their needs, and must reflect their preferences.
- Regulation 12: Safe Care and Treatment, includes a requirement for service providers to ensure that care and treatment is provided in a safe way for people, including where responsibility for the care and treatment of people who use services is shared with, or transferred to, other persons, working with such other persons, people who use services and other appropriate persons to ensure that timely care planning takes place to ensure the health, safety and welfare of the individual.
When people come to live in {{org_field_name}} they are registered with a medical practice that they can contact or can be contacted on their behalf to make sure that their healthcare needs are fully met. If a person living in the home requires medical attention the home will refer him or her to the GP or out-of-hours service contracted by the practice for advice and treatment.
The home always aims to keep emergency admissions to hospital to the minimum and works closely with the GP services to provide the necessary medical treatment and care in the home wherever possible. This helps to reduce the anxiety and distress that hospital admission inevitably creates. The home also makes every effort to prevent the need for hospital admission through the risk assessment and management strategies that form part of individuals’ care plans and through its staff development and training programmes.
Decisions to seek admission to hospital will nearly always be made by the GP as a result of a referral to that service. In some cases, where it is vital to seek medical attention urgently it might be necessary to take the person directly to the local accident and emergency department with information flowing back to the GP as a result of the normal procedures and protocols, which are then followed.
In all cases of transfer to hospital on a planned or emergency basis, the home seeks to maintain the dignity of the person and to make sure that the person is treated with dignity on transfer to hospital, also on discharge from hospital.
Procedures for Transfer to Hospital
The procedures to be followed depend on the circumstances under which transfer is required: planned or emergency.
Planned transfers
Planned transfers to hospital are made to address needs for medical procedures and treatment on an in-patient basis. They will follow the processes that apply to anyone receiving health service treatment. The home will work closely with GP and hospital services to make sure that the person receives their treatment efficiently and effectively by making sure that all required information concerning the person’s care needs and medication is passed to the relevant people and that all consent issues have been addressed, including where the person might lack the mental capacity to give their informed consent to the proposed treatment.
Before a person’s admission to hospital the staff of the home will prepare and support the person for their transfer by discussion and counselling where needed. It will work closely with relatives and others involved in order to resolve any concerns, including any relating to the person’s terms and conditions of residence and discharge arrangements.
On the day of transfer the home will make sure that there is someone to go with the person to the hospital to make sure that the admission is achieved smoothly and according to plan and to provide general support. The home will have discussed with the person and others involved and decided who will accompany them, which could be a relative or staff member. The home makes sure that no person is ever transferred to hospital unaccompanied. It will also make sure that the appropriate means of transport are obtained and provided.
Once the person has been admitted to hospital the home will continue to link up with the hospital and with relatives to make sure that the person’s stay in hospital is to an acceptable quality and standard. This might involve, amongst other matters, making sure that the person’s hydration and nutritional needs are being fully met and that they are being treated with dignity and respect at all times.
The home will arrange for the return of the person from hospital in line with the medical decisions taken and the home’s terms and conditions of residence, which might affect room retention and payments. The home makes sure before a person returns to the home following a stay in hospital that it can continue to meet their needs and any special requirements resulting from the person’s hospital treatment.
The great majority of people will return to {{org_field_name}} as they would to their own homes with agreed plans made for their after-care, which the home will proceed to implement.
Unplanned and emergency admissions
Where a person has to be transferred to hospital in an emergency, the home will proceed to follow the principles and procedures that apply to planned transfers, ie:
- making sure that the person’s dignity is retained throughout the process by, for example, wearing appropriate clothing and keeping them informed of the events that are taking place
- making sure that the person’s consent has been obtained or where they are unable to give their consent that the transfer is taking place in their best interests
- working closely and co-operatively with medical and paramedical staff so that they have the information they need, eg about the person’s condition, medication and any advance decisions regarding resuscitation, etc
- making sure that the person is accompanied by a suitable person or people who can act as their representative and provide support
- making sure that any health and safety issues are properly addressed according to the specific circumstances (infections illnesses will be treated differently in these respects than, say, accidents or falls)
- informing those who need to know about the transfer as soon as possible (including the CQC under its notifications procedures if required)
- arrangements are made for return to the home and following up the situation.
In Hospital
- The home continues to support all of the people who use its services while in hospital by staff visiting, keeping contact with relatives and friends and checking on their progress with hospital staff.
- How it does this will depend on individual needs and circumstances.
- Relevant information will be recorded to help with the care planning and continuity of care and treatment required on their discharge from hospital.
Procedures for Discharge from Hospital
- When people return from hospital the home makes sure that they are transported safely and in a dignified way with appropriate escorts and assistance provided, according to individual circumstances.
- The home will make sure that the person is welcomed back and will have the individual’s accommodation properly prepared to enable the person settle back quickly and without experiencing undue stress.
- The home will make sure that it receives all of the information from the hospital regarding the person’s healthcare needs to enable it to continue the person’s care, treatment, convalescence and rehabilitation.
- It will review the person’s medication with the hospital staff and GP to make sure that it can comply with any changes to their medication regime and new medications prescribed.
- It will review the person’s care plan, particularly in respect of their healthcare to make sure that any changes in their care needs are fully addressed.
Training
All staff receive training on the home’s policies and procedures on responding to emergencies that might result in hospital admission and on planned admissions as part of their induction training.
All staff involved in supporting and accompanying someone to and from hospital and following discharge are trained to carry out their tasks and responsibilities in line with the policy and procedures.
Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next review date: this policy is reviewed annually (every 12 months). When needed, this policy is also updated in response to changes in legislation, regulation, best practices, or organisational changes.
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