LIVINGSTONE ASHFORD UNIT BECCLES & DISTRICT WAR MEMORIAL HOSPITAL

1. LIVINGSTONE ASHFORD UNITBECCLES & DISTRICT WAR MEMORIAL HOSPITAL KAREN THOMSON TD RGN SERVICE MANAGER WAVENEY PRIMARY CARE TRUST

2. Livingstone Ashford Unit Beccles War Memorial Hospital LOWESTOFT James Paget Hospital A146 BECCLES Beccles & District War Memorial Hospital BUNGAY A144 KESSINGLAND A12 HALESWORTH Patrick Stead Hospital SOUTHWOLD Southwold Hospital B1123 WALBERSWICK July 2002 Produced by Eileen Whiting Innovation & Best Practice

3. Livingstone Ashford Unit Beccles War Memorial Hospital In the three South Waveney Community Hospitals, during the financial year April 2000: • A monthly average of fourteen delayed discharges • Majority of which result from insufficient, • suitable residential or nursing home vacancies July 2002 Produced by Eileen Whiting Innovation & Best Practice

4. Livingstone Ashford Unit Beccles War Memorial Hospital ‘Step Down’ Beds for patients who:- • Identified as fit for discharge • No longer required specialist health care • input of medical staff, nurses or therapists • Awaiting discharge to a residential home or • their own home environment July 2002 Produced by Eileen Whiting Innovation & Best Practice

5. Livingstone Ashford Unit Beccles War Memorial Hospital July 2002 Produced by Eileen Whiting Innovation & Best Practice

6. Livingstone Ashford Unit Beccles War Memorial Hospital What did we hope to achieve? • A reduction in numbers of delayed discharges • Length of stay would be 7 - 28 days • Residents final choice of destination made by forward planning • in consultationwith resident, family members and Community • Social Care Assessor • Enable and facilitate the resident to maximise their • independence with day to day living skills and personal care July 2002 Produced by Eileen Whiting Innovation & Best Practice

7. Livingstone Ashford Unit Beccles War Memorial Hospital How did we go about it? A proposal between Local Health Partnerships NHS Trust and Suffolk Social Services Resources were established • Staff recruitment commenced Nov/Dec 2000 • Ward prepared for admissions Nov 2000 • Plans for closure of unit 31.03.01 Nov 2000 • Joint Health / Social Services specification Nov 2000 July 2002 Produced by Eileen Whiting Innovation & Best Practice

8. Livingstone Ashford Unit Beccles War Memorial Hospital • Service specifications communicated to all Stakeholders Dec 2000 • ‘Step Down’ Facility Opens Jan 2001 • Monitoring of service Jan - Mar 2001 • Formal evaluation Feb - Mar 2001 • Closure of facility 31st March 2001 • Prior to the first admission staff had three days induction • involving Moving and Handling, Health & Safety, Health & • Hygiene July 2002 Produced by Eileen Whiting Innovation & Best Practice

9. Livingstone Ashford Unit Beccles War Memorial Hospital What helped? • Team Working • Established Practices July 2002 Produced by Eileen Whiting Innovation & Best Practice

10. Livingstone Ashford Unit Beccles War Memorial Hospital What hindered? • Funding initially for three months over the winter period • Staff had to be recruited and selected for this period only • Extension of service short term • Implications for forward planning and specifying clear, set, • timely objectives and goals for the unit • Permanent funding July 2002 Produced by Eileen Whiting Innovation & Best Practice

11. Livingstone Ashford Unit Beccles War Memorial Hospital What does the service offer? • Social care, physical and mental stimulation in a homely • environment • Reduction in number of delayed discharges in acute and • intermediate care beds • Enhancement of joint working between James Paget • Hospital, Community Hospital and Social Services • Single sex occupancy, as it is a Nightingale style ward July 2002 Produced by Eileen Whiting Innovation & Best Practice

12. Livingstone Ashford Unit Beccles War Memorial Hospital July 2002 Produced by Eileen Whiting Innovation & Best Practice

13. Livingstone Ashford Unit Beccles War Memorial Hospital What does the service offer? • Social care with health care • Medical care provided through general medical services. • Admissions through the Co-ordinator working in • partnership • Removal from an ill health environment to a relaxed • homely environment • Time for reflection July 2002 Produced by Eileen Whiting Innovation & Best Practice

14. Livingstone Ashford Unit Beccles War Memorial Hospital • Self determination & choice regarding day to day living • A safe, non-rigid environment where resident is • empowered to participate in their days structure • A model which is furnished and decorated towards a • residential setting • Colourful murals throughout bathroom / toilet areas. July 2002 Produced by Eileen Whiting Innovation & Best Practice

15. Livingstone Ashford Unit Beccles War Memorial Hospital July 2002 Produced by Eileen Whiting Innovation & Best Practice

16. Livingstone Ashford Unit Beccles War Memorial Hospital • A personal Key worker to monitor, review and consult • on ongoing care needs and development. • The opportunity to change pre made decisions • Families and carers encouraged to work alongside staff • Identification of adaptations and equipment that enables • maintaining independence with day to day living skills • The opportunity for planned trial periods within their • home environment, prior to discharge • Key worker visits resident at home one month after discharge July 2002 Produced by Eileen Whiting Innovation & Best Practice

17. Livingstone Ashford Unit Beccles War Memorial Hospital Benefits to the organisation: • Releases beds hospitals for those who have nursing needs • Cost effective • User led service • A social model that sits well within a health setting • Promotes / maintains joint working and multi-disciplinary teams • Proven evidence that staff who are encouraged and supported • develop rapidly as individuals and groups when empowered July 2002 Produced by Eileen Whiting Innovation & Best Practice

18. Livingstone Ashford Unit Beccles War Memorial Hospital What methods are used to evaluate? • Formal evaluation completed 22nd - 31st • March 2002 - positive outcomes which • resulted in recurring of funds July 2002 Produced by Eileen Whiting Innovation & Best Practice

19. Livingstone Ashford Unit Beccles War Memorial Hospital Questionnaires devised for both resident and immediate carer or family member July 2002 Produced by Eileen Whiting Innovation & Best Practice

20. Livingstone Ashford Unit Beccles War Memorial Hospital Future Plans • To train and develop staff skills in rehabilitation and • re-ablement • NVQ qualifications in Health & Social Care • Maintain current high standards, strengthen joint working • and multi-disciplinary team approach to the Unit July 2002 Produced by Eileen Whiting Innovation & Best Practice

21. Livingstone Ashford Unit Beccles War Memorial Hospital • What lessons are there for others? • Forward Planning with adequate time scales • Situation of the Unit • Transition from Health Environment July 2002 Produced by Eileen Whiting Innovation & Best Practice

22. Livingstone Ashford Unit Beccles War Memorial Hospital July 2002 Produced by Eileen Whiting Innovation & Best Practice