Hospital discharge and regaining independence
I have been in hospital, and I am returning home
Regaining your independence after a hospital stay takes planning, support, and care. This is called ‘reablement’ and in Buckinghamshire, it is known as Home Independence.
When you are about to leave the hospital, staff might think you need extra help at home. If so, they may refer you to our Home Independence Team.
Social care workers from the Council will then work with you to move from hospital back home.
If you are not referred into the Home Independence Team service, but you are identified as needing support still, you may be referred into:
- Home First: A free 4-week service that helps you at home with care, physiotherapy, and occupational therapy
- Rapid Response and Intermediate Care: Urgent NHS care that lets you stay at home during a crisis
- Buckinghamshire Council Assessment: We will assess your long-term needs under the Care Act to see if you qualify for support or other community services
What is reablement
Reablement is a short and intensive period of home support to help you recover after time in hospital. The aim of reablement is to improve the skills and confidence of those leaving hospital and allow you to go on living in their own home.
Reablement services can include:
- practising daily activities, such as cooking and bathing, to help regain skills and confidence
- finding new ways to complete daily jobs
- equipment or home adaptations, such as a personal alarm or bath rail
- support for relatives or carer
Home Independence Team (HIT)
The Home Independence Team (HIT) are social care workers who help you move from the hospital to your home and become independent again. This support includes:
- help with your personal care
- managing medication
- preparing a meal
- help you get out and about
The Home Independence service can also help provide equipment you might need to help you with your daily living.
This is a short-term support option, free of charge for a maximum of 6 weeks. If you require further ongoing support after the 6 weeks, we will work with you to decide how best to meet your future care needs.
- Hospital staff or a social worker will refer you to the service if you’ve been in the hospital, had a fall, or your ability to do things at home has changed
- Home Independence staff will complete an assessment with you in your home. They will agree with you what to focus on and which tasks will help you to live as independently as possible
- They will review your progress to ensure you achieve your goals
- Your personal assessment and reviewing officer will keep in regular contact with you, check your progress and discuss options for your future
- you have had a professional referral
- you are 18 or over
- you live in Buckinghamshire
- you have had a loss of confidence and function following illness, disability or recent stay in hospital
- you will work towards clear, measurable goals, linked to your level of functioning
- you have not already had help in the last three months from the Rapid Response Intermediate Care or Home Independence teams
- personal care: Help with bathing, dressing, and other daily activities
- equipment provision: Supply of necessary aids and adaptations to support independent living
- care coordination: Linking you with community services and ongoing care providers
Reablement services are not always suitable for everyone. It is recommended only if you can regain full or significant independence in the short term. You may not qualify if:
- your care needs are high, and home independence support is unlikely to improve your situation
- If it is determined that your recovery period will exceed the maximum 6-week period we offer this for
If you are unable to receive home independence services, you may still be able to get help from us. You will still need a care needs assessment and a financial assessment.
Contact our Home Independence Team:
Telephone: 0300 777 2002
Email: [email protected]