Admission, Emergency Admission, Referral And Discharge
We understand that the admission of a person into a home can be traumatic, confusing and upsetting. The impact that this process can have on a person and/or their family members is important to us and taken into consideration. With this in mind, we aim to be supportive and understanding in helping people deal with the transitions.
Pre-Assessments: As the process around moving into a home is often stressful, we need to be confident that we are able to meet the needs and support of individuals to avoid further moves and upset. Therefore, a pre-assessment is essential for us to gather information about the individual and ensure that their required needs and support can be fully met. We will only accept a person if we feel we can provide them the support they require.
The assessment process starts with the Manager or her deputies who will arrange a suitable time to invite a person to Derbyshire House, visit a person (and their family/advocates if they wish), in their own home/place they are living, or via telephone to carry out a Pre-Assessment of Needs. The assessment gathers person-centred information about the support and needs a person may require, this includes care, history, social, cultural and spiritual needs/support and any medical/health issues. It is also in conjunction with the Local Authority assessments where there is one, or where a person is funded. The meeting is also an opportunity for the Manager or her deputies to answer any questions or concerns and initially determine if we would be properly able to provide care and support for the relevant needs identified. Where appropriate, filling out the online application and initial needs assessment forms, will assist in the pre-admission assessment processes.
If the Manager is confident that we are able to meet the needs, she may offer the individual an opportunity to visit the home, either for lunch, the day or a short respite for a trial visit, or to view a room available if there is one, any trial will also be a chance to be introduced to others living at Derbyshire House and staff.
As we are a charity, we rely on rooms to be occupied and therefore if there is a respite or permanent room available, we would need a decision about the placement within 72 hours, after which, the room would be deemed available to others, unless prior agreement has been made. A date will be agreed for when the room will need to be paid from, this will usually be the date in which you agree to take the room, unless you have agreed otherwise with the Manager. From the date of admission and/or the date the payment commences, both the occupant and Derbyshire House operate on a 12-week Probationary period, classed as respite care which also helps individuals make their choice slowly and gives them time to settle. After the 3 months, a permanent contract of residence will be offered if both parties are happy that needs and support are being met fully.
Moving In: Once it is determined that needs can be met the person is happy with the move and a room is available, dates can be set for the move/taking on the room. This can be done gradually if wished, so that people can prepare their room as they wish. Alternatively, we are happy to help with any preparation. Families, friends and advocates can stay where required, and if the person moving in wants to be left to settle in their own private room, meals, snacks and drinks will be provided and privacy will be afforded.
Emergency Admission: We are only able to take emergency admissions if we have a room available, and where possible, we avoid these admissions. If a room is available, we would allow short-term care provided we were confident needs could be met. The home does reserve the right to refuse admission or placement to any person whom we would feel would be inappropriately placed and for whom we would not have the required skills, resources or provision.
Referrals: Derbyshire House functions to provide individual, person-centred care and support for people and help them maximise their skills to live in their chosen settings. We will consider referrals based on the information provided from the referrer, which should include a full needs and support assessment, a current Care Plan or summary and a brief social report. If the Manager feels the home is able to meet the needs, a meeting to suit all parties will be arranged so a Pre-Assessment of Needs form can be completed.
Discharges: Being discharged can be as traumatic for a person as admission, and we endeavour to avoid discharges wherever possible. However, we need to take into account the needs and support of the individual and if we are able to meet them. During pre-assessment and Care Planning, fluctuating needs are taken into account and where necessary discussed, but unavoidable and unforeseen situations may arise where we are no longer able to provide the needs and support which are fundamental to the individuals well-being and it is in their best interests to move to a home or place where their needs can be fully met.
If a person’s physical or mental condition deteriorates to such a degree that they require a level of care or professional input that we are unable to provide, we will liaise with the individual and/or their families/advocates, their GP and/or other community nursing teams and where necessary other health professionals to discuss arrangements and possible discharge. No person will be moved without consultation with the GP and NOK (next of kin) and where necessary, the Local Authority.
When a discharge is planned, Derbyshire House will adhere to a certain procedure which has been drawn up with the individual, their relatives, the professional care team responsible for them and where possible the staff from the home where they will be discharged to. The plan must:
- State the reason for the transfer or discharge
- Summarise the services that are provided by the home
- Contain the signature and title of the person who prepares the summary
- The plan for the transfer or discharge will be explained to a person in a language and manner that they understand
- Enter all details into the individuals Care Plan
- Set a discharge date with the individual or their representative
If a person is being discharged from the home to relatives or private carers, then the above procedure will still be followed as far as is reasonably practical and the relevant carer or relative will be asked to sign a form taking full responsibility for the discharge.
Self-Discharge at Short Notice: In the event of a person demanding to be discharged at short notice, Derbyshire House will adhere to the following procedure
- The person’s legal right to take their own discharge will be respected
- We will do all that we can do to advice and encourage them to remain here whilst the discharge is planned in collaboration with their relatives, advocated and friends
- In the event of the person demanding to be discharged, despite this advice, the person will be asked to sign a form stating that they are taking their discharge against the advice of the home
- The individuals’ relatives, GP, necessary advocate or friends or CPN will be informed.
If Derbyshire House feels that there is a cause for concern upon discharge of a person, for their own safety and the safety of others, the police may be called and the GP, Manager, Safeguarding and/or CPN will be informed and any necessary referrals made.
Termination: Derbyshire House reserves the right to terminate placement upon one calendar-months’ notice given in writing, should the management deem fit. Placement may be terminated immediately in the event of the breach of the terms and conditions of the Contract of Residence or, because of physical or mental health that is no longer possible for Derbyshire House to provide care for. Unacceptable behaviour to the operation or the management of the home and the well-being of other people and staff could also lead to termination of contract.
Full details of any admission or discharge can be found in our terms and conditions. And further details for termination due to unacceptable behaviours can be found in our keeping staff safe policy, please ask the office for one if required.