Home First is a short-term rapid response service for Derby City residents being discharged from hospital who need a short period of assessment for their ongoing needs, where no existing care arrangements are in place. Home First, run by Derby City Council, provides a seven-day-and-night responsive service where staff assess care needs and enable people to achieve their best outcome and maintain their independence.
People being discharged from hospital meeting the Discharge to Assess (D2A) criteria, or referred from the community, are triaged by the Hospital to Home team in the Integrated Discharge Hub to the most appropriate pathway. The Integrated Discharge Hub provides a single point of access to the Home First service.
Home First, alongside Derbyshire Community Health Services (DCHS), delivers a service for people returning home for assessment (pathway one) and for those who need a short-term period of assessment and enablement in an integrated assessment bed (pathway two). The Derby D2A model provides a streamlined journey for patients out of hospital which helps prevent delayed transfers of care. This model is now being developed further to incorporate Home First services in Community Urgent Response for crisis situations to prevent admissions to hospital.
The Home First pathway two service operates as an integrated assessment hub, in partnership with DCHS, with 24 beds at Perth House and a community ‘at home’ care service. DCHS provide therapy and nursing services and NHS intermediate care in the community. Medical and pharmacy services for pathway two beds are provided by Macklin Street surgery and Clinical Care Pharmacy respectively.
This short-term service is free but for those assessed as needing on-going support at home or residential care, the care is brokered in the independent care sector.
Home First provides personal care including help with dressing, washing, assisting and moving and assistance with meal preparation. The ethos of the service is to increase confidence and promote independent living and wellbeing to achieve the best possible outcome for each person.
Integrated working takes place between Home First (Derby City Council) and nursing and therapy services run by DCHS, including daily board rounds and weekly multi-disciplinary team meetings to consider an individual’s care holistically.
Information on the service is available from the Derby City Council website.
How was the team set up? See their LGC awards win.
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