Intermediate Care is a range of services, which provide intensive care and support in the community. This can be in a person’s own home or in an intermediate care unit – short-stay residential homes where we assess and support people to give them every chance of regaining and maintaining their independence.
What do you do?
For one reason or another, someone may need extra support to stay living at home or they may have been through the hospital a number of times. Therapists, nurses, care staff and social workers all work towards getting someone back to their baseline. We also have mental health liaison, all working towards getting someone home.
Our role as social workers is to assess what ongoing needs a person has, what outcomes they want to achieve and to co-ordinate the care and support they need to meet those outcomes. This could include mobility and meal preparation but also it might be a housing issue, a mental health issue or a social issue such as isolation.
Our clients may have complex needs and often lack mental capacity, so we look for the least restrictive options. We look at how we can minimise the risks enough to enable a person to return home. This can be challenging for some services and for the family, so there is a lot of liaison and communication.
For example, someone might come into the service and they are having all their medication organised for them, using a Venalink blister pack [where a pharmacist arranges all the tablets a person needs and put each set of tablets in their own blister pack]. We will ask whether the person was self-medicating before, why are they on the Venalink now? Can they try a self-medication trial? We’re pushing for evidence all the time – why does the person need 24-hour care? Why won’t they manage at home? Have we tried telecare? Can we look at doing things differently?
We also act as advocates for the person, where the family might want 24-hour care, without realising how much their loved one can do for themselves.
How will the ICO benefit you, your colleagues and the people of Salford?
We already have some really good relationships with colleagues in Salford Royal, especially in the intermediate care units and with hospital discharge co-ordinators. We had a brilliant meeting recently with a consultant where we co-developed a plan for getting someone home. The staff in the intermediate care units all understand and value each other’s roles and we all work to promote a holistic approach to health and social care and support.
We want to build the same understanding and value with colleagues based in the hospital and being part of the ICO will help us with this.
After all, we all want what is best for the client – a timely and safe discharge, or even better, that we can keep someone from needing hospital care at all.
The ICO should ensure that people won’t bounce from service to service – it should be seamless for them.
Information will be shared better between services, which should make it all easier, quicker and better. Our clients won’t have to repeat themselves over and over again. They should only need to tell their situation to one person who can pass the information on and all the different services will be able to work together more effectively.
Our work reduces demand on hospital and long-term residential care services. We can stop people needing to go into hospital in the first place and we can help people to minimise the length of their hospital stay.