The Challenge Facing Hospitals
It is well known that hospitals are facing major challenges in discharging patients. The equation is a very simple one: only one patient can occupy one bed at one time. Therefore, every patient who is not discharged prevents a new patient being admitted.Many patients who are discharged require a package of care to be put in place, typically provided by home care companies. It has today been reported in several newspapers and other media that trials are to take place in Essex under which homeowners will be paid £50 a night (perhaps up to £1000 per month) to accept patients who are discharged from hospital. The homeowner will prepare three microwave meals per day and provide a bed for the patient. It has been referred to as Airbnb style care and, obviously, there have been accusations of care on the cheap.
Who Could Possibly Benefit?
There are many arguments - social, ethical, political, business - that can be put against such a service. However, for me the most compelling argument against it is that I find it very hard to see who is going to accept - willingly - this service.The reason I find this so difficult to fathom, is that the one group of people who might benefit from such a service are people who will need some personal care or medication support upon discharge. This is a fairly usual situation. However, the provision of a regulated activity - as many people have pointed out - must be delivered by a provider who is registered with the Care Quality Commission. The company leading this trial in Essex, a company called CareRooms, would appear not to be so registered. However, their website reads:
"We have converted spare rooms in people's private homes
within the local community. These CareRooms are equipped with monitoring
equipment, mobility aids, external carers and technology to educate patients on their illness/injury and how best
to avoid readmission."
Forgive the note of cynicism in my voice as I point out the obvious. If the rooms are "equipped with ...external carers...", are these carers in addition to the home owner? If they are, will they be there all the time? If the answer to that is yes who pays? Even if the answer is no, who pays? And if they are carers, are they carrying out anything that is classed as a regulated activity? I could go on, but I won't.
I won't go on because I want to share this with you. CareRooms' website also says:
"Rent out your spare room when it suits you, get complimentary care training all the while you help those in need."
I'm sorry, but I have to state the obvious, again. Why provide care training if the people you train do not deliver care?
Just one more nugget from CareRooms:
"Assist those who want to stay in the family home and live independently longer."
Nothing wrong with that apart from the question of whose family home is being referred to?
If CareRooms are going to be providing a regulated activity, either they must have to play by the same rules as every other care company or every other care company gets to play by the same rules as CareRooms.
If there is no care - regulated activity care - then who is going to stay with a stranger after being discharged from hospital? If you need a meal preparation service only, surely you will go home and have the service provided by a domiciliary care company. Three meal preparation calls a day will be cheaper than paying CareRooms. If you are fit to be discharged, there is only one place to go: home. If you are not fit to be discharged, there is only one place to be: hospital. If you are fit to be discharged but need a little help there is only one alternative: care from a registered provider.
And Finally
I wonder if hospitals would considered renting out their beds to people looking for bed and breakfast accommodation? What do you think?
Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.
