Background
Currently there are a number of beds in the system which can be accessed at the point of discharge from the hospital or whilst experiencing crisis in the community. Discharge guidance issued during the coronavirus pandemic further endorses the need for safe and timely discharge from hospital and the need to effective community services to prevent unnecessary admissions.

Reason to Reside is now used to determine whether a person needs to remain in hospital or can be discharged.

Home First is the overarching principle where possible, however for some people they require a further period of recovery and/or rehabilitation in non-acute bedded care.

Access to community beds is via the Trusted Assessment using the principle of Discharge to Assess (D2A). It is acknowledged that further assessments out of hospital to determine the longer term needs of a person are more effective to maintain and maximise a person’s independence for as long as possible.

Home First services including reablement and home care more people are being discharged home. This means that people who are admitted to community beds have higher level nursing needs.

Current Commissioning
Within Calderdale there are currently 28 Intermediate Care Nursing Beds and Discharge to Assess (D2A) beds block and spot purchased. The block arrangements support 7 people at a time: 5 in residential beds and 2 in nursing beds. D2A placements typically last for up to 6 weeks.

A definition of each bed type can be found at Appendix one. There are different eligibility criteria for all the different types of beds currently in the system.

Therapy support to Intermediate Care is provided by CHFT via a dedicated team; wider therapy input is available also from CHFT via the Community Rehabilitation Team.

Future Commissioning
Integrated Community Beds
It is proposed that future commissioning would establish a more flexible nursing bed base which meets both Intermediate Care and Discharge to Assess requirements for step up and step down referrals.

The Provider will be expected to work with commissioners and the wider health and social care system to develop a category of bedded care known as ‘Integrated Community Beds’. This could include attendance and contribution to local workshops to further develop the service and the community model for Calderdale.