In innovative partnership scheme, delivered by East Suffolk Council to support hospital patients returning home from hospital, has been highly commended by national award judges.
Stepping Home was launched in 2018 as a way of recognising the impact of housing on the health, wellbeing and independence of communities, and to provide support for patients awaiting hospital discharge or at risk of admission.
A partnership covering the five Suffolk local authority areas, as well as the West Suffolk and East Suffolk Clinical Commissioning Group, Stepping Home launched as a pilot service but proved successful enough to be adopted permanently to support all agencies and service users.
On Wednesday 20 July, the service received high commendation from judges in the Health and Social Care category of the annual Local Government Chronicle (LGC) Awards at Grosvenor House, London.
Judges praised the service’s “fantastic, well-led team, with incredible skills being deployed to the benefit of local people”.
The Stepping Home service grew out of work to address fuel poverty, including Suffolk's Warm Homes Healthy People project to help vulnerable people and families make their homes warmer and cheaper to heat, which provided a base for the models of engagement and delivery to be built and succeed from the start.
While reducing pressure on stretched NHS services, and helping the health and care system to be more efficient, Stepping Home recognises that many people’s needs arise from circumstances beyond the purely medical – helping them to connect with care and support options available in their communities.
Two service coordinators are tasked with identifying and connecting with patients in hospital, including being part of the discharge planning team and social worker team, as well as identifying and supporting patients in the community who may be at risk of hospitalisation, and integrating with the Early Intervention team (EIT) and Reactive Emergency Assessment Community Team (REACT).
They are also responsible for identifying and facilitating individual support and funding packages, and identifying other needs presented and linking signposting to all relevant support services.
Any resulting data collected on the nature and frequency of potential hidden housing issues will, in turn, be used to inform local policy and service development.
The service also offers three, fully furnished temporary accommodation units, providing a safe and secure environment for patients to stay for the short term, free of charge, while their home is being fixed, cleaned, adapted or altered.
The units are used as soon as patients are medically fit, avoiding any discharge delay, or deconditioning, while facilitating independence and rehabilitation.
Total estimated service savings, after service running costs, are in the region of £404,220 – equivalent to almost 1,700 hospital bed days, 16 band five nurses, or 700 ambulance call-outs.
Cllr Richard Kerry, Cabinet Member with responsibility for Housing at East Suffolk Council, said:
“Many congratulations are due to the Stepping Home service team on this thoroughly deserved recognition.
“It is testament to their incredibly hard work and dedication from the moment of inception, when we realised a particular need for the service, to building on existing partnership and working innovatively, effectively and efficiently for the benefit of some of society’s most vulnerable people.
“I’m very proud to know that this service began in East Suffolk and has already made a real difference to people’s lives by addressing the sometimes unique and complex circumstances of patients unable to be accommodated by the traditional health and social care system, and offering support with housing and environment, loneliness, finance and community integration.”