Live-in nursing could help older people stay at home

Nurses can provide 24/7 medical and personal care that is cheaper than keeping a person in an NHS bed.

  ‘A cost comparison between keeping a person in an NHS acute bed versus allowing them to return home with support is favourable.’     Photograph: Glyn Allan/Alamy

‘A cost comparison between keeping a person in an NHS acute bed versus allowing them to return home with support is favourable.’ Photograph: Glyn Allan/Alamy

 

When asked about the care they would like to receive in old age, the overwhelming majority of people say care in their own home is their ideal choice. Our recent survey of 2,000 adults found just 3% of people would choose a residential home as their ideal, and yet many end up with this as a default option.

Our Care Choice Gap report, based on the survey, calls on NHS commissioners, local authorities and individuals to think about ways to meet increasing care needs.

The NHS and local authorities are struggling to cope with the demands of an ageing population and the increasing co-morbidities affecting many older people. Traditional packages of care are under increasing strain and appear unable to offer the person-centred, at home support that older people say they want.

As a care provider, we at Consultus believe that live-in nursing provides a practical solution for people who want to stay living at home but need 24/7 medical and personal care. There is a lack of integrated health and social care teams in the community to support older people in their usual place of residence.

We know from our clients’ experience that, for many, being able to stay in their own home, or return there after a hospital stay, improves their sense of wellbeing and their health outcomes.

With the Care Act coming into force next year and the challenges of the Better Care Fund, it is the right time to raise awareness of live-in carers and nurses. From our discussions with clinical commissioning groups and local councils, it is clear that understanding of the cost benefits of this form of care is still relatively low.

Live-in nursing could fill the gap in community health needs in England and offer potential savings on hospital readmissions estimated at £1.5bn. As Clare Marx, president of the Royal College of Surgeons, has commented, better integration and planning for care following hospital discharge is needed to prevent unnecessary readmissions. Catering for an older person’s medical needs in their own home provides vital support and allows people to regain some control over their treatment. Families can visit at any time of the day; older people are able to stay in their community and be with a partner. They benefit from the support of people familiar to them, particularly important to those with chronic conditions.

By facilitating early hospital discharge, live-in nurses reduce pressure on hospital beds and can hand over to live-in carers as the individual’s recovery progresses, if necessary. A cost comparison between keeping a person in an NHS acute bed versus allowing them to return home with support is favourable. A hospital bed, before accounting for other expenses, costs between £1,820 and £2,1702 per week. A live-in nurse could cost around £1,475 a week. This offers a potential saving to commissioners of between £345 and £695 per patient per week.

We have around 45 professional nurses who provide nursing care throughout the country. Each nurse can provide up to two weeks round-the-clock nursing care and a comprehensive handover to the next nurse. Two nurses are allocated to a patient, each working on a two weeks on, two weeks off basis, ensuring continuity of care. There are other providers of live-in nurses around the country, and this nursing can be funded under the NHS Continuing Care scheme, or privately, depending on the level of health needs.

Reablement packages can be offered via community hospitals or residential nursing homes after illness or surgery. However, we believe that the speed and efficacy of reablement is improved when patients are treated in their own homes; something which live-in nurses are trained to facilitate. This has potential to help local authorities to meet their reablement and care package offer as part of the Better Care Fund.

Live-in nursing embodies the ethos of the Better Care Fund by drawing together NHS and social care services. Nurses work closely with patients and their families, the GP, district nurse and other healthcare professionals. They provide co-ordinated, round-the-clock nursing care, companionship and reassurance. They promote patients’ wellbeing, providing nutritious meals and undertaking light housekeeping duties.

Live-in nursing could not only help to fulfil the state’s duty to provide better, more cost effective, person-centred care, but also provide the care people want, in the environment they prefer – their own home.

The adult social care hub is funded by Liverpool city council and Liverpool clinical commissioning group. All content is editorially independent except for pieces labelled advertisement feature.