The Proposed NHS ‘Rent-A-Room’ Pilot Is A Worrying Sign Of The Social Care Crisis
Reports last week in national newspapers suggested that householders could earn up to £1,000 a month renting a room in their home for an NHS hospital patient, medically fit to be discharged, but who was not able to return to their own home.
It was reported that a start-up company, CareRooms UK, was working with the NHS and councils in Southend and Essex to pilot and finalise this model, designed for patients recuperating from minor procedures. Householders would be expected to welcome the patient, cook three microwave meals a day and offer conversation.
Following widespread concerns – notably about safeguarding and accountability – it was confirmed that Southend University Hospital NHS Foundation Trust is no longer supporting this pilot. Deputy chief executive Tom Abell said in a statement: “We will never compromise the safety and quality of care for patients and we will not support this pilot until the necessary safeguarding and quality arrangements are in place and there has been full engagement and discussion with our local communities on the proposal, this will happen after a period of detailed work and scoping that we have requested.”
This scheme may have been put on hold but it is a worrying symptom of a crisis in ‘bed-blocking’ where local press are reporting that NHS England are threatening to withhold funds from councils that cannot meet ambitious targets to reduce delays in moving people from hospitals into adult social care.
Our Community Care Law solicitors are frequently contacted by family members and carers for patients, where a hospital discharge is imminent, but no adequate care package has been put in place. Our Safe Discharge From Hospital factsheet explains that health and social care needs assessments should be carried out and an appropriate package of care should be set up before the patient is discharged to a safe setting. Depending on the circumstances, this could be to care in their own home, or to a regulated care home, nursing home or hospice.
While quality of care can vary in all of these settings, there are safeguards for all individuals. Care and nursing homes and hospices are all regulated and inspected by the Care Quality Commission and local councils have safeguarding responsibilities towards adults at risk. In addition, health and social care services have a range of legal responsibilities which make them accountable to patients and their families.
It is unclear how householders providing a room to someone with care needs could fit within this framework. Safeguarding would be jeopardised. If the target for the rent-a-room scheme was patients without families to care for them, who would be coming in to check on the patient and whether they were safe and happy in the setting? What about patients who lacked mental capacity or whose capacity was fluctuating?
While it is understandable that the NHS will try to seek inexpensive ways to free up hospital beds, pushing patients into unregulated and potentially unsafe situations, in the private homes of strangers, is not the answer.
Proper discharge planning which involves the NHS, appropriate specialists, the local authority and families and carers should start in the weeks leading up to discharge.
All too often we see families only informed of a planned discharge in the 24 hours or so before it is due to take place, as this case study shows.
Our Community Care Lawyers will always take urgent action to ensure that our clients are discharged safely. We often have to remind authorities about their responsibilities, including those under the Care Act 2014, to ensure that our client receives integrated health and social care provision.