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Our emergency care and recovery services are here to help you recover after a stay in hospital, and to avoid being readmitted.

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Leaving hospital

Your care needs can change after a stay in hospital, so we have a dedicated social care team based at QA Hospital to support you when you are ready to be discharged.

The hospital social care team make short-term arrangements to ensure you are safe when you leave hospital.

The same financial assessment and eligibility process applies.

I did not have care and support before my hospital stay

If you did not have care and support services before being admitted, but you will need support after you leave, the ward staff will need to refer you to our hospital social work team.

If you are worried that this hasn’t happened, ask the ward staff whether they are considering making a referral.

Support from the hospital team will be short-term, as your needs can change as you recover from your treatment. You may be referred to our rehabilitation or reablement services (more information available below) for a short-term period of support.

If you continue to need ongoing support, you will be referred to our community social work team.

If you are discharged without being referred to Adult Social Care, and you believe you need care and support you can request an assessment once you return home by calling our helpdesk on 023 9268 0810.

See Your Assessment for information about assessment and support in the community.

I had care and support before my hospital stay

When you are ready to be discharged, the ward staff should refer you to our hospital social care team.

If you are worried that this hasn’t happened, let the ward staff know that you use care and support services. Your social worker or ISA (Independence Support Assistant) will not usually be told that you are in hospital until the ward staff refer you to the hospital social care team.

The hospital team will check that your care arrangements will be safe in the short-term when you leave hospital. You may be referred to our rehabilitation or reablement services for a short-term period of support.

I arrange my care and support privately

When you’re ready to be discharged, the ward staff can, if you wish, refer you to our hospital social care team for an assessment. You can decline if you prefer to manage your own care needs, but the assessment may help ensure you are receiving all the support you need.

Find private, voluntary and community services to support you after a hospital stay on the Healthwatch Service Directory.

Rehabilitation and reablement

Our range of reablement services work to help you achieve your goals for independence.

The Portsmouth Rehabilitation and Reablement Team (PRRT) works to help you prevent an avoidable stay in hospital, or to recover after a stay in hospital.

The team is made up of both council and NHS staff, who can work together to provide the particular support you need, whether that is social care, occupational therapy, physiotherapy or nursing.

As part of your treatment, you may be asked to stay at one of our “step up” or “step down” units. These are wards within the community, so that if it is not possible for you to be at home, you can receive all the support you need without having to be in hospital.

Our reablement services are time limited. You may be discharged after a few days or a few weeks, depending on your assessed needs. If you need to stay longer than six weeks there may be a charge.

A range of community rehabilitation projects are also available, as part of Better Care in Portsmouth. These include emotional support, practical assistance, and social groups to help you to stay independent and well.

Below includes the Care Quality Commission (CQC) rating and a link to the CQC report for PRRT and the Victory Unit in Hilsea:

Continuing Healthcare

If your main needs after leaving hospital are health related, your care and support may be arranged through Continuing Healthcare and funded by the NHS.

Your Assessment

If the ward staff or social care team believe you will need continuing healthcare, the hospital social worker or a member of our continuing healthcare team will contact you to arrange an assessment.

During the assessment we will ask you about your healthcare needs. We might also ask other health and social care staff involved in your care for their views.

The eligibility criteria looks at what treatment you need, how complex and severe your healthcare needs are, and how stable your condition is.

If you are not eligible for continuing healthcare, we will discuss with you what your other options are and put you in touch with other organisations that may be able to help.

Mental health

Detention under the Mental Health Act 1983

If you are admitted to hospital for an assessment under the Mental Health Act 1983, you will receive a booklet that says what you need to know, what you can expect and what you can do.

Your nearest relative will also be given a booklet about their role. Both booklets can be found in the documents section below.

Information for Nearest Relatives can be found under Support for Carers below.

Details of local organisations and services that can support you if you have a mental health condition can be found by searching “mental health” or for your condition on the Healthwatch Service Directory.

Deprivation of Liberty

Deprivation of Liberty means not being free to do as you choose. The Mental Capacity Act 2005, which is the law that protects people who do not have the mental capacity to make decisions for themselves, has Deprivation of Liberty Safeguards to make sure that people are not restricted unfairly. The law says,

“A deprivation of liberty occurs when the person is under continuous supervision and control and is not free to leave, and the person lacks capacity to consent to these arrangements.”

This could be:

  • Being restrained or sedated to be admitted to a care home or hospital
  • Staff having complete control over the person’s daily life for a long time
  • Staff making all the person’s decisions, including decisions about assessments, treatments and visitors
  • Being unable to keep in touch with friends and family because of restrictions

A care home or hospital is not allowed to deprive a person of their liberty without authorisation. They must apply to the council for authorisation, and a trained Best Interests Assessor and mental health assessor will assess whether the case meets strict criteria. For example, the council must agree that:

  • The arrangements are in the person’s best interests
  • There are no less restrictive options
  • The person has not made an Advance Decision to Refuse Treatment that applies to these arrangements

If you believe a person is being deprived of their liberty, you can:

  • Ask the care home or hospital to change their arrangements to be less restrictive. They should speak to you about why they believe the arrangements are necessary, and whether there are any other options.
  • Ask the care home or hospital to apply to the council for authorisation. Deprivation of Liberty is serious, and the care home or hospital should look into this quickly.

If you believe the person continues to be deprived of their liberty without authorisation, you can contact the council and ask us to investigate whether an unlawful deprivation of liberty is taking place. Call the Adult Social Care Helpdesk on 023 9268 0810.

Support for carers

The word ‘carer’ is sometimes used to mean paid care workers. But when we talk about support for carers, we mean friends and family that help out when you need it.

If you look after a friend or family member who wouldn’t be able to cope without your support, you are a carer. One in ten people in the UK are carers, either helping someone through a temporary illness, or long-term condition.

We can become carers suddenly, after someone close to us has an accident or a stroke, or slip into it over time as their condition progresses – see our dedicated carers pages for more information and to find out about support available for carers in all aspects of life.

Emergency Plan

The Carers Centre can support you to create an emergency plan. This gives you the peace of mind to know that if you are not able to carry out your caring role for any reason, the person you look after will be safe.

Carers Support at QA Hospital

A number of support services and facilities for friends and family of patients are available onsite at QA Hospital. These include information, advice and support around specific health conditions, alongside more general support. Search ‘hospital’ on the Healthwatch Directory for details.

Safeguarding adults at risk

Safeguarding means protecting people from harm. The Adult Safeguarding Team works with adults who have care and support needs, who may be at risk.

For further details see our Safeguarding Adults at Risk page.

Safeguarding is everyone’s business, so if you’re worried about someone don’t assume someone else is doing something to help. Contact the Adult Safeguarding Team on 023 9268 0810.

Hospital and benefits

Some welfare benefits can be affected by a stay in hospital.

Follow the link for information about which benefits are affected by a hospital stay.

Turn2Us is an organisation that gives information about welfare benefits and charitable grants. If you are struggling financially for any reason, use the Turn2Us benefits calculator and grants search to make sure you’re claiming everything you are eligible for.

Search ‘money’ on the Healthwatch Services Directory for details of other services that offer advice and support on bills, money, issues at work, or debt.