Community beds Community beds

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As part of our commitment to create high quality care, closer to home for the people of our local population, we have implemented a new community bed model across six localities in Hambleton and Richmondshire known as ‘step-up and step-down beds’

Background
Following a public consultation carried out by the CCG and South Tees Hospitals NHS Foundation Trust in 2016 (Transforming Our Communities), a number of beds were introduced across Hambleton and Richmondshire for patients needing some health care to either prevent them from having to go into hospital, or to provide patients with some further health care after a stay in hospital. These beds, known as step-up/step-down beds were introduced as part of the CCG’s wider vision to provide health care as close to home as possible.  

What are step-up/step-down beds?
Step-up/step-down beds are a short stay arrangement in extra supported housing schemes, available for up to six weeks to deliver care closer to home. They can also be a preferred place of care for patients at end of life as well as those patients requiring rehabilitation or to prevent them from going into an acute hospital. The beds, medical equipment, basic furnishings and services are funded by the CCG and are located within extra care housing facilities.

The majority of our beds are in extra care housing facilities. The beds are flats within an assisted living complex which are private self-contained accommodation with a bedroom, bathroom, living room and small kitchen. 

There are carers on site who are available to care for you alongside other care teams involved in your care - just as if you were cared for at home. You will have a call button to alert the carers onsite that you need assistance. 

The extra care housing facilities also have a restaurant on site and some have services which are used by the local community such as a village shop, hair dressing and library facilities. Family are welcome to stay with you in the flat. The extra care facility also has a visitor’s room which can be used by your family at a small cost if it is available. 

How do patients get referred to the beds?
The doctors and nurses who are caring for you will be able to provide more information about this service to see if this would suit your needs. Patients will then be referred to the beds by a local healthcare professional. 

Where are the beds?
A number of beds have now been commissioned in total with some allocated as ‘step up/down beds’ and others as a dedicated end of life beds. They have been commissioned by the CCG to be managed by ‘Integrated Locality Teams’ working as part of local primary care clusters, with medical accountability from local GPs. They are located in the following areas:

Monitoring and evaluation
After we introduced the new step-up/step-down beds across Hambleton and Richmondshire, we promised to regularly monitor and formally evaluate the usage of the community beds to ensure they are meeting the needs of our population. 

The evaluation has confirmed that the model provides high quality intermediate and end of life care but that demand has varied across the different localities. 

To ensure this new model of care is sustainable long term, we need an average total bed occupancy rate of 80%. We have seen a continued increase in bed occupancy with a current position of 67% occupancy expecting this to reach 80% over the winter. 

Through our evaluation we also found there is currently more need for step-up/step-down beds in the Northallerton area compared with the Thirsk area and therefore recently took the decision to relocate one bed from the Thirsk area to the Northallerton area. The increase in beds in this area now matches what the CCG had originally planned for before the first allocation and implementation of the community beds. We will continue to monitor usage and need consider any other opportunities should they arise.