SCOPE OF THIS CHAPTER

This procedure should be used to inform both planned discharge from residential care and also self discharges. The key aims of discharge are that it meets the customer’s needs and that their safety and care is ensured during the process.

1. Principles

Every customer who is discharged from a residential care home should do so as part of a planned process and should be fully supported so that the move to a new home or environment can be made as easy and as safe as possible. A planned discharge can be defined as an agreement between the customer, their care team, their relatives / carers or advocate and the home, which considers and addresses the rights and responsibilities of all those concerned in the discharge process.

Wherever possible the Registered Manager will ensure that discharges from the home are planned well in advance so that proper continuity of care can be established, and so that individual customers can have independence, autonomy and control over their lives.

Good quality information and discussion with the customer, their carers or advocate is essential to a safe discharge, as are effective referral to future care providers, and the availability of ongoing support services.

2. Procedural Steps

Step Action By Whom
1. When discharge is planned, a multi disciplinary meeting will agree to a discharge plan with the customer, their relatives, carers or advocate, the social work team, their keyworker and, where possible, representatives of any new service providers. This will include a care programme approach meeting if appropriate. The plan must:
  • Specify the resources available to the customer upon discharge;
  • State the reason for the transfer or discharge;
  • Summarise the services that were provided by the home;
  • Evaluate the achievement of the goals and objectives of the customer;
  • Contain the signature and title of the person who prepared the summary.
Registered Manager / deputy / social worker
2. The plan for the transfer and discharge of the customer must be explained to the customer in a language or manner that he or she understands and shared with their relatives / carers or advocate. If the customer lacks the capacity to consent to the discharge or transfer, it must be demonstrably in their Best Interest to be discharged or transferred. (See also Mental Capacity Act 2005: Guidance for Best Interests Meetings Guidance.) Registered Manager / deputy
3. A discharge date should be agreed with the customer, relatives / carers or advocate and with representatives of any new services. Registered Manager / deputy
4. The customer, their relative / carer or advocate should be asked to fill in an evaluation/satisfaction questionnaire before they leave. The customer’s weight should be checked prior to their discharge. Registered Manager / deputy
5. Discharge documentation should be completed upon discharge. The fire book should be amended, the SSD 13 (Safe custody of valuables) and SSD24 (List of belongings) checked and signed by the customer or their representative to acknowledge receipt of the person’s possessions. Care Leader
6. A copy of the discharge plan should be sent to the relevant Long Term Support Team, the customer’s keyworker, GP (where appropriate) and all agencies involved. Keyworker
7. If the customer decides to discharge him / herself and has the capacity to do so, his / her legal right must be respected. An assessment of mental capacity must take place and any risks must be managed using the Positive Risk Assessment Guidance (see Positive Risk Taking Policy). Registered Manager
8. If the person has the capacity to decide, staff in the home must do all that they can to advise and encourage the customer to remain in the home while their discharge is planned in collaboration with their keyworker, relatives / carers, advocates or friends. However, if the customer decides to discharge themselves despite this advice, they must be asked to sign a form stating that they are discharging themselves against the advice of the home. Registered Manager / deputy / senior staff on duty
9. If the person does not have the capacity to make this decision, they cannot be physically prevented from leaving unless an order to do so is in place under the Deprivation of Liberty Safeguards (see Deprivation of Liberty Safeguards Procedure).

If the customer lacks capacity or, in the opinion of the senior staff member on duty is placing themselves or others at risk of serious harm by leaving then the member of staff in charge of the home should phone the police immediately. They should inform the GP or duty GP service, the customer’s relatives, social worker and all other agencies involved with the customer.

When the customer has been made safe, protection planning should take place which should include consideration of whether an order should be sought under Deprivation of Liberty Safeguards.

Registered Manager / deputy / senior staff on duty