This procedure covers both planned discharges from residential care and also self-discharges. The key aims of discharge are that it meets the person’s needs, and that their safety and care is ensured during the process.

1. Principles

When a person is discharged from a Hull City Council residential care home, this should be part of a planned process and they should be fully supported so that the move to a new home or environment is as easy and as safe as possible. A planned discharge can be defined as an agreement between the person, 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 that people can have independence, autonomy and control over their lives.

Providing good quality information as part of discussions with the person, their carers or advocate is essential to a safe discharge, as is 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 be held agree the discharge plan with the person, their relatives, carers or advocate, the social work team, their keyworker and, where possible, representatives of any new service providers. The discharge plan must:
  • Specify the resources available to the person upon discharge;
  • State the reason for the transfer or discharge;
  • Summarise the services that were provided by the home;
  • Evaluate how well the person’s goals and achievements have been met.
Registered Manager / deputy / social worker
2. The plan for the transfer and discharge must be explained to the person in a language or manner that they understand, and shared with their relatives / carers or advocate. If the person lacks the mental capacity to consent to the discharge or transfer, it must be demonstrably in their best interests 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 person, relatives / carers or advocate and with representatives of any new services. Registered Manager / deputy
4. The person, their relatives / carer or advocate should be asked to fill in an evaluation/satisfaction questionnaire before they leave. The person’s weight should be checked prior to their discharge. Registered Manager / deputy
5. On discharge, all relevant documentation should be completed The fire book should be amended, the SSD13 (Safe custody of valuables) and SSD24 (List of belongings) checked and signed by the person or their representative to acknowledge return of personal possessions. Care Leader
6. A copy of the discharge plan should be sent to the relevant Long Term Support Team, the person’s keyworker, GP (where appropriate) and all agencies involved. Keyworker
7. If the person decides to discharge themselves and has the mental capacity to do so, their 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 mental capacity to decide, staff in the home must do all that they can to advise and encourage them to remain in the home while their discharge is planned in collaboration with their keyworker, relatives / carers, advocates or friends. However, if the person 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 mental 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 person lacks mental 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. The the GP or duty GP service and the person’s relatives, social worker and all other agencies involved should also be informed.

When the person 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
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