LIVINGSTONE ASHFORD UNIT
BECCLES & DISTRICT WAR MEMORIAL HOSPITAL
KAREN THOMSON TD RGN
SERVICE MANAGER
WAVENEY PRIMARY CARE TRUST
Livingstone Ashford Unit
Beccles War Memorial Hospital
LOWESTOFT
James Paget Hospital
BECCLES
BUNGAY
A146
Beccles & District War
Memorial Hospital
A144
KESSINGLAND
A12
HALESWORTH
Patrick Stead Hospital
B1123
SOUTHWOLD
Southwold Hospital
WALBERSWICK
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
In the three South Waveney Community
Hospitals, during the financial year April 2000:
 A monthly average of fourteen delayed
discharges
 Majority of which result from insufficient,
suitable residential or nursing home vacancies
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
‘Step Down’ Beds for patients who: Identified as fit for discharge
 No longer required specialist health care
input of medical staff, nurses or therapists
 Awaiting discharge to a residential home or
their own home environment
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
What did we hope to achieve?
 A reduction in numbers of delayed discharges
 Length of stay would be 7 - 28 days
 Residents final choice of destination made by forward planning
in consultation with resident, family members and Community
Social Care Assessor

Enable and facilitate the resident to maximise their
independence with day to day living skills and personal care
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
How did we go about it?
A proposal between Local Health Partnerships NHS
Trust and Suffolk Social Services
Resources were established
 Staff recruitment commenced
 Ward prepared for admissions
Nov/Dec 2000
Nov 2000
 Plans for closure of unit 31.03.01
Nov 2000
 Joint Health / Social Services specification
Nov 2000
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
 Service specifications communicated
to all Stakeholders
Dec 2000
 ‘Step Down’ Facility Opens
 Monitoring of service
 Formal evaluation
 Closure of facility
Jan 2001
Jan - Mar 2001
Feb - Mar 2001
31st March 2001
 Prior to the first admission staff had three days induction
involving Moving and Handling, Health & Safety, Health &
Hygiene
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
What helped?
 Team Working
 Established Practices
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
What hindered?
 Funding initially for three months over the winter period
 Staff had to be recruited and selected for this period only
 Extension of service short term
 Implications for forward planning and specifying clear, set,
timely objectives and goals for the unit
 Permanent funding
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
What does the service offer?
 Social care, physical and mental stimulation in a homely
environment
 Reduction in number of delayed discharges in acute and
intermediate care beds
 Enhancement of joint working between James Paget
Hospital, Community Hospital and Social Services
 Single sex occupancy, as it is a Nightingale style ward
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
What does the service offer?
 Social care with health care
 Medical care provided through general medical services.
 Admissions through the Co-ordinator working in
partnership
 Removal from an ill health environment to a relaxed
homely environment
 Time for reflection
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
 Self determination & choice regarding day to day living
 A safe, non-rigid environment where resident is
empowered to participate in their days structure
 A model which is furnished and decorated towards a
residential setting
 Colourful murals throughout bathroom / toilet areas.
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital

July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
 A personal Key worker to monitor, review and consult
on ongoing care needs and development.
 The opportunity to change pre made decisions
 Families and carers encouraged to work alongside staff
 Identification of adaptations and equipment that enables
maintaining independence with day to day living skills
 The opportunity for planned trial periods within their
home environment, prior to discharge
 Key worker visits resident at home one month after discharge
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
Benefits to the organisation:
 Releases beds hospitals for those who have nursing needs
 Cost effective
 User led service
 A social model that sits well within a health setting
 Promotes / maintains joint working and multi-disciplinary teams
 Proven evidence that staff who are encouraged and supported
develop rapidly as individuals and groups when empowered
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
What methods are used to evaluate?
 Formal evaluation completed 22nd - 31st
March 2002 - positive outcomes which
resulted in recurring of funds
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
Questionnaires devised for both resident and immediate carer or
family member
Question
%
Yes
% No
%
Unsure
Were you consulted on your discharge from hospital to the LAU?
Were you clear about the reason for your discharge from hospital
to the LAU?
Were there any difficulties encountered in your discharge from
hospital to the LAU?
Did you feel welcome and comfortable on arrival in the LAU?
70
30
-
90
10
-
-
100
-
90
-
10
78
2
20
98
-
2
100
-
-
-
90
10
100
-
-
100
-
-
48
40
Was the food service, choice and quality of food good?
Were you actively encouraged to participate in activities whilst a
resident in the LAU
Were you consulted about the activities?
Did you feel like a (hospital) patient whilst in the LAU?
Were you fully prepared for discharge from the LAU?
Were you consulted and informed on any decision about your stay
or discharge plans?
Would you be prepared to become part of a residents group?
(Focus Group)
July 2002
Produced by Eileen Whiting
22
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
Future Plans
 To train and develop staff skills in rehabilitation and
re-ablement
 NVQ qualifications in Health & Social Care
 Maintain current high standards, strengthen joint working
and multi-disciplinary team approach to the Unit
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
What lessons are there for others?
 Forward Planning with adequate time scales
 Situation of the Unit
 Transition from Health Environment
July 2002
Produced by Eileen Whiting
Innovation & Best Practice
Livingstone Ashford Unit
Beccles War Memorial Hospital
July 2002
Produced by Eileen Whiting
Innovation & Best Practice