Not everyone needs treatment in hospital or needs to stay there when there are other alternatives. Intermediate care is an alternative to hospital care.

A rapid assessment and treatment service provided by a range of professionals was identified as a gap in Denbighshire. Health and Social Services have been working together to create a new service, which began on November 5th, 2007.

This service is for people who have experienced a change in their physical or mental well-being or a temporary change in their social situation which makes it difficult to carry on without a short period of intervention from perhaps a nurse, physiotherapist, occupational therapist or social worker. The team will be supported by assistants and support workers on a limited, short-term basis (from 1-2 days up to 2 weeks) to reduce/address the critical need and reduce the immediate risk. When the critical element is addressed, the individual can then be referred to other services as appropriate.

The aim of this service is to provide short term rehabilitation to people in the community.

By helping people, for example, to improve their mobility and their ability to do every day tasks, the team aims to promote people’s well-being and reduce the risk of them being admitted to hospital for things like falls, hypothermia and social reasons such as an inability to prepare adequate meals for themselves.

The Team has Occupational Therapists and Physiotherapists who will plan an active programme of therapy and the programmes will be carried out by Rehabilitation officers and support workers.

After discharge from hospital or being unwell, people can quickly become dependent on their family or carers. Reablement Advisors can help them identify and achieve their recovery goals, regain their confidence and improve their independence. There are 3 Reablement Advisors working within Social Work teams in Denbighshire Social Services.

The Advisors are trained to understand when more formal rehabilitation is required, involving an assessment by a Physiotherapist or an Occupational Therapist. They work closely with the Denbighshire Rehabilitation Support Service.

It is intended some beds in community hospitals will be effectively used as both ‘step up’ and ‘step down’ facilities. These beds could also be provided in a care home.

‘Step down’ is a term used to describe the use of a facility such as an bed that provides a level of intervention less than the person is currently receiving because their needs have reduced because their acute medical condition has stabilised but they still require rehabilitation intervention for them to return home safely.

‘Step up’ is a term used to describe the use of a facility such as an intermediate care bed that provides additional support required for a person who for whatever reason could not have that service effectively provided in their current setting for example medical monitoring might be required at such a level that it could not be provided at home.