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Support Leaving Hospital (Joint Care Provider Services)

Helping adults to return home from hospital safely and in a timely way

Coming home from hospital can be a difficult and worrying process. The Joint Care Provider Services Team (JCPS) work to make sure that your return home from hospital is safe and timely.

We work closely with adults leaving hospital who have a care need, to help them adjust to new health and personal circumstances on their return home. Our first contact with you will usually be made before you leave hospital, to discuss your needs and find out about any extra support you need.

The Joint Care Provider Services Team (JCPS) will:

  • work closely with hospital staff to make sure that your care and equipment needs are met when you are discharged home
     
  • provide you with a Hospital Link Worker as a first point of contact - these are experienced social care professionals working at each of the local NHS hospitals, and they will provide you and your family with information and support
     
  • arrange a care and support needs assessment (under The Care and Support (Eligibility Criteria) Regulations 2014) to determine whether you meet the eligibility criteria for further help - this may be necessary if you are unable to return home and require a residential or nursing home placement

About the Joint Care Provider Services Team (JCPS)

The JCPS are part of an integrated service between West Berkshire Council and the Berkshire NHS Intermediate Care Team. The service is multi professional and includes managers, team leaders, social workers, therapists, social care practitioners and therapy assistants.

Anyone requiring a package of care, to support them at home when they return from hospital, will be referred through the Joint Care Pathway. A Trusted Assessor approach is adopted, and the therapy staff working with you in the hospital will assess and determine the level of care and support you require for a safe discharge.

The JCPS Team will arrange the care package requested, and an allocated clinician will then begin working with you through an ongoing process of assessment. The clinician will work with you to enable you to regain maximum independence - the service is goal focused, reviewed regularly by clinicians and is available for a period of time, as determined by your clinician.

If you require a long term care package, you will be assessed against eligibility criteria and referred for a financial assessment by one of the Adult Locality Teams.

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