Importance of Preventing Hospital Admissions

This article identifies actions and interventions that can empower the social care sector to identify people at risk of emergency admissions and take action to find and commission support for people who need it the most.

Hospital admission is sometimes the most appropriate care solution for people, depending on specific circumstances and health challenges. However, most people prefer receiving care in the comfort of their home, surrounded by those they love.

An admission that could have been avoided is when there was an opportunity for earlier or alternative action to prevent a person’s health or social situation from worsening to the point where hospitalisation, long-term bed-based residential care, or nursing care was required.

People with learning disabilities, autism and mental health challenges often experience unnecessary hospital admission. Our years-long experience and intensive research showed that these environments often cause adverse effects on people’s health. For example, the average hospital stay for a person with learning disabilities and/or autism is over five years, which affects people’s quality of life and overall well-being.

Common Risks of Preventable Hospital Admissions and Re-admissions

Under the Mental Health Act, neurodiverse individuals and people with mental health challenges can be formally detailed in a hospital in the interests of their own health and safety or for protecting other people in the community.

30 to 50% of individuals with neurological or neurodevelopmental differences may exhibit a range of behaviours, including challenging behaviour, which can be triggered by physical and emotional challenges and communication difficulties. At the point of crisis escalation, people with diverse care needs are frequently moved to costly residential facilities that are often far from their families due to behaviour that challenges.

This raises the question of what can we, as a community, do to prevent these unnecessary emergency admissions.

Our experience has shown that reducing hospital admissions can only be achieved through person-centred care provided with empathy, compassion and a profound understanding of the person in need of support.

Medication Mismanagement

A CQC survey of people with learning disabilities detained in a hospital under the Mental Health Act collected information about prescribed medications reviewed by SOADs. The data shows that more than 50% did not have a diagnosis for the prescribed medication. Plus, in the majority of cases, medication manufacturers do not provide supporting information about their use for people with learning disabilities, which indicates that these drugs are not specifically licensed for this neurodiverse population.

The survey further found that 57% received more than one medication daily, while 40% were prescribed five or more medications. The study, however, doesn’t include information on whether these drugs were given to manage behaviour or to treat mental health challenges. If the prescribing intended to control behaviour, it indicates that the hospital lacked resources or skills to manage behaviours they found challenging.

Lack of Primary Care

The lack of primary care in mental health hospitals in the UK represents a significant gap in the overall healthcare system, posing challenges to people’s well-being. Mental health hospitals often focus primarily on a person’s medication treatment, with limited emphasis on addressing the individual’s general health needs.

Primary care services, encompassing routine medical care and preventive measures, are essential for overall health. In mental health hospitals, where people may have complex and varied health concerns, the absence of primary care can lead to neglect of physical health concerns. This gap is becoming significantly emphasised, considering the higher prevalence of co-occurring health concerns among people with mental health challenges.

Falls and Injuries

Inpatient falls are a major cause of concern and a safety issue for people being admitted to a hospital or residential home for a prolonged time. These care settings can be significantly more difficult for people with sensory impairments (hearing and vision), neurological conditions (such as epilepsy) or people prescribed with high medication doses. The lack of a personalised and holistic approach in hospital settings can be detrimental for older people as well, posing an increased risk for falls and injuries with severe or even fatal health consequences.

Mental Health Crisis

Mental health crises are the most common cause of unnecessary admissions and re-admissions to hospital settings. Due to multifactorial backgrounds, many people with autism, learning disabilities or mental health challenges may exhibit mental health crises that, without person-centred and holistic care, can result in unnecessary hospital admission.

The mental health crisis among individuals with autism and learning disabilities detained in hospitals is a pressing concern that demands immediate attention. These vulnerable individuals often face unique challenges in institutional settings, where their unique needs may be overlooked. The lack of specialised care exacerbates their mental health struggles, leading to distressing consequences.

The restrictive nature of hospitals can contribute to heightened anxiety and sensory overload for autistic people and people with learning disabilities. Inappropriate or insufficient support may lead to behaviour that challenges, and the extended duration of hospital stay due to limited community-based alternatives intensifies the impact on their mental well-being.

The Role of Proper Care in Preventing Hospitalisation

Providing person-centred care and support is essential to delivering the right care at the right time and reducing preventable admissions and readmissions. The transforming care agenda involves working in partnerships with different social care providers, local authorities, care recipients and their families to prevent unnecessary admissions.

This involves a dedication to support people in their homes or a familiar place of residence when they are experiencing a health or social care crisis. Preventing hospital admission or long-term care that keeps individuals apart from their loved ones can be achieved by supporting people to regain skills, confidence and independence.

Strategies for Reducing Preventable Hospital Admissions

Catalyst Care Group uses proactive and preventive strategies based on research, established evidence and lessons learned. Our team understands the people we serve and places the person at the centre of care. Providing the ‘right care, at the right time and in the right place’ is central to all our activities as an organisation.

Reducing avoidable admissions starts with partnerships that are inclusive, person-centred, and strength-based with communities and individuals. Working together can encourage organisations to use joint efforts to achieve better outcomes for people.

There are several principles that are central to every strategy dedicated to providing person-centred and personalised care and support in our practices, including:

• All people are equal citizens in the community.
• We see people as human beings with unique skills, abilities and strengths, and capable of achieving their own goals and aspirations.
• Positive relationships, a sense of belonging, and contributing to the community are essential to people’s physical and emotional well-being.
• Involving people in conversations empowers them to share their voice on what really matters to them.
• Co-production is fundamental. People are equally included in their own care and support planning.
• Support is arranged around people’s skills, strengths, their own networks of support and resources that can be commissioned from the community.

In addition, we will share the key practices and approaches that we use to provide high-quality care and to achieve the best outcomes possible for each individual.

Crisis Management and Rapid Response Care

Crisis management and rapid response care provide urgent care and support for people in crisis in the local community, allowing them to stay safely in their own homes or a residential care setting. With our internal multidisciplinary teams (MDT) and Positive Behaviour Support (PBS) professionals, we provide rapid response and proactive solutions for people with complex care needs. Our experienced team is also trained in providing smooth and gradual hospital transitions to ensure the best outcome for the person in need of support.

Personalised Care Plans

Personalised care plans contribute to a range of positive outcomes that significantly impact people’s well-being. By tailoring health care to specific needs, preferences, and circumstances, these plans contribute to improved overall health outcomes. Individuals actively engaged in shaping their care experience better outcomes, fostering a sense of control and partnership in their healthcare journey. Additionally, this personalised approach allows for efficient resource allocation, preventing unnecessary hospital admissions and promoting a better overall experience for people in need of support and their families.

Holistic Approach to Care

A holistic approach to care is the core of our care and support practices, but it’s also deeply rooted in our way of working and communicating with people. Holistic care involves an in-depth understanding of people and their individual needs and has significant consequences in health and social care. The holistic view comprises an understanding of a person as a whole, including their personal, physical and emotional well-being, rather than focusing only on what’s to be ‘fixed’. Based on our intensive research, holistic care empowers independence and self-responsibility in people. In addition, it helps in building a strong and genuine partnership between the individual and the care practitioner, paving the way towards recovery and a fulfilled life.

Person-centred Care

In a person-centred approach, people are central to the decision-making, care planning and the dynamics of the care and support they receive. With a person-centred model of care, people of all ages are empowered to have control and share their voices about things that are important to them.

The impact and positive outcomes of person-centred care provided by our Catalyst Care Group brands are reflected in the personal stories of the people we support, sharing a powerful message to the entire community. We were all born under the same sun, and there is a place for everyone in society, we just have to make it. With the human rights-based model of care, every individual with complex care needs deserves access to person-centred and holistic care in the comfort of their own home, with the people they love.

Catalyst Care Group is Dedicated in Preventing Avoidable Hospital Admissions

The government created the Transforming Care Agenda to address the problem of care recipients held in hospital wards needlessly. Prioritising admission avoidance and developing community capacity to support individuals in their homes before they reach the point of admission is essential if we are to accomplish the aims and outcomes of the NHS Long-Term Plan.

Building capable workplaces with a long-term strategic focus requires cooperation from all of us. There’s a strong link between the rising prevalence of neurological differences like autism and mental health challenges among neurodiverse people. People will always need to be at home in their local areas, where they can access person-centred care and improve their quality of life.

Contact us today to collaborate on creating the future that we all want to see.