Step Down Beds service from Arch Healthcare and partners

Step Down Beds: working together to link hospital and community services

Arch has collaborated with local services to provide seven step down beds in the city, to ensure people who have been admitted to hospital, and are at risk of homelessness at the time of discharge have a safe place to recover, with regular clinical input. This service has been in place from February 2021.

The Step Down Beds service is a link between community and hospital services – providing patients experiencing homelessness who are discharged from hospital, with accommodation in a supportive hostel, daily clinical visits, and dedicated support workers to ensure they can recover fully after a hospital admission. It can also support patients to stay within the community and receive care and treatment, in order to prevent a hospital admission.

A nurse in scrubs sitting in a clinic with a patient, smiling and talking to the patient (back view, blurred), nurse is in focus and smiling at the patient.

Step Down Beds partners

Step Down Beds is a partnership project and brings together the different skills and expertise of homelessness and inclusion health in the city to provide an integrated and accessible service for those facing homelessness before, during or after a hospital stay. This joined up working enables a holistic approach to inclusion health. The expertise and roles of the partnership are laid out below:

Arch Healthcare (Specialist primary care and GP surgery)

Clinical team visit every day Mon-Fri to monitor existing conditions, change dressings, manage and prescribe medication and refer into other support services (such as substance misuse and mental health)
Ensure Step-Down resident is registered with Arch GP surgery
Able to support patients to link in with other primary and secondary care services.

St Patrick’s YMCA DownsLink Group and New Steine Mews Hostel (Brighton and Hove City Council) (hostel accommodation provider)

Manage the accommodation where the beds are located
Provide Personal Assistants who are responsible for supporting patients while they are in stepdown beds, for example supporting to attend appointments, providing companionship, helping with benefits, advocating.
Support patients to access food, cleaning and laundry services.
Manage move on plans

Pathway hospital inreach team

Identify people within the hospital, carry out initial assessment and start housing process
Refer into step-down beds
Ensure safe travel to hostel

Homeless Prevention Officer (BHCC)

Works with clients in step down beds to find suitable move on accommodation.

Brighton and Hove City Council

Project commissioning and reporting
Identifies move on accommodation from St Patrick’s

A man and a woman looking at something on a computer screen together, smiling

A force for good

There have been many positive outcomes for those accessing this service including:

Lower rates of unplanned hospital admissions and lower rates of unscheduled care (e.g. going to A&E, and getting admitted to hospital).
Enabling access to detox and rehab and accessing substance misuse services
Stabilising physical and mental health
Residents have stabilised with the input from clinical and non-clinical staff
Improved health engagement, including GP registration, accessing dentists, sexual health clinics, specialist services for diabetes and secondary care teams.
Supporting patients to better manage medications.
Moving on to permanent accommodation
Moving on to employment

Step Down Beds service