Home Assessment Protocol

PROTOCOL FOR OCCUPATIONAL THERAPY HOME ASSESSMENTS

(Taking in-patients home for assessment prior to discharge)

1. The Occupational Therapist will make the decision  as to whether a home visit is required based on their clinical judgement.
2. Patients who require a home assessment will first have been assessed in hospital by the Occupational Therapy staff to ensure that a home assessment can be safely and appropriately undertaken without placing the patient or staff at undue risk.
3.  Verbal permission will be sought from the patient prior to carrying out a home assessment and an information leaflet will be provided.
4. Once the decision to undertake a home assessment has been made the visit will, except under extenuating circumstances, take place within 2 working days unless a later date is clinically  more appropriate.
5. Under their professional code of practice Occupational Therapists are unable to make discharge home assessments . In certain circumstances it may be possible to do a follow up, post discharge assessment. This is only recommended when the patients has been fully assessed by the Occupational Therapist in the hospital and the team are confident that the patient is safe to be discharged and all equipment and support services are in place.
6. All home assessments with the patient require a minimum of 2 staff members in attendance. On rare occasions it may be necessary to request that the patient's ward supply a member of staff. Unfortunately, if a second member of staff is unavailable the home assessment will be postponed  and reasons documented.
7. The Occupational Therapist will be responsible for arranging a time which is suitable for  interested parties. If a time cannot be arranged which is suitable for all interested parties then the home assessment will be booked at a time when the perceived main carers on discharge are available.
8. The Occupational Therapist reserves the right to limit the number of persons present on a home assessment. In cases where it is felt that an excess of persons will affect the patient's performance the Occupational Therapist will prioritise who will attend on the basis of predicted involvement with the patient on discharge.
9. The Occupational Therapist will immediately inform the ward staff of the date and time of the home assessment once it has been agreed. It is the responsibility of the ward staff to ensure that this is recorded in the ward diary.
10. The ward staff will be responsible for ensuring that the patient has suitable warm and weatherproof outdoor wear i.e. coat/shoes to wear on the home assessment.
11. Patients who have MRSA can be taken on home assessments provided that the wounds are covered appropriately, and the ward staff have been liaised with  regarding the situation.
12. The ward staff will be responsible for ensuring that access to the patient's home is available for the home assessment i.e. key is available on the ward or key-holder will be present at the house.
13. Mobile phones will be carried on all home assessments, being switched on when leaving the hospital and off when returning.
14. Contact details including mobile phone number will be left in the department for emergency use, along with expected time of return.  Buddy system protocol to be used.
15. Staff will carry a full home assessment kit on each visit, used items to be replaced on return.
16. Verbal permission will be obtained from the patient before any furniture, rugs etc. are moved or removed.
17. A pro forma will be used to obtain written permission  from the patient before adaptations are requested on their behalf.
18. Verbal permission will be obtained from the patient for equipment requested/ provided on their behalf 
19. In the case of privately rented accommodation written permission is required from the landlord of the property, prior to fitting adaptations.
20. No transport belonging to patient or relatives will be used to transport patients and /or staff on home visits.
21. No relatives of the patient can travel in the taxis, or any other transport being used e.g. Patient Transport ambulance.
22. If a building is felt to be unsafe (either for structural or hygiene reasons) then the visit should be abandoned.
23. WYMAS ambulance visits.  If oxygen is required, the patient needs to be transported by ambulance. The ward will be responsible for arranging portable oxygen if required.  Ideally ambulance visits to be done in a morning.   An ambulance may be required if lifting is going to be an issue for access, stairs etc. 
24. On completion of the home assessment visit the Occupational Therapist will offer an  immediate verbal report to the nurse in charge of the ward or the patient's named nurse. A written report, (preferably typed) will be supplied within 2 working days of the home assessment taking place. Copies will be sent to the ward, all agencies involved and the patient's GP.