What if you can’t return home straight away?

Some people are not able to return home immediately after a hospital stay. This may be due to ongoing recovery needs, a delay in care arrangements, or because their current home environment is no longer safe. This page outlines your options, what support is available, and what happens next.

Why you might not be ready to return home

You may need a temporary alternative to home if:

• you are still recovering from surgery, illness, or injury
• you need rehabilitation before you can manage safely at home
• your home is not currently safe or accessible (eg. due to stairs or lack of equipment)
• you are waiting for care or support to be arranged
• you need a full assessment of your long-term needs before returning home

In these cases, the hospital team will work with you and Adult Social Care to arrange a suitable interim solution.

What are the options?

If you can’t return home straight away, you may be offered:

Intermediate care or rehabilitation placement

• short-term support in a community hospital, care home, or rehab unit
• focused on recovery and building independence
• often includes physiotherapy, occupational therapy, or nursing support

Discharge to assess (D2A)

• temporary placement in a care setting so that your assessment can take place outside of hospital
• helps reduce hospital stays and ensures assessments are done in the most appropriate environment

Temporary residential or nursing care

• short-term stay in a care or nursing home while waiting for a long-term solution
• may be used if your home is being adapted or if further planning is needed

Step-down or transitional care beds

• beds provided in supported settings for people who are medically stable but not ready to return home
• support is provided while next steps are arranged

Will I be involved in the decision?

Yes. You will be involved in any decisions about where you will stay and what support you will receive. If you have family, carers or advocates, they can be part of the discussion (with your consent).

No one should be discharged without a safe and appropriate plan in place.

What happens to my belongings or tenancy?

If you are unable to return home:

• you may need to arrange for someone to collect essential items, such as clothing or medication
• if you live alone, you should consider asking someone to check on your home
• in some cases, support can be provided to help with tenancy-related issues, benefits, or temporary storage

Speak to the hospital discharge team or social worker if you are worried about your home, belongings, or tenancy.

What if I need longer-term care?

If your condition has changed and returning home is not possible, you may need to explore other options such as:

• long-term residential or nursing care extra care housing with on-site support
• supported accommodation (if you have a learning disability or mental health need)

Adult Social Care will carry out a full care needs assessment and financial assessment to help you understand your options and any costs involved.

Will I have to pay?

Short-term care in transitional settings is usually free at the point of discharge if:

• you are receiving intermediate care or enablement services
• you are being discharged under the discharge to assess pathway

If a longer stay is needed, a financial assessment will determine whether you need to contribute towards the cost of your care. The hospital or Adult Social Care team will explain this to you in advance.

Who can I speak to for help?

• speak to the hospital discharge coordinator or ward staff if you have concerns about returning home
• contact Lewisham Adult Social Care for help with assessments, support planning, or housing-related issues

Contact details

Lewisham Adult Social Care: phone: 020 8314 7777 or email: gateway@lewisham.gov.uk.