Bespoke Personal Home Care
Complex needs & personalised care at home
Call: YOUR-PHONE-NUMBER Help with discharge

Arranging home care after hospital discharge in and around Milton Keynes

When someone you love is in hospital, it’s natural to worry about what will happen when they come home. This guide explains the key steps, what “reablement” means and how home care can help you plan a safe discharge.

1. Understand what kind of support is needed at home

Before you can plan care, you need a clear picture of what life at home will look like after discharge. The ward team and therapists are important sources of information.

Questions to ask the ward team

  • What can my loved one do independently now?
  • What do they need help with – personal care, mobility, transfers, medication, meals?
  • Have there been any falls or concerns while on the ward?
  • Are there any clinical tasks that will continue at home (for example, wound care, PEG feeding)?

Therapy & reablement goals

Ask therapists what goals they’re working towards – for example walking to the bathroom, washing at the sink or preparing a simple meal. This helps home care providers focus on building independence, not just “doing for” the person.

2. What is “reablement” – and how does it fit with home care?

Reablement is short-term, goal-focused support designed to help people regain skills and confidence after illness, a fall or a hospital stay. It usually lasts a few weeks and aims to help people live as independently as possible at home.

Key features of reablement

  • Short-term (often up to 6 weeks, sometimes less)
  • Focuses on what the person can relearn or do for themselves
  • Often provided or arranged by local health and social care teams

How it links with ongoing home care

After reablement, some people no longer need much support. Others will still need complex or long-term care. In those cases, a home care provider like Bespoke Personal Home Care can pick up ongoing visits, nights or live-in care.

Ask this before discharge

  • Will my loved one be offered reablement or intermediate care?
  • How long is it likely to last – and what happens when it ends?
  • Who will coordinate any longer-term care arrangements?

3. Plan your home environment

Small changes at home can make a big difference to safety and independence after hospital.

Access & mobility

  • Are there stairs to manage? Is a stairlift or bedroom move needed?
  • Is there space for walking aids, wheelchairs or hoists?
  • Are there trip hazards such as loose rugs or clutter?

Bathroom & toilet

  • Is a shower chair, grab rails or commode required?
  • Can the person manage steps or a bath edge safely?
  • Is there a downstairs toilet if stairs are difficult?

Equipment & aids

The hospital or community teams may recommend equipment – for example hospital beds, pressure mattresses or transfer aids. Make sure you know who is ordering what and when it will arrive.

4. Choosing a home care provider for after discharge

If you know your loved one will need ongoing support, it’s worth talking to home care providers while discharge planning is still happening.

What to tell us when you call

  • Which hospital and ward your loved one is on
  • Any diagnoses or conditions you know about
  • Planned discharge date (if known)
  • Whether any clinical tasks will continue at home
  • Where they will be living (including postcode)

How Bespoke Personal Home Care can help

We can:

  • Attend discharge planning meetings (with permission)
  • Help you think through what support is realistic at home
  • Provide short-term reablement-style visits and longer-term complex care
  • Work alongside therapists to support rehab goals
More about our discharge support →

5. Look after yourself as a family carer

It’s common for families to say “we’ll manage” after discharge – then feel overwhelmed a few weeks later. Planning support for yourself is just as important as planning support for your loved one.

Questions to ask yourself honestly

  • Can I provide this level of care safely without harming my own health?
  • Do I understand the clinical tasks involved and feel confident with them?
  • How will I cope with broken sleep, work and other responsibilities?
  • Who can step in if I’m unwell or need a break?

How home care can support family carers

  • Regular visits so you’re not doing everything alone
  • Overnight support to protect your sleep
  • Live-in care during particularly intensive periods
  • Respite visits so you can rest or attend appointments

Need help planning a safe discharge in or around Milton Keynes?

If your loved one is in hospital now – or you know a stay is coming up – we can talk through what home care might look like afterwards.

Share some details

Let us know where your loved one is, what support they are likely to need and when discharge is being discussed.

Send an enquiry