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Regenerate-RISE: How we solved hospital bed-blocking

21 June 2024

One Christian charity is finding ways to help people get out of hospital. Christine Miles finds out more

Regenerate-RISE staff help someone to move house

Regenerate-RISE staff help someone to move house

IN THE London Borough of Wandsworth, one Christian charity has developed an initiative to respond to the problem of bed-blocking by elderly people who are medically fit to leave hospital but who are unable to leave for other reasons.

The founder and chair of the trustees of Regenerate-RISE, Mo Smith, says that these reasons are largely the result of deprivation and isolation.

She reports that an elderly person is often unable to leave hospital because their home needs a deep clean, or is unsafe, owing to excessive hoarding; because they have no one to accept the delivery of a hospital bed; or because they have no cooking facilities. Sometimes, the delay is because social services have not yet been able to put a care package in place to assist a patient with their return.

These things are often exacerbated because the elderly person has no family, or family that they are in contact with, who can help them, Mrs Smith says.


THE charity has been working to reduce isolation among the elderly in Wandsworth for the past 24 years, starting with a lunch club in Roehampton, in 2000, which was quickly followed by a visiting programme, lunches, and a weekly outing.

“We’ve always visited people in hospital; we’ve provided dressing gowns to the wards in St George’s Hospital for a number of years, and we’ve always wanted to try and be there for people who are at their most vulnerable,” Mrs Smith says.

The RISE+ (Home from Hospital) discharge programme received funding from the South West London Integrated Care Board (ICB), from January 2023 until March 2024, to assist older patients in St George’s Hospital, Tooting, and Queen Mary’s Hospital, Roehampton.

Regenerate-RISE staff are given a cup of tea in a patient’s home

“It has been so successful, from the point of view of the wards and the patients, that when the funding came to an end, Wandsworth Council and the ICB looked at what they could do to keep it going. So, we have got funding for another year, to the end of March 2025,” Mrs Smith says.

Although other services exist, RISE+ (Home from Hospital) seeks to go the extra mile. “If you need something doing today, we’ll do it. You’ve not got to wait a week or two to be assessed. And nothing is too difficult for us: if the hospital say we’ve got a person who can’t go back home until such and such is done — it needs decluttering, it needs cleaning, they need new curtains, they’ve got no cooking facilities — we’ll say: ‘OK, we’ll go in.’

“We have come across people who have had no running water for months; who have not used the toilet and used other means, collecting urine in water bottles — things like that; people who have not cleaned the house for months; people who’ve had no cooking facilities.

“We can provide microwaves. And, for people with no heating in winter, we provide plug-in heaters. One lady, whose water was turned off, we provided with bottles and bottles of water while social services tried to sort out why this person didn’t have any.”

The charity often has to go into elderly people’s houses to wait for a company, NRS, which provides hospital beds. “Often, their environment needs moving from an upstairs bedroom to downstairs. So, we are asked to move furniture, get rid of furniture, make a micro-environment for people to come home from hospital.

“The hospital bed arrives; we make the bed; we make sure it’s clear and clean. We will make the room, take photos, and send them back to the ward, so they can see what the person is going back to.

“When the person is discharged, we will visit them; we will give them a food hamper, which will keep them going for a few days. Wandsworth, hopefully, will have sorted out their package of care. And we will carry on visiting for as long as is necessary, to make sure a person is doing OK when they get home.” They can also help people to link into the day centre that they run in the borough.

Referrals come by email from occupational therapists, physiotherapists, discharge co-ordinators, or social workers. From St George’s, they receive referrals from about 15 different wards, including A&E.


THE most important part of the project, and what it has always done as part of the work of Regenerate-RISE, is hospital ward-visiting, Mrs Smith says. It is there that they can start to tackle an elderly person’s isolation.

Two mornings a week, the team visits three specific wards at St George’s Hospital. Another two mornings a week are spent visiting patients on a senior-health ward at Queen Mary’s Hospital.

“We just go round the bays and talk to people. We introduce ourselves, say what we do, and have a chat. When we go the next day, or the next week, and the person is still there, we go and talk to them again. So, when it’s time for discharge, if the discharge co-ordinator on the ward sends us a referral, we’ve already met the patient, and they’ve already met us.

“When we visit, we give them a postcard with a picture of us on it and the phone number. Sometimes, relatives contact us and say: ‘Can you help?’

“We had one man who was in hospital for about nine months. One of our staff took him to Luton to pick up his laptop. We helped to get him shaved, get a haircut, and we got him back into living again. That’s our aim, really. We’re here to try and get people into living again, enjoying life, getting the support that they need, and, hopefully, stay well.”

Another man they helped fell down the stairs because he had so much clutter on them. The charity agreed to help declutter, and found they could hardly get through the door. ‘It was probably piled five- or six-foot high with newspapers, all down his corridor, into every room.

“He had no running water, no heating, no fridge. He’d been living like that until he fell. . . Now, he is back living at home. His neighbours have actually helped to clear as well. And he’s now got running water.”

Mrs Smith says that the organisation is “seeing deprivation that we didn’t expect to see in London”. While there are people whom it supports by paying for their lunch every day, because they don’t have the income, “when I think about deprivation, it’s not necessarily down to how much money they have: it’s how they’re living. And it’s isolation that brings that on.

“So, it’s loss of family, or loss of relationships — because there are many people who fall out with their family; so they’re not getting support. Or, in some cases, family move abroad, and then they’re not there to help look after them.

A free event, Kings and Queens, which Regenerate-RISE holds every year for older people

“We step in, in lots of situations. And then there are safeguarding issues, where families are trying to take money from their parents. That happens as well. So, there are lots of conflicts going on in the lives of older people.

“The man in the newspaper house never got married; so he doesn’t have any children. His mother and father died in the house, and then his sister committed suicide in the house. That may have triggered his lack of looking after himself, and his hoarding. Circumstances in life can lead to these kinds of things. And we are a more and more fragmented society.

“We seem to find the hidden people, the people that no one knows are their neighbours. GPs are not aware of their home situations because they don’t visit at home.

“Wandsworth social services — everything these days seems to be done by Zoom, or by phone: people are not visiting. Even at the hospital, they’re asking us to go and take photos of people’s houses, because the occupational therapists are not always visiting as they used to be able to.”


THE charity’s day centre operates out of its own building, the Platt Mission, in west Putney, which it brought from Livability in 2021, and which has a Christian history dating back to 1807.

The day centre currently opens four days a week (but usually five), from 9 a.m. until 4 p.m. There is also a Saturday café once a month.

“People can have breakfast; they can play dominoes. They can do therapeutic colouring. We have a magic table — for people with dementia — with games projected on to it. There’s tea and coffee. Then we’ll have a 12.30 lunch, followed by an afternoon activity. One day, it will be strength and balance exercises; another day, bingo; art and crafts another day; or table games, quizzes. There may be health and well-being talks; blood-pressure clinics, things like that. Then there’s more tea and coffee. And transport back home starts at 3.15 p.m.

“During the day, we have a hairdresser; so they might get their hair done. Or there might be someone who needs help with filling in some forms. There might be someone who needs to be accompanied to a doctor’s appointment; so we would do that. There might be someone who needs to be taken to the bank, or someone might need a bit of shopping. . .

“So, there’s the general overall support to a group of people; then there’s individual support for those that need it, on a daily basis.”

Regenerate-RISE caters for 200-plus people at each of its day centres. But the relationship does not stop there. “The people who choose to come to us, we give them support right through until the time they die. If they go into a care home or hospital, we visit and continue to support. Many of the people that come say they were isolated — not so much, now,” Mrs Smith says proudly.


IN ADDITION to the day-centre service in Putney, the charity has recently opened a RISE project in Woking. “Woking Council went bankrupt and stopped all their services for older people apart from one, where they have 15 places a day. So we started a day service in Woking, which will be similar to our RISE programme in Putney,” Mrs Smith says.

One of the day-centre users, Mary, with the then Mayor of Wandsworth, Cllr Jeremy Ambache, on her 100th birthday

In the past, the charity has also worked to run similar services to reduce elderly isolation in partnership with churches in Sheffield (Salvation Army), Ealing (Anglican and Baptist), and Nottingham (Anglican and Methodist).

After the disruption brought to services by the pandemic, the charity is keen to explore partnership with other churches again, and to encourage the Church not to forget the needs of the elderly in pursuit of the young. “Older people are vulnerable: they are the widows, often the poor and the needy. They’re in isolation, and they need all kinds of support,” Mrs Smith says.

Over the years, Regenerate-RISE has provided help and support to thousands of people. “We’ve always asked: ‘What is the current need that people are facing?’”

To that end, Mrs Smith’s sights are already on the next development of RISE+ (Home from Hospital), albeit the vision was there 11 years ago, which is to develop a Re-ablement Centre, with 12 residential units, above the Platt Mission building, to accommodate people waiting to go home after being in hospital.

“Social services is as broken as the Health Service is at the moment. Someone can be medically fit and ready to go home, but has not got that care package in place. If they came to us, we would look after them while that care package is being put in place.

“Similarly, if someone needs to go into a care home from hospital, they could come to us while we help them to find the appropriate care home. At the moment, they do have a system where they can go into a step-down bed in a care home, and then either go home, or to another care home; but no one helps them to choose which home to go into, or even to take their belongings.

“We would see that as the stage where we can help: we can help them to choose where they’re going to spend the end of their lives, whether at home with a care package, or being cared for in a home.

“Social services are fined daily, every day after a person is medically fit, if they’ve not got a care package in place. We can help that situation by taking someone intermediately into our care.

“Coming to us would be a stage to get that work done. It would also work like a health and well-being centre, so people upstairs could come downstairs, and it would help them socialise again. We’d find out what their interests are, and, hopefully, signpost them to places in their own locality where they could get help and support, or find a volunteer to visit them every week — things like that, to get people living more fully.”

Mrs Smith says that a hospital bed costs £4000 a week; £1600 a day in intensive care. She estimates that their Reablement Centre bed will cost something in the region of £950 a week, which could save the NHS significant amounts.

Regenerate-RISE will be going for planning permission in the next few weeks for the Reablement Centre. Once planning permission is granted, the charity will set out on a two-year, £3-million fund-raising drive to “see the vision through to reality”.


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