On any given day in England, more than 4,000 people are discharged from hospital who need support at home. Many of them leave without any care in place. Not because their family did not want to help, and not because the NHS did not try. Simply because no one told the family what to arrange, who to contact, or how quickly it needed to happen.
If your loved one is currently in hospital, or if a discharge is likely in the coming days, this guide is for you. The first 72 hours after discharge are the highest-risk period. What happens in that window determines whether someone recovers well at home — or ends up back in an ambulance within a week.
Why the discharge process feels like falling off a cliff
Families consistently describe the hospital discharge process the same way: one day their relative is in hospital receiving round-the-clock care; the next, they are at home with a carrier bag of medication, a letter full of medical terminology, and no clear idea of what to do next.
This is not unusual. It is, unfortunately, common. NHS discharge teams work under enormous pressure, and their job ends at the hospital door. What happens on the other side of that door is, in the eyes of the system, someone else's responsibility. That someone else is usually you.
What you need to do in the first 72 hours
The following steps are listed in order of priority. You do not need to complete all of them before your loved one leaves hospital. You need to begin them the moment discharge becomes a possibility.
Request a discharge assessment
Ask the ward sister or discharge coordinator whether a formal discharge assessment has been completed. This assessment should identify what support your relative will need at home. You are entitled to ask for this. If no assessment has taken place, request one before the discharge date is confirmed. In England, the Care Act 2014 gives patients and families the right to ask for a needs assessment.
Ask specifically about medication management
One of the most common causes of readmission within the first week is medication error at home. Before discharge, confirm: is your relative able to manage their own medication independently? If not, who will be responsible for prompting or administering it? A professional care provider registered for medication support can provide this — but not all agencies are. Ask specifically.
Do not rush the handover
The pressure to vacate a hospital bed is real. You may feel hurried. Do not accept the discharge until you have received, in writing: the discharge summary including diagnosis and medication list; the name and contact details of the person responsible for follow-up care; any equipment your relative needs at home; and confirmation of any follow-up appointments.
Assess the home environment
Before your relative arrives home, walk through the property with fresh eyes. Check: is the pathway from the front door clear and safe? Are there trip hazards on floor surfaces? Is the bathroom safe to use independently, or is equipment such as a grab rail or shower chair needed? Is there food and essential supplies in the house? These are things discharge teams rarely check.
Arrange professional care if needed
If your relative needs regular support at home with washing, dressing, medication, mobility, or wound care following surgery, this is the window to arrange it. A regulated domiciliary care provider can usually begin visits within 48 to 72 hours of contact. Do not wait until the first crisis before calling.
Watch for the warning signs
The most common reasons for readmission in the first week are: confusion or sudden change in behaviour; difficulty with breathing; a fall; infection signs such as fever or redness around a wound; dehydration; and inability to take medication. If any of these occur, contact the GP or 111 promptly. Do not wait to see if it passes.
What if your relative needs clinical support at home?
Standard homecare agencies are registered to provide personal care: washing, dressing, meal preparation, and similar support. However, some people returning from hospital need more than this — wound care, rehabilitation support, post-operative monitoring, or health assessments at home.
Not all homecare providers are legally registered to deliver these clinical services. You need a provider that holds a Treatment of Disease, Disorder or Injury (TDDI) registration alongside their personal care certificate. This is a specific CQC registration that relatively few domiciliary care providers hold.
What to look for in a post-discharge care provider
- CQC registration for both personal care and, if clinically needed, Treatment of Disease, Disorder or Injury (TDDI)
- Ability to begin care within 48 to 72 hours of contact
- Staff trained to CSTF standards with current DBS checks
- A clear care plan process — every service user should receive a written, personalised care plan before care begins
- Transparent communication with family members and, where relevant, with the discharging clinical team
What Acrux Support Services can do for your family
Acrux Support Services is a CQC-registered domiciliary care provider serving adults across East London and surrounding areas. We hold both a personal care registration and a Treatment of Disease, Disorder or Injury registration, meaning we can accept post-discharge care packages that include clinical elements alongside personal care support.
We can typically begin care within 72 hours of your first contact with us. We also accept clients funding their own care, clients with local authority direct payments, and NHS-referred packages through hospital discharge teams.
💡 The most important thing a family can do
Do not wait for a crisis before asking for help. The families who arrange care proactively — before the discharge, or in the days immediately following it — consistently report better outcomes than those who wait until a fall, a missed medication, or a second admission forces the issue.
You are not giving up on your relative by asking a professional to help care for them at home. You are giving them the best possible chance of staying there.
Arrange a free, no-obligation assessment today — we respond to all enquiries within four working hours.
Book a Free AssessmentAcrux Support Services is CQC-registered (Provider ID: 1-18041750500) for personal care and Treatment of Disease, Disorder or Injury. We serve adults across East London and beyond.