Hospital discharge but the house isn't suitable: what now?

If you have just been told your mum or dad is coming home from hospital and you know the house is not suitable, this page is written to be read quickly, possibly in a corridor. It covers what must happen before a hospital discharge, the first 48 hours at home, the first month, and exactly who to call.

Before discharge: five things to do from the ward

1. Find the discharge coordinator. Every ward has someone responsible for discharge planning. Ask a nurse who it is and how to speak to them today.
2. Ask for the discharge assessment. Before your parent leaves, staff must assess whether they will need care afterwards (NHS guidance on being discharged). If ongoing support is needed, it is a "complex discharge" and a care plan should exist before they travel.
3. Describe the house, specifically. "There are thirteen stairs and the only toilet is upstairs" lands harder than "the house isn't suitable". Do not assume anyone has checked — one Mumsnet poster whose mother was sent home without support found the staff "seemed surprised that the OT and discharge people hadn't visited her house" (Mumsnet, elderly parents board).
4. Use the words "unsafe discharge" if you mean them. If you believe going home without support would put your parent at risk, say so to the ward sister and the discharge team, then contact PALS — the Patient Advice and Liaison Service, based in the hospital — the same day. NHS guidance is explicit that you should talk to hospital staff if you are unhappy with a suggested discharge or transfer date.
5. Ask which equipment will be in place on day one. Bed, commode, rails: ask the discharge team exactly what will be delivered, when, and who to phone if it does not arrive.

What "discharge to assess" means

England's official approach is called discharge to assess, sometimes "home first". In the government's words, it means "providing short-term care, rehabilitation and reablement, where needed, and then assessing people's longer-term needs for care and support once they've reached a point of optimal recovery" (gov.uk hospital discharge and community support guidance).

Two practical consequences matter to you:

• Your parent should not have to wait in hospital for the full long-term assessment — support is supposed to follow them home and the assessment happens once they have recovered as far as they are likely to.
• That short-term support, called intermediate care or reablement, must be free for up to six weeks.

The guidance sets out four discharge pathways: home with no new needs (pathway 0), home with new care needs (pathway 1), a short-term community bed for rehabilitation (pathway 2), or, in exceptional circumstances only, straight to a care home (pathway 3). Asking "which pathway is Mum on?" gets you a specific answer instead of reassurance.

The first 48 hours at home

1. Set up ground-floor living if the stairs are the problem. A bed in the living room and a commode are not defeat — they are buying time safely while the proper solution is arranged. One Carers UK forum member described a parent stuck the other way round, "effectively a prisoner in his upstairs bedroom" — if you must pick a floor, pick the one with the toilet or the one closest to the front door (Carers UK forum).
2. Chase the reablement service if visits have not started. If the discharge plan promised carers and nobody has come, phone the number on the discharge paperwork, then the council's adult social care duty line.
3. Ask for a community OT referral. The community occupational therapist recommends the equipment and minor adaptations that make the house workable — and their waiting list starts at the referral, so ask now.
4. If your parent is at risk, say exactly that. Phone adult social care and use plain words: "the discharge has left her at risk". It changes the urgency of the response.

The first month

1. Ask the council for a needs assessment for your parent under the Care Act — this is the gateway to ongoing care and equipment — and a carer's assessment for you. Both are free.
2. Get the free minor aids in. Grab rails, half steps and similar works costing under £1,000 are provided free by the council, with no means test.
3. Start the grant conversation now if bigger works look likely. Stairlifts and wet rooms are commonly funded by the Disabled Facilities Grant, but waits are long — the queue starts at the OT referral, so do not wait for a crisis to settle first.
4. Keep notes. Dates, names, what was promised. If you later need to complain through PALS or push social care, a timeline is worth more than a memory.

The longer decision: adapt or move

Once the immediate crisis settles, the real question surfaces: can this house work long-term, or would the money and the waiting be better spent moving somewhere that already works? Our guides to choosing between a stairlift and moving and future-proofing a home walk through it calmly. If moving looks likely, you can triage listings without dragging anyone to viewings: paste a Rightmove link into Senso — it's free — and it checks the photos and floorplan for step-free entrances, door widths and bathroom layout, and says honestly when it cannot tell. And if you are checking homes for a parent rather than yourself, Senso for families explains how to check a property on someone else's behalf, before you visit.

Who to call

• The ward's discharge coordinator — before discharge, for anything about the plan
• PALS (Patient Advice and Liaison Service, based in the hospital) — if you are not being heard about an unsafe discharge
• Adult social care duty line at your parent's council — after discharge, for urgent care concerns and assessments
• Carers UK helpline: 0808 808 7777, Monday to Friday, 9am to 6pm — practical advice from people who understand the system (Carers UK)
• NHS 111 if their condition worsens at home, or 999 in an emergency