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Healthwatch Southwark carried a number of engagement events, gathering the views of 4 patients who used the Lime Tree House service, between March and October 2016. The work was done as part of a programme of engagement on the step-down scheme that was piloted in Southwark to provide accommodation to patients upon hospital discharge. The report identifies a number of key issues. Information given to patients at hospital about the scheme was described as ‘not clear’, had little information what facility that patients would be going to, or when they would be moving. Some patients arriving at the facility had no support for their mobility issues. Settling in in the facility was a mixed experience. Some patients were pleased to leave hospital and be in the facility, while other patients were anxious because they had no information what to expect in the new facility. Equipment support had some problems, such as faulty Zimmer frame, or a mobile phone. Patients reported issues but problems were not solved for at least a week. Activities were arranged at the house, but they were not always appropriate. One patient with arthritis found it difficult to do art activities. There was no access to a computer. The quality of care was described as ‘rushed’, and ‘it takes a long time’ for staff to check on patients. One patient said, “[I would] probably better off in hospital with permanent supervision than here where you only have people popping in”. The report made several recommendations. The first 2 recommendations included: • All patients and carers/family are supported to make an informed choice about accepting a step-down flat. Written information about the step-down scheme should be given so that patients and carers/family can understand what is being offered, • Southwark Council should consider a care navigator scheme to support patients through step-down. This should include a named person who will visit the patient in hospital to ensure that accurate and useful information is given so that they understand each stage of the process. Patients should be able to contact this person easily to ask any questions and give their views. A response was received from Southwark CCG and Southwark Council.

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