When Enablement Isn’t an Option: Planning for Care at Home
What to do when short-term NHS support is unavailable and how Bluebird Care can help
Discharge day is often filled with hope. After days or even weeks in hospital, it’s a relief to know your loved one is finally coming home. But for many families, that relief quickly gives way to questions, especially when the expected support from the NHS or local authority isn’t available.
This blog explains what enablement care is, why it may be refused, and what your options are if you’re left to arrange care on your own. Being informed can help you feel more in control and that’s exactly what we want for you.
Enablement, sometimes called reablement, is a short-term care package provided after hospital discharge. It’s designed to help people regain skills and independence, whether that’s walking unaided, getting dressed, washing, or preparing meals. It usually lasts for up to six weeks and is free of charge, acting as a bridge between hospital and home life. According to the Social Care Institute for Excellence (SCIE), between 45% and 60% of people who receive enablement go on to need no further care. When it works well, it can be life changing.
However, not everyone is offered enablement. It may be refused if the person isn’t expected to make significant progress, if the hospital team deems the support unnecessary or if funding and staffing shortages make it difficult to provide. In these situations, families are often left to make urgent decisions, sometimes with little guidance or warning.
What Are Your Options When Enablement Isn’t Offered?
If enablement isn’t available, the next step is often a referral to the local authority for a social care assessment. While this is an important part of planning long-term support, it can take time and doesn’t always lead to funded care. Understandably, many families find this stage overwhelming, especially when there’s uncertainty about who is responsible for what.
That’s when private care becomes more than just a choice, it becomes a vital safety net. At Bluebird Care, we step in when the public system can’t. We offer immediate start dates, flexible care plans, consistent carers who become trusted companions and full involvement of families in decision-making. While private care is an investment, it offers peace of mind and practical support when you need it most.
Hospital discharge should always be a planned event, but under the NHS ‘Discharge to Assess’ model, care needs are often reviewed after the patient is back at home. This means final decisions about care might not be made until after discharge, leaving care gaps. That’s why we always recommend asking early on who is responsible for discharge planning and requesting a copy of the discharge summary before your loved one leaves the hospital.
If enablement isn’t offered and your loved one is instead referred for a Care Needs assessment, it’s helpful to understand what this means. The assessment looks at needs and whether the person qualifies for funded support, but even if funding isn’t available, you’re not alone. Private care can bridge the gap or be tailored around what is available.
To make the most informed decisions, here are some key questions to ask the hospital team:
- Will enablement care be offered? If not, why?
- Who is responsible for creating the care plan?
- What equipment or home adaptations are being arranged?
- How will we know if more support is needed?
- What happens if I can’t manage as a carer?
To support you further, we’ve created some free guides:
- Hospital Discharge Planning Checklist
- Bluebird Care e-brochure
These are available to view on our website, or we can send you a printed copy if you get in touch.