I THINK I have found the answer to the bed blocking problem.

Wiltshire Council has an office on the site of the Royal United Hospital, but they only visit the elderly in hospital when they are referred/ready for discharge.

The social workers are reliant on their admin office communicating when an elderly person has reached this point.

There is no swift procedure, a member of the patient experience team at the RUH found it hard to contact them as they were separate from the hospital.

Therefore, if the elderly patient stays in bed with not enough staff to motivate, there may be quick deterioration of muscle and motivation to care for themself.

The elderly person is still an adult and may not be aware of the significant change in their circumstance, and this should be discussed, checking that their home is clean and safe to go home, not arrive out of hospital in the dark where a carer just sees the family into a home after discharge, another box ticked; life is not black and white.

I believe that once an elderly patient has arrived at hospital, especially if they have been fairly mobile before, that action should be taken at the admission stage.

A social worker need not be present to issue a small pamphlet with the care process, guidelines, policy, a web link to the care assessment page, a telephone number. The general public/carer needs to have an informed choice. They will have in-depth knowledge of their relative, and also their own shortcomings.

Circumstances may decree that a carer has ill health, a disabled child or work issues, and the arrival of an unexpected change in their life can lead to intolerable stress and possible visits to their own GP.

Social Services needs to understand the holistic approach to caring for the elderly that everyone has to be a willing participant, and that maybe eventually they will be helping everybody stay happy and healthy. The dots do need to join up, and the Care Act is there to do it. At the moment it seems to be the property of the Social Services and not a legal requirement.

Name and address withheld