Bath: Home First/D2A

CURO is a not-for-profit housing and support organisation based in Bath, providing affordable homes and care and support services across the West of England. This example of a local initiative forms part of our managing transfers of care resource.

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The plan

As part of the Better Care Fund, CURO provides a Step down service for adults discharged from hospital with no ongoing medical need to remain in hospital, but who are unable to return home immediately.


CURO has six apartments for patients throughout Bath and North East Somerset. The Step down service can be commissioned by any hospital clinician or health care professional involved in the discharge process. The apartments are offered free to patients for up to 12 weeks with fully funded care and support packages to meet patient needs, and each apartment is accessible and tailored to each service user. CURO staff can also come and collect people from hospital, transport them to the apartments and help them to settle in.

Extra Care, care packages are provided out of the local Extra Care Schemes by experienced and qualified staff. Support from Independent Living Service is also offered and tailor-made to the individual.

The service has developed to now include “winter pressure units”, which are funded through the Better Care Fund to provide three months of extra beds to be used when needed. These are like hotel rooms, but provide a high level of care which helps to alleviate strain and reduce public sector spending. In addition, there is a Wellbeing House which provides step-down mental health beds in a calm and supportive environment. This is for a maximum of four people and they are able to stay free of charge for up to five working days, and is a way to avoid keeping them in hospital beds. This is funded through the Bath and North East Somerset (BANES) pooled Health and Social Care budget.


People have really benefitted from the step-down offer, which provides an opportunity to recuperate (including with a partner, which can’t happen in a hospital bed), and this has been shown through the clear emotional and wellbeing impact of not being in a hospital bed.

One of the challenges for the service has been around hospital engagement and supporting hospital staff to understand the housing offer. CURO have tackled some of these challenges by attending Monday discharge meetings with hospital colleagues and taking a proactive approach to suggesting CURO as a service that could support an individual’s housing needs.

In terms of outcomes, a previous review of the service found that the CUROs 6 units saved £561,762 for the NHS by enabling discharge of patients, and the Social Return on Investment was £6.21 for every £1 invested (where no reablement care package is required).


Curo Choice

[email protected]

This case study is an example of the High Impact Change Model (Change 4): Home First.