App screen: fictional people and data
Coming Home: Family Care
Our own iPhone app for families looking after someone at home, including questions to ask the ward, a home readiness list and a shared 30 day plan.
Solutions
Patient flow and retention
People should leave hospital when they are ready, get the right support at home, and be looked after by care teams who want to stay. When one of those links is weak, the whole system slows. We help NHS teams, councils, care providers and their suppliers find where things get stuck and fix it, with workflow analysis, data, digital tools, training and marketing.
The bigger picture
Three problems, one system
A hospital can only discharge someone when the next step is ready, often a care package at home or a bed somewhere else. That next step depends on care providers who can keep their clients and keep their staff. So patient flow, client retention and carer retention are not three separate projects. They are three views of the same journey, and improving one helps the others.
Client and customer retention.
Helping care providers and suppliers keep the people and organisations they serve.
Go to sectionPillar one
Patient flow: from hospital to home
Most people leave hospital on the day they are ready. For those who do not, every extra day is a day away from home, and a bed that someone else is waiting for. Delays usually build up where hospital teams, councils, community services and care providers hand over to each other.
85.7%
of patients leaving acute hospitals in August 2026 were discharged on the day they were ready to leave. 14.3% left one or more days later.
Source: NHS England, Discharge Ready Date statistics, August 2026 [S1]
13,647
patients a day, on average, were still in hospital in September 2026 although they no longer needed to be there.
Source: NHS England, Acute discharge situation report, September 2026 (management information) [S4]
6.4 days
was the average wait from being ready to leave to actually leaving, for patients whose discharge was delayed in August 2026.
Source: NHS England, Discharge Ready Date statistics, August 2026 [S3]
What gets in the way
- Hospital discharge and step down. Leaving hospital often means a move to reablement at home, a short stay in a community bed, or a new care home place. Each step needs an assessment, a referral, a provider with space and a family who knows the plan. Every handover is a chance for a delay. In August 2026, delayed discharges added up to 306,740 bed days in acute hospitals. [S2]
- Delayed discharges. National data now records why people wait, from hospital processes to arranging care outside hospital. The Nuffield Trust found that in 2025, a lack of capacity in the services people needed next was the leading cause of delay, affecting nearly 3,700 patients a week who had been in hospital for 7 days or more. [S5]
- Home first. National guidance expects most people to go home after hospital, with any assessment of longer term needs done once they are settled, rather than on a ward. [P1] That only works when support at home can start quickly and families know what to expect.
- Social care capacity and NHS flow. Hospital discharge is one of the main routes into social care: 17% of new requests for council funded support in 2024/25 came from hospital discharge. [S6] When home care, reablement or care home places are short, people wait in hospital, and the Nuffield Trust notes that long stays also slow admissions from A&E and ambulance handovers. [S5]
What we can do about it
- Map the discharge journey with the people who run it, from ward to front door, and find where time is lost.
- Turn discharge and capacity data into clear dashboards, so teams see the same picture each morning.
- Design digital tools for referrals, handovers and updates between hospital, council and provider teams.
- Create plain English information for patients and families: what happens next, who to call, and how to get the home ready.
- Help suppliers of discharge and home support services explain what they offer to the NHS and councils.
“
Under the discharge to assess model and home first approach to hospital discharge, the vast majority of people are expected to go home (that is, to their usual place of residence) following discharge.
Department of Health and Social Care and NHS England, Hospital discharge and community support guidance, updated 26 January 2024 [P1]
Pillar two
Keeping the people and organisations you serve
For a care provider, every client who leaves early, and every family who chooses someone else, means lost income and a broken relationship. For a supplier, every council or provider that does not renew is a gap to fill. Keeping customers starts long before a contract ends.
889,000
people received publicly funded long term care in 2024/25, up 3% on the year before.
Source: The King's Fund, Social care 360, published April 2026 [S7]
Where retention is won or lost
- Onboarding. The first days with a new client set the tone: a clear care plan, the right carers, a named contact, and no surprises on the first invoice. The same goes for a new council or NHS customer.
- Experience. Families judge a provider on the small things: carers who arrive when expected, messages that get answered, changes that are explained. Organisations judge suppliers on reliability and how easy they are to work with.
- Churn signals. Clients and customers rarely leave without warning. Missed visits, repeated complaints, slower payments, fewer referrals and quieter contacts are all signals, if someone is looking for them.
- Digital touchpoints. Websites, portals, apps, emails and text messages are now part of the service. When they are clear, joined up and accessible, people find it easier to stay.
What we can do about it
- Map the client journey from first enquiry to the end of care, and find the moments that matter most.
- Set up simple measures and alerts for early warning signs, so someone follows up before a client or customer drifts away.
- Improve onboarding: welcome packs, first week check ins and clear information for families and commissioners.
- Design and build the digital touchpoints: websites, client portals, apps and automated messages.
- Plan marketing and account management for suppliers selling to the NHS, councils and care providers.
Pillar three
Helping care teams recruit well and stay
Care depends on people. Recruiting care workers costs time and money, new starters need support to settle in, and good carers need reasons to stay. The national figures show both progress and pressure.
23.6%
staff turnover in the independent adult social care sector in 2025/26, down from 24.7% the year before.
Source: Skills for Care, The size and structure of the adult social care sector and workforce in England, 2026 [S8]
6.2%
vacancy rate in adult social care in 2025/26, about 96,000 vacant posts, and around three times higher than the wider economy.
Source: Skills for Care, The size and structure of the adult social care sector and workforce in England, 2026 [S9]
33.7%
turnover among care workers in their first year in a role, compared with 12.6% for those with 20 years or more.
Source: Skills for Care, The state of the adult social care sector and workforce in England, 2026 [S11]
29.8%
turnover among care workers on zero hours contracts, compared with 19.1% for those contracted for 35 hours or more.
Source: Skills for Care, The state of the adult social care sector and workforce in England, 2026 [S12]
£7,870
estimated median cost to a provider of recruiting a new care worker, including recruitment, training and agency cover. Based on data from 11 providers.
Source: Joseph Rowntree Foundation, The hidden cost of low pay in the social care sector, February 2026 [S18]
410,000
more posts will be needed in adult social care by 2040, according to Skills for Care's projections.
Source: Skills for Care, The size and structure of the adult social care sector and workforce in England, 2026 [S10]
Skills for Care notes that these turnover figures show an association, not necessarily the reason people leave. [S11]
What makes people stay
- Workforce turnover. Leavers are most likely in the first year, and half of new starters in 2025/26 (50%) were recruited from within adult social care, so many people move between employers rather than leave the sector. [S11] [S14] The first weeks and months matter most.
- Recruitment cost. Every leaver means advertising, checks, induction, training and often agency cover while the post is empty. [S18] Fewer early leavers means less of that cost.
- Wellbeing. Care work is demanding. Skills for Care recorded an average of 4.9 sickness days per employee in 2025/26. [S15] Reasonable rotas, realistic travel time and managers who notice can all help.
- Training and progression. 45% of the adult social care workforce, excluding regulated professions, held a relevant social care qualification. [S17] Care workers and support workers with five or more years' experience earned on average around 12p an hour more than those with less than a year. [S16] Clear training, recognition and routes to senior roles give people a reason to stay.
- Rostering and app support. Guaranteed hours and full time hours are among the employment factors Skills for Care links with lower turnover, alongside pay, training and a relevant qualification. Care workers with all five positive factors in place had a turnover rate of 15.3%, compared with 34.3% for those with none. [S13] Good rostering, and apps that make shifts, notes and messages simple, help managers offer that stability.
What we can do about it
- Map recruitment and onboarding from advert to first solo visit, and remove the steps that lose good candidates.
- Build dashboards for starters, leavers, sickness and training, so managers spot problems early.
- Design and build staff apps and admin tools for rotas, shift updates, notes and training records.
- Write and produce training content, from plain English guides to short training videos.
- Create recruitment marketing that shows the real job honestly and reaches the right people.
How we help
How Caresque helps
We bring five kinds of help to all three areas. Use one, or bring us in from first conversation to launch.
Workflow analysis.
We map how discharge, onboarding and recruitment really work, with the people who do them, then agree what to change.
Workflow analysis and digitalised improvementsData and dashboards.
We turn the data you already hold into simple dashboards, alerts and regular reports that the right people actually read. In our Cura+ Admin work, this included alerts for stalled work and a weekly KPI email.
Cura+ Admin case studyDigital tools and apps.
Web apps, admin systems, portals and iPhone apps for staff, clients and families, designed around how care really works.
Bespoke web apps and iOS appsTraining content.
Plain English guides, courses and short training videos. Our own example is Coming Home Carer Skills, a free course for family carers whose topics follow the Care Certificate standards. It is not the Care Certificate and not a qualification. We also made short staff training videos for the Cura+ Admin platform.
Staff training contentMarketing.
Positioning, literature, websites and campaigns for providers and suppliers, including recruitment marketing and materials for councils, occupational therapists and families.
Marketing strategies and collateralSelling into the NHS or councils? See Go to market strategy and Consultancy.
Our work
Work that connects to this
App screen: fictional people and data
Real project work: Dignity Access website design, launch planned
Dignity Access brand and digital programme
Brand, literature and a new website for the company behind WashPod accessible wetrooms, which help people stay at home or come home from hospital, including a brochure for councils and occupational therapists.
Real Cura+ Admin screen: client details hidden
Cura+ Admin platform
Workflow improvements, alerts, a weekly KPI email and short staff training videos for an operations platform.
Where to start
A practical first step
Most projects start small: one pathway, one service or one team. In a discovery call we will ask where things get stuck for you, what data you already have, and what a good result would look like. Then we will suggest a first piece of work with a clear scope and fee.
Questions
We work with suppliers, care providers and innovators, and with NHS and council teams where that fits.
We only publish results that have been measured and that the client has approved. Our case studies describe what we did, not numbers we cannot stand behind.
No. Decisions about whether someone is ready to leave hospital are clinical. We work on the processes, data, tools, training and communication around them, alongside your clinical leads.
From named public sources, listed at the foot of this page with dates. We update them when new data is published.
Sources
- S1 to S3 NHS England, Timeliness of Acute Hospital Discharges (Discharge Ready Date), August 2026, published 9 October 2026
- S4 NHS England, Acute discharge situation report, September 2026, published 8 October 2026
- S5 Nuffield Trust, QualityWatch: Delayed discharges from hospital, updated 4 June 2026
- S6 and S7 The King's Fund, Social care 360: access, 8 April 2026
- S8 to S10 Skills for Care, The size and structure of the adult social care sector and workforce in England, 2026, published 24 June 2026
- S11 to S17 Skills for Care, The state of the adult social care sector and workforce in England, 2026, published 14 October 2026
- S18 Joseph Rowntree Foundation, The hidden cost of low pay in the social care sector, 27 February 2026
- P1 Department of Health and Social Care and NHS England, Hospital discharge and community support guidance, updated 26 January 2024
Figures checked on 14 October 2026.
Let's talk
Where does flow get stuck for you?
Tell us about the pathway, service or team you want to improve. A free discovery call is the easiest way to find out whether we can help.
