After a hospital stay, a person may need rehabilitation and assessment before anyone can decide whether home or long-term residential care is appropriate. Scottish Government guidance says long-term decisions should ideally not be made in an acute hospital and identifies intermediate care as a suitable non-acute setting. In its 2026–27 charging schedule, Scottish Borders Council lists intermediate care as free for the first 42 days.
That local rule is useful but must not be treated as a Scotland-wide promise or a permanent free care-home place. Families need written confirmation of eligibility, start date, planned discharge and the price if the arrangement changes or continues.
Confirm that the offer is intermediate care
A bed in a care-home building may be commissioned for intermediate care, respite or long-term residence. The label in the building brochure is not decisive. Ask the hospital and council to name the service, commissioner, purpose and expected duration on the written offer.
If the placement is described only as temporary, ask whether the Scottish Borders 42-day charging provision applies to this person. Record the contact who confirms it.
Fix the first chargeable date
Obtain the admission date and how the 42 days are counted. Ask whether the day of arrival counts, how hospital readmission or absence affects the clock and what happens if the resident moves between settings. Put the calculated final free day and first potentially chargeable day in the family calendar.
Do not wait until day 41. A review should be scheduled early enough to arrange home support or compare long-term homes.
Confirm the review date in writing and name the professional responsible for updating the plan.
Use the Planned Date of Discharge
Scottish guidance makes the Planned Date of Discharge, or PDD, central to discharge without delay. When someone transfers to intermediate care, the PDD should be reassessed on admission and a new one established. Ask for that date and the recovery goals linked to it.
The plan should identify mobility, personal care, cognition, medication and home-safety outcomes. A placement without goals can drift from rehabilitation into an expensive holding arrangement.
Compare the three possible exits
The main routes are return home with support, further rehabilitation or long-term care. For home, list equipment, carers, medication support and property changes. For long-term care, complete the needs and financial assessments and compare available homes. For further rehabilitation, confirm medical criteria and funding.
Give each route an owner and deadline. A family meeting alone is not a discharge plan unless actions and decision dates are recorded.
Price the position after day 42
The Scottish Borders schedule shows an intermediate-care maximum charge of £767.03 per week after the free first 42 days. Ask whether that figure would apply to this placement, whether a financial assessment changes the amount and which services are included. Do not generalise the figure to another council.
Calculate one, four and eight weeks beyond the initial period. Add personal expenses, transport, hairdressing, phone and any services outside the assessed package.
Ask for the answer in pounds per day as well as per week, because a move or discharge may occur midweek. The written calculation should identify the assessment date, any resident contribution and whether the published maximum is being used. If the council has not completed the financial assessment, budget for the highest stated exposure until a decision arrives.
Do not sign a long-term contract by default
An intermediate-care agreement and a permanent care-home contract have different purposes. If permanent admission is proposed, request a new written offer showing room, weekly fee, nursing component, third-party contribution, annual increases, notice and deposit terms.
Check whether choosing the current building is voluntary or merely convenient. The person should be offered suitable choices within the applicable assessment and funding framework.
Test clinical suitability during the transition
Ask whether staffing and therapy match the recovery plan. Record progress in transfers, walking, continence, eating, cognition and medication management. If needs increase, request reassessment instead of assuming the same setting remains appropriate.
For a permanent home, confirm dementia support, nighttime staffing, nursing capability and access to primary care. Financial eligibility cannot substitute for clinical acceptance.
Protect the family from an urgent top-up
If a preferred long-term home costs more than the authority’s usual amount, ask who is requesting the additional contribution, what alternatives were offered and what happens if the payer can no longer continue. Never agree to an open-ended top-up on a phone call.
Compare the full weekly liability and escalation clause. A room may be emotionally attractive but unsustainable after annual fee increases.
Check referral commissions
A placement service can be paid by selected homes. Ask whether the adviser receives a fee, whether non-paying homes were included and whether the intermediate-care deadline created pressure toward a partner provider. Disclosure helps the family judge the recommendation.
Curalune can help organise options by care needs, geography, deadline and budget. Its fuller contact service can ask homes consistent questions and record replies. Curalune does not guarantee availability or admission and cannot determine council funding.
Make the day-42 file complete
Keep the service confirmation, admission date, day count, PDD, review notes, financial assessment, post-period price, permanent-care options, contract terms and fallback. Review the file weekly. The goal is not merely to avoid a charge; it is to reach a safe and sustainable decision outside the pressure of an acute ward.
Frequently asked questions
Is all intermediate care in Scotland free for 42 days?
Do not assume that. The cited 2026–27 charging rule is from Scottish Borders Council and must be confirmed for the individual placement.
Does the person have to choose permanent care during hospital discharge?
Scottish guidance says long-term decisions should ideally not be made in an acute hospital and recovery potential should be considered first.
What happens on day 43?
Ask the council for the exact applicable charge, assessment and service status before the date. The published local maximum does not answer every personal case.
Can the existing room automatically become permanent?
No automatic conversion should be assumed. Permanent admission requires suitability, availability, assessment and a separate clear contract.
