"They have to be cruel to be kind... It is no good sitting and saying you cannot do it."

It's lunchtime at Archways. Elderly people, many of them in wheelchairs, sit around a check-clothed table in the bright, modern dining room. Cheerful nursing assistants prepare to hand out hot meals supplied by York Hospital.

Pat Eland hasn't joined the others for lunch. Instead, she's sitting in a high-backed chair in her own room. Like the dining room, this is bright, clean, modern. There is a narrow bed covered in a cheerful tartan, an en-suite bathroom and a view through the window of the street outside.

It's a big day for Pat. For the first time since she smashed her hip and broke her arm in a fall, she is about to go home. She will be accompanied by two therapists, and she won't be staying long. But she's hopeful that, if she copes well, she could soon be going home for good.

Home is a small terrace in the centre of York. "My own little haven," Pat calls it. She lives there alone, and is fiercely proud of her independence. And despite having had her right hip replaced two and a half years ago because of arthritis, the 75-year-old has always kept busy. "Since I retired, I have done a lot of voluntary work and things," she says. "I lead a pretty active life."

Until her fall. "I was watching a film on the TV and thought 'I'll get up and make myself a coffee'," she says. She doesn't remember feeling faint or dizzy, but the next thing she knew she was falling. "I did a half pirouette and thought 'I'm going to go in the fireplace!'," she says. "I just keeled over and fell on my left side and arm."

It turned out later she had smashed her left hip and badly broken her left arm. She managed to shuffle across the floor to telephone a neighbour for help, and was rushed to York Hospital. There, her broken arm was set and she had emergency surgery to replace her left hip. "So I've got two new hips now," she says. "I'm like the Bionic Woman!"

She spent the next two weeks in hospital, gradually recovering, before being brought here to Archways.

Archways is the new £1.4m intermediate care unit run by the Selby and York Primary Care Trust. Converted from a former sheltered housing complex near the hospital, the 28-bed unit took its first patients last month and was officially opened yesterday by Look North's Harry Gration.

Its purpose is to 'bridge the gap' between hospital and a patient's home. It does this in two ways: by offering support to older people who, because of illness or accident, need to be looked after but do not need to be in hospital; and by offering a programme of rehabilitation to patients who are well enough to leave hospital but require extra, specialised care before returning home.

What it is not, stresses Sue Beckett, head of therapeutic services for the primary care trust, is a bed-blocking unit.

It is not difficult to see why she objects to that term. Yes, there will be a knock-on effect of freeing up hospital beds. But a bed-blocking unit implies a place where people are sent because there is no room in hospital - a convenient place to park them because there is nowhere else for them to go.

And that is not what Archways is about at all. It has been built following a lengthy period of consultation with older people and user groups; it is staffed by fully-trained health professionals, including nurses, physiotherapists and occupational therapists; and it has a specific purpose - to help patients recover and regain their confidence quickly as possible so they can go home.

"If somebody needs to be in hospital, that is where they will go," says Sue.

"But the last thing you or I need is to be going into hospital if you do not need to be there. And if you talk to older people, they want to stay in their own homes as long as they possibly can, they want to be independent for as long as they can. This unit is all about facilitating that."

A bad fall or accident can not only leave an elderly patient physically weak and vulnerable: it can dent their confidence as well. To help patients regain the strength and confidence they need to be able to look after themselves, Archways has a fully equipped physiotherapy room, with bars to help patients walk and a physiotherapy bed.

There is also an occupational therapy treatment kitchen, where patients can practice making themselves a cup of tea or cooking a simple meal - all the things they will need to do once back at home.

Each patient has a tailored programme of rehab. Pat Eland's consists of walking with the help of bars, and leg exercises to strengthen her hip. She also has a set of exercises she does in her own room, and spends a lot of time walking up and down the corridors and stairs to see how far she can drive herself.

The trained staff do push quite hard, she says, but that is exactly what she needs.

"They have to be cruel to be kind, and you do have to help yourself. It is no good sitting and saying you cannot do it. They will help you to a certain degree, then will watch you and assess you."

It is an approach that works, she says. Apart from anything else, the fall badly shook her confidence. "But this is preparing me for going back home. I'm feeling much more confident."

Peter Barrett agrees there is much more emphasis on rehabilitation at Archways than there could ever be in hospital. That is not a criticism of hospital, he says, it is because the whole ethos of Archways is different.

Peter, a 72-year-old retired businessman from Easingwold, spent three weeks in intensive care and seven months altogether in hospital after developing Churg-Strauss Syndrome. This is a very rare auto-immune disorder, in which white blood cells attack the patient's own body. They cluster together to form tiny granules, which inflame and damage the blood vessels, damage the digestive system and block the tiny blood vessels leading to the hands and feet, causing pain and paralysis.

Peter was admitted to hospital with severe pain in his arms and hands. After being first taken on to an orthopaedic ward, he was transferred to neurology. He doesn't remember much more. He developed internal bleeding, and spent three weeks in intensive care.

Then began the long, slow process of recovery. The disorder had effectively disabled his hands and feet, so that he had to learn to walk again. He made slow but steady progress throughout another six months in hospital. But since transferring to Archways three weeks ago, as one of its first patients, he has noticed the difference.

He can now walk the corridors with the help of a frame, and has daily sessions in the gym with a physio, as well as doing more exercises in his own room. It is, he says, altogether different to being in hospital.

"The purpose of this place is rehabilitation. It is more relaxed than hospital, everybody has their own private room, and the staff here are particularly trained to encourage all the patients to try and be self-sufficient."

He has one goal: to return to the home in Easingwold he shares with his wife. How long does he think it will take? "How long is a piece of string?" he asks. "I hope no more than six or seven weeks. I have my sights on being home by the end of the year."

With the help of the staff at Archways, he may make it.

Updated: 11:02 Wednesday, November 24, 2004