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Care in the home

Sue Collins, head of health and social care at the British Red Cross, says its core principle of ‘refusing to ignore people in crisis’ is at the very heart of its care policy.

The Care Bill, chaos in A&E, promises of reform and integration – in the last few weeks the issue of health and social care services have not been out of the news.

But as the Government continues to build consensus over legislation, for the British Red Cross it’s business as usual. With over 170 social care initiatives across the country, this is an organisation that knows the difficult realities of caring for older people and those living in adverse circumstances.

The importance of prevention

Sue Collins is fresh out of the British Red Cross’s welcome meeting. Just six weeks into the job as head of health and social care, she already has a broad vision of where the Red Cross’s care focus should lie: prevention.

The Red Cross movement is 150 years old this year and is celebrated for its neutrality and impartiality. The British Red Cross’s tagline states ‘refusing to ignore people in crisis’ and that message is at the very heart of its health and social care policy.

Collins said: “At the British Red Cross we want to see everyone in or at risk of a health and social care crisis receive an offer of practical and emotional help, and shape the services they receive to boost their independence and resilience.

“And it should be made simple. People want support early on with a simple package of care that is tailored to their individual needs, with one point of contact, rather than having to fit in with complicated service structures.”

The Care Bill

With over 30 years’ experience in the care sector, she is clearly enthused and delighted about the potential of the Care Bill. She said: “The Bill is a real opportunity for organisations like the British Red Cross because it has enshrined our principle of working with in the field of prevention. In the future, every single person who goes to a local authority in need of care and support will be assessed and, even if they’re not entitled to get anything, they will be entitled to be offered some preventative help.

“It’s really fantastic for the British Red Cross because we are the glue between the health and social care system.”

That ‘glue’ consists of different projects run in local authorities across the country. ‘Home from Hospital’ services assist older people or those in need to make the transition from the wards back to their own homes, a service deemed invaluable by hospitals facing acute bed shortages. The assistance can also be a relief for families who aren’t able to help their loved ones, and most importantly, for the individual, it is a source of reassurance.

Reablement

A recent Age UK report found that on average, elderly people spend 30.3 days longer in hospital than they really need to. Collins explained: “In many cases our staff and volunteers first meet the beneficiary in hospital. There is an opportunity for them to build up a rapport so when it comes to the point of discharge, they are being assisted and driven home by a friendly face who can help them settle back in.

“It can be as simple as making sure the heating’s on and there’s food in the fridge. And we’re on hand, generally for six to eight weeks, to help with restoring their confidence, help them get to appointments, pick up prescriptions and give much-needed practical support.

“Our volunteers really can be a lifeline and often make the difference between coping or rapidly deteriorating into crisis.”

Assisting people with transport is not all the British Red Cross does. The ‘Crisis Intervention Service’ in Nottingham focuses more keenly on prevention. Contracted by the Nottingham North East and Nottingham West commissioning groups, volunteers are on hand to assist people referred by GPs, the ambulance service or community nurses.

Often A&E is seen as the first port of call, but the British Red Cross can step in to ensure those who don’t need to be admitted are adequately supported at home.

Collins said: “We are a key part of avoiding costly hospital admissions, so it’s a pretty unique and responsive service.

“And we see all sorts of cases, from people with long term conditions, to those in need of palliative care, and even new mothers struggling or suffering with depression. We are there to help anyone over 18, whatever their crisis.”

Home-based services

Recent independent economic analysis of British Red Cross services showed the programmes could save commissioners up to £10,000 per patient. Prevention and enablement projects are estimated to save £1.50 for every £1 spent. In times of budget cuts and increased pressure on local authorities, and with over 75% of GPs surveyed by the Red Cross saying lack of home-based services will lead to greater isolation and vulnerability, the charitable sector is an obvious place to turn to.

But with so many care providers our there what is it that makes British Red Cross services stand out? Collins said: “I feel very strongly about this; our volunteers are frontline ambassadors for the organisation.

“These generous men and women offer an added value service that many can’t compete with. They are often local, and able to get alongside our beneficiaries. But crucially they don’t have limits on their time.

“While professional carers are required to see a certain number of people a day, our volunteers have the time to really spend with people. They can sit with them, do extra bits and pieces to help; like a spot of shopping. One of the most common themes with our beneficiaries is that they are, very simply, lonely. Having one of our volunteers pop round for a cup of tea and a chat can make a world of difference.”

With the Care Bill going through Parliament the British Red Cross has its eyes on a greater share of the care market. It may sound surprising but it is in fact one of the largest care providers in the UK, reaching 400,000 people last year alone. Its mobility aids service, which loans out equipment such as wheelchairs and walking frames, helped 75,000 people in 2012.

Collins said: “We are a fantastic brand and our potential to reach out to those who want practical support is just phenomenal.

“For me another thing that is special about us is our reach because not only do we work in the four UK countries, but we can also draw on international lessons because care is a challenge being faced across the globe.

“We support care in the home primarily because that’s where people want to be, and we have an advantage because we are not condition specific. We are not an older people’s charity, we’re there for person in need, working to support people to avoid reaching a crisis. And we’re working to enable more, older people and those in need to live independent lives.”

'I can’t sing their praises enough'

Justine Hillier is a medical matron at St Peter’s Hospital in Surrey, which works in partnership with the Red Cross care in the home service. Each year, its volunteers and staff ensure short-term care and support at home for more than 400 people in the area.

The Red Cross’ service is brilliant. We both work from a hub within the hospital itself, so there’s always someone from their team on site Monday to Friday, nine to five. Most of the team are volunteers and they deliver care fantastically well.

Because they’re right beside us, we literally work really closely together. They provide advice and solutions to the things we need – and for us in acute services, that makes a huge difference. There hasn’t been a single occasion when they haven’t been able to offer the support we ask of them.

There’s no doubt we’re now getting people out of hospital and back into their own homes more speedily and safely. The Red Cross’ support plugs gaps we hadn’t previously been able to fill through social services or nursing care – such as helping with social support, shopping and all those things.

Increased confidence

People are also getting full support once they return home. Even when people are only in hospital for a short period, you tend to see that their confidence gets knocked.

We’ve seen how – especially for those who don’t require nursing or social care, but still need help rebuilding their confidence – the Red Cross has made a massive difference. In fact, many patients are pleasantly shocked to find they can access this kind of care through the hospital.

This kind of support is really important because, if someone is more confident, they are less likely to bounce back into the hospital as quickly, if at all. They know they’ll have someone to turn to if they need support.

‘Massive achievement’

From a nursing point of view, our ward staff are more comfortable knowing that those people who don’t meet the criteria for nursing care at home or social support will – thanks to the Red Cross – still get the help and reassurance they need.

That’s made a real difference to their work.

The care in the home service is one of those things we knew was out there in the community, but never properly picked up on before. Now, it will become a bigger and bigger part of our discharge network.

We have built up a great team of people and it’s working incredibly well.

I can’t sing the praises of everyone involved enough – it’s been a massive achievement.