Category: Hospice @Home

Caring for patients in the comfort of their own home was started by East Cheshire Hospice five years ago this month.

Its Hospice @Home service has been an overwhelming success during that time, expanding greatly to meet the needs of the community.

An initial team of six has grown to more than 25, including nurses, health care assistants, co-ordinators and bank staff. Home visits are made in cars painted in blue Hospice colours.

From left, Hospice @Home clinical co-ordinator Gill Tomlinson, manager Tess Cleaver and health care assistant Joanne Helm.

Figures show that since October 2017 staff have –

* Received 1,830 referrals.

* Made 14,400 home visits.

* Helped 1,028 people to die in their preferred place of death, either at home, or in the Hospice.

* Taken 1,107 SOS phone calls from users, possibly avoiding call-outs, ambulance visits, or hospital admissions.

* Made 6,036 planned phone calls to users, saving similar trips.

* Made 150 night sits.

Hospice @Home began as an out-of-hours rapid response service for patients in the last two weeks of life, later extended to 12 weeks.

It supported patients overnight and at weekends where access to health care professionals was limited. It also offered ad hoc care for patients with little or no package of care wishing to stay at home as long as possible.

A gap in regular care provision was identified in certain places, often due to locality and availability of care agencies in those areas.

That led to a day service, beginning in April 2020, providing high quality packages of care to patients rapidly deteriorating and thought to be entering a terminal phase.

Staffing levels were increased significantly to provide this round-the-clock service.

Meanwhile, carer breaks were introduced in January 2021, giving respite for carers of loved ones in the last six months of life.

Fifth birthday celebrations for the Hospice @Home service. Manager Tess Cleaver (left) with clinical co-ordinator Gill Tomlinson.

The Hospice is also now the East Cheshire hub for Palliative Care in Partnership, assessing patient suitability for community-based fast track care applications.

Since April, this hub project has provided night care in collaboration with Marie Curie, with an average of five night sits a week.

Hospice @Home Manager Tess Cleaver said: “I’m proud of what our exceptional team have achieved over the last five years. Everyone is so invested in providing excellent care tailored to each individual.

“Importantly, we’re part of a much wider healthcare network and close co-ordination with other community services is vital. We strive to provide high quality care and always learn from feedback to further improve our services.”

Nurses are now driving round in a second car to further help Hospice @Home patients.

The Ford Kuga was bought thanks to the generosity of the What Women Want fundraisers who also purchased the first vehicle for the service.

Hospice @Home has been an outstanding success since its launch in 2017, with the two cars enabling staff to get out and about more easily.

The latest car – also painted in the light blue Hospice colour -is a hybrid in line with the Hospice’s environmental initiative.

Both cars were supplied at discounted rates by Ford dealers Sidney Jackson and Son, long-standing supporters of the Hospice.

Healthcare assistants Rachel Barker (left) and Elaine Taylor with the new Hospice @Home car.

The charity’s green push includes a new appeal to buy solar panels. It is also reducing its carbon footprint in other ways via its garden and kitchen produce.

The five WWW girls raised £27,000 from a ball at Cranage Hall in November, a total generously match-funded by one of their close friends and benefactors.

Those donations funded the latest car and decoration of a lounge for patients and families.

Hospice @Home manager Tess Cleaver:  “We can’t thank the What Women Want group enough for yet another amazing donation.

“With two cars, both kindly funded by the group, we can reach more patients more easily and that makes a huge difference to us.

“We cover such a wide geographical area in East Cheshire and moving between homes can be quite complex, but this extra car simplifies our task. We’re extremely grateful.”

Caring for patients with life-limiting illnesses in their own homes has been ‘challenging and emotional’ during Covid-19, according to a senior nurse at East Cheshire Hospice.

Tess Cleaver is manager of the charity’s Hospice @Home team which has made home visits during the pandemic.

While the country was on lockdown, her dedicated team were on the front-line of health care visiting patients as usual.

Gloves, aprons, water-resistant face masks and visors have been worn at all times by the 12 specialist nurses and highly-trained healthcare assistants.

Following rapidly changing guidance on PPE presented a challenge in itself.

The Hospice @Home team did have to suspend its services for two weeks early in May so further precautions could be put in place.

Tess said: “It’s been challenging and closing the service temporarily was difficult. We didn’t take the decision lightly, but it was made by the senior team to ensure we were operating in the safest possible way.

“That was our guiding factor and without that adjustment we’d have struggled to function as normal.

“We had great support from other health care providers and family members were amazing. They understood that we were doing everything to make sure we kept their loved ones safe.”

From left, East Cheshire Hospice @Home manager Tess Cleaver and healthcare assistants Kim Lamb and Karen Buckley.

 

Hospice @Home now covers 24 hours a day – it had operated overnight and at weekends until April.  The extension was planned before coronavirus.

Tess added: “We’ve had to make a lot of changes and be adaptable and the response from Hospice staff has been fantastic. Everyone has pulled together.

“Staff have been flexible, helping out in other Hospice roles when we shut down, and I can’t thank them enough.

“When the virus started some patients were scared. They wanted us to get in touch, but didn’t want staff visiting to reduce footfall in their homes.

“Then when they saw us and district nurses wearing the PPE that was re-assuring.

“Staff might finish visiting at 8 pm during the Clap for Carers and that was touching. It was lovely for the clinical staff on the inpatient ward to receive a visit from Macclesfield police one Thursday.

“One staff member had to move away from a relative who was in the high risk group. It’s been emotional at times and we’ve all had to make difficult decisions.”

Some staff tested positive for coronavirus and guidelines were followed immediately. Thankfully, those affected are now recovered.

Hospice @Home has had a ‘massive impact’ since the service was set up by East Cheshire Hospice two years ago.

A growing number of patients are accessing the charity’s specialist palliative care services in the comfort of their own home.

Figures released on the second anniversary of the service show that so far Hospice@ Home staff  have –

* Received 713 referrals.

* Made 6,815 home visits and 3,854 supportive telephone calls.

* Supported 412 people enabling them to die in their preferred place.

Tess Cleaver recently took over a new role as Hospice @Home Manager, having moved from the inpatient unit where she was a staff nurse.

She said: “Hospice @Home is about taking the excellent care we offer here in the inpatient unit and providing that in the community in people’s own homes.

“That was the vision for the service and that’s what’s being delivered. The impact has been massive.”

The service provides hands-on medical care, psychological support, symptom management, end-of- life care and care after death.

Nurses and co-ordinators work closely with other health care agencies, including GPs, district nurses, Macmillan and Marie Curie.

The service is ‘out-of-hours’ operating from 6.30 pm until 8 am and 24 hours at weekends.

Tess added: “If people can stay at home for their end-of-life care it avoids unwanted hospital admissions.

“Families try to do everything they can to look after their loved one and keep them at home but sometimes it becomes too much and they can’t help them in the way they’d like any more.

“Typically, a patient might need assistance with getting ready for bed, having a wash or going to the bathroom at 2 am. For them and their family that’s a crisis.

“That’s when our services come in to support the family. If no care were available, they may want to get them into hospital and because we’re helping we avoid those situations and that helps the NHS.”

Hospice @Home costs £2.2m for the first five years and is funded entirely by donors.

Tess said: “We wouldn’t be able to offer this service without the donors’ commitment so we’d like to thank them.

“People can’t put into words their gratitude for our service which involves collaborative working between several agencies. The need for those services will only become greater.”