Revolutionising thinking around care – the impact of hospice-ethos delivered social care

Categories: Care.

In a time of financial austerity, hospices are constantly seeking innovative solutions to income generate. Thirty minutes was all it took to revolutionise the thinking around the way in which domiciliary care was delivered to the wider local community of St Giles Hospice’s catchment.

It was on hearing a presentation by Martlets Hospice that the senior management team at St Giles were inspired to establish their own care agency.

With 10 years of knowledge and experience of providing end of life care to people in their own homes, St Giles found the transition to domiciliary care a relatively easy one.

The greatest challenge has been the interface between hospice services and the commissioned services provided by the care agency with regard to end of life. The hospice was acutely aware of the potential crossover of paid for and charity-based care provision. This blurring was addressed with a distinct emphasis on catering first and foremost for the client’s needs.

Hospice at home services remain in close communication with the care agency whenever a client is known to them. These close working practices ensure that the client receives equitable services. In other words, patients who might previously have received charitably funded hospice at home services may now receive care agency support with Continuing Care funding. This means greater opportunity to access services for those who do not meet the criteria for benefits to help pay for their care. The collaborative working practices of the teams have greatly enhanced the ability to deliver care to those most vulnerable in the community.

Collaborative case study

Anne, 49 years old, was introduced to the care agency by her clinical nurse specialist (CNS) due to the progression of her Motor Neurone Disease (MND). Having received ad hoc respite care from the hospice at home team for a number of months, Anne became eligible for funding to help pay for her personal care needs.

The close working relationship between the CNS, hospice at home and the care agency ensured that Anne received the best standard of care due to swift, effective communication across the departments, which included utilising multi-professional documentation.

As Anne’s needs changed, a respite stay was offered as an inpatient at St Giles Hospice. Due to the MND making communication increasingly difficult, and at the request of Anne’s husband Steve, the same team of agency carers were able to care for her on St Giles inpatient unit to provide continuity and maintain that level of trust that is developed over a long period of time caring for someone with a degenerative neurological disorder. Anne had always become anxious at the introduction of new carers. The close working across the departments gave Anne and her husband peace of mind and alleviated any anxiety around a new set of carers being introduced. Anne sadly died during her time on the unit, but those who had cared for her longest and knew her best were there to perform last offices as their final act of care and respect.

This synergistic way of working has been incredibly useful, from an educative and collaborative perspective. Maintaining the focus of care on the individual allowed some innovative thinking about ways of working which have created an imprint to benefit other patients with long-term degenerative terminal illness.

The easy accessibility to training and the expertise of the whole range of hospice departments and staff has been essential to the success of the care agency.

This has ensured that the care agency upholds the high standards in quality of care delivered with compassion and understanding with which St Giles’s name has become synonymous. 

The commitment to a holistic approach permeates throughout the care agency, with the wellbeing of the family, as well as the client, being paramount.

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