Care@Home hub

Project overview

St Wilfrid’s Hospice in Eastbourne wanted to improve the end-of-life experience for patients and carers living in the rural north of its catchment area. This includes the towns and villages of Uckfield, Heathfield, Hellingly, Herstmonceux and Buxted and the hamlets and villages in between.

The hospice established a Care@Home hub in Uckfield Community Hospital, to provide comprehensive and holistic support to patients at the end of their lives.

Through the Care@Home hub, the hospice offers packages of care (such as washing, toileting, getting dressed) seven days a week, to ensure patients' needs are met out of normal working hours. The team supports families and carers by providing daytime respite care (available Monday to Friday). Overnight respite is planned for via Continuing Healthcare.

Outcomes

The hospice has increased its geographical reach. Between January and December 2023, 49 new patients were supported with Care@Home visits.

Feedback from patients and carers shows that patients have been able to remain at home, if they wish to do so. Patients and families are less anxious as they have regular contact with hospice teams, and they are able to access personalised support more quickly than before.

Because carers are supported, there has been a reduction in the number of patients reaching crisis point and having to be admitted into hospital.

The team has also supported District Nurses and other care providers, by giving regular updates on a patient’s progress and helping with dressings and pressure area care.

The Care@Home staff are more confident and enjoy their role. Staff retention rates are high and individuals are reporting good job satisfaction. In particular, working from the hub has reduced their travel time and enabled them to build good relationships with patients, carers and families.

Key facilitators

St Wilfrid’s was grateful to receive a grant from St James’s Place Charitable Foundation via Hospice UK's Grants programme in 2022/2023. This enabled them to set up the Care@Home Hub, recruit and train staff.

St Wilfrid’s has developed strong partnerships with GPs and District Nurses in the north of the catchment area. This has helped publicise the new personal care service and put the referral pathways in place.

The hospice created a comprehensive training programme for all care assistants to ensure they are confident and meet general and medical competencies. This includes completing the Care Certificate.

Challenges

It was difficult at first to recruit staff for the Care@Home service. Initially, the hospice was seeking staff who lived in the project area. However, having access to the hub in Uckfield means this is no longer necessary. Staff who live out of the area can be based at the hub and visit patients on a ‘loop’ to reduce travel.

There are some risks associated with lone working in a rural area. All staff have been given Guardian24 devices and trained how to use them. They also have work mobile phones. There is a process for staff to check in with the hospice when they are working outside of standard hours.

St Wilfrid’s plans to offer career progression to the Care@Home carers, giving them the opportunity to complete a diploma in Healthcare Support so they can become Healthcare Assistants (HCAs).