Home‎ > ‎Full Report‎ > ‎Projects‎ > ‎

Hull Churches Home from Hospital Service

Hull Churches Home from Hospital Service (HCHFHS) caters in various ways for people who might otherwise require hospitalisation or other forms of residential care. It aims:

1. To provide a high quality short-term service to adults during the vulnerable period on discharge from hospital, who reside within the boundaries of Kingston Upon Hull
2. To provide reassurance, practical support and assistance in rehabilitation for those returning home alone or without support networks locally
3. To encourage and promote the return to self volition, independence and self confidence through innovative and flexible service provision

Origins

In 1993, the small Church of St Cuthbert’s looked at various ways to outreach to and serve the community. A large questionnaire survey was undertaken, which was followed by needs analysis. The eventual report in 1995 entitled, The Avenues: Services, Amenities & Crime looked at services and the use of services for older people, children and young families and young people. This evidenced a high level of distress and difficulty for people being discharged from hospital who did not meet the recently reduced criteria of statutory support across all ages. As well as uncovering unmet needs, steps were taken to determine the church’s ability to meet these needs. The conclusion was that there was enormous capacity in terms of offering time for training and voluntary involvement, but no one at that time wanted to be responsible in terms of leadership. The current Chief Executive Officer therefore took a one year employment sabbatical to become a full-time volunteer to drive the project forward.

HCHFHS philosophy

· We believe that every individual should be respected, valued and have dignity.
· We believe that above all people matter: they matter more than bureaucracies and structures and accordingly the whole person is at the heart of our policies.
· We believe that every individual should be encouraged to reach his or her full potential.
· We believe in cooperation and are actively aware that we do not have a monopoly of concern for the good of the community and are pleased to work alongside or in partnership with other agencies.

Activities

HCHFHS has five projects, each concentrates on a specific specialisation as the organisation has responded to and targeted the needs that were identified.

· Adult Reablement Service (generic)

This serves all people newly discharged from hospital via practical and emotional input for 6-8 weeks. Trained volunteers change anti-embolism stockings; shop, assist with welfare rights and swift access to other services and to additional income for users per annum via successful attendance allowance applications (£236,500+). Overall 48% of service users gain further support from other agencies. New carers are supported and informed of services; service users are supported back into social activities to mitigate against isolation.

· Carers' Support Scheme

Aims to meet the real needs of carers and thus enable carers to remain healthy and able to continue caring for someone with life-limiting illness. The carer identifies the nature of support required which can range from welfare rights guidance to a sitting service to being taken to social venues. Some have two volunteers to enable them, for example, to go to church. Evidence is increasing that support for carers relieves stress and reduces the need for crisis intervention. Support is offered through bereavement.

· GP Development Service

This pioneering service identifies and supports hidden carers through a GP Registration Project. The process is communicated via GP staff training. It improves access, communication and information sharing.

· Families Together Project

This project gives practical and emotional support through a specialist worker, a trained nursery nurse and volunteers. They provide input to maintain family routines as a parent undertakes chemotherapy, radiotherapy or surgical intervention. Dual sites at HCHFHS and Acute Trust Oncology Building enable rapid access. This project enables parent to maintain difficult treatment programmes aware that childcare issues are manageable due to flexible and trained staff and volunteers. There is also support to bereaved families.

· TeleHealth (Assistive Technology) Project

This project introduces home based TeleHealth monitoring equipment and familiarises service users and families with new easy routines in relation to chronic heart failure; chronic obstructive pulmonary disease (COPD); diabetes; and high blood pressure. This enables service users to be part of managing their chronic condition. It increases their quality of life.

Further developments

The initial core Adult Reablement Project to support older people was formed as a safe vehicle facilitating parishioners to befriend those returning to their community at a critical period. This rapidly expanded to a citywide service in partnership with churches across the city, then attracted volunteers of other faiths and no faith. As funding was offered from community and local authority sources, the involvement in further projects gained momentum.

Organisation

The organisation is a registered charity governed by a Declaration of Trust dated July 2000. It has attracted trustees of the highest calibre selected to include appropriate skills and knowledge for managing the charity and knowledge of the social and health sectors across the area of benefit. The vicar of St Cuthbert’s and two church members will always have Trustee Board positions. The Bishop of Hull is the Patron of the charity. Kingston upon Hull and East Yorkshire Churches Together also has the right to nominate trustees. Trustees meet about once every two months.

The organisation has benefitted from the current Chief Executive Officer remaining involved since the founding of the project as having a central person taking management responsibility at the core of the services has enabled continuity. There are three full-time and sixteen part-time staff.

Resources

The resources required at first were

· A room.
· A dedicated telephone, for example for hospital/community/GP and client referrals, volunteer training and allocation of service users. (Initially this could be in a domestic property.)
· Funding to cover volunteer reimbursement.
· Volunteer time.
· A leader to ensure systems are in place and to ensure safety.

The current requirements are for premises and funding. Premises are rented to house the professional staff managing the five projects and provide space for the training and supervision of volunteers. We use church buildings across the city to put on training events as near to our volunteers as possible. We use a city convent for large conferences or training events for staff and volunteers together.

Funding has been difficult through the recession with a loss of one third of the grant value from Social Services for the Adult Reablement Service and grant funding for Volunteer Training and Recruitment. However, in increasing our partnerships and relationships, we have recently included the business partners, International Assistive Technology Companies. Although we cannot accept any direct funding, we are able to accept offers of assistance with information to the media from their advertising departments to attract volunteers. The absence of funding for the training and recruitment post impacts considerably on the organisation as volunteers are at the heart of all the projects.

The organisation is currently financially secure for three years. Sources of funding are:

· Contracts with the Primary Care Trust and the local authority
· Grants from Macmillan Cancer Support and Church Urban Fund (Initially £12,000 over 3 years)
· Various donations
· Church giving

Volunteers

The service relies on volunteer input. Volunteers are all CRB checked, trained and supported to a high standard and insured. They are trained via accredited workshop programmes (Health and Safety; First Aid and Safeguarding). They then have a fieldwork mini-apprenticeship with clinical mentors for 6-8 weeks and compile their own portfolio of experience. They are requested to give 1-2 hours weekly, giving support in their own geographical area of the city. They are matched to clients and requested to stay with their client for the full 6 weeks service to provide continuity. However after that they can choose whether to continue with a further service user or have a break for a month or so. By maintaining a flexible approach, we support the volunteers to stay happy and stimulated with the work. The quality of training and portfolio evidence, signed off by professional tutors has meant (in the past when fully staffed) 40 plus volunteers moving on into employment or higher education per year.

Calculated on the basis of the minimum wage rate, the value of the time of the 80 volunteers is a minimum of £56,000 per annum.

Other forms of support

The Diocesan Church and Community Officer has been supportive and there have been volunteers from other churches and faith groups. HCHFHS is currently the City Lord Mayor’s chosen charity for the year and there have been visits from the Minister of Health and NHS civil servants to share information.

Outcomes

HCHFHS deals with a large number of people through the different projects:

· 1,469 p.a. in the Adult Reablement Service;
· 63 clients p.a. in the Carers’ Support Scheme;
· 400 new clients p.a. in the GP Development Scheme;
· 20 families p.a. in Families Together;
· 180 clients p.a. in the Telehealth Project.

As well as monitoring the number of people using the services, feedback is gathered from them about the services and their health outcomes are tracked (up to 1 year post service). Impact is measured and services planned in relation to:

· Reduced readmission rates: from the national average of 36.2% to 11.7% for HCHFHS clients.
· Low re-referral rates: 78% of the Telehealth clients felt less need to see GP or attend outpatient clinics and 90% felt less anxious and many have extended a poor prognosis of months to 3 years plus.
· Cost savings calculated by Health Partners.
· Qualitative data from user satisfaction surveys and quality of life indicators such as reduced anxiety.
· Volunteer surveys.
· Safe vehicle for volunteers from churches and the community to use skills.

At a strategic level, HCHFHS has been included in NHS Tenders as non-negotiable partners for new projects. It has also received awards: the Kings Fund Impact Award and the Queens Award (which is an organisational equivalent to an OBE).

Success factors

One of the key elements from inception has been the policies and procedures originally put in place and then developed to protect both volunteers and service users. Initially volunteers were police checked via computer Data Act 72 plus GP letter and two visited referees. The accent has always been on education and information sharing; management and supervision; processes in place to ensure safety whilst lone visiting; and an open door for immediate access to support when a volunteer is anxious regarding any issue/problem. The organisation seeks to know and understand legislation and to minimise to efficient levels any paperwork/monitoring by volunteers. Hopefully this ensures that volunteers feel happy and supported as they give their time and effort with such generosity. Through the mini-apprenticeship mentoring training system, we monitor how volunteers interact with service users and ensure that our values and training regarding respect and care and user empowerment is continually assessed and our training is reflecting our policy documents.

Being a small organisation we can be innovative and test new services underpinned by the organisation’s quality and accountability within an evaluative framework. Holding evidence of interventions has been successful when seeking funding.

Barriers

One barrier is politics (with a small ‘p’) within the Church, local authority politics and NHS. The organisation was initially viewed with suspicion and a degree of hostility despite filling a much needed gap in service. It has taken some years to grow the respect with which the organisation is now held. Interestingly no-one offered the service by nursing staff at ward level, prior to discharge, has ever refused it, in fact at that level the name, Hull Churches Home from Hospital Service, seems to be beneficial.

Another barrier from the perspective of someone with a background in local authority was the unrealistic expectation of a management structure operating at parish level upwards, which is not available (in a formal sense) and the rapid turnover/change of post of the supportive bishop and vicar.

Challenges and opportunities

· To maintain the services seen to be supportive to an aging population.
· To offer a real opportunity to other church communities to take a significant role if requested.
· Strategic direction.
· To ensure the values and ethos central to the organisation remain and we are not diverted through chasing funding opportunities which take us into different directions.

Finally, it would be good if the Church of England nationally would state what is happening beneficially in communities across the UK and concentrate on driving more of these projects forward.


Jean Templeton