Long Term Respite requirements

What was the issue you were addressing or working on?

Support for carers where the continual disturbance of sleep is placing an intolerable pressure on family carers, placing the carers health at risk and affects their capacity to continue with caring tasks safely and adequately, and may result in the breakdown of care at home arrangements.

What you did?

The project commenced quickly after funding was received by utilising capacity within existing workforce.

The project set targets for the duration of the fund is 4 nights per week  across Lewis, meeting the needs of 2, 3 or 4 households offering between 1 or 2 nights each. In total we anticipate providing 208 nights per year and 312 for duration of fund supporting 15 Carers and 15 Service Users.

Crossroads Caring Scotland guidance was used for referrals, care  assessment and planning and  process records.

To ensure a personal outcomes approach the project used JIT guidance to develop Personal Outcomes Record and Carer Quality of Life Prior/ After Feedback questionnaires.

From the time of referral we monitor the benefit of the service to Carers and the Cared For by using the questionnaires, completing home visits and by telephone. We consult with the Care Attendants providing the service to seek their views on the benefits of each service.

The project is exploring options to support the personalisation agenda, Self Directed Support Payments and the purchasing of care support hours.

  • The service has been averaging 4 nights per week support to service users.
  • The project posted out 30 needs survey prior to start of project 17 were returned with 7 carers expressing interest in the service.
  • As part of our care service needs assessment the project provides the opportunity for carers to express their interest in the service and it can be best tailored to their need.
  • The project monitors the service every week by phone to assess the impact on Carer wellbeing, prior to a home visit at the end of each 6 week block of support.
  • The project uses a Personal Outcomes approach in planning, implementing, monitoring and review of each service. We do this by asking carers to complete a ‘Quality of Life’ questionnaire prior to the service starting and at the end of each six week block of service thereafter.
  • The project involves the Community Care Team & Social Care Assessors in referring Carers for the service to ensure we support those Carers and Cared For who would benefit from the service the most.
  • The project also use a Personal Outcomes Record to show what the intended outcomes are on a review basis for each carer and note the changes.

The project has been proactive in ensuring that service users are aware of service provision through a variety of methods including

  • Developed Good Night’s Sleep Service information leaflets, posted leaflets out to all existing service users and to those on the current waiting list.
  • Used the local press and our website to advertise the service.
  • Developed referral, planning and evaluation ‘Carer Quality of Life Feedback‘ forms based on information provided by Talking Points.
  • Completed home visits to gathered evidence from 4 referrals as to expected outcomes
  • Contacted all GP practice managers in Lewis and invite to North Lochs Practice meeting in May to present service information.
  • Contacted and sent leaflets to Community Care Team CnES
  • Information about project listed on Crossroads Lewis website.
  • Publicity in local press and Radio nan Gaidheal.

Crossroads Lewis has achieved Grade 6 (Excellent) in all 3 Quality Themes inspected at their inspection in February 2013.

The project team were finalists in STV’s Real Heroes Awards.  From over eight hundred entries, the team of twenty-one Care Attendants have made it into the top three in the category ‘Carer of the Year.’

What were the outcomes - benefits or otherwise?

The benefits outlined below are taken from evaluations from service users after receiving the service:

Good Nights Sleep Case Study 1

A fulltime Carer who cares for her mother who is living with dementia. The mother is agitated and restless throughout the day and night. They live in a remote area of the island and are unable to benefit from day or residential respite. The Carer is visibly exhausted and is concerned as to how she will be able to continue in her caring role.

Initial assessment  revealed Quality of Life  for the Carer  as follows:

-Sleep, Stress levels, emotional levels as ‘Very Poor’

-Mental Wellbeing, Energy levels and Social life as ‘Poor’

6 weeks of one night per week commenced 8/02/13.

After the first 6 weeks of service, the review assessment revealed:

-Mental Wellbeing as ’Adequate’

-Emotional, energy, sleep, stress and social life as Poor.

-Physical health remained ‘Adequate’ in both assessments.

The Carer comments:

“The service is very valuable, absolutely amazing… to be able to close my door at night without having to listen and knowing I don’t have to get up through the night”.

“ The overnight support is fantastic and came at a time when I really needed it”

“ I wished you could get more funding…….it’s only one night a week”

After the first 6 weeks of service the Carer has been reassessed and is currently receiving a further 6 weeks. A second night per week is currently being provided for 3 weeks whilst another Carer receiving the service was able to benefit from 3 weeks statutory respite provision.

Good Nights Sleep Case Study 2

A fulltime Carer who cares for his mother and has given up fulltime work to do so. The mother lives with dementia and is unable to distinguish between night and day, either refusing to go to bed or wakening throughout the night. The mother is unable to be left unsupervised at any time following incidents of leaving the house alone and wandering and also causing a fire in the kitchen.  The Carer is stressed and exhausted but determined to care for his mother in her own home for as long as possible. They have no family support on the island but the daughter visits from mainland every few months. The Carer is able to benefit from residential respite for his mother every few months. They live in a remote area of the island and are unable to benefit from day respite.

Initial assessment  revealed Quality of Life  for the Carer  as follows:

-Sleep. Energy, Stress and Social life as ‘Poor’

-Mental Wellbeing, Emotional levels and Physical health as ‘Adequate’

Carers Comments on what gained from the service as follows:

‘Peace of mind and good rest from constantly listening out for my mother’.

The Carer was able to stay overnight at a nearby family home to benefit fully from an undisturbed Good Nights Sleep.

Contacts - to find out more

Nicky Cowsill, Crossroads.lewis1@btinternet.com