Themes:
- Setting up a new pilot project
- Policies and Procedures
- Recruitment and Training
- Launch and Marketing
- Audit and Evaluation
Grove House provides specialist palliative care on a daily basis to people affected by cancer or a life threatening illness. A range of specialist services ranging from Day Care, Outpatients Clinics, Family Support Services, Therapies and Information and Support is offered at our purpose built building in the grounds of St Albans City Hospital. Unlike some organisations who only help people with advanced disease, we are able to offer help from the point of diagnosis. We are not an in- patient unit but work closely with other hospices in the region who can offer this facility. Grove House has a team of over 220 volunteers who carry out a wide range of tasks including complementary therapy, counselling, driving, reception, day care etc.
Setting up a new Pilot Project
For some time we have wanted to take our services out into the community so that people who are unable to come into Grove House can have equal access to some of the services we offer. Consequently a series of meetings was held with local Macmillan Nurses, District Nurses and representatives from local hospices. The purpose of these meetings was to gauge the level of need and the type of service that our colleagues already working in the community felt was most needed. One of the things we were keen to avoid was duplicating what was already on offer and we wanted to ensure that we worked collaboratively with the Primary Care Trusts and other local agencies. As a result of these meetings, it was decided that our new service, to be called Grove House at Home, would offer Home Sitting, Befriending and Complementary Therapy from 8am to 8pm seven days per week.
A business case was prepared for submission to our Board of Trustees and we were given approval to start the one year pilot on 5th April 2004. At this stage our Occupational Therapist and I were given extra hours to cover the roles of Pilot Managers, making us both full-time and allowing a combined total of 27.5 hours management time per week.
Visits were made to other Home Sitting and Befriending Services to gain an insight into the ways other schemes were set up and to learn from their experience. One of the main points to emerge from these visits was that although the schemes have many similarities, there is a lot of diversity within the way the schemes are run and what their volunteers are allowed to do. The visits helped us to define what we expected from our own service and how we would start to prepare our own policies and procedures.
A pilot timetable was then prepared allowing us five months to do the preparation before the service goes live in month six.
Policies and Procedures
We have written our operational policy and are currently working on our volunteer handbook, referral system, discharge policy, lone worker policy and are developing audit and evaluation tools. We will use the Grove House multi-disciplinary assessment form for all referrals which we expect to come from the Macmillan nurses, District Nurses, GP’s and other healthcare professionals. People will also be able to refer themselves. All referrals will be discussed at the weekly Multi-disciplinary Meeting and a system of prioritising needs will be set up.
An assessment visit will then be made, a risk assessment carried out and an appropriate volunteer matched to the client. Clear guidelines will establish the framework in which the volunteer will work and the clients will confirm in writing that they understand what can and cannot be undertaken.
It is anticipated that a six week course of complementary therapy will be offered initially and then reviewed. Home Sitting and Befriending will be reviewed three monthly.
The aim of the pilot is to evaluate the need, to identify what is an appropriate length of time that a patient should receive the service, to analyse other areas where help is needed, to determine what is a manageable caseload and to assess the management and administration requirements.
Recruitment and Training
We plan to recruit approximately 15 volunteers initially. Some of our existing volunters have expressed an interest in becoming involved and we envisage that the team will be a mixture of experienced volunteers and new people who have joined specifically to work in the community. Part of our remit will be to encourage a more diverse volunteer team and to market our service to ethnic minority groups. Whilst we are not offering nursing, it is hoped that some ex nurses or health care assistants will be interested. We intend to hold an information evening for prospective volunteers where they will be given a presentation, an information pack and application form.
All volunteers will be CRB checked and will undertake a comprehensive training programme which will cover:
- The Role of the Volunteer
- Boundaries/ Case Studies
- Cancer and palliative care
- Loss and Bereavement
- Active listening
- Personal safety/Moving and Handling
- Working in the home environment
- Emergencies
- Policies and Procedures
- Supervision
External trainers will be employed where appropriate.
The volunteers will be expected to attend monthly supervision sessions which will be led by the two Pilot Managers. They will also be required to submit a monthly report sheet detailing the visits they have made during the month.
Mileage expenses will be paid and there is a small budget to pay for costs incurred if a befriender takes a client out.
Launch and Marketing
Representatives from the Primary Care Trust and all the relevant local agencies, together with the media will be invited to the launch which we hope will gain maximum publicity for the service.
Articles in the local papers, on radio stations etc and leaflets and posters will alert the community.
A series of presentations to local groups and health care professionals will be undertaken.
Audit and Evaluation
We will use a range of monitoring and audit tools, together with client satisfaction surveys and feedback from referrers to evaluate the service and ensure that we meet our aims and objectives.
October 2005 – update on the Grove House at Home Pilot
The pilot officially ended at the end of September but there is funding to carry on until December 2005. An end of pilot report is being compiled and some experiences are highlighted below:
- Twenty volunteers from diverse ethnic backgrounds were initially recruited. Three of these volunteers were complementary therapists. One volunteer dropped out during training and one of our therapists has moved from the area, leaving 18 volunteers still involved with the project.
- Two hundred and fifty seven visits were delivered during the year, mainly during the day but with some visits at weekends. The demand for evening and weekend visits has not been quite as great as anticipated but it was part of the project’s aim to determine this.
- One of the key benefits has been to carers, who even if they did not want to leave the house, have really valued having someone sit with the patient, allowing the carer to get on with things such as catching up with paperwork, gardening, etc.
- Complementary therapy has been very much valued, both by carer and patient.
- Referrals have come from across the range of healthcare professionals and some people have referred themselves.
- The volunteers have welcomed the level of support offered, especially in view of some of the complex cases they have been dealing with.
The Future
A bid has now been submitted to Macmillan Cancer Relief to continue the service in St Albans and Harpenden and to extend it to the Dacorum area which is part of the Grove House catchment area. If successful, another clinician will be appointed, specifically an occupational therapist, who will be able to carry out assessments of the patient and the home environment. Grove House is very hopeful about securing this funding, however, should this not be the case, it will continue with the existing scheme though will be unable to expand the project any further.
For further information, contact:
Wendy Burns
Voluntary Services Manager
Grove House
Waverley Road
St Albans
AL3 5QX
Tel. 01727 897119
Email - wendy@grove-house.org.uk
