Colchester Borough Homes: Caring for dying people

An award winning new approach to palliative care - believed to be the first scheme of this kind in the country - is being tried out in Colchester in Essex. The government has long recognised there are problems around how people receive palliative care. Research shows that half of all terminally ill adults would like to die at home, but only one in five are able to do so. Colchester Borough Homes wanted to do something about that problem.

Colchester Borough Homes is an an arms length management organisation (ALMO) managing over six thousand homes for the borough council. It was created in 2003.

Sheltered housing manager Jacqui Tavner and NHS community matron Jan Secretan came up with the idea late last year. Colchester Borough Homes already has a strong working relationship the community matrons, because of the work they do for the extra-care schemes. An extra-care scheme is a form of sheltered housing which gives residents higher levels of support than conventional sheltered schemes.

Tavner says: “Jan and I came up with the idea last year, when she came to me and asked me if there was any way we could help a terminally ill man. She asked if he could be cared for in one of our extra-care schemes. I was keen to help.

“We found that we had a suitable [extra care] home which was available. He then moved in, and the community matrons and their team provided all the medical care and equipment. It all worked out very well. He had a much better quality of life than if he had been in hospital. He was in the environment he wanted to be in, and was able to have his friends and family visit whenever they wanted. They could even stay in the on-site guest room.”

Tavner says that after his death, his family told Colchester Borough Homes how great they thought the scheme was. Because of the good response, Colchester Borough Homes decided to examine ways of extending the scheme. Another person has since used the service.

He had a much better quality of life than if he had been in hospital.

Jacqui Tavner

Residents become a tenant of the borough council when they move into the scheme. They also get a full care package provided by community matrons, which is worked out based on their needs. It may include care from Macmillan or Marie Curie nurses. This approach has number of advantages, not least the cost. It is considerably cheaper to care for people in this way compared with keeping people in hospital or a nursing home. It can cost the NHS up to £500 a week to keep someone in hospital. The patient also benefits by being in their own home, with their own belongings. The problem of hospital “bed-blocking” is also reduced.

The scheme is still in its very early stages, but there are plans to expand it.

Colchester Borough Homes' care home

Tavner says: “We would like to take this scheme forward. One of the major issues that we have is homes don’t always become vacant when we need them. This means we can’t care for as many people as we would like. In the long run we are looking to identify a home which can permanently be used by the scheme.”

The potential impact of the scheme on the healthcare sector was recognised by the National Federation of ALMOs which gave the scheme the Most Innovative Project 2008 award.

Tavner believes this project illustrates what public sector organisations can do when they work together. She says: “This is what joint working really means: coming with new ideas, finding a better way of doing something to benefit members of the public. And all this has the added benefit of saving the taxpayer money. We couldn’t have done this on our own - the NHS and its community matrons played a crucial role.”