Home care services for travellers

Finding your way up an unmade road to a travellers’ site where dogs roam freely and you’re viewed with suspicion can be intimidating for care workers. But the fact remains that travellers, particularly those who are elderly or vulnerable, need health and social care services to be delivered in their homes just as the settled community does.

So when Essex Council’s older people team in Billericay and Wickford discovered that an elderly traveller was not receiving value from a care package set up when she left hospital, it decided to act.

“There’s been a lot of prejudice with getting care workers to go over there,” says Hazel Churchyard, deputy team manager. “When one client was discharged from hospital the care worker hadn’t been making sure that she was eating and drinking properly and that shouldn’t happen.”

This state of affairs galvanised team manager Noreen Fry to kick-start an initiative now known as The Travellers’ Project. Over the past two years, by combining forces with health and education workers and making fortnightly visits in a mobile unit to the site, Fry and her team have helped local authority care staff build bridges with the travelling community by working through the anxieties of each party. The aim has been to promote understanding of travellers’ needs so that better services can be delivered to those who need help to remain in their homes.

Part of this effort has involved familiarising agency workers employed to deliver care packages with travelling culture. Breaking down prejudices can be difficult, Churchyard says. Many agency staff are migrant workers and communication can be tricky but training workshops continue to be given and the situation is improving, she adds.

Carrying out a thorough risk assessment on the travellers’ site has also helped. Poor lighting gave care workers a sense of vulnerability on winter evenings. Dogs, often left to wander freely outside, also made workers feel nervous. And home-made speed bumps installed by travellers on the unmade road leading to the site risked damaging workers’ cars. Each of these points was addressed with the travelling community, says Churchyard. Dogs are now kept inside at night and the speed bumps have been removed.

The travellers too were wary of people arriving to “do them good”. Recruiting a representative from their community to help plan each element of the project has fostered trust and eased communication on contentious issues.

Confidence in medication

Realising that many older travellers are illiterate and cannot read their medication dosage, the team persuaded a local pharmacy to dispense prescriptions in blister packs. “They would have big carrier bags full of tablets that they didn’t know how to take,” says Churchyard. “But the pharmacy has been great, going over to dispense to people in their caravans, and the blister packs mean people are now confident in taking their medication, so their health isn’t deteriorating.”

Nora Sheridan, 79, who lives on the site, says it is this kind of attention to her welfare that makes her less stressed than in the past. “Care staff come in to help me in the morning and the afternoon. They do personal care when I need it and tidy up my kitchen. I’ve got illnesses that make it quite painful sometimes, and I can’t read to see the instructions so they help me with taking my tablets. The new packets help too.”

Did she feel worried when the workers first came on site and approached her with offers of help? “I was relieved,” she says. “Before I got the care package sorted out, my life wasn’t that good. It’s been two years since then and I’m a lot happier now.”

Churchyard says many older people on the site will have been left to fend for themselves as younger family members seek seasonal work some distance away. Finances can become stretched with no family back-up, so just as maintaining someone’s health is crucial, so is receiving benefits and now benefits officers also visit the site.

After all this hard work, what does she think the project team has managed to achieve? “We’re able to provide a service, and it’s something that would probably have dropped by the wayside without the effort that’s been made,” she says. “That would have resulted in a lot more hospital admissions for elderly travellers.”

Lessons learned

● Engage with the travelling community to find out what they want before trying to the deliver the services you think they need.

● Get a traveller representative to sit on the planning team: it’s helpful in gaining an understanding of the community’s priorities and anxieties. It also helps to familiarise the team with a community.

● Breaking down the barriers of prejudice that workers had about travellers was essential to the success of the project. You have to listen to your team’s concerns about visiting the site – for example, lack of lighting on night visits, dogs wandering round the site – and then address them by carrying out risk assessments and collaborating with the travellers to find solutions.

This article appeared in the 7 June issue under the headline “Travellers’ checks”