Epic style of care

A one-stop solution ending the threat to elderly people’s
independence has been imported to Derbyshire from San Francisco.
Sue Mapp reports.

As the community care funding crisis progresses, user choice and
consultation are being eroded. This poses serious problems for
elderly people living at home as regular access to a range of
services is essential to their independence. Without it, they are
at risk of isolation, increased frailty and a premature place in a
residential home.

According to Derbyshire social services, its Elderly Persons
Integrated Care Scheme is the answer. Providing locally based
one-stop care shops, the scheme enables elderly people and their
carers to get a range of services and advice all under one
roof.

This way, elderly people can live independently in their own
homes for much longer.

Devised in San Francisco, this approach to care provision has
been developed in the UK by the Helen Hamlyn Foundation, a
London-based charity. The charity brought the idea to Derbyshire
social services department’s attention six years ago.

As a result, a working partnership was formed between the social
services department, the charity, Southern Derbyshire health
community services, and Derbyshire family health services
authority.

Supported by a joint management team with funding from health
and the Helen Hamlyn Foundation, Derbyshire social services opened
its first pilot EPICS centre four years ago.

The pilot proved so successful it was decided to develop five
more schemes. Three have already opened and two more will do so in
the next two months. ‘The key to these resource centres is
flexibility,’ said Maggi Nelson, manager of Arthur Neal House,
where the pilot took place. ‘People’s individual needs are taken
into account at every stage and we tailor services around
them.’

Arthur Neal House, located on a housing estate on the outskirts
of Derby, was adapted to accommodate a range of medical and social
care professionals normally scattered across the county. This way
elderly clients could make one trip and get the help they needed.
At the last count, about 200 elderly people were using the
resource.

Clients are referred by social workers, GPs, district nurses,
home helps and families with a few self-referrals. All referrals
are made to a multi-disciplinary core group, which meets
weekly.

The group is made up of Maggi Nelson, domiciliary services
officers, a district nurse, a community psychiatric nurse and the
area social worker. It agrees care packages and is supported by the
social services department’s service manager for older people. The
centre operates on a 24-hour basis, seven days a week. Users can
choose anything from dropping in for a coffee to having their eyes
tested, or if they find it hard to sleep they can activate a
special night sitting service.

The highlight of the scheme is its multi-use treatment room,
adapted so elderly clients can be seen by GPs, district nurses,
physiotherapists, occupational therapists, chiropodists, dentists
and opticians.

A pharmacist runs a monthly surgery, giving advice on
medication, and will do home visits when required. There is a
weekly hearing aid service and a database welfare rights service.
There are bath and shower facilities, a bathing service, and a
fully equipped hairdressing salon for anyone over 60 in the
catchment area.

The day centre accommodates 85 elderly people. Each client is
charged a fee of £1.50 which goes towards a three-week rolling
programme of activities and entertainment.

Most clients are transported to EPICS by a community bus or the
social care scheme. Relatives or friends can visit users during the
day. Besides a choice of lunch, users can make their own snacks. A
drop-in service operates during the evening from 7.30 to 10pm so
carers can go to the cinema or the pub.

There are also three short-term respite care beds, two enhanced
nursing care beds and 20 permanent residential beds.

Dorothy Poole, aged 70, who lives alone in sheltered
accommodation uses the scheme at Arthur Neal House twice a week.
‘It makes a difference to my life,’ she said. ‘I like the company.
I bring my knitting and maybe do a quiz and get my hair and feet
done.’

‘There is a mixture of people here. A lot of elderly people who
are in residential care used to use our day care or short-term
respite care service,’ said Nelson.

‘They are already familiar with the surroundings and the staff.
Many have made friends and know the way things work and what they
can access.’

A common theme among elderly clients using the day care services
is the importance of having the support to live at home.

If they had to go into a residential home, they would want it to
be Arthur Neal House, claimed Nelson.

‘Having a choice is important.’