Case Study

Often hospital is where people find themselves in the caring role for the first time, unsure where to turn. The Carers Lounge is an innovative partnership between Bedford Hospital, CiB, Bedford Borough Council (BBC) and Bedfordshire CCG, established to give carers visiting the hospital a safe, confidential, non-judgmental space where they can find support, information and advice. Support for the carer continues after the patient has been discharged. The Lounge Coordinator leads a team of support workers and volunteers, specialising in areas of support, including benefits, support for carers of children with additional needs, and for carers of individuals living with dementia. The coordinator keeps records of contact made with carers, which are reported to all stakeholders along with case studies. First fiscal year (2012 to 2103) the Lounge had contact with 427 carers, rising year on year to 2073 carers in 2014  – 2015, demonstrating a substantial impact. These have also been shared with others looking at starting similar projects.

In 2010, the Government published a strategy to improve health and social care support for the UK’s 6.5 million carers. Priority areas were identified which form the key principles of the 2014 Care Act;-

• Supporting early self-identification and involvement in local and individual care planning
• Enabling carers to fulfil their educational and employment potential;
• Personalised support for carers;
• Support carers to remain healthy.

Carers need the knowledge and skills to care safely in a way that promotes wellbeing for the care recipient. The CEO of CiB’s business plan for the Carers Lounge at Bedford Hospital was also informed by the Moffat Project pilot in Scotland (2009-10) which placed carer support workers into hospitals and social work departments. The program aimed to get support for carers at an early stage, to advise carers of their rights and offer them a carer’s assessment, reduce the pressure on carer’s health, and involve carers in discharge planning.

Almost 3,000 new carers were identified and more than 3,500 health and social care professionals were trained in carer awareness. The directors of Bedford Hospital and the CEO of CiB recognized the importance of learning from this pilot and the need for a sustainable long term plan. They engaged Bedfordshire CCG and BBC as funding parties in the initiative and the hospital agreed to provide an area where carers could find information, advice and support. The Carers Lounge was born.

The shared aim was to ensure all carers coming into contact with Bedford Hospital were identified, directed to appropriate services, advised, and made aware of their rights. The partnership plan was to provide a base within Bedford Hospital with skilled staff to support carers. The business plan had a vision to deliver:-

• Identification of new carers
• Access to professional advice from the range of hospital services
• A quiet area for carers
• Referral and support for carers assessments
• Practical advice
• Welfare check on carers staying overnight
• Linking to end of life services, dementia, orthopaedics supportingcarers� involvement in discharge planning with a strong re enablementfocus
• Benefits checks
• Support for young carers
• Support for parent/carers of children admitted to the hospital
• And parent /carers of adults

Christina Offord was employed as the Carers Lounge Coordinator to deliver this initiative. She consulted with carers and attended carers groups. Feedback suggested the Lounge should have opening times to cover visiting hours and times out-patients departments operate. It should be accessible to carers in daytime employment, without the need of a referral or appointment. Carers said the service should be reliable, sustainable and robust and cater for their often overlooked needs.

Since the Lounge opened in 2012, 5653 carers have been contacted, 4252 who were carers unknown to any other health or social care service, and may otherwise have remained unidentified. Carers were informed of their right to a Carers Assessment and offered benefits advice. Carers feedback informed a Carers Charter and Carers Information Pack which were launched in the hospital to provide carers with knowledge of what is available and their rights.

• The average age of carer using the Lounge has been over 65
• Common conditions were stroke, mental illness, heart disease, COPD and dementia.
• 62% were women and 38% were men. Carers contacted through the Lounge are recorded and each return visit is counted.

We record if the carer has received benefits advice or been referred for a carers assessment. Statistics are shared with hospital directors and funders, to evidence the value and importance of the Carers Lounge. Example in additional information. Qualitative feedback is collected through carers self-reporting and case studies to ensure soft outcomes are collected.

The plan is for

• Bedford Lounge to become firmly embedded into the internal structure of the hospital, as much as the x ray department.
• For Lounges to become part of the internal structure of more hospitals. Nearby hospitals are following our initiative, and CiB opened a Lounge in the Luton and Dunstable Hospital in September 2015.
• Lounges have also been opened in Stoke Mandeville, Milton Keynes and Lister Hospital. Kettering and Watford Hospital have also now followed.
• Bedford Hospital is looking to increase the space the Carers Lounge operates from. This includes a second room that can be used as a private area for services such as benefits advice and counselling.
• Other plans include supporting the carer more through discharge, and continuing that support in the community to help reduce hospital readmissions. One study found that problems associated with the carer contributed to readmission in 62% of cases.
• Carers of people readmitted were more likely than other carers to:
•  – be experiencing ill-health, fatigue and interrupted sleep;
•  – be conducting at least one intimate task;
•  – Generally feel frustrated.
• Our vision is to make an impact on readmissions locally.

The Carers Lounge initiative is one of the first of its kind, achieved through an innovative partnership between statutory services, the voluntary sector, and the local community, with proven results in identifying unpaid carers and keeping them informed and safe. Carers save the government 139 billion pounds a year. Initiatives like the Carers Lounge help give carers recognition, within communities and with professional staff. If we help support carers then we help to reduce pressures on hospitals and re admissions. The Carers Lounge is unique and different from other projects, with key success factors –

•  – it came from a shared vision
•  – determination to make it a reality
•  – having the Lounge firmly embedded, physically and working in partnership with the

Key learning for lounge projects are

•  – The need for persistent promotion and raising awareness
•  – Staff within the Lounge need to be resilient, reliable and robust
•  – The need to build trust within the hospital to maintain momentum
•  – To be able to offer a consistent service.
•  – Other parties interested in doing something similar, should consult and value carers and take their views into account. The carers are at the heart of the success of the Lounge, they helped to shape the Lounge following consultation at carers support groups. Carers asked for the Lounge to be easily accessible.
•  – The Carers Lounge is managed as a drop in. Carers do not need an appointment or to be referred. Hospital staff use the services at the Lounge either for themselves or to direct carers to.
•  – The use of reliable volunteers to visit the clinics and wards and promote the services offered at the Lounge directly to carers has been an invaluable way to raise awareness, in addition to the posters, leaflets and giving talks to staff.
•  – We have also continually improved the Lounge space to create a welcoming area that combines comfort and professionalism. Information on the Carers Lounge is shared on Bedford Hospital’s and CiB’s website, along with other publications such as the Carers Information Booklet.

Watch the Presentation Here!