Exploring the difference made by Support at home 33 2. Supporting carers > The clear need for staff and volunteers to ensure service users have information about “It provides enormous relief and support to and access to the services they need has been families and carers of the individuals that we the catalyst for the development of this role are actually supporting because [they may not] locally. Advocating on behalf of individual have the knowledge of the local community service users varies in its depth across Support nor the knowledge of the welfare system in at home services and, critical as it is in order to know what can be done in order to strengthening health and wellbeing outcomes help them out.” (Red Cross staff member) for service users, currently it is not supported by any organisational training/development. > One of the consistent research findings about the failure of many hospital discharge 4.4 What service challenges do processes is the lack of attention paid to the needs of carers. Not only is inadequate we face? information available to carers, they are often not provided with sufficient discharge notice The research also found a number of challenges for their family member (Glasby, 2003). to our services working to deliver a quality service, and responding to people’s needs and the > Amongst the vast majority of staff and changing external environment. Challenges were volunteers consulted for this study, there was highlighted in the following areas: a consensus that Support at home has, as one of its by-products, strong support for > Supporting more people with long-term health the service users’ carers or families. This is conditions achieved in a number of ways: > Enabling families to have a few hours > Transitioning people off our service a week to themselves when the staff appropriately through effective signposting member or volunteer is present in the home – thereby alleviating some of their stress. > Recruiting volunteers and running a volunteer- delivered service > Helping carers to identify longer-term local services, options for respite care > Targeting our resources most efficiently to (e.g. day centres) and local carers’ achieve greatest impact support organisations – providing both the information/advice and support to > Service visibility and outreach work access these. > Pressures to meet internal and external targets > Providing reassurance to families who and grow services in an uncertain external do not reside close to their relative that environment an eye is being kept on them. > Collecting systematic data and information on 3. Enabling patient advocacy – developing our service users’ contexts and needs advocates for our service users The learning from these challenges are reflected “Everything from helping me move in to and incorporated into the Implications and helping me get a GP, change my address with Recommendations in section 7 of this report. everybody that I have to, [negotiating with] all the agencies....” (Red Cross service user) > Another clear outcome of Support at home is the development of a group of skilled negotiators, knowledgeable about where and how to access a range of local services on behalf of their service users. The development of this skill has been occurring over the life of the service. This has significant implications for supporting service users to get the best services for their particular needs in the longer term.