Exploring the difference made by Support at home 25 that participants talked about in the interviews Clearly, Support at home sees a population that included arthritis, poor memory, poor vision, is older, largely female, often living on their own, lupus, diabetes, high blood pressure, mental and with significant chronic health conditions. health (depression, schizophrenia and addiction), In some areas, our service users also appear to be stroke, cancer, fractures and hip replacements. quite homogenous, with limited diversity within the group. Further insights into the types of medical/health conditions experienced by service users were 4.2 What are their needs (before highlighted in the NHS data collated by the Nuffield Trust for a separate analysis of hospital receiving Support at home)? utilisation patterns. Figure 1 shows the diagnostic histories of 1,573 service users upon discharge We asked participants about their state of health from hospital (records taken from Support at and state of mind prior to receiving support 14 home schemes in seven hospitals across London). from the Red Cross. People were asked to score The most common health conditions largely align themselves on a number of questions using a with five-point scale. Our focus when reporting these those directly reported by respondents themselves findings is to explore the needs of our services in our study. users, those who felt less than able to cope with their lives, on the range of dimensions we A heavily medically-reliant population with measured. Participant scores of one and two were complex health care and social needs, 99% of taken as a self-rating of having “poor” ability to respondents had accessed their GP, nurse or carry out the task in question. hospital in the three months before referral to the service, 21% had accessed a social service Table 2 shows some of the key measures we will carer, and 27% had other help/support services report on in the sections to follow, with the items such as cleaning, gardening, shopping or a (or individual questions) that make up each of 13 meals-on-wheels service. the dimensions explored. See the questionnaire in Appendix D for the specific question wording. TABLE 2 DIMENSIONS MEASuRED IN THE SuRVEY Section dimensions items Physical & Practical Daily activities Ability to look after yourself capabilities (4.2.1) Ability to do daily tasks around the home Ability to get out and about Manage finances Ability to manage your finances (e.g. organise payments and bills) Control Control over daily life Psychological Coping skills Ability to take your mind off your worries capabilities/ State of Ability to make your own decisions mind (4.2.2) Ability to keep on top of things Ability to cope with life at home Wellbeing Feeling good about yourself Feeling in good spirits Safe at home Feeling safe and secure in your home Satisfaction with life Satisfaction with life as a whole Social support, Social contact Contact with family, friends and neighbours emotional support & Someone to talk to Can find someone who will really listen to me if leisure (4.2.3) I need to talk Leisure activities Have activities that I enjoy doing with my time 13 Based on all 90 PRE-service interviews 14 Based on all 90 PRE-service interviews