Hospice Care in Focus: The Homeless Health Inclusion Project

Image credit: Centre for Homelessness Impact

Having identified a demand for better knowledge in end of life care, they collaborated with a number of other social care organisations in the Brighton and Hove area, including Brighton Housing First, New Steine Mews, and Just Life, to train and upskill their staff on how to provide end of life care to people experiencing homelessness.

Importantly, the project helped remove accessibility barriers for end of life care by ensuring that information and support was available to professionals.

Also based in Brighton, council-run Glenwood Lodge – the second largest hostel in Brighton – is a 48 bed homeless hostel for men, with 30 beds for men who are placed by social services as an ‘off-the-street’ offer and 18 beds for men with complex health needs, substance abuse or ex-offenders. Many of the men with more complex needs see the hostel as their home.

Staff at Glenwood Lodge had limited experience of end of life care with their client group. However, they required much better support, skills and knowledge to enable them to feel confident when dealing with clients who are at the end of life. 

In 2020, hospices cared for more than 300,000 people – both in hospices and in the community. This included almost a million ‘hospice at home’ visits. [source: Hospice UK Annual Report 2020]

However, it’s estimated that 100,000 people don’t get the care they need at the end of life. And some groups miss out more than others, including people experiencing homelessness. [source: Nuffield Report 2022]

The Hospice UK/Masonic Charitable Foundation grant provided Helen Lyons (Senior Staff Nurse at Martlets Hospice, and Project Lead) with the ability to train staff at social care organisations on how to deal with end of life care issues. 

Glenwood Lodge staff highlighted that the training from Helen was seen as incredibly beneficial. It has helped them with a lack of confidence, knowledge and how to best support people at the end of their lives.

Culture change was one of a number of key outcomes that the grant enabled. Sara Emerson, Team Lead for Just Life Health Engagement Team, says: “this idea of putting into our culture of hostels and outreach teams, to think about end of life, and longer term work – the dignity and respect that comes with good quality end of life work – this training has added that to our style of working.”

Sophie Howard-Thomas, Brighton Housing First Coordinator, said that improving their staff’s confidence in having those difficult conversations has been highly beneficial: “our model is the main support mechanism for those clients…so we need the support to have those kind of conversations.”

Sophie also added that as a result of the training, Brighton Housing First now includes a ‘frailty score’ in their initial assessments to help them understand the physical health of their incoming clients and ensure that wraparound support is available.

Staff at Glenwood also learned how to best secure medication and administer – a big concern for them, given the environment in which they work – and the training enabled them to link up much more effectively with the hospices and CNS. They say it’s now much easier to know who to go to for end of life care support for their clients.

Karen Leenders, of supported accommodation at New Steine Mews, said that the training has given their staff “a better insight into the levels of end of life care services available to them and their clients.” 

Sara Emerson also commented that the project had finally given their clients choice – and the opportunity to be properly looked after – sometimes for the very first time in their life: “these people may have lived in homeless accommodation for a long time, where there are really strict rules… and there is no choice.