Home from Hospital Funds

Caring and Sharing Rochdale

£21,269.12

We have identified a significant need to not only reintroduce the sessions for older adults but also extend our support to their carers, who often shoulder immense responsibilities with limited resources and emotional support. Many of these carers come from Black, Asian, and Minority Ethnic (BAME) backgrounds and frequently encounter considerable barriers when trying to access mainstream services. Our project seeks to fill this gap by offering culturally appropriate, accessible support tailored to their unique experiences.

The project will operate on two key fronts:

1. Group Sessions for Older Adults (VIPs Over 60): This would be a continuation of our previous project, but we would make the group sessions more frequent to better support our seniors. These sessions will focus on social activities and gentle exercises aimed at improving overall health and wellbeing and preventing falls. The group will serve as a safe and inclusive space where older people can engage with peers, reducing feelings of loneliness and isolation.

2. Culturally Sensitive Carer Support: We will organise peer support groups which will provide practical advice, mental health support, and social connections to carers of older people. The goal is to empower these carers, giving them the crucial support and backbone they often lack, while ensuring they feel valued and understood.

In addition to structured sessions, we plan to offer weekly befriending check-ins (both in-person and by phone) to elderly participants, particularly those who are homebound or have mobility issues. This will allow us to maintain continuous engagement and offer emotional support.

Finally, we will introduce practical support services for seniors recently discharged from the hospital. This will include prescription deliveries, food parcels, and assistance with transport to medical appointments. By doing so, we hope to ease the transition from hospital to home, minimising the risk of readmission and promoting a smoother recovery process.

Crescent Community Radio

Deeplish Community Centre Association

£18,292

Our service is aimed at people from the South Asian community in the Deeplish, Freehold and Spotland neighbourhoods, who do not access care homes or centres for cultural reasons. We are running very limited women's sessions at both centres and nothing else is available, so due to previous experiences and current demand we wanted to expand our reach and sessions.  We now want to start men's sessions as well as women’s including exercise, mental health therapy, digital inclusion and other wellbeing sessions. Also extended welfare sessions. This will include community engagement for many who are unable to connect with community centres or services in the neighbourhood. We want to offer a home wellbeing visits to people who live independently to help them manage their day to day needs whilst recovering. This will include:

• Support to collect medications or other prescribed items
• Support to collect shopping
• Support to transport furniture/equipment if needed, such as beds, mattresses, chairs etc,
• Support to travel to group activities if walking or using public transport is a barrier
• Support to travel to wellbeing welfare activities at Deeplish Community Centre(DCCA) and Spotland CC(SCC)
• Welfare advice support, at home as well as at Centres to check eligibility for welfare benefits for example PIP, Pension Credits and Carers Allowance etc.
• CAB Advice – Face to face Debt and energy advice at DCCA and SCC
• Energy Advice by Electricity North West at both centres
• Warm offers – This include help with Slow cookers, Carbon Monoxide detectors, blankets or an emergency food parcel/meal in case of crisis intervention.

We will deliver two wellbeing sessions per week at Deeplish CC and two sessions at Spotland CC, focussing on managing health, welfare and wellbeing, reducing isolation including movement sessions, digital inclusion and mental well-being.  We can offer minibus transport to and from the sessions for people unable to travel independently or with family. We will offer regular health checks, Health seminars including blood pressure, diabetes and cholesterol. Our sessions will offer refreshments and hot drinks as part of social and wellbeing support.

The aim of the service is to undertake tasks that deliver preventative and practical support to vulnerable people enabling them to live independently and safely within their own homes.

To ensure that those that are most vulnerable (for example, older people, those with disabilities, mental health conditions, illness, frailty, lack of capacity to make decisions) are receiving a quality job free of charge for the work undertaken, whether that means transitioning from hospital to home or enhancing their current living conditions with improvements that will help individuals who require assistance to reintegrate into their daily lives. “Many of the individuals we support face significant barriers, including a lack of suitable housing, lacking essential household items, or funds for their care needs, to maintain their homes in a safe and functional condition”.

Tasks such as minor repairs, safety modifications, and routine maintenance  often go unmet due to physical, financial or social limitations. Without timely intervention, the unmet needs can lead to unsafe living conditions, reduced independence, and preventable hospitalisations - placing additional strain on both healthcare and social care systems.

A dedicated handyperson service will address these issues, providing a practical solution to ensure that residents can remain in their homes safely and with dignity.

We will provide social and recreational activities, sessions will include;

• Talking about Changes in the Body With Aging, such as Effects of Aging on the Musculoskeletal System
• Menopause, Symptoms of Menopause
• Sleep disturbances
• Bladder control. Exercises, Pelvic floor muscle exercises, such as Kegel exercises
• Depression, anxiety, and irritability
• Older People’s Health Issues
• Aging and Medications, Aging and Quality of Life
• Elder Abuse, Falls in Older Adults.

Providing Care to Older Adults the session will be for carers Social Issues Affecting Older People. Alzheimer Disease

Three session a week will be delivered for 44 weeks, in 2 hour sessions, this will include helping the clients with keep fit, hot meals and awareness sessions on the topics mentioned. We will also network with care homes and hospice to deliver some session there.

The grant will pay towards co-ordinate and sessional workers to deliver this project.

The Resilience Recovery Relief Project will deliver a three-month culturally tailored program in Rochdale to support 20 young black carers, aged 15-25, who care for older people with serious mental illness, including bipolar disorder. This initiative aims to address the systemic and cultural barriers faced by these carers, providing emotional, practical, and social support to improve their mental health and caregiving capacity.

Over 12 weeks, participants will engage in weekly sessions designed to build their resilience, confidence, and support network while reducing isolation and stress. The program focuses on culturally sensitive approaches to mental health, empowering young carers to navigate the challenges of caregiving effectively.

In 2024, training, education and information played a key part of the Stay Strong Stay Safe project; now we wish to expand this further.

In 2024, a wide variety of health professionals and carers attended our training, including care at home staff, unpaid carer’s for family members, NHS intermediate care staff, dementia care staff and care home staff, as well as individuals for their own learning. Now, as well as continuing to train these groups, we also want to really target our wider community including younger people who will be able to share this advice across the generations.

As such, working with partner agencies, community groups and community venues we will promote and embed falls prevention work into the education and information offered to all residents of the borough. We will upskill and educate people in the borough to not only support the people they care for and their family and friends, but to look after themselves whilst at home and outside and to share this information and education with others in their community. This will allow us to effectively contribute to the prevention of falls and hospital admissions, now and in the future.

Training will be administered by our trained instructors out in the community and at Your Trust and partner facilities.

Eight courses will be offered in 2025 (as within our phased approach below), each course comprising four one-hour modules (i.e. 32 hours in total). Participants can choose to do all the modules or a selection dependent on their wants and needs.

The training modules will include:

1. Backwards chaining – ability to get up from floor after a fall
2. Strength and Balance exercise session – including Super 6
3. RoSPA training (Link: Make a real difference – become a RoSPA Fall Fighter | Free Fall Prevention Course - RoSPA)

Once completed, we will hand out certificates and a welcome guide to participants, plus other information to help prevent falls and build an army of “fall fighters” across the Borough. To support project sustainability and build a programme of volunteer support across the community and care homes, we will also utilise a network of volunteers aiming to recruit between two-six in each township. Pathways into volunteering are already well established at Your Trust, and across key stakeholders including hospitals, HMR Circle, and Community Champions.

Volunteers will be able to apply via Your Trust’s established volunteer pathway, managed by our dedicated Volunteer Coordinator. They will be invited to chat through their interests with the Volunteering Coordinator, who will then be able to direct them to support this project where their skills and interests align.

The volunteer will then be connected with the Stay Strong Stay Safe team who will upskill and train them to help deliver RoSPA fall fighter training sessions, to support residents in continuing to be physically active, and encourage them to try and join other activities and groups in the community. We will also link in with other partners to access the expertise of their volunteers, such as HMR Circle’s volunteer driver’s scheme, digital support and befriending.

Hospital Discharge Project – Our idea is to increase identification of unpaid carers at the point of discharge from hospital and provide them with the support required to manage their caring role effectively at home. This may be the carer themselves who is being discharged, or more likely they will be caring for an older patient who is leaving hospital into a home environment.

By putting measures in place to support the carer to help ensure they have everything in place to support the person they care for in their home, and by helping them to continue in their caring role by aiding with their health and wellbeing, this will in turn take pressure off other services by decreasing contact with and reliance on GPs, Hospital and Social Care and decreasing risk of admission/readmission.

In partnership with Tracing Steps, this initiative will hold engaging and inclusive exercise classes at both Demesne Community Centre, and at care homes across the borough. Working with the Adult Social Care Team, this will target homes with fewer activities or higher levels of falls.

These classes have been thoughtfully crafted to improve mobility and combat feelings of isolation and loneliness for people aged 60 and above. The instructor, Tracey, has 20 years of experience working with a wide range of mobility and fragility, including an OCN in leading older people in dance and movement. She specialises in clients with low mobility, and in recovery from operations, as well as in regards to dementia, Parkinson’s and Multiple Sclerosis.

Working with the four ‘Cluster Hospitals’ of Rochdale Infirmary, North Manchester General, Royal Oldham and Fairfield, this project will offer home from hospital transport alongside a structured programme of 1:1 support at home or in community venues, built on each individual’s needs, alongside wider group support and social activities.

The team will build on existing relationships with discharge teams as well as working with Social Prescribing Link Workers to identify people recently discharged or at risk of readmission. HMR Circle works in partnership with Wai Yin Society, Caribbean and African Health Network (CAHN) and Care & Repair to provide culturally appropriate support.

The grant will expand the reach and impact of an existing program funded through the 10GM Hospital Discharge Pilot. The Prevention and Wellbeing Link Worker will offer in person support in a hospital setting prior to discharge, through the Petrus Hub and over the phone with a predominant focus on identifying and supporting individuals at risk of homelessness by:

• Assessing needs 
• Understanding barriers 
• Promoting MDT and multi-agency approach 
• Identify and link into established support networks 
• Act as a navigator to safely leave the hospital setting and build community-based support
• networks

This project will build on an existing Delayed Transfer of Care project working within mental health wards to address barriers to discharge in a holistic way. The approach has already had a demonstrable impact on the number of people with no reason to reside.

Increasing the capacity of the team will enable Mind to work with people over a longer timeframe including practical support, signposting and liaising with professionals and the wider VCFSE sector to support discharge.

RWWA will prevent hospital admissions through self-management education to help South Asian women with long-term conditions develop an understanding of how their condition affects their lives and how to cope with their symptoms. The service will address linguistic and cultural barriers by providing a multi-lingual prevention offer including:

• Bilingual counselling
• Art and walking therapies
• Gardening project
• Self-management programme to support with COPD, diabetes etc
• Wellbeing programmes to focus on anxiety, depression and panic attacks
• Mental Health Level 2 First Aider
• Social programme – including lunch club and meal on wheel
• Armchair Exercise
• Chia and Chat group therapy
• Health cooking club to focus on nutrition and healthy eating

The Stay Strong Stay Safe Project will create a sustainable prevention model to increase the health & wellbeing of older people through targeted exercise and education interventions for residents at care homes across the Rochdale Borough. Working in partnership with HMR Circle and a wide range of other organisations, it will not only help the residents at the care homes but also support their families and carers.

• Stay Strong Stay Safe consists of four key elements:
• Library of Online Exercises
• Masterclass Training
• Volunteer Network
• Supporting families and carers

This project will take the work of the Hospice to support people to self-manage their symptoms and bring it into the community, in settings close to home where people feel comfortable. The Hospice supports people at high risk of hospital admission due to living with a palliative life limiting condition, but there is lots that people can do around managing fatigue, anxiety, breathlessness, sleep, pain, falls prevention, nutrition and planning for the future.

A registered nurse, nursing assistant and creative therapist will host sessions in the community where people can receive advice and take part in relaxing, therapeutic and creative activities. These will give people new skills and coping strategies to improve their quality of life and keep them out of hospital.

Hospital discharge service: this service will be delivered in people’s homes and the community from the point of discharge for 6-8 weeks until both the beneficiary and our care assistant agree that the person is confident and well enough to continue to live independently without the support. Support to attend sessions at Deeplish Community Centre can be ongoing, for example wellbeing sessions or to see the local Imam if they are unable to attend their local mosque, as this can prevent future hospital admissions.

Prevention service: two half-day sessions per week from Deeplish Community Centre, including minibus transport to and from the Centre for those unable to travel independently. Each session will include a health check element. DCC staff are already trained to measure blood pressure, glucose and cholesterol. Health professionals will be invited to give talks on preventable diseases including stroke, heart disease and diabetes.

The prevention offer will also include culturally appropriate therapeutic activities delivered by mental health specialists in each session. This will include arts and crafts; storytelling; reading and music by groups such as Living Well, Rochdale MIND and Cartwheel Arts.

KYP will strengthen and build on their existing culturally appropriate day care service for BAME and marginalised communities, providing support to BAME communities to enable social connection, boost self-esteem and confidence, reduce isolation and loneliness, raise awareness of health issues, promote well-being and resilience in later life and generally help maintain a good, healthy lifestyle.

One male and one female community worker will provide multi-lingual culturally appropriate support around social connections, gentle exercise, wellbeing and health talks and screenings.