In this section we describe the services that are provided now in Craven, as well as those at Castleberg Hospital prior to its temporary closure.

A wide range of services are available to people over the age of 18 years who need intermediate care,rehabilitation, symptom control, palliative care and end-of-life care. NHS services have a strong history of working with North Yorkshire County Council (NYCC) and the voluntary and independent sectors to deliver personalised services to individuals and their carers at home, and in other places where people live (such as in care homes).

These include:

 

Services for people at home (or other places where they live)

 

• Primary care – general medical care provided by family doctors at their surgeries and in people’s homes.

 

• Craven community nursing – the 24-hour/seven-day district nursing service cares for people in their own homes and plays a key role in supporting independence, managing long-term conditions and preventing and treating acute illness. Mainly, it supports adults with disabilities, older people living with
  frailty and long-term conditions, and those nearing the end of their lives.

 

• Craven Collaborative Care Team (CCCT) – a 24-hour/seven-day team offering intermediate care in people’s own homes, helping to prevent them being admitted to hospital or as a response to a crisis. This team includes advanced nurse practitioners, general and mental health nurses, social workers, occupational therapists, physiotherapists, community support workers and carers’ support.

 

• Community specialist services – such as tissue viability (wound care), continence services (bladder), neurology (for people with Parkinson’s Disease, Multiple Sclerosis, stroke, etc), cardiac (for heart failure) and respiratory (breathing conditions).

 

• Community rehabilitation team – this is a dedicated therapy team (including physiotherapy and occupational therapy) that offers rehabilitation programmes to people with lung and heart conditions, or who have had a stroke, to help them return to independence. This takes place over a few weeks – in people’s homes or community venues – and involves education, support, advice and exercise.

 

• Integrated community equipment service – this joint NHS and local authority service provides equipment to help people be more independent, such as simple aids to daily living or more specialist equipment (eg beds and hoists). This service works closely with the CCCT’s occupational therapists and physiotherapists.

 

• Goldline – offers 24-hour telephone support to people with a serious illness who are in their last year of life, and to their carers. This award-winning end-of-life service is run by senior nurses based at AGH.

 

• Night sitting service – supporting people in their preferred place of care, the Marie Curie night sitting service offers night-time care at home for people who are approaching the end of their life.

 

• Telemedicine in nursing and residential homes – staff from care homes can call the telehealth hub at AGH, 24-hours a day, for information and advice from a senior nurse. This includes opportunities for assessment by video link. The nurse directs care home staff to other services as necessary.

 

• Complex care – a health and social care team that supports people who are assessed as having complex care needs who may have had high use of NHS and other care services.

 

• Independence team – this NYCC service helps people to look after themselves better in their own homes.

 

• Domiciliary care – helps with personal care and household tasks
  for people who are frail or have long-term needs.

 

• Voluntary and community services, including – for example – Home from Hospital and Carers’ Resource.

 

• Specialist palliative care team – an expert community team that offers a variety of services – including rehabilitation and day services – to people who have a
  life-limiting condition, either at home or in hospices.

 

• Fast-track provision – when someone’s condition is deteriorating quickly and they are nearing the end of their life, the NHS continuing healthcare fast track pathway enables an appropriate care and support package to be put in place as soon as possible – usually within 48 hours.

 

Care homes, hospices and hospitals

 

• Hospices – care for people with a life-limiting illness at Manorlands in Oxenhope or St John’s Hospice in Lancaster.

 

• Continuing healthcare within care homes – this is care arranged and funded by the NHS, following assessment of a patient’s long-term care needs.

 

• Craven care home quality improvement support service – supports continuous quality improvement of care, and develops personalised care plans, for people in care homes.

 

• Residential and nursing homes – we have an agreement with NYCC to buy beds, as needed, for people to have short periods of care until able to return home. These are available at Ashfield in Skipton and Neville House in Gargrave, both of which are residential homes. These provide “step-up” and “step-down” care to help a person reach the stage where they can safely return home. We also buy beds through continuing healthcare and fast-track (as described earlier). Some nursing homes are “Gold Standard Framework” (GSF) accredited and care for people who have palliative or end-of-life care needs. This means that their staff have been specially trained to provide appropriate services. Other homes are dementia friendly, also having received specialist training. As well as being cared for on a day-to-day basis in nursing/residential homes, residents also receive the same additional care – such as the services of GPs – as those living in their own homes.

 

• Inpatient intermediate care – ward 10 at AGH (Airedale General Hospital) provides in-patient intermediate care. It is nurse and therapy led with input from a consultant for older people.

 

The people involved in these teams are multi-skilled. They assess people and gather lots of information – such as dietary needs, possibility of falling, risk of skin damage (pressure ulcers), carers’ needs, etc – as well as their health conditions. They develop personalised plans of care which support patients and their carers.
Unlike the rest of Craven (whose services are commissioned by Airedale, Wharfedale and Craven CCG), Morecambe Bay CCG commissions services for people registered with the GP practice in Bentham. The majority – but not all – of the services described above are available to people registered with the practice, as well as some others (for example, the University Hospitals of Morecambe Bay NHS Foundation Trust delivers
specialist palliative care, acute hospital and some community services).