News Opinion

A Very Different Care Village

Professor Deborah Sturdy OBE Director of Health & Wellbeing, the Royal Hospital Chelsea

By Deborah Sturdy OBE, Director of Health & Wellbeing, the Royal Hospital Chelsea

At 325 years old the Royal Hospital Chelsea must be one of the UK’s oldest institutions for the care older people. It provides care and support today for 300 ex-army veterans. This “care village” has much to recommend it, uniquely taking ex British Army veterans over the age of 65 years. The community provides a comradeship and integrated care model which supports people from independence through to end of life.

The expectation at admission is that you will contribute to life at the Royal Hospital in terms of representation in many forms. The clear identity of the iconic uniform creates a pride and purpose for all who wear it. These are ordinary people who have served their country and who have chosen to return to a quasi-military community in which to live in their retirement. Communal living is not for all and many of those who choose to join “the ranks” are often led by personal loss following the death of a spouse and loneliness in later life.

Contributing to the community using its many opportunities for social and recreation activity provides purpose and positive engagement. The allotments and gardening club, bowls, boules clubs, pottery classes, calligraphy and choir are but a few social gatherings where friendships form and interests maintained. Volunteering and therapeutic occupation also from part of life with a number of opportunities to give something back, including Prison visits, a local homeless charity and links to a range of military charities.

The military heritage is the essence of why the Royal Hospital exists and it is why pensioners choose to regain their affiliation with their military careers, it is an active part of life and gives meaning and identity. The current serving British Army retain a link through the representation of the Chelsea Pensioners at numerous national and international events. Building and maintain those links is vital in ensuring that the Hospital is current, known and sets out its purpose for more recent veterans and those to come. Age is not a barrier to participation and everyone regardless of ability is encouraged to participate, young and old share experiences and stories which enhance both lives. A number of Pensioners have active roles in supporting army charities including Veterans Aid, the ABF and support a local homeless charity and participate in a prison visits programme. This is key to retaining purpose and contributing back to the community.

The structure and clear boundaries in which army personnel operate are translated into a meaningful identifiable sub community of approximately 300 men and women, called ‘companies’. These companies are led by a Captain who is an ex- army officer who provides a role as welfare advisor, confident, care navigator and support, and provides   continuity in a service users life from admission to end. The consistency that is provided through the relationship built over time is key in helping Pensioners live well and long. The Captains hold a significant role in the  military parades and ceremonial duties of witch Pensioners participate, and this is over seen by the Sergeant Major who is the conduit for all such matters and day to day organisations of events. He is critical in maintaining order and compliance with the rules and ethos of the community. The very significant role these ex-army personal make means that support is available 24/7 by people known personally to the Pensioners not over weeks but over years. This helps in the navigation of needs, rapid identification when things change and deteriorate and a constant in the lives of families with whom they build a relationship. These care navigators are successful in their task, committed to their purpose and have longevity in these roles. The occupational shared life experience from a time in the army really impacts on how people relate and how support is delivered.

A truly integrated care community is supported by 49 registered care beds. These two nursing wards are provide a range of services including support for those living with dementia, at end of life, those requiring 24 hour nursing care and a step up / down facility for admission avoidance and to help expedite discharge from hospital. The nursing and care team are loyal and committed to supporting our veterans and have fulltime occupational therapist, physiotherapist and chiropody support on site. Activity co-ordinators provide a full and varied weekly activity programme  and are supported by long standing and extremely dedicated volunteers whose contribution enhances life.

Additionally the Medical Centre dedicated to all those living within the community has a full and part time GP. The ability to see a doctor quickly means that Pensioners receive a very responsive service, and management of long term conditions.

I do not underestimate how fortunate this institution is to house some of the country’s most deserving older population. I do believe that some of the lessons learned from the organic growth of such an iconic care provider are transferable to the wider social care community. Investing in a volunteer programme has so many benefits to enhanced wellbeing. Active social engagement through linking with the wider community including through occupational links (in our case the army) but for others, former local employers, and while the transformation of wearing a scarlet uniform  is unfortunately unachievable for all but sharing within the community in which you live, emphasising the positive, creating meaningful links and participating in external groups and clubs is.

Having lived a full and active life, why would you want to stop in your later years? The benefits in seeing people engaged, having fun and meaningful lives every day is palpable in those living at the Royal Hospital and can be achieved elsewhere.




Edel Harris





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