Special Report: Elderly care in Nightingale

By Robyn Rosen, March 4, 2010

Big is beautiful at Nightingale House, Britain's largest residential home, where the 200 residents are served by over 500 staff and volunteers and have access to a GP surgery, pharmacy, dentist, hairdressers and shul.

Nightingale has been offering residential and nursing care to elderly Jews in its Clapham premises for over 100 years. It opened in 1908 after banker and philanthropist Lord Wandsworth, the Viscount de Stern, purchased the Nightingale Lane building for £5,200. The first residents moved from the Home for Aged Jews in Hackney, created by the merger of three charities in 1894.

"In the mid-1800s, the church was responsible for looking after the poor and destitute," explained Nightingale chief executive Leon Smith.

"It was felt there was a need for something in the Jewish community, which was predominantly Orthodox. Many were escaping persecution and wanted to be with like-minded people."

Initially a ward set-up, the purchase of the adjacent property in the 1960s led to the addition of single rooms with en suite bathrooms.

Today every resident in all six units has their own private bedroom and bathroom.

"Because of our unusual size, we are able to provide a range of facilities that wouldn't be viable in a smaller home," Mr Smith said.

"We put an enormous emphasis on entertainment, education, outings and activities. We believe it's really important. Many here are very sick with dementia or depression. Their peers are dying. They need a purpose in life and a reason to get out of bed. We want to give meaning to their lives and people find they have fantastic

There are communal areas in each unit with a television and a kitchenette. Active residents are encouraged to eat in the main communal dining area.

A sense of community is palpable at the hairdressers, full of women in curlers preparing to look their best for Shabbat. A café in a bright conservatory serves teas and cakes and volunteers man a small gift shop.

On the ground floor, residents enjoy a range of pursuits and classes in a large activities centre filled with books, pottery wheels, arts and crafts equipment and a kitchen. Tai chi and circle dancing are also among a plethora of leisure and fitness options.

Examples of residents' art and pottery works are displayed in hallways while photos of recent outings and group activities decorate pin boards.

In 37 years with Nightingale, Mr Smith has witnessed many changes. "The buildings are unrecognisable today from when I first came."

The socio-economic background
of the residents was also markedly

"Before the 1980s, moving into a home was stigmatised. It was for poor people who were down on their luck. Many were from working class backgrounds.

"Today we have a complete cross-section of the Jewish community. All people are thinking about is going to where they think they will get the best care.

"Years ago people came into care homes who were lonely, wanted stimulation and felt isolated. People with dementia and those that were very frail were the minority. Now it's the other way round."

Two-thirds of residents have some form of dementia and building has begun on a £6.5 million dementia unit, designed by specialist architects and with features including a reminiscence room and sensory mats setting off an alarm if residents step out of bed during the night.

"We want to be at the cutting edge of dementia care," Mr Smith said. "Research shows surroundings can very much effect wellbeing of dementia clients."

But running such a massive enterprise presents financial challenges in a difficult financial climate. Annual running costs are £12 million and the home faces an operating deficit of £2.5 million.

Fees are £750 per week for active residents and £1,025 for people needing nursing care. Local authorities will support only those with less than £23,500 in assets, including property, and whose condition is assessed to justify a place.

Even then, the authorities do not pay the full fees - on average providing £435 for residential and £630 for nursing care.

The family is asked to make a donation and the rest is made up from charitable contributions.

Another issue to contend with is the number of private homes opening in predominantly Jewish areas, which appeal to the less observant.

"People needed to come to a Jewish home because they wanted kosher food and a place which recognised the festivals," Mr Smith said.

"Now we're in a secular age, it doesn't matter to some people whether there is kosher food. They just want to be around other Jewish people.

"The message we want to get out is that we are value for money with no hidden extra costs and a great network of volunteers."

With care of the elderly a key general election topic, Mr Smith has a message for Gordon Brown or his successor to take on board.

"Care of older people is a serious problem for the country. Both parties are beginning to recognise they need to pay attention.

"However, I think it will disappear from the agenda straight after the election because there are more pressing issues and they need to cut costs, not increase them.

"We have a funding system which is very complex, unfair and opaque. Above all, the system has to be simplified.

"Life expectancy is higher and the number of people in paid employment is not going up. So where is the money supposed to come from to care for an ever-growing group of older people?"

His immediate goal is to raise the remaining £2.3 million for the dementia unit, due to be completed next February, and begin upgrading other parts of the building to ensure Nightingale remains at the forefront of residential care.

Loving the Jewish lifestyle — with added pottery

Great-grandmother Rebecca Nathan, 92, moved to Nightingale four years ago, having lived in Elephant and Castle. “I didn’t want to come here but my kids kept saying they thought it was time to go to a home,” she said.

“I wanted to stay in a Jewish place. All my life, I was always the ‘Jewish girl’ and people always pointed out that I was Jewish. I thought if I went to a place where everyone was Jewish they wouldn’t be looking at me because I was Jewish.

“When I first moved, one of the teachers got hold of me and said I should try pottery. I didn’t want to but she put a piece of clay into my hands and I was sunk. I love doing pottery every day.”

Actively appreciating home help

Rosalie Maydorf, 97, has been a Nightingale resident for three years.

“I had a couple of strokes and was living on my own,” she said. “I thought it was time to move and I think it’s very good here. I always try to stay busy. Some people just sit upstairs but I think it’s important to come downstairs every day and stay active.

“There is a lot on offer at Nightingale and I enjoy the painting and knitting.”

Last updated: 9:58am, March 5 2010