The Elms, Care Home, Barry Road: A Home for Life
A short local history of care in a fast-changing world by Dorothy Oxley
After all the suffering of the Second World War, the early 1950s were a positive time of recovery, growth and a determination among many people to make the world a better place. For Deacon George Jennings of Rye Lane Chapel, worried about what would happen to the elderly members of his congregation when they could no longer look after themselves, that meant convincing the people of his church that they should raise the funds to establish an old people's home in the local area. By sheer persistence, he succeeded, and in 1952 the Minutes Book of the Rye Lane Committee records that: “This meeting of Rye Lane Chapel members considers and approves the purchase of 147 Barry Road as an old folks’ hostel and pledges itself to help financially and in other ways to further its objects”.
The Committee might have been idealistic, but it was also hard-nosed enough to ensure that the project would not go ahead unless the people of the Church proved they could and would back it financially, because they set the condition that: “The sum of £2,300 must be promised by way of gifts and loans within one week of the issue of an appeal to all members of the Fellowship”. This was quite a tall order, when you consider that £2,300 in 1952 represented quite a large sum of money - in the following year, when staff were being recruited, the Minutes note that the rate offered to a part time cook would be £200 per year, with a part time domestic help earning £156 per year. Nonetheless, the condition was met, and the house purchased by the Housing Association the original Committee had set up to run it - South East London Baptist Homes (given the plural in the name, they had clearly hoped this would just be the first of many,!) 147 Barry Road cost £4,750, with almost as much again being spent on improvements, furnishings and fittings, and the gifts and loans of church members were backed up by a mortgage from London County Council. In order to ensure that the Home retained the active support of the local Christian community, members of Rye Lane Baptist Church, and other churches which by then had also become involved, were invited to become 'Shareholders' - supporters who paid an initial £1 for the privilege and were in return allowed to vote at AGMs. The aim was, of course, to encourage their continued interest and support, both as donors and as volunteers, and to help the Home in any way they could.
Even before the house was quite ready for occupation, the process of selection for both staff and residents began, and the Minutes of 1953 outline the decisions made, some people being rejected because they required a higher degree of care than the small, new Home could provide. But Mr Jennings had not underestimated the need for residential care with a loving, Christian focus - the rooms were soon filled, and by the time of George Jennings' death on 5 July 1958, the Home's Committee had already recognised that it was too small to meet this need, and an extension was planned. The LCC again agreed to consider a loan for this (which they agreed in 1959) and the 1958 AGM Minutes report that £668.15s.2d has been received in donations to the Building Fund. Donor support was also crucial to running the Home, since the fees charged to each resident in 1958, £5.7s.6d fees per week, were not sufficient to offset the operating costs. This remained true in 1960, when the AGM Minutes record that 'Losses in running the Home are more than covered by some wonderful legacies'.
By 1960 building work had begun. However, the extension work did not go smoothly; the original builders, Messrs. Champion of Scilla Road, went into liquidation and the work had to be completed by Messrs. Sawyer & Son Ltd., which meant of course that it finished later than scheduled. However the new extension (named the Jennings Wing, and officially opened by the then President of South East London Baptist Homes , Revd. Theo M. Bamber. in 1962) enabled the Home to increase its residents to 24 (which could include some sharing a room).
Staff shortages are first reported at the 1962 AGM, with a plaintive note about the Home having “brought one lady all the way from Yorkshire for interview at our expense” (it's not stated whether or not she got the job, but presumably not!). At this time the Home recruited mostly locally, and certainly within the UK, though there were two Australian sisters, Pearl and Connie Couchman, who had come to England for a short working holiday, worked at the Elms on a temporary basis, and loved it so much that after a brief scheduled return home to Australia, they returned and stayed working at The Elms for many years. Young people rarely did 'gap years' between school and university in the 1960s - but there was a steady flow of young working people travelling from Australia to England, and from England to Australia, for 'working holidays'.
In 1965, the way London was governed changed, with the over-arching LCC, passing local responsibility to Southwark Borough Council. For The Elms, this brought one immediate benefit, in that it had been agreed that charitable organisations would be excused 75% of rates, whereas previously it had been only 50%.
Meanwhile, social change was happening both outside and within the Home. TV had become a big part of everyday life - even though it wasn't that long since people were crowding round the only TV in the street to watch the Coronation! The Elms acquired its first TV for residents in 1966, via the Wireless for the Bedridden Society, and the Minutes record that one resident, aged 95, was thrilled to see TV for the first time. There was, however, an informal rule that the TV should only be used to watch religious services on Sundays. In 1988, by which time a second TV had been acquired, some of the residents were protesting that they wanted to watch other programmes and the Committee decided that the TV in the lounge should be reserved, on Sundays, for religious programmes but residents could watch anything they like in the Garden Room!
Less welcome changes also took place. In 1967 the AGM minutes recorded that the Committee were already noticing a growing change in patterns of care for the elderly: “The Local Authorities are endeavouring to keep people in their own homes as long as possible. If they are not well, they are taken into hospital for rehabilitation then returned to their own homes, so that this means that people are older when they apply to come into such a home as ours. We are now getting applications from people in their 90s. Some are strong-minded individuals, having had a lifetime of doing what they wish and now, in the close of their lives, having to live with a lot of other people.” Obviously, this adjustment wasn't always easy, for them or for their fellow residents and staff! But some clearly appreciated the atmosphere in The Elms - one resident, in 1968, told the Matron “I do hope that I don't ever have to leave here and go into a HOME”
In 1971, the President of South East London Baptist Homes, the Revd. Theo Bamber, died and his place was taken by Dr Spiers, who had been the Home's doctor since it first opened its doors in 1953. By then an increasing number of applications were being received from people with higher care needs, and the Committee knew they had to consider how they could meet these needs. Was it time to start raising funds for yet another extension? But there were also other demands which first needed to be met in the next few years; by 1976, new fire safety regulations for residential homes had been brought in, requiring around £6,000 of extra expenditure - though a Trust met the cost of half of this, funding an automatic fire warning system. The Home had its first ever fire drill, and got everybody out in 6 minutes (improving this to 3 minutes the second time round!). Over the next few years they seem to have become quite expert at this, and in 1982 they hosted a delegation from the International Hospital Federation, when people from 17 different countries came to look at the Fire Detection system and see a practice evacuation.
By 1980, the Home was full, but this included 16 short stay residents - The Elms was branching out into respite care when rooms were available, and the AGM Minutes report “We have been able to relieve families of the burden of looking after a loved one while they can have a holiday, which is a very worthwhile service.”. In the same year, the Home had started to take on young people 'with a background' from Southwark's Springboard Centre; the Home gave them a job and some training, while the Council paid their wages for a year, then tried to place them in a permanent job. Unfortunately, it's not recorded if any of them ended up permanently employed by The Elms. But despite what was obviously quite a good working relationship with Southwark Council, the Home was finding it difficult to get Council funding for the elderly people who wanted to come in ... “Hospitals are unable to take in geriatric patients and we have 18 on our waiting list and it is tremendously difficult to admit ladies needing financial assistance from the Borough Council.” The position wasn't helped by the fact that a downward trend in donations meant the Home could not afford to prop up operational losses as they had done in the past, when fees were unrealistically low. The Home had to pay for itself. Any money raised was being put towards new developments essential to meet the increasing need for a higher level of care.
An original aim was always to build a 'sick bay' wing, and in January 1986 it was agreed to purchase some land from the house next door (145 Barry Road, owned then by Mr and Mrs Wylie, the Warden and Matron of the Home). However, advice from the Centre for Policy on Ageing was that having a 'sick bay' would not only probably require a 'dual registration' (i.e. as a nursing as well as a care home, which would mean they'd have to employ a State Registered Nurse day and night), it was also against the Code of Practice for residential homes, which stated that: 'intensive or terminal care should be provided in the resident's own room, not a special care unit.” The Elms has abided by this Code ever since, and tries, whenever possible, to give end of life care to residents this way, helped by specialist hospice nurses.
So the eventual plans for the new wing changed to include four rooms plus a sluice, two toilets suitable for wheelchair users, a bathroom, a laundry and a store room. (These were still the days when Homes were not expected to provide en suite rooms for their residents - the regulations to that effect didn't come in until later- so bathrooms and toilets were shared). Work on the wing began in the latter part of 1987 (and before this, a sun room had also been added, at a cost of £12,000, in memory of Ray Rickman). The new wing, named in honour of Dr Spiers, was completed in May 1988 and formally opened the following month.
In 1995, the Home's oldest ever resident, Mrs Elizabeth Ponman, celebrated her 107th birthday. Can you imagine all the changes this lady must have seen taking place in her very long life? Two World Wars; an explosion in technological developments, the institution of the National Health Service, and a huge range of social and cultural changes. She would have known a time when there was no alternative but the 'Workhouse' if you were poor and vulnerable; but by the time her life came to an end there were benefits that acted as a safety net for many people, and financial support from the Council ensured that an elderly person without sufficient funds could go into residential care (though it was sometimes a struggle to get this!). Her education had probably ended at the age of 14 (if not earlier), and, as a girl, her opportunities for a career would have been very limited, with marriage the preferred option, provided the love of her life didn't get killed in the First World War or the outbreak of influenza which followed in its wake. She would also have seen London becoming far more multi-cultural and multi-faith, with Acts passed to try to protect those facing discrimination, whether because of their colour, race, sex, creed or disability. Music, fashion, cinema, the Arts, everything had undergone a whole series of sweeping changes, at a much faster pace, perhaps, than ever before. Even within the Elms she would have seen the impact of some of these changes - but the initial aim of the Home remained unchanged - to provide a loving, caring environment where elderly residents could feel secure and valued until the end of their lives.
Considerable changes were also taking place in the Care Homes sector, with stricter and more complex regulations and monitoring. This wasn't a bad thing in itself - horror stories of what could happen to residents in a badly run, uncaring Home mean that standards and inspections are vital. But the requirement to set up and adhere to a whole range of care policies, to keep in line with employment, immigration and safeguarding regulations and to meet the standards of both Councils and the CQC, involve a great amount of paperwork, much of which is handled by the management, but in a small, charity run Home, the overall responsibility still falls on the volunteers who make up such organisation's Boards. The pool from which these volunteers could be recruited was also getting smaller, as over the years the Minutes record a slow but steady reduction in the number of 'Shareholders' and supporters, as some of those who had been involved from the beginning either became too ill or old to continue - quite a number in due course became residents of the Home themselves- or because they moved away. And, sadly, although local churches were circulated with updates on the Home's activities, such as the Open Day and the Thanksgiving Service, vital links had been lost and the new generation of churchgoers just didn't seem to want to get involved to the same degree. This is not, of course, something which only affects voluntarily run Care Homes - it's a pattern in many organisations, where finding people who have the time and interest to take on committee responsibilities is becoming increasingly difficult.
Nonetheless, South East London Baptist Homes continued in maintaining a small but very active Board, and they were keen to continue the development of The Elms, not least, to start to provide the kind of en suite facilities which had now become the norm in Care Homes built since the regulations changed. But this would cost quite a lot of money (it had originally been hoped this might be between £250,000 - £300,000 but by the time the work went out to tender in 2008, the estimate had risen to £600,000). The winding up of the Herschell’s Trust in 1997 brought £110,000 to The Elms (half of the monies held by this Trust after they sold the almshouses they owned at Loughborough Junction, which had become so run down that the Trust could not possibly afford to bring them up to standard; the other half of the funds went to another independent care home, Trinity House). However, the Elms were required to treat these funds as an investment, and only to use the income from this to help meet running costs So further redevelopment only became possible when two generous legacies were left to the Home, and the Board decided to use these to redevelop the original front part of The Elms to provide six en suite rooms on the first floor, (where there was at that time only a small sleep-in flat) with lift access, plus improved kitchen and other facilities on the ground floor. Following a tender process, a local firm called Standages were given the contract to carry out the work.
Before they could begin, however, up to six residents had to be temporarily rehoused. Fortunately, London & Quadrant Housing Association kindly allowed The Elms to use their property at 164 Friern Road (which backed onto The Elms and was vacant, pending a proposed change of use to a home for people with learning difficulties), and a route was created between the main Home and this house so that the fitter Elms residents could move in and 'commute' back to The Elms for main meals, activities and to socialise with their friends there. A temporary kitchen and storeroom (housed in a Portacabin) also had to be set up in the car park at the front of the building. Work then commenced in late July 2009 with 'practical completion' (when the work was signed off, subject to a 6 months' snagging period) at the end of September 2010, well over the original 32 weeks' estimated duration. Although minor problems were still being corrected into the spring of 2011, this work allowed the Home to offer to its fitter residents the kind of en suite facilities they could expect in more recently built homes, but the redevelopment work ran over budget, leaving The Elms with severely depleted reserves. Further, the local Councils which had provided financial support for residents unable to meet their own fees were themselves increasingly facing cuts and unable or unwilling to provide fees at the level which The Elms needs to maintain its high staffing ratio and level of care provided
So, financially, the past few years have been a struggle, and the Board might have been expected to simply sit tight and try to ride out the storm. Instead, in 2013 (the 60th anniversary of the first residents moving in to the Home), they made the bold decision to purchase 145 Barry Road, with the aid of what remained of their investments and a mortgage from NatWest. The aim was threefold. Firstly, they still had a vision for improving the facilities of the Home, so that every resident could enjoy en suite facilities, and this will require more land. Secondly, the past use of the land on which 145 Barry Road sits - thought at one time to be used for growing watercress - and perhaps with insufficient depth of foundations, when the two new wings were built, has meant some settling has occurred. Installation of water capture tanks beneath the lawns has helped to improve this, but it is not a long term solution. Within the next 20 - 30 years, major rebuilding is likely to be necessary. Thirdly, with such invested monies as remained producing only low income, but property prices still showing a healthy rise in London, even if part of the extensive back garden was first transferred to The Elms for future development use, the resale of the house should provide a better return. Many charities might nonetheless shrink from a quite risky strategy that would inevitably leave them with very low cash reserves - but the Board of South East London Baptist Homes has always been a bit different. Their discussions, recorded in their Minutes, have always seemed to have been one part careful thought given to the strategic options, and one part faith that the Lord will provide!
So, what is The Elms like today? The Home which began as a small care home where a few fairly able old people could spend the rest of their lives has become one which is now permitted to take up to 30 residents, many of whom are very frail, and may be disabled, confused, or both. Although the Elms is not a nursing home, they are able to care for terminally ill residents, supported by District, Hospice and MacMillan nurses; this is usually what residents and their families prefer; a peaceful passing in a familiar place where they feel safe and loved and among friends. The Home is still however a place for living, not just waiting to die, with a weekly pattern of varied activities such as arts and crafts, exercise, poetry and reminiscences arranged by staff and supported by volunteers including young people from the Brit School and Alleyns. Residents are involved in choosing what they want to do, and what they want to eat (the excellent cook comes to all residents' meetings to ask them for menu suggestions).
While once the emphasis was on taking residents who were committed Christians (a reference from a minister initially being required), The Elms now welcomes people of all faiths and none, though it is still seen as the 'home of choice' by many elderly Christians. Recently more men have been taking up residency - the Home used to be dominated by ladies, who tend to live longer - and some couples have also moved in together. Staff, too, are multi-faith and multi-national, though stricter regulations, especially with regard to what courses can be taken by those on student visas, and how many hours they may work, means most overseas staff now come either from the European Union or already have full working visas. Recruitment continues to be something of a challenge, but it is perhaps a tribute to the atmosphere at The Elms - and a tribute to them for working so hard to create that atmosphere - that the current Care Manager of the Home, Susan Baterip, has worked there now for over 25 years, with her deputy, Hyacinth Shand. They too have seen, and weathered, a huge amount of change.