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borough council, whose financial contribution in the first year was £1,500 towards
the initial costs and £3,500 towards the running expenses.
The site, although in the centre of the older part of the borough, is eccentric to the
borough as a whole, because of many new estates in the periphery. There is accommodation
for 20 old people. The centre (fig. 1) consists of a day room, treatment room,
surgery, sister's office, general office, kitchen, bathroom, and toilet accommodation.
The building itself is a Swift-plan factory-made structure, assembled in sections.
The colour scheme inside is white with yellow doors, the whole having a light, clean,
and pleasing appearance. Heating is by tubular electric heaters, their safety being a
large consideration in the decision to instal them. The kitchen is equipped with an
electric cooker, and water is heated by an immersion heater in a 50-gallon tank.
This type of building is particularly convenient for a purpose of this sort, in that
considerable freedom is given to the occupier to plan the partitioning for his particular
needs.
The staff of the centre comprises a sister-in-charge, an assistant nurse, and a clerk.
Careful choice of staff is of the utmost importance in a scheme of this kind. We
were fortunate in obtaining the services of a sister with a wide background of general
and social medicine, whose experience included health visiting and home nursing as
well as hospital appointments.
The clerk has given willing assistance in helping patients to and from the ambulance,
in distributing meals, and in many other ways besides her clerical duties. This has
contributed greatly to the success of the staffing arrangements and to the smooth
running of the centre. In addition, a part-time cleaner is employed after the centre
is closed. It need hardly be said that a genuine understanding of old people and a
desire to help them is the overall consideration when engaging staff for such a centre.
The Routine of the Centre
The centre was opened in May, 1961. Patients are admitted exclusively through
their general practitioner. This is done by application to the honorary medical adviser,
who decides on their suitability. As a general rule the decision has been to admit all
applicants at least on a trial basis, rather than to refuse admission in the first instance.
But three categories of patients who cannot be catered for, have been refused admission:
1. Incontinent patients.
2. Patients with mental illness. This, of course, does not bar those with some
degree of mental confusion—a common component of ageing. Indeed, the
foibles of such patients often prove endearing to the staff and other patients
3. Patients who are not well enough to spend most of the day sitting in a chair.
Although admission is only by request of the patient's general pactitioner, it often
occurs first to the home-help service or home nursing service that a particular old
person would benefit from a period at the centre. When this happens the patient's
doctor is informed, and he invariably agrees to apply for his patient's admission.
After a patient has been accepted, a letter is sent to him informing him of the date
and time of admission and enclosing a sketch map of the area. If transport has been
requested the patient is asked to be ready at the required time. The county ambulance
service supplies the transport under Section 27 of the National Health Service Act;
a sitting car is usually employed. About 60% of attendances have been by ambulance.
The centre is open between 8.30 a.m. and 6 p.m. from Monday to Friday.
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