Transcript Presentation title - National Homecare Council

SUPPORTING PEOPLE TO STAY AT HOME –
DOING IT DIFFERENTLY IN WILTSHIRE
Improving outcomes for customers and reducing costs
by improving the way we work
The Geography of Wiltshire
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Midsized unitary authority
More than average older people
Pockets of deprivation
3 acute hospitals
Large number of self funders
1300 domiciliary care customers
3000 sheltered housing tenants
1000 care staff
Top 15 Statements from EVOC
Voice of the Customer
I want help when I am in a crisis
I want to be free from abuse
I want you to be honest with me
I want to stay at home as long as possible
I want to feel safe
I want to speak to someone face to face
I want good quality information that is easy to access
I want to be able go to the toilet independently
I want to see and talk to people
I want to know how much it will cost me
I want a simple way to access information and advice
I want the right to choose how I live my life
I want to go outside my home
I want to keep as active as I can
I want to speak to someone at the right time for me
3.45 3.50 3.55 3.60 3.65 3.70 3.75 3.80 3.85 3.90 3.95
The Customer
Ranked ‘top six’ themes
DESIGN PRINCIPLES
• Fewer providers = strategic partnerships
• Developing the workforce = making care work a
valued profession
• All services jointly commissioned with the NHS
• Assumes most people want to be independent
• All services available to the whole population
• Support planning – a provider responsibility
MORE DESIGN PRINCIPLES
• All care time limited
• Commissioning outcomes not hours
• Simplification of processes = reduction in back
office costs
• Most people want to stay at home
• Strategic partners access care management
database
Help to Live at Home Programme – key
elements
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Care and support service
Integrated equipment service
Telecare and response service
Independent support planning and brokerage
service
• Right information at the right time
HTLAH - High Level Process Overview
Signposting
& Advice
8,000
Complex Services &
Residential Care
2,000
Equipment
6,000
No Service Required
1,000
10,000
2,000
1,000
STEP 1
STEP 2
STEP 3
STEP 4
Referral &
Contact
Statutory
Assessment
‘Working with You’
Take ‘request for
help’ and decide
how to proceed
Council carry out
Person centred
assessment,
proportionate to level
of need
• Does this
person need
a statutory
assessment
• Handle Self
Assessment
• Would Telecare
remove / reduce cost
of support?
• Does this person
require intensive
support?
• Will this person need
to contribute to
support?
• How many hours
would this person
need to achieve their
outcomes and for how
long?
• Does this person just
need equipment and
be referred to
equipment provider?
Help to manage on their own or what
needs to be done together to get them
more independent. Provider delivers initial
intensive support and reviews customer
on pre-agreed date against identified
outcomes
RAS
18,000
• What progress is being made
towards the agreed outcomes?
• Can we reduce the level of support?
• Will this person need another
package of support?
• How well is
Provider reducing
need for on-going
support and
achieving
outcomes?
Support Planning
Planning what to do with you
and how we can help you.
Provider develops plan with
customer, accessing local
community resources
1,000
STEP 5
1st
Care Package
Working with you to achieve what was planned.
Provider delivers agreed support and will review at
the agreed end date of package
• How can support be
• Do we need to adjust level of support /
delivered for less than the
review customer as customer has improved
indicative amount?
/ got worse?
• When should the next
• Can we identify alternative ways to support
review point be?
customer to reduce cost of support?
• What support is available
if a crisis occurs at any
point within the plan?
• Would this customer need
support out of hours?
• How well is the Provider
• How well is
delivering cost effective
Provider reducing
support plans?
need for on-going
support and
achieving
outcomes?
Council Performance and Contract Monitoring
Care and Support Service - scope
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Personal Care
Reablement including in house service
Housing related support
Intermediate care
Preventive services
Older people and other vulnerable people who
need support to stay at home
EQUIPMENT, TELECARE AND
RESPONSE SERVICE
• 5 equipment contracts down to 1
• Retail outlets and access for self funders
• Telecare to replace paid for care where
appropriate
• Commissioning telecare response service
Crisis Response, Equipment & Out of Hours Response
Equipment
Provider
(Trusted
Assessors)
VCS Retail Outlet
(Trusted
Assessors)
Council
H2L@H
Provider
Customer
Out of Hours
Care &
Support
Crisis
Response
Call Centre
Lead Provider owns 24/7 care and support for customer
Crisis Response provides the mandatory facility for managing all crisis calls and Telecare triggers
Equipment Provider is the mandatory provider for assessing, procuring, delivery, installation and disposal of all equipment (including telecare)
Out of Hours care and support for when a visit is required – either a single team managed by Crisis Response or managed by Lead Providers
WHERE WE ARE NOW
• 120 providers down to 4
• Transferred 800 customers to new providers
• Transferred support planning function to
providers
• Appointed equipment provider
• Appointed telecare response provider
CURRENT POSITION
• Working with strategic partners to develop Help to Live
at Home as a service
• Saved £2.6m from procurement
• Shadow implementation of payment by outcomes
• Electronic monitoring
• Independent support planning and brokerage service
• Independent financial advice
NEXT STEPS
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Information and advice services
Transfer remaining customers
Promotion and marketing
Residential care