Information for All

Examples of Practice

  • How to try and promote awareness and a greater understanding of the 3rd and independent sector to health and council staff.
  • Promoting the services that third sector and independent sector can and do already provide for older people and how they can prevent avoidable admissions and delayed discharges.  Also how to access the organisations and services their, referral systems, costs etc

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Carers Support Community Hospital Discharge Team

Examples of Practice

All parts of the patient’s support system (the carer, acute and community care services etc) should work together to achieve the best outcome for both the cared for person and the carer.  Despite the policy and good practice advice which has been developed to guide us across this pathway, carers often report  that they feel ill-informed and that policy is often not reflected in practice.

Establishing Carer Support as a key component of the hospital discharge process addresses the need to identify carers at an early stage and ensure that they are well informed and supported.  It also addresses the need to support carers at key times of transition, eg where the admission meant the carer was no longer able to continue care at home and the person they cared for was being admitted to long term care.

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Care at Home Pharmacy Team

Examples of Practice

The increased number of older people living at home with one or more long term condition means there is increased risk of errors with medication. This has been identified as a risk for emergency admission to hospital. These older people are not a group who would routinely receive a review.   Post Hospital Discharge a ‘transition’ time for many older people was originally targeted with the service now being available for all Care at Home clients.

Additional support to vulnerable older people to manage their medications can avoid emergency admission to hospital.

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Care and Repair Extra – Public Social Partnership

Examples of Practice

Introduction of the national agenda has recognised that there is a need to shift the focus of services for older people away from ‘bed based’ care towards preventative services.

The outcome of the review highlighted that there are gaps in service provision in the current North Ayrshire Care and Repair Service.

North Ayrshire Council wants to ensure that residents have access to a fair and equitable Service which can significantly reduce the incidence of falls and optimise the independence and wellbeing of older people and support them to remain safely at home or in a homely setting.

This Service will support the national agenda to shift the balance of care and prevention as well as delivering improved outcomes to residents in North Ayrshire.

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Homecare Redesign

Examples of Practice

Falkirk Council Home Care Service provides care to approximately 1,600 in house service users and manages the care of approximately 300 + external agency only and in-house plus external agency and or voluntary provider service users.

The traditional model of management for this service had been to appoint home care managers on a geographical basis to manage the whole range of services to be provided. Whilst this was acceptable 15 years ago with the changes to care provision, increased volume of care at home services and the changing ethos of how we provide services, e.g. re-ablement, use of private providers etc. the traditional model was outdated, no longer met the needs of the service users and was preventing the capacity of managers to provide the high quality of care services which we aim to provide.

As part of our self evaluation exercise we highlighted the need to diversify our management arrangements and specifically aim to target the effective splitting of the patch home care manager’s role into three specialism’s. These will be long term service provision within a geographical patch, resource management of agency providers, shopping meals and laundry services and our 24/7 service providing specialist re-hab at home, crisis care and to move into a more involved relationship with facilitating more appropriate and timely discharge of patients as well as preventing hospital admission by extending the remit of our rapid response services and working closer with our colleagues in Reach.

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