As the telecare service developed in Aberdeen City it soon become apparent that training was required for professionals to raise their awareness around telecare, inform them of the functions of telecare equipment and the importance of considering telecare in assessment.
The service had delivered many awareness sessions in telecare events and to individual teams, but it was felt we needed staff across all sectors trained to an enhanced level so they could act as a point of reference for their colleagues.
The aim of establishing ICASS in Fife was to transform community services by bringing together uni-disciplinary teams to utilise fully resources available in line with demand, and to coordinate care through a single point of access (SPOA). It contributes to our commitment to ensure the closer integration of the range of community services under one system.
It aims to improve quality of care and outcomes for older people whilst allowing them to remain independent within their own homes or communities, provides alternatives to hospital admission, reduces the number requiring long term institutional care, reduces length of stay for those who require a hospital admission. It aims to address the following:
Moving from an inpatient model of care to a robust community based model of care involving older people and their carers and families in care planning
Bringing together teams to make more efficient use of resources to meet the needs/demands of the increasingly elderly population
To provide a single point of access
To provide alternatives to hospital admission
To reduce length of stay if an admission is necessary
To provide assessment and care in the person’s own home or a homely setting
To achieve and sustain maximum potential and independence; and
To reduce numbers going into long term institutional care.
Previous mapping of the falls pathway had demonstrated that there was no clear systematic approach to the identification and onward referral of those presenting to the A&E department at the local hospital with a fall.
The case study illustrates the impact of the investment made in Targeted Housing Adaptations to support hospital discharge. This is an example of addressing a barrier to timeous, appropriate discharge (ie suitable housing) through much speedier access to adaptation resources. There has been a range of linked improvements in waiting times for adaptations as set out below.
To deliver an integrated approach to support patients and their carers sustain care in their own home for end of life care.
Figures produced by ISD show that those in the final year of life accounted for around 30% of all bed days. While 50% of patients continue to die in hospital, Marie Curie can evidence that 98% of those cared for at home with Marie Curie input can be sustained at home.
P&K CHP currently deliver 3 Marie Curie shifts per week for each patient assessed to be in the last 12 weeks of life regardless of diagnosis. Evidence from the last 2 years data shows that existing and predicted increasing demand for enhanced services is no longer sustainable.