Homecare Redesign

What was the issue you were addressing or working on?

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 the traditional model was outdated, no longer met the needs of the service users and was preventing the capacity of managers to provide the high quality of care services which we aim to provide.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.

What you did?

We have

  • Progressed the re-design model within home care services to split the roles and responsibilities of the patch home care managers.
  • This is beginning to evidence that we are better placed to enable service users care supplied both in-house and externally to be reviewed appropriately and timely.
  • We are encouraging the re-ablement approach to care, thus freeing up much needed resources to be re-allocated to those of greatest need within the community.
  • By developing greater links with our health colleagues we are beginning to highlight our services more to health staff both within the community and the acute setting so that staff are well aware of the services available to enable them to confidently and quickly discharge patients home in particular from A&E, and to access additional support for service users in the community to prevent hospital admission during not only the normal working week but out of hours and at weekends.
  • Begun the separation of the allocation of staff time and the management of staff and support of service users from home care managers remits this will enable us to more effectively monitor staff availability and achieve maximum use of their available time through the appropriate usage of our new real time monitoring system when it is implemented early 2014.
  • We have created resource managers and are beginning to work more effectively with our private providers and will look towards a move away from ad hoc provision to a more acceptable block contract arrangement late 2013.


What were the outcomes - benefits or otherwise?

We have introduced four resource home care managers to assess and manage the care provided by our external providers, using the council’s eligibility criteria and re-ablement ethos. We have been able to reduce the level of service currently provided which has freed up care hours to be re-allocated to those service users identified as most in need in our communities.

We have also carried out service user feedback on the services they are receiving from their private providers by implementing a quality assurance system.

We have progressed the service re-design and begun to move some of the responsibilities from patch home care managers to enable them to concentrate on assessment and re-assessment of service users as well as management of care staff.

The resultant increase in the number of procedures and pathways required to be drawn up has enhance communication and understanding. It has assisted staff, service users and stakeholders through the service re-design change management programme and enhanced our care provision generally by ensuring quality, with all staff both internal and external understanding better their roles and responsibilities within the re-shaping care agenda.

Contacts - to find out more

Liz McGhee,  Liz.mcghee@falkirk.gov.uk  01324 506400