What was the issue you were addressing or working on?
The re ablement and crisis care service has re-focused its activity to intervene earlier and promote the independence of older people. The new service design has delivered the following improvements
- 24/7 response to any crisis
- Fast Track provision of technology and equipment
- Single point of contact for responding to falls
- Falls prevention programme
- Respite for Carers
- Intensive Re-ablement Programme, building personal resilience
- Improved alignment of social and health care staff, making better use of resources
What you did?
This has been a joint initiative with health colleagues and other internal stakeholders. The re design was in the planning phase for approximately 12 months, and included a consultation with existing service users to capture their views on the benefits of a reablement service.
The first phase of the project which was the implementation of the Crisis Care Team which took place in February of 2012. This was quickly followed with the implementation of the re ablement service.
A significant effort has gone into the financial modelling for the redesign, which was built on a three year plan to take us to full implementation. Throughout the implementation we have consulted with JIT and more recently had discussion around the development of our performance framework.
We have emphasised from the outset that as far as possible we will seek to promote the concept of the generic worker, where traditional service boundaries can be crossed where people are appropriately trained to do so and that in so doing we aim to reduce service duplication for service users. We have agreed across health and social care that this will be a theme for all service developments.
What were the outcomes - benefits or otherwise?
There is already significant evidence that preventative interventions are benefiting customers by avoiding unnecessary hospital admissions, delaying admissions to care homes and providing effective support to carers. Partnership working has resulted in the availability of complex occupational and physiotherapy services being delivered at an earlier stage and co-ordinated with the re-ablement process resulting in faster recovery and increased independence.
Since April 2012, (to October 2013), 314 residents in West Lothian have benefited from a Re-ablement Service. Of those
- 126 reached full independence
- 77 became more independent and needed less formal care
This resulted in an efficiency of approximately 1,000 care hours per week which would have been an annual resource equivalent of £780,000.
For the Crisis Care Service during the period 1st May – 31st March 2013 the service responded to:
- 474 Falls with an average response time of 35 minutes
- 541 Personal care calls with an average response time of 45 minutes
- 395 HSS equipment calls with an average response time of 40 minutes
- 176 General assistance calls with an average response time of 45 minutes
Further key features of the CC service;
- Response offered via Careline regardless of whether the person in need has Home Safety Service.
- Falls Prevention Programme with every response being followed by a screening process to determine whether a full and comprehensive risk assessment and management plan is appropriate
- Up to five days intensive support for service users and carers (including overnight support) to avoid the disruption of a move from their own home
It is of note that that the level of positive feedback from the public and from other key partners, including G.P’s, Community Nursing, Police and Ambulance Service, has been unprecedented. The impact of this development on other service areas was recognised surprisingly quickly post implementation.