What was the issue you were addressing or working on?
An integrated housing and social care plan across local authority, health, third and independent sector providers was implemented to promote service improvement and cost efficiencies whilst improving outcomes for individuals and their carers. Specifically:
- To provide services designed to promote independence and wellbeing through flexible and integrated onsite personal care and housing support teams within sheltered and very sheltered housing.
- To address recruitment difficulties
- To reduce in-house service costs, maximise capacity, reduce duplication and reduce travel time.
- To reduce the number of admissions to hospital and facilitate a speedy return home following an illness/crisis.
What you did?
Social work, housing and the Independent Sector care at home providers agreed responsibilities for meeting service users needs by different providers across the City. In all Aberdeen City Council Sheltered and Very Sheltered housing the local authority would provide for personal care and most housing support needs. The private and voluntary sector providers would in the main provide care and support to those service users living in the community (outwith sheltered housing).
Revised eligibility criteria were introduced and care packages for each service user were reviewed and consultation on transfer to other providers carried out. Particular needs, eg continuity of care, and service user choice were accommodated.
Within sheltered housing we removed duplication of tasks by combining tasks undertaken by sheltered housing wardens and senior carers into one role – Senior Personal Carers. Each complex was allocated a team of personal carers who work both within the complex and can provide short term interventions in the local area as required. The Senior Personal Carers lead the teams and monitor and review individuals’ care plans, allocate work to staff both ongoing and short term interventions, and provide support and supervision to the staff. The teams do not change thus ensuring a team who are known to service users and importantly staff who know the needs and preferences of their service users.
Since we changed the service 3 years ago staff have worked much more closely with our colleagues in health to ensure a more holistic and responsive service.
What were the outcomes - benefits or otherwise?
Service users and carers report being better supported especially during illness or a crisis.
Fewer people have moved to care homes and this is evidenced by the increasing number of vacant care home beds in the City, and decreasing numbers of people admitted to care homes.
A customer survey was undertaken in 2010. A total return of 1492 surveys, equating to 69.5% of the questionnaires distributed.
- Services provided on site had high satisfaction ratings from those residents who answered that they had used them. 94% of respondents stated they were very satisfied or satisfied with the service they had received.
- When comparing respondents replies regarding the importance of activities undertaken by Senior Personal Carers the top “very important” activities indicated are “assistance from staff in emergencies” (63%), “knowing a senior personal carer is available if needed” (60%), “knowing personal care is on hand” (59% ) and “ensuring communal areas are kept clean and tidy” (59%).
- When asked about how satisfied or very satisfied they were with any of the 12 listed services provided by Senior Personal Carers in the last 6 months, respondents to these options scored between 91% and 96% for 11 of the tasks.
4 wellbeing coordinators have now been appointed to support individual and group activities, health promotion and to make best use of the many dedicated and talented volunteers in the City, by linking individuals to volunteers.
Systematic review of all individuals’ medication and needs in supporting them. This has reduced the amounts of different medications being taken and also appropriately and safely reduced the numbers of multiple daily visits to administer the medication where this level of support is required.
Staff receive regular supervision, training and support, and are much more aware of what other services and supports are available for service users and make referrals or provide assistance to access these. This could be simple aids, Occupational Therapy or Physiotherapy and increasingly the uptake of telecare.
Financial benefits were a considerable reduction of the care at home costs. This was partly achieved by the Voluntary Severance of 90+ staff, predominantly wardens and domestic support staff.
Personal Carer travel time and travel associated costs was reduced by around 80%.
“Freetime” for the inhouse service reduced considerably also.
Rehabilitation teams have greater capacity to support those being discharged from hospital to home in the community, with short term packages of care.
Care Inspectorate grades have improved consistently over the past 3 years.
Complaints have reduced and letters or cards complimenting have risen.
In 2012 we completed a full scale review of our sheltered and very sheltered housing which we call our homes for varying need (Extra Care Housing). An action plan was put in place to implement the findings through which some complexes will be being upgraded to Very Sheltered standard where a meal and 24 hour onsite staff is standard provision. An overprovision of sheltered housing will mean some becoming Amenity or Amenity Plus Housing.
Contacts - to find out more
Tel: 01224 522664