supporting people to stay at home –doing it differently in wiltshire
DESCRIPTION
SUPPORTING PEOPLE TO STAY AT HOME –DOING IT DIFFERENTLY IN WILTSHIRE. Improving outcomes for customers and reducing costs by improving the way we work. The Geography of Wiltshire. Midsized unitary authority More than average older people Pockets of deprivation 3 acute hospitals - PowerPoint PPT PresentationTRANSCRIPT
SUPPORTING PEOPLE TO STAY AT HOME –DOING IT DIFFERENTLY IN WILTSHIRE
Improving outcomes for customers and reducing costsby improving the way we work
• Midsized unitary authority• More than average older people• Pockets of deprivation• 3 acute hospitals• Large number of self funders• 1300 domiciliary care customers• 3000 sheltered housing tenants• 1000 care staff
The Geography of Wiltshire
Voice of the CustomerTop 15 Statements from EVOC
3.45 3.50 3.55 3.60 3.65 3.70 3.75 3.80 3.85 3.90 3.95
I want to speak to someone at the right time for me
I want to keep as active as I can
I want to go outside my home
I want the right to choose how I live my life
I want a simple way to access information and advice
I want to know how much it will cost me
I want to see and talk to people
I want to be able go to the toilet independently
I want good quality information that is easy to access
I want to speak to someone face to face
I want to feel safe
I want to stay at home as long as possible
I want you to be honest with me
I want to be free from abuse
I want help when I am in a crisis
The Customer
Ranked ‘top six’ themes
DESIGN PRINCIPLES
• Fewer providers = strategic partnerships• Developing the workforce = making care work a
valued profession• All services jointly commissioned with the NHS• Assumes most people want to be independent• All services available to the whole population• Support planning – a provider responsibility
MORE DESIGN PRINCIPLES
• All care time limited• Commissioning outcomes not hours• Simplification of processes = reduction in back
office costs• Most people want to stay at home• Strategic partners access care management
database
Help to Live at Home Programme – key elements
• Care and support service• Integrated equipment service• Telecare and response service• Independent support planning and brokerage
service• Right information at the right time
STEP 1Referral &
ContactTake ‘request for help’ and decide how to proceed
STEP 2Statutory
AssessmentCouncil carry out Person centred
assessment, proportionate to level
of need
STEP 3‘Working with You’
Help to manage on their own or what needs to be done together to get them
more independent. Provider delivers initial intensive support and reviews customer
on pre-agreed date against identified outcomes
STEP 4Support Planning
Planning what to do with you and how we can help you.
Provider develops plan with customer, accessing local
community resources
STEP 51st Care Package
Working with you to achieve what was planned. Provider delivers agreed support and will review at
the agreed end date of package
RA
S
HTLAH - High Level Process Overview
• Does this person need a statutory assessment
• Handle Self Assessment
• Would Telecare remove / reduce cost of support?
• Does this person require intensive support?
• Will this person need to contribute to support?
• How many hours would this person need to achieve their outcomes and for how long?
• Does this person just need equipment and be referred to equipment provider?
• What progress is being made towards the agreed outcomes?
• Can we reduce the level of support?• Will this person need another
package of support?
• How can support be delivered for less than the indicative amount?
• When should the next review point be?
• What support is available if a crisis occurs at any point within the plan?
• Would this customer need support out of hours?
• Do we need to adjust level of support / review customer as customer has improved / got worse?
• Can we identify alternative ways to support customer to reduce cost of support?
• How well is the Provider delivering cost effective support plans?
• How well is Provider reducing need for on-going support and achieving outcomes?
• How well is Provider reducing need for on-going support and achieving outcomes?
Council Performance and Contract Monitoring
18,000 10,000
Signposting & Advice
8,000
Equipment6,000
2,000 1,000
No Service Required1,000
Complex Services & Residential Care
2,000
1,000
Care and Support Service - scope
• Personal Care• Reablement including in house service• Housing related support• Intermediate care• Preventive services• Older people and other vulnerable people who
need support to stay at home
EQUIPMENT, TELECARE AND RESPONSE SERVICE• 5 equipment contracts down to 1• Retail outlets and access for self funders• Telecare to replace paid for care where
appropriate• Commissioning telecare response service
Crisis Response, Equipment & Out of Hours Response
CouncilH2L@H Provider
EquipmentProvider(Trusted
Assessors)
Out of HoursCare &Support
CrisisResponseCall Centre
Customer
VCS Retail Outlet(Trusted
Assessors)
Lead Provider owns 24/7 care and support for customerCrisis Response provides the mandatory facility for managing all crisis calls and Telecare triggersEquipment Provider is the mandatory provider for assessing, procuring, delivery, installation and disposal of all equipment (including telecare)Out of Hours care and support for when a visit is required – either a single team managed by Crisis Response or managed by Lead Providers
WHERE WE ARE NOW
• 120 providers down to 4• Transferred 800 customers to new providers• Transferred support planning function to
providers• Appointed equipment provider• Appointed telecare response provider
CURRENT POSITION• Working with strategic partners to develop Help to Live
at Home as a service• Saved £2.6m from procurement• Shadow implementation of payment by outcomes• Electronic monitoring• Independent support planning and brokerage service• Independent financial advice
NEXT STEPS
• Information and advice services• Transfer remaining customers• Promotion and marketing• Residential care