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SUPPORTING PEOPLE TO STAY AT HOME –DOING IT DIFFERENTLY IN WILTSHIRE

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

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SUPPORTING PEOPLE TO STAY AT HOME –DOING IT DIFFERENTLY IN WILTSHIRE

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  1. SUPPORTING PEOPLE TO STAY AT HOME –DOING IT DIFFERENTLY IN WILTSHIRE Improving outcomes for customers and reducing costsby improving the way we work

  2. The Geography of Wiltshire • 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

  3. Voice of the Customer

  4. The Customer Ranked ‘top six’ themes

  5. 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

  6. 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

  7. 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

  8. HTLAH - High Level Process Overview Signposting & Advice 8,000 Equipment 6,000 No Service Required 1,000 Complex Services & Residential Care 2,000 18,000 10,000 2,000 1,000 1,000 STEP 1 Referral & Contact Take ‘request for help’ and decide how to proceed STEP 2 Statutory Assessment Council 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 RAS STEP 4 Support Planning Planning what to do with you and how we can help you. Provider develops plan with customer, accessing local community resources STEP 5 1st Care Package Working with you to achieve what was planned. Provider delivers agreed support and will review at the agreed end date of package • 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 Provider reducing need for on-going support and achieving outcomes? • How well is the Provider delivering cost effective support plans? • How well is Provider reducing need for on-going support and achieving outcomes? Council Performance and Contract Monitoring

  9. 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

  10. 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

  11. Crisis Response, Equipment & Out of Hours Response Equipment Provider (Trusted Assessors) VCS Retail Outlet (Trusted Assessors) Council H2L@H Provider Customer Out of Hours Care & Support Crisis Response Call Centre Lead Provider owns 24/7 care and support for customer Crisis Response provides the mandatory facility for managing all crisis calls and Telecare triggers Equipment 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

  12. 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

  13. 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

  14. NEXT STEPS • Information and advice services • Transfer remaining customers • Promotion and marketing • Residential care

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