Implementing the Single Assessment Process across the South West Peninsula Basic awareness

1. Implementing the Single Assessment Process across the South West PeninsulaBasic awareness A Devon wide non-organisational approach to the Single Assessment process A Devon wide non-organisational approach to the Single Assessment process

2. What is the Single Assessment Process (SAP) ? Originated from the National Service Framework (NSF)Older People Standard 2: Person Centred Care -a single agreed approach to assessment for health /social care -type of assessment is appropriate to needs -agencies do not duplicate assessment -effective contribution by range of professionals/agencies -resulting in a single holistic service or care plan -contributed to and agreed by all (including the person) In South West Peninsula SAP will cover all adults 18+ except mental health Standard 2 states that NHS and Social Care Services treat older people as individuals and enable them to make choices about their own careStandard 2 states that NHS and Social Care Services treat older people as individuals and enable them to make choices about their own care

3. What is FACE ? FACE stands for : Functional Evaluation of Care Environments FACE is a national SAP tool supplier accredited by Dept Health Each partner in the SAP south west peninsula has bought a licence to use the SAP FACE tools. SAP is still the same as ever – FACE just provide the tools to use for it.

4. Who will be using SAP? All health & social care staff South west peninsula partnership All organisations using same tools and eSAP system PCTs, adult social care,acute trusts,(Devon doctors,SWAST eSAP) For full list of partners see SAP website

5. Don’t you people talk to each other !

6. Protecting & Sharing Information Most service users/carers expect us to share information If the person has given written or verbal consent and this is recorded once on the : “Consent to share and protect your information” form Use other assessment tools to check this still applies with every new assessment Agreed protocol in place across the health & social care agencies in SWP – see website

7. Making the links with SAP Computer-based patient record Lifetime record across care settings Single underlying database Continuous availability Unlimited scalability Simple Web-based access Integrated suite of clinical applications Core applications concept Automates healthcare workflow Proven solution for large, complex, multi-site health care organizations Patient Centered System and database designed around the patient, not around the account, across care communities Always Available Non-Stop simply the best for scaling and 7x24 availability Usable Sub-second response times Highly configurable Reportable Ccomplete, accurate, encoded, and permanent medical database Computer-based patient record Lifetime record across care settings Single underlying database Continuous availability Unlimited scalability Simple Web-based access Integrated suite of clinical applications Core applications concept Automates healthcare workflow Proven solution for large, complex, multi-site health care organizations Patient Centered System and database designed around the patient, not around the account, across care communities Always Available Non-Stop simply the best for scaling and 7x24 availability Usable Sub-second response times Highly configurable Reportable Ccomplete, accurate, encoded, and permanent medical database

8. What is an assessment?

9. SAP 4 types of assessment Contact Overview Specialist Comprehensive Most include: publishing information about service evaluation of information problem solving eligibility decisions care planning monitoring & review Most include: publishing information about service evaluation of information problem solving eligibility decisions care planning monitoring & review

10. Contact Assessment Not every contact needs one -an initial contact if needs recording -multi-agency referral form -basic personal information -difficulties, risks & significant life events -any staff member who is trained -not necessarily professionally qualified -may be partially completed and added to Signpost to most appropriate service Depth of assessment and appropriate to need Signpost to most appropriate service Depth of assessment and appropriate to need

11. Overview -More detailed assessment -At any stage in SAP -More complete picture of an individual -Incorporates core information -Includes information on providers/agencies -Risk triggers -Identifies need for further assessment Actual needs Potential needs impact on: independence daily functioning quality of lifeActual needs Potential needs impact on: independence daily functioning quality of life

12. Specialist Specific difficulties identified at contact/overview Specialist professional is required . May be one or more specialist assessments Specialist tools/scales/measures required SAP Health needs assessment (HNA) -only specialist tool in place across whole SWP and will be on eSAP . FACE developing other specialist assessments -COPD, Diabetes , Heart Failure , Telecare – otherwise use existing local tools e.g:Care Programme Approach for Mental health , Housing, Speech & language etc Provide more in-depth specialist information to the process Tools & Scales must be valid, reliable and culturally sensitive. (see Guidance Step 9) website for Department of Health tools & scales: www.doh.gov.uk/scg/sap/toolsandscales Provide more in-depth specialist information to the process Tools & Scales must be valid, reliable and culturally sensitive. (see Guidance Step 9) website for Department of Health tools & scales: www.doh.gov.uk/scg/sap/toolsandscales

13.  Comprehensive ( in the SWP a process not a tool) Contributions from different professionals Co-ordinated by skilled professionals Evidence base for detailed care planning Includes all domains of overview / specialist Intensive/prolonged support / treatment Complex care packages - e.g. residential/nursing care Must include the user / carer contribution to addressing the needs. Include a nursing care plan where appropriate.Must include the user / carer contribution to addressing the needs. Include a nursing care plan where appropriate.

14. Care Plan The Care plan is joint agency Identifies what care or treatment is in place and who is providing this. Includes contingency plan for emergencies Diary sheet shows who visits/when Copy should be given to service user & record that this has been done No longer needs service user’s signature

15. Review All care plans should set review date A review should take place with the person and their carer The review tool is to record this and set next review date FACE review form includes headings from overview assessment

16. What do FACE tools replace? FACE tools will replace most existing documentation and SAP home-grown tools Some SAP tools were previously numbered like SAP 1 Now all tools are known by their name Not all FACE tools will be on eSAP Only these key tools will need sharing across agencies

17. FACE tools on eSAP Background & Contact Assessment Overview Care Plan Review Learning disability Core Assessment Consent to share and protect information Health needs assessment ( HNA) – SWP version

18. What is eSAP? SAP can’t work without IT! eSAP enables assessment and care plan information to be stored electronically , shared with professionals across health and social care and sent to each other This is possible using your own computer and your organisation's IT system Web based browser- very safe & secure Could be used with mobile devices in people’s homes such as laptops.

19. Benefits of eSAP In addition to being better for the service users and carers……. Reduction in delayed transfers of care -Improved communication/access to information Reduction in unplanned admissions -Better information /improved risk management/ better decisions -reduce unnecessary admissions Better use of workforce -Reduce duplication and staff time spent in recording. -Easier and faster transfer of information between agencies. -More appropriate use of skills Less faxing , photocopying, storage

20. Person-held record Folder (usually yellow) held in person’s home Contains SAP documentation, communication sheet diary, self-care information Enables service user and carer to be and kept informed professionals to communicate Useful for emergencies Flag on eSAP will show it is in place Issued by PCT providing following criteria is met:

21. Criteria for Person Held Record

22. Single Assessment Process For further information contact: SAP Programme Team Email: bruce.oconnor @ exeter-PCT.nhs.uk :Tel: 01392 687142 Website address: ‘www.devon.gov.uk/sap’ Or staff area: ‘www.devon.gov.uk/sap-pro’ (all tools, guidance , newsletters etc)