Domiciliary Care Workshop
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Domiciliary Care Workshop. Waterfront Place, Chelmsford 11 October 2007. Person Centred Care. Gill Herbert September 2007. Where did the idea come from?. Social work professional values HAP professional values Tom Kitwood’s work in dementia care NSF Older People Standard 2

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Domiciliary Care Workshop

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Domiciliary care workshop

Domiciliary Care Workshop

Waterfront Place, Chelmsford

11 October 2007

Gill Herbert, Consultancy & Development Ltd


Person centred care

Person Centred Care

Gill Herbert

September 2007


Where did the idea come from

Where did the idea come from?

  • Social work professional values

  • HAP professional values

  • Tom Kitwood’s work in dementia care

  • NSF Older People Standard 2

    “NHS and social care services treat older people as individuals and enable them to make choices about their own care. This achieved through the single assessment process, integrated commissioning arrangements and integrated provision of services, including community equipment and continence services.”

    And most policy initiatives in the last decade

Gill Herbert, Consultancy & Development Ltd


Practice conflicts inconsistencies in the last decade

Practice Conflicts & Inconsistencies in the last decade

  • Service-led responses vs person-centred care

    avoiding process and pathway oriented case management and clinically focused approaches (Matrix, 2005)

  • Resource management for cost efficiencies vs commissioning and provision for quality

    finding “smart commissioning” solutions with

    outcome focus (SPRU, 2003)

  • High caseloads driving short-term interventions vs whole person approaches over time

    long-term care management models

Gill Herbert, Consultancy & Development Ltd


And more conflicts

And more conflicts…

  • Tight eligibility criteria vs investment in prevention and well-being

    Modernising social care, 2007

  • Bureaucracy vs professional integrity

    duplication & single assessment process

  • Uni-professional interventions vs inter-disciplinary working

    experiences in intermediate care &

    mental health

  • Task-centred time allocations vs enablement & person centred support packages

    Social care and PFIs

Gill Herbert, Consultancy & Development Ltd


Initiatives that make a difference

Initiatives that make a difference

  • Everybody’s Business – DH guidance on making sure all services respond to OPMHP

  • “In control” – support for people with learning disabilities to use direct payment

  • “HOOP” – support for people to make their own decisions relating to housing needs

  • “Intermediate Care” – a real shift of emphasis to rehabilitation and re-ablement for those who access it

Gill Herbert, Consultancy & Development Ltd


Challenges for commissioners

Challenges for commissioners

  • Understanding how outcomes for individuals relate to outcomes for populations or groups

  • Making sure commissioning does result in person-centred care for individuals – across agencies and professions as well as within service

  • Enablement focus rather than just crisis interventions

  • Ensuring links are made to voluntary, community groups and social networks

  • Turning individual budgets into well managed market development

Gill Herbert, Consultancy & Development Ltd


Challenges for providers

Challenges for Providers

  • Ensuring quality through active listening to customers

  • Achieving consistency, stability and practice which enables and supports independence

  • Developing partnerships with voluntary and community groups and social networks which work

  • Developing monitoring and evaluation systems which can inform future commissioning

Gill Herbert, Consultancy & Development Ltd


And to make it all work

And to make it all work?

  • Active partnerships between commissioners and providers to encourage learning and service improvements

  • Good information

  • Supportive management that drives change

  • Encouraging, not disabling, social networks and voluntary support

Gill Herbert, Consultancy & Development Ltd


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