slide care services efficiency delivery: supporting sustainable transformation 1 homecare...

Care Services Efficiency Delivery: supporting sustainable transformation 1Slide

Homecare Re-ablementEast Midlands Personalisation ProgrammeFriday 26th March 2010


HOMECARE RE-ABLEMENT: Objectives of this Presentation

Re-ablement: expanding intensive short-term intervention across mental health, learning disabilities and physical disabilites

To provide:

• an overview of current limited knowledge base

• an extract from the interim report on the current prospective longitudinal study

• Questions


HOMECARE RE-ABLEMENT: Potential target spend ?

Older Adults Phy & Sens Dis LD MH

Residential Care 3,324 241 2,003 279317

Support & Other Accomm

58 15 375 61

Direct Payments 129 231 92 13

Homecare 1,989 315 506 62

Daycare 382 131 770 113

Sub total 5,882

64%

933

59%

3,746

84%

567

44%

Rest 3,292 648 732 726

TOTAL 9,174 1,581 4,478 1,293

Total annual spend £11,128m of £16,526m in 2007/08 *

* Gross PSSEX data 2007/08 (excluding Capital Charges) Adults £17,110m (excluding asylum and children & families)


HOMECARE RE-ABLEMENT: Evidence of Benefits (1)

Home Assessment and Re-ablement Team, Leicestershire

• Based on data for 2005/06 (1,836 users)• 50% required no ongoing care package = £61k per week• 29% had ongoing care package but reduced on average by 30% = £13k

per week• 18% referred onto others services with 16% reduction = £10K per week• Service costs approx. £36k per week

• No further package: average duration 4.6 weeks • Ongoing care package: average duration10.3 weeks • Referred to other services: average duration 11 weeks


HOMECARE RE-ABLEMENT: Prospective Longitudinal Study – Interim Report

This current study involves nine councils and an interim report was published in October 2009 – final report in October 2010.

Interim Report - The Organisation and Content of Homecare Re-ablement Services

Amongst other observations, the study considered

• Key features of re-ablement services– access to equipment, such as grab rails, walkers and trolleys to carry food around play a vital role in

helping people become more independent. – there was a common view among teams that people with dementia and mental health problems required

different patterns of engagement, where workers undertake a wider range of tasks themselves but encourage clients to help with those tasks

– workers identified by the re-ablement services as being less experienced were those who had spent less time working within traditional home care services. However, in general, these workers appear to involve people a lot more than those identified as being more experienced. This involvement was both in terms of decision making (e.g. asking people what they would want to do on the day) and hands on ‘doing with’ involvement in practical activities

– more experienced workers were more likely to look for ways of improving physical access, ensuring safety and making suggestions about other equipment that service users might find helpful, such as a ramp to remove a high step at kitchen door and a hydraulic seat in the bath


HOMECARE RE-ABLEMENT: Working with other client groups

Data shows that the majority of people currently undergoing homecare re-ablement are frail older adults

Phy / Sensory LD MH

Cornwall (pilot) 21%

Hackney 4% 4%

Hammersmith & Fulham 6% 12%

Hampshire 6% 2%

Leicestershire 18%

Newcastle City 9% 1%

North East Lincolnshire 4% 1%

Plymouth (small no) 22%

Sutton 10% 2% 7%

Telford 4%

Wandsworth 4%

Warwickshire (pilot) 10%

Wiltshire 13% 6% 6%

Wirral 5% 1%

Care Services Efficiency Delivery: supporting sustainable transformation 7SlideCare Services Efficiency Delivery: supporting sustainable transformation 7

HOMECARE RE-ABLEMENT: Outline of Direction for 2008/09 +Focusing on 4 projects

• Continued roll-out of the Homecare Re-ablement model– CSSR Homecare Re-ablement Scheme directory – completed May 2008 but updating Feb 2009– Benefits of homecare re-ablement – completed Jan 2009– Outsourced services – Clients with mental health, physical, sensory and learning disability needs

• Prospective Longitudinal Study – interim report published Oct 2009Working with nine CSSRs– to identify the features of an effective and cost efficient service– to maximise both outcome and duration of benefits and reduce variability between services– to understand and reduce the demands on other formal care, including

• other social care services e.g. delay or prevent admission to residential care• other council services• delay or reduce demands on health

• Homecare Re-ablement for those on ‘maintenance’ packages – on hold– seek to provide evidence through case studies and supporting information of the benefits of homecare re-

ablement for those who have been in receipt of a maintenance homecare package.

• Post initial phase homecare re-ablement – on hold– seek to provide evidence through case studies and supporting information of the benefits of additional phases of

homecare re-ablement for those whose needs increase at subsequent reviews following an initial phase of homecare re-ablement


HOMECARE RE-ABLEMENT: Contact with CSED

Gerald K Pilkington

CSED Lead

Homecare Re-ablement

[email protected]

www.dhcarenetworks.org.uk/csed

Telephone: 020 7972 4161

slide care services efficiency delivery: supporting sustainable transformation 1 homecare...

Documents