Thumbs up for Jim’s technology drive

Staffordshire County Council’s Assistive Technology Project Manager, Jim Ellam, has been praised for his promotion of assistive technology at the Smart Healthcare Live event, in a recent Guardian online article.

Jim spoke at last month’s conference, about the range of technology available to keep people out of hospitals and living independently in their own homes.

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Bringing down the cost of public services

Improvement and Efficiency West Midlands (IEWM) has launched its latest film Bringing down the Bill: Improving Efficiency in the West Midlands. 

The film demonstrates how IEWM is working with local authorities and their partners to help bring down the costs of local public services, and can be viewed on the IEWM website.  

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Services for Later Life 2011

Age UK is holding its first ever conference dedicated to promoting excellence in older people’s services on Wednesday 13 July 2011, at the Radisson Blu Portman Hotel in London.


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Care at home breaching human rights

Older people’s basic human rights are being overlooked in the provision of care at home, according to the Equality and Human Rights Commission.

Interim findings from the Commission’s  major inquiry into home care, reveal significant shortcomings in the way older people are cared for.   These include:

·        People left in bed for 17 hours or more between care visits

·        Failure to wash people regularly and provide them with the support they need to eat and drink

·        Individuals left in soiled beds and clothes for long periods

·        A high staff turnover, resulting in some people having a huge number of different carers performing intimate tasks such as washing and dressing.  In one case a woman recorded receiving 32 different carers over a two week period.

The findings are early results from the Commission’s inquiry into the protection and promotion of human rights of older people in England, who require or receive home based care and support.  It will report fully by the end of 2011. 

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Research into Dementia steps up

More money and resources will be ploughed into finding the causes of dementia following the launch of a ‘Route Map for Dementia Research’, an initiative involving 17 experts and representatives from government, universities, charities, industry and research organisations.  The group will look at ways to work together to increase the volume and impact of dementia research, and improve the lives of people with the condition.

The Route Map:

·        pledges up to £20 million from DH over five years for four new National Institute for Health Research Biomedical Research Units

·        commits the Medical Research Council to increase funding for neurodegeneration research by 10 percent to £150 million over the next four years to 2015

·        boosts the number of experts in the dementia field through new Academic Clinical Fellowships

·        strengthens links between public and private research sectors to identify new opportunities for partnership

·        ensures more patients and carers get involved in research through the NHR’s Dementia and Neurodegenerative Diseases Research Network, which will facilitate research in the NHS and care home sector.

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Gardening and GPS make life better - case study

Staffordshire based community mental health nurse, Karen Phillips, gives her account of helping a service user with dementia to maintain his independence with the help of a gardening scheme and a GPS tracking device, financed by direct payments
Doug is a fit and able man in his eighties who has been diagnosed with dementia.

He enjoyed going out on long walks but stopped when he became disorientated and lost his confidence. 

Doug and his wife said he had always been very active and a keen gardener, but since moving to a smaller property he no longer had a garden to tend. They also said he often became fidgety at night and was frequently “interfering with things”.

The situation at home had become stressful and quality of life for the couple was poor.

I had recently set up a gardening group for three service users supported by one adult placement worker. A float of £300 was allocated to buy plants and equipment. After many hours of determined work the garden was turned into an allotment. The scheme is funded by direct payments based on £21 per person for four hours.   

I told Doug about the group two months after his diagnosis, and he was keen to attend. His wife was relieved to know she had two afternoons a week when she did not have to worry about him, but she needed help with the rest of the week. 

We discussed his love of walking and suggested using a BUDDI GPS tracking device, which would allow him to raise the alarm if he got lost, and for his wife to locate him if she wanted to know his whereabouts.

The device has given Doug the confidence to take longer walks if he chooses. He likes using the Buddi and wears it on a neck loop as part of his dressing routine each morning. He then puts it to charge when he undresses each evening.

The BUDDI can be bought outright for £750 for the life of the unit, or £299 plus £10 per month. The latter is the option chosen by the Enablement Team. Doug’s package of two afternoons of gardening a week and the BUDDI, costs £44.50 per week, whereas two days traditional day care a week would cost approximately £106 a week. 

With these two measures in place, Doug now has the type of active routine that he is used to.  His wife worries much less about him when he is not with her, and she says he is much more settled in the evenings. The added bonus is they now have more to talk about and life is better for both of them. 

Looking to the future, I would like to set up similar small groups offering shopping or coffee mornings, cinema or bowling sessions; for service users with dementia who do not fit into traditional day service provision. 

Contact: Karen Phillips, telephone: 01543 511078, email:Karen.phillips@staffordshire.gov.uk

Funding Commission's recommendations welcomed

Directors of adult social services have welcomed "without reservation" recommendations made by the Commission on Funding of Care and Support.  ADASS president Peter Hay said the report from the Commission published this month "signals what will become the moment when adult social care was put on a footing to become fit for purpose in the twenty first century.” 

The Commission led by Andrew Dilnot, was set up in July 2010 and asked to recommend a fair and sustainable funding system for adult social care in England.

Among the recommendations made in the Commission’s report are:

• Individuals’ lifetime contributions towards their social care costs – which are currently potentially unlimited – should be capped. After the cap is reached, individuals would be eligible for full state support. This cap should be between £25,000 and £50,000. £35,000 is considered the most appropriate and fair figure
• The means-tested threshold, above which people are liable for their full care costs, should be increased from £23,250 to £100,000
• National eligibility criteria and portable assessments should be introduced to ensure greater consistency
• All those who enter adulthood with a care and support need should be eligible for free state support immediately rather than being subjected to a means test.
  

The Commission estimates that its proposals – based on a cap of £35,000 – would cost the State around £1.7billion.

Recommendations will form the basis of future consultation with government.

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Supporting innovation and excellence

The JIP’s support of innovation and excellence in social care has led to a number of successful projects taking shape over the last two years, contributing to the transformation of adult social care in the region.

Some of the partnership’s key achievements include:

Improving the quality of information, for example: 
AskTARA, a dedicated online resource giving information about assistive technology and telecare products, and services councils provide. It is simple to use and similar to the popular Amazon website with clear instructions on how to navigate the site.  The JIP has invested in this project as it supports the requirement for councils to improve the quality of information about social care, and has the benefit of promoting independence with the use of technology.

Prevention, for example:
The Automated Pill Dispenser, a device that automatically reminds the user when to take pills, increasing their independence and wellbeing by ensuring tablets are taken at the right time and dosage.

The JIP set up a pilot project to determine the benefits of the dispenser, such as the potential to reduce admissions to hospital or residential care as a result of either overdosing or not taking the prescribed medication.  So far, with 170 people having trialled the gadget, savings of £2,300 per person in health and social care costs have been calculated. The next stage is to roll out a further 400 devices.

Improving Customer Choice and control, for example:
The Mobilising Community Capital programme, which is designed to increase the range of adult social care services and suppliers, including social enterprise and the voluntary sector, and encourage new ways of commissioning. The programme has been set up in response to direct budgets and the personalisation of care whereby service users increasingly have more choice and control over the way their needs are met.

The JIP has embarked on a region wide market shaping exercise, with the purpose of identifying existing and potential services and suppliers, and to find out what measures are needed to support growth of the new adult social care market. 

The next stage is to publish position statements for each local authority, detailing the state of the market in their locality and what the council will do to stimulate innovation and development.

Smarter commissioning, for example:
The Care Funding Calculator is a pricing tool that helps local authorities and PCTs to manage the cost of providing care for adults with learning disabilities. It provides a breakdown of care costs using national data and regional variances, allowing the authorities to negotiate fair prices with service providers. 

To date 10 local authorities in the region have saved £5.6 million.  The next step is to rollout the calculator to clusters of PCTS to help meet the QIPP challenge. 

Redesigning care pathways, for example:
In South Birmingham, where redesigning of care pathways; i.e. the process of mapping out what integrated care will be provided, when, and the  time frames; will involve the local authority, PCT, University Hospital Birmingham, the third sector, GPs, the Mental Health Trust and Community Health.

The scheme has the potential to save £29.3million across health and social care by 2021.

The next stage is to create a Community Geriatric Service to reduce hospital admissions and the need for complex residential or nursing care.

The JIP will continue over the next two years to support health and social care initiatives that create a richer, more efficient market, that is shaped around customer need, providing better care and improved outcomes. 

Contact: Matt Bowsher, Head of Adult Social Care, Communications and Strategy, telephone: 0121 245 0170, email: mbowsher@westmidlandsiep.gov.uk .

Councils meet 30 per cent target for personal budgets

A third of all people eligible for social care support are now receiving a personal budget, with half of those received by people over the age of 65, according to an ADASS survey of 153 councils in England.

More than 338,000 people are now managing their own support: double the number of people from this time last year. The total amount of money allocated in personal budgets overall has now passed the £1.5bn mark, representing almost £1 in every £7 spent by councils directly on care and support services.

Of the 132 councils that responded to the ADASS survey, the majority (83) are now delivering personal budgets to a third or more of eligible people, and 27 of these councils give personal budgets to over half of their eligible people.

The rate of increase in personal budget delivery was much faster in the second half of 2010/11, showing that the move to personal budgets is picking up speed.

Nearly all of the increase has been in 'managed' personal budgets, with no significant increase in direct payment numbers in the last year.

The survey also found that a significant minority of councils (at least 19) are delivering personal budgets to less than a fifth of potentially eligible users.

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Dudley’s independence team shows early results

Dudley’s Living Independently Team has helped scores of people to maintain their independence since its formation.

Set up in November 2010, the multidisciplinary team consisting of social workers, occupational therapists, physiotherapists, nurses and short term assessment and reablement workers, has dealt with more than 376 referrals.

The team helps people stay independent in their own homes for longer.  Help can include anything from installing telecare equipment to providing occupational therapy.  

Of the people referred,139 regained their independence, with only 19 people needing to be referred for longer term care.

Contact Joanne Vaughan, telephone 01384 817599 01384 817599 email: joanne.vaughan@dudley.gov.uk

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Acute support for dementia patients and carers

A fresh approach to caring for dementia patients and supporting their carers is being tested by Worcestershire’s Acute Hospital Trust Integrated Discharge Team, in a year-long pilot project. 

Greater emphasis has been placed on involving carers at the admission and discharge stage to reduce the likelihood of readmission and ease the process of resettling patients back home.

Two non-clinical members of staff have been appointed to the team. Their role is to find out as much as possible about the needs of patients and carers at the point of admission.  Appropriate information, advice and support is then be provided.

This includes details of support available in the wider community, as well as what to expect from the hospital process and what is available to carers when they are in hospital.

Links are also made with social work and health professionals, along with referrals to outside organisations offering support to carers.

Carers are given the opportunity to complete a booklet known as ’About Me’, providing a summary of the patient’s needs.  Information about likes, dislikes and preferred methods of communication is included, plus any specific behaviour that staff need to aware off.

The booklet is held in the patient’s notes and a Forget me Knot flower sticker placed above their bed.  This indicates to staff there is information they need to familiarise themselves with. 

Although the pilot runs until March 2012, early indications show the quality of care for patients, and discharge procedures have already improved.  Awareness is also growing among internal and external agencies of the range of support services needed.

University of Worcester is evaluating the pilot.  The Trust plans to extend the service to the county’s community hospitals. 

Contact: Rachel Fowler, Carers Unit Manager, telephone: 01905 728824, email: RFowler@worcestershire.gov.uk

Building a community workforce for the future

Moves to create a more diverse and flexible workforce that will deliver personalised services and care closer to home are underway in Herefordshire.

The council plans to co-ordinate a community workforce, by bringing together a range of partners and harnessing skills, resources and expertise that exist beyond traditional health and social care workforce boundaries. 

Sectors already identified as contributing to workforce are personal assistants, carers, individual volunteers, universal services, the commercial sector, council staff, NHS employees, other public services, private individuals, as well as the private, independent and voluntary sector.

Next stage of the council’s plan is to:

·        Map out the community workforce in the South Wye area to find out what exists where

·        Engage with the community workforce to explore and understand how best to facilitate their contribution to the care close to home and personalisation agendas

·        Deliver a range of learning and development opportunities across the neighbourhood to assist the workforce in maximising their contribution

·        Devise a ‘lifestyle pathway’ tool for service users and carers that will help them identify their neighbourhood workforce and get support

·        Evaluate to assess cost benefits with a view to further development, and how this approach might inform local commissioning.

Contact: Andrew Hasler, Workforce Development Lead, telephone: 01432 261816, email: AHasler@herefordshire.gov.uk

QIPP updates online

Updates on QIPP can be found on the Modernisation of health and care pages of the DH website.

Containing news, information and conversations, the site gives an overview of developments and guidance on how to make health and care services more efficient and effective.

Visit

Fast track to setting up a QIPP business case

Health and social care workers can acquire new skills needed to develop a QIPP business case and implementation plan, from September this year. 

The JIP, NHS West Midlands and ADASS, have funded the Integrated Care Development Programme which will help individuals from GP commissioning, community health, adult and children’s services, to plan and deliver integrated health and social care services and to work together in multi-disciplinary teams.  Emphasis is on improving results for service users and reducing costs.

The JIP is the strategic link between local authorities in the region. QIPP is one of the partnership’s priorities to be worked on over the next two years. 

The 10 day fast track programme is designed to meet three objectives:

·        efficiency savings released through the development of a high quality  evidence-based business case

·        increased staff competence in collaborative commissioning

·        stronger partnerships across primary and community care in health and social care.

The programme runs from September 2011 at the University of Birmingham over a series of individual days, and ends in February 2012.

It is open to group applications from local teams of two to four participants who:

·        are senior practitioners, clinicians or managers (social care or health), who is the lead person for QIPP

·       have previous experience of designing new services, or developing a business case

·        expect to remain in their current role until March 2012.

Teams must include at least one person from social care and one from health.

The programme will be delivered by the Health Services Management Centre at the University of Birmingham with Finnamore Ltd.

Deadline for submitting applications is July 15 2011.

Further details and the application form are available from Ann Thomas, telephone: 0121 414 7058, email: a.d.thomas@bham.ac.uk .

Putting QIPP at the heart of care

Quality, Innovation, Productivity and Prevention (QIPP) is the new programme for improving quality and productivity across the NHS and social care, and for delivering £20 billion savings in the NHS by 2015.

It forms the basis on which health and local authorities will redesign services with the purpose of improving quality and efficiency.

This is prompting greater integration of services between health and social care. Savings made from adopting more efficient ways of working are earmarked for reinvestment in patient care.

A number of workstreams have been set up by the DH to support the new approach; some focus on commissioning care, others on the way staff are managed and organisations are run.

QIPP has been introduced in response to the need to make savings due to growing demands put on health and social care by an ageing population. Its aim is to ensure that each pound spent is used to bring maximum benefit and quality of care to patients.   

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