Archived decisions

REPORT OF THE

EXECUTIVE MEMBER

ADULT SOCIAL CARE

PART II

HOME CARE MODERNISATION

1 The Executive Member was pleased to agree the future direction of the Home Care Service.

2 The in-house home care service currently has 22% of the domiciliary market in Hampshire and employs 650 full time equivalent front line staff delivering 9,800 hours of care per week. Approximately 80% of the hours are used to provide general mainstream domiciliary care similar to the services purchased from the independent sector.

3 During the past 2 years 20% of the home care service has been moved into new service developments. This has led to the development of Intermediate Care Teams, First Response Teams and more recently a dedicated dementia care team based in the Havant/Petersfield area. Twenty four hour care is now available in the Winchester/Andover area.

4 The publication of the Government's Green paper on the future of Adults Services has shown that there is likely to be an impact on the way that domiciliary care is provided in the future. The home care service will need to be clear about its role in the market and be in a position to support and compliment the move towards personalised budgets and anticipatory models of care.

5 Further integration of the home care service with community health teams will be fundamental to the successful management of long term conditions and there will be opportunities to support the development of home based care as an alternative to hospital based care.

6 There is now a need to build on the successful services that are currently in place within the home care service and to move away from the provision of general mainstream domiciliary care.

7 It is proposed that the home care service should move the majority of its business from providing long term maintenance care to the provision of short term assessment and reablement service. This will develop on a locality basis linking closely with community health partners and complementing the jointly managed intermediate care teams that are providing therapeutic specialist care.

8 The service will aim to provide intensive care and support to service users requiring assistance to regain confidence and independence following an episode of illness, deterioration of health or hospitalisation. It will be provided for a period of 6 weeks and during this time care plans of achievable goals and outcomes will be drawn up by trained home care staff together with service users to ensure that the care package is tailored to meet individual needs.

9 The care plans will be reviewed frequently and those people requiring long term home care will continue their care through either an independent care provider, direct payments or the specialist in-house home long term care service. One of the key principles is that people requiring a complex on-going package of care will have been assessed and stabilised to the most appropriate level by care management and home care staff. By focussing on short term interventions that aim to `right size' packages of care, there will be an increase in the numbers of people being able to access the service and efficiencies will be gained through a reduction in costs of care packages, the reviewing process and care management time.

10 The proposed changes to the home care service will need to be carried out on an incremental basis and there will be a need to consult with care management at a local level to ensure the capacity within the independent sector is sufficient to enable service users to be transferred from the reablement service following the 6 week intervention.

11 It is expected that the majority of home care staff will move across to the short term reablement service. However it recognised that for some staff there will be good reasons as to why they are unable to work as flexibly as required, these staff will continue to provide the smaller mainstream service that will be supporting difficult to place care packages.

12 A full consultation period with home care staff on the modernisation of the home care service commenced in July 2005 and will be concluded in September 2005.

PATRICIA BANKS

Executive Member for Adult Social Care

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