Appendix 1 Demonstrator for Older People’s Housing, Support, Health and Care Detailed Request for Demonstrator Area Status Section 1 Partnership Details Q1 Name of partnership Inverclyde Joint Care Organisations and/or services party to this application Inverclyde Council, Riverclyde Homes, Trust Housing Association, NHS Greater Glasgow and Clyde, Inverclyde CHP.and Communities Scotland. What level of support exists between the partners (e.g. including elected members, non-exec members of CHPs/HBs, users and carers) for this proposal? (Please note the requirements set out in para 23 of the specification for the demonstrators.) High level commitment Partnership commitment is derived through the Joint Care Board in Inverclyde where the proposed application was discussed and approved at a meeting on 30th January 2008. This is the high level strategic joint board developed to support the joint future agenda. Membership includes the Director of the CHP, Director of Education and Social Care, CHP Clinical Director, Chief Social Work Officer, Trade Unions, Inverclyde Community Care Forum and Elected Members, with the Chair being the Health and Social Care convenor and also vice-chair of the CHP. A multi agency Housing and Accommodation Group forms part of the joint structures in Inverclyde and is the forum for ensuring health, social care and housing matters link together across the care groups and agencies and also into the local Housing Association Forum. There is also a well developed providers forum that includes all private and voluntary sector providers (National and local), including care home providers, housing providers, housing support providers and care at home providers. NHS Non-acute Service redesign The partnership is currently progressing a whole system redesign of older people’s services and mental health services as part of the closure of Ravenscraig Hospital. Detailed plans for the redesign/re-provisioning of services for Older People with Mental Illness services have been developed and discussion to agree a financial envelope around these plans is underway. Detailed Application for Demonstrator 1 Joint Improvement Team: January 2008 Appendix 1 Background work to begin to redesign Older People’s services has been ongoing for a period of time, with final requirements currently being updated based on hospital useage and throughput over the past year and also the present hospital population. The aforementioned plans are being developed through joint structures and encompass a whole system approach, both in terms of being multi-disciplinary but also multi-agency, ranging from redesign of NHS continuing care provision, through intermediate tiers of care to intensive community care in a range of housing provision, to maintenance and preventative work. Sheltered Housing A comprehensive review of sheltered housing has taken place, with the final stage being wider consultation with key stakeholders including the community and service providers. This work will take place at the end of March 2008. Reports outlining preliminary findings from the review have been submitted to and approved by appropriate committees within the local authority including the Corporate Management Team. Consultation with the wider community will be led by the Inverclyde Community Care Forum who have access to and involvement with, over 900 local stakeholders including individuals and community groups across Inverclyde. The review process has included an audit of the condition and standard of current sheltered housing provision and a minimum standard has been drawn up with relevant costings for implementation. This would allow for joint working with the community occupational therapy service to link adaptation requirements into upgrading programmes across sheltered housing. Work is underway to change a sheltered housing unit to housing with care. This is a partnership development with Trust Housing Association and the local authority. The supporting people budget plays a key role in the funding of this initiative. This project has involved the transfer of care coordination and provision of care services from the local authority to the housing provider. Telecare The telecare work in Inverclyde makes clear links between community alarm services and sheltered housing, and this is an area that continues to develop with RSLs and the council. Care at Home services A Best Value review of older people’s services in the local authority was undertaken in 2003 and implementation is ongoing. This has included the development of services that are better able to adapt and respond to the changing requirements of service users as other services redesign. These services include care at home in its widest sense: – Homecare – both internal and external provision – Day services – Respite services – Community Alarm services – Meals on Wheels Detailed Application for Demonstrator 2 Joint Improvement Team: January 2008 Appendix 1 The review was undertaken jointly with Community Nursing services to ensure that the support was available as patients/clients became more dependent but chose to be cared for in their own homes. The joint working developed at this time has continued to progress with community nurses and homecare staff working comfortably together to provide intensive support in the community. A recent joint efficiency review has been requested for homecare services by the corporate management team and this piece of work is nearing completion. One of the requirements of the review is to develop a joint commissioning strategy for homecare provision. Balance of Care and delayed discharges The delayed discharge agenda is managed and monitored through the Older Person’s Development Group, with a single manager being responsible for a pooled budget of approx £2m to support this work. Attached is a list of the range of services covered through this budget. (See Appendix 1) Use of the care home budget and allocation of care home places links into the delayed discharge process and care home places allocated are monitored carefully to ensure that the balance of care does not tip in the wrong direction. A new care home is being built in the area at present with completion date being due for August 2008. Discussions have already begun with the care home provider to link their facilities into the Ravenscraig Hospital closure, looking at specialist services for older people with mental illness and also as a possible alternative to long stay NHS continuing care. The number of older people being supported in the community has not increased dramatically, but the intensity of care packages has changed significantly. The delayed discharge work in Inverclyde has ensured that people are being delayed for shorter periods and are able to access a range of services both on discharge and to prevent admission. Bed days occupied have reduced by 56% from April 2006 to January 2008. Joint store and adaptations A singly managed joint equipment store has been developed in Inverclyde with full commitment from local authority and NHS attracting additional funding for equipment. Inverclyde has many topographic challenges that impact both on the ability of some adaptations to be made and in the costs of the adaptations. It is therefore essential that housing plans take into account not only the needs of older people who can and want to move house, but also making best use of existing property that could come back into the housing stock to benefit other tenants, maximising the value of any investment made. Community Occupational Therapy staff work closely with Care and Repair colleagues who administer the grants for Owner Occupiers on behalf of Inverclyde Council. Detailed Application for Demonstrator 3 Joint Improvement Team: January 2008 Appendix 1 Additional funding has been obtained for 2007/2008 which has resulted in £370,000 being spent to date on Adaptations for disabled people, £54,000 being spent on repair grants and £24,000 being spent on lead pipe replacements. The small repairs service is also widely used and advice is also given to people regarding contractors, other sources of funding etc. Community Occupational Therapy staff also carry out assessments for other Housing Providers. Following the assessment of need the Housing Provider will carry out the required work. Invest also have a large role in providing advice/guidance on insulation and safety aspects for older people. The Joint Equipment Store is part of the service operated at The Centre for Independent Living. As part of the display area Telecare equipment can be viewed and tried in addition to a stairlift/level access shower/clos-o-mat toilet. Such demonstration sites in Inverclyde have been of significant interest to service users, family carers and professionals to allow them to see what assistive techmology can really do to support people in their own homes. Early evidence suggests that admissions into care are now being avoided as a result. Q2 Contact Details Name of Main Contact Gillian McCready Position/Designation Service Manager, Older People and Physical Disability Services Address Inverclyde Council, Education and Social Care Services, 195 Dalrymple Street Greenock PA15 1UN Telephone Number 01475 714079 Email address [email protected] Detailed Application for Demonstrator 4 Joint Improvement Team: January 2008 Appendix 1 Section 2 Your Proposal Q3 Demonstrator Area What geographical area do you propose to use as the demonstrator? The partnership acknowledges the suggestion in the demonstrator