Presentation on theme: "Stoke-on-Trent City Council Adult Social Care Transformation programme"— Presentation transcript:
1 Stoke-on-Trent City Council Adult Social Care Transformation programme Community team plusStoke-on-Trent City CouncilAdult Social Care Transformation programme
2 What if we told you that… What if we told you that… ..we think we’ve found a way to deliver excellent outcomes for more citizens, within the same (or reduced) cost envelope?Falling ‘repeat’ demandIncreased efficiency/capacity – reablement resourcesReduction in res/nursing placementsReduction in ‘maintenance’ care and support costsIncrease in Direct paymentsExcellent outcomes for citizensHigh levels of staff satisfaction
3 History of Community Team plus Case for change:A sense of overwhelming demand across the systemSystem on its head – demand defaulting to acute sector (49% of people who receive a service for the first time on discharge had approached us previously for help)High levels of res/nursing placementsHigh levels of Safeguarding, crisis interventionThe Story of ‘M’
4 The Story of M 7 - different agencies involved A 75 year old white gentleman with COPD and high level of involvement from health and social care. He was a frequent user of acute/non-acute bed based services.Over a 2 year period there were:different agencies involved30 - different teams or professionals gave input162 - acute/sub-acute beds days consumed(at least) of these were ‘excess’ bed daysassessments receivedtelecare interventions receivedIn the most recent calendar year M had cost health and social care £40k+; we calculated that with a redesign approach, we could have reduced these costs by 25%
5 What we did…. In January 2014, we assembled a team of: social workers and social work assistantsan OTAsenior care assistants/care assistants (from our in house reablement service)Team based in the Longton area of the city, aligned to local primary and community health servicesGiven a mandate to be accessible, be creative, resourceful and ‘helpful’A fresh start!
6 ‘Help me to help myself live my life well’. Purpose & Principles‘Help me to help myself live my life well’.You fully understand me and the real problem to solveYou will help me find sustainable solutions to my problemsYou will help me build my own networks of supportYou will pull in expertise as neededYou will stay with me for as long as neededIn addition the team applies the following ‘efficiency’ principles:Be proportionateWork in ‘real time’ to provide the help needed
7 How our model has evolved.. First Contact function – accessibility!Focus on Quality and Assurance (span of control)Alignment with Primary/Community healthRemoval of internalpurchaser/provider ‘split’Asset-based practice and a focus on ‘what matters’Reflective Practice FrameworkPerformance FrameworkCommunity NetworksNew systems and processesCase managementNew arrangements with independent providers
9 Tier 1: Individual Outcomes and Economics Level of support estimated at start compared to actual end level of supportOutcome Scores SummaryMonthJune 2014July 14August 14% with improved score37(55.2%)91(75.8%)95(75.4%)Change in Resilience ScoreOf the completed cases, almost 10% (6 cases) moved down the level of need when understood compared to initial viewInitial indications show that more clients are leaving with level 1 and 2 services (advice and information/ short term services)We are showing consistent progress in meeting peoples “What Matters” demandsPeople feel more resilient after help and support with 84% showing an improved resilience score. The other 16% have remained stable
10 Tier 1: Individual Outcomes and Economics Comparative costs – Recording, Assessment and weekly service costComparative costs – Estimated annual spend (based on average weekly cost)Assessment and recording costs have increased for the pilot cases when compared to the current delivery by an estimated £179 per caseReablement costs increased by £552 per caseThe projected annual service cost has reduced by £7,938 per case based on the current average weekly costThis could lead to a net cost reduction of £7,207 per case per year (assuming review/ assessment every year)
12 The volume of clients receiving domiciliary care and day care as part of a long term package of care is significantly lower than both the two comparator groups and the wider Longton ILCTCT+ put in place 84%-88% less dom care packages than the two control groupsNo Day Care cases1 permanent admission into residential or nursing care compared to an average 1.5 per month for the control groupsFor the time period April to August 2014, 20.2% of all new clients through CT+ receiving long term support had direct payments. This compares favourably with around 8-9% for the two control groups.The numbers of clients receiving DP’s are significantly higher than the rest of the city with 2.04 direct payments per 1000 population. This outturn is 195% higher than Meir control group and 155% higher than Stoke West control group.