Adapting for Change Margaret Moore 20 May 2016

Adapting for Change Context Health and social care integration The 5 sites What we’ve learned so far What are the next steps Your input

Independently chaired group to consider streamlining and case for more fundamental change Guiding principles Case for fundamental change 15 opportunities for change within existing framework Housing adaptations

6 Key features of recommended approach 1.Strategic leadership from the local housing authority, working in partnership with health and social care, and a clear local strategy; 2.A strategy for housing adaptations, which is ‘tenure neutral’ with a single funding pot; 3.Arrangements enabling people to have control and choice through personalisation and self-directed support; 4.A single point of access with a lead agency – ‘one-stop shop’ – with clear communication and a single point of contact for service users throughout the process; 5.A broader outcomes-focused service with early consideration of overall housing options; and 6.Streamlined local partnership working and governance.

Issues and focus  Self-directed support approach in housing adaptations  Single funding pot, with tenure neutral access/eligibility  Prevention and early intervention  Adaptations for people with dementia  Design aspects  Adaptations as one response in an integrated menu of options to secure suitable/fit for purpose housing  Partnership governance - which includes people using services – and integrates with health and social care  Improved data collection on impact and effectiveness, including added value  Helping people to help themselves, offering services other than associated with funding  Integrating the use of technology solutions

Governance & Evaluation Co-ordinated as a Programme Consistent elements of Reporting Focus on base-lining & measuring improvements Building a robust evidence base Developing 2 consistent outcome measures Evaluation supported by research staff Executive Sponsor at appropriate level Regular ‘flash reports’ Series of webinars/learning sessions & feeding in to national events where possible Sharing learning with Adaptations network & wider

Dementia Strategy – Commitment 5 We will take further action to support safe and supportive home environments and the importance of the use adaptations and assistive technology, in maintaining the independence and quality of life of people living with dementia and their carers.

Health and Wellbeing Outcomes Outcome 2 People,including those with disabilities, long term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community

Technology Enanbled Care Programme AFC TEC Programme TEC and Housing Programme hosted at SFHA TEC Charter for people living with dementia

AFC TEC Objectives 1.To ensure that technology enabled care forms an integral part of adaptations processes and reviews of people’s home environment 2.To test approaches for active case finding and improved collaboration 3.To improve approaches to asset management 4.To test and provide illustrations of the role that housing organisations can play in supporting people to use technology

5 Demonstration Sites Aberdeen Borders Falkirk Fife Lochaber

Aberdeen Demo- site Bon Accord Care lead Very broad coalition of partners Focussing on - –Person-centred approach –Consistent streamlined pathways across all tenures –Faster service delivery timescales Currently – –Canvassing previous customers’ views/feedback –Mapping current pathways in all RSLs –Targeting delayed discharge –Aligning local & demo-site TEC bids –

Borders Demo- site Care & Repair lead Project was already in flight, Change Fund input Focussing on – –A one stop shop approach –Tenure neutral assessment, provision and access –Self referral/advice only included in approach –OT based within C & R –Outcomes for service - users Currently – –Nearly 6 months into implementation –About to carry out 6 month review of improvements –

What is the impact…. For the individual: – Reduced waiting time for assessment. – Knowing outcome of assessment sooner. – Follow-up on assessment where other outcome recommended. – One point of contact. – Feeling safe and confident enough to remain at home. – One stop shop – knowledge of housing in the area.

What is the impact For family members/carers: – One point of contact for adaptation process; – Delay the need for formal care at home; – Other OT actions as a result of holistic assessment – bed raisers; referral for community alarm. – Information about wheelchair and physiotherapy services, – Advice on private adaptations; – Signposting for disability benefits; – Information about self-directed support and social work services. – Emotional support;

What is the impact One stop shop model reduces confusion and increases sharing of information with NHS OTs – providing consistency in applying eligibility criteria across NHS and SW services. Future planning – knowledge of housing needs in Borders as a whole informing potential new builds and re-use of existing adapted housing stock. Increase in self-referrals and referrals from other sources by-passing social work frees up social work OTs to focus on rehabilitation and other use of OT specific skills. No challenges over eligibility criteria during the pilot phase to date this is compared with 5 meetings in 2013/14(D).

Lochaber Demonstration Site Care & Repair Lead One stop shop- all adaptations Handyperson & telecare services Tenure neutral, single pot OT alignment Learning processes Removing duplication

Lochaber – local one stop shop Range of practical services to help people to be at home with independence and confidence. Open to all Adaptations/technology/small repairs/houisng options Support for people living with dementia

Fife Fife Council Housing & Neighbourhood Lead Integrate,Streamline,improve efficiency Faster end to end process Personalisation Link to equipment & minor adaps

Falkirk Demo site Social Work and Housing lead, with NHS Project had been initiated previously with Change Fund input Focussing on – –-Tenure neutral seamless pathways, widening - assessment across health, housing and social care; – -Governance and Partnership Agreement; –-Outcomes and performance framework; – -Training programme. Currently – pending testing of draft Assessment & specifications tool, Adaptations definitions, and new Pathways proposal.

What we have learned so far Borders – improved process, experience and outcomes for people Re-designed pathways OT alignment Virtual budgets? Health and social care agenda?/delayed discharge priority Keeping it visible

What are the next steps Evaluation Measurement and outcomes Tests of change Positioning in integration agenda Informing SG framework

Your input If you had a free hand to design a new policy and funding framework what would be your 3 top priorities?