Occupational Therapy Contribution within Social Care Denise Cross Service Manager for Integrated care & Professional Lead OT Warwickshire County Council WARWICKSHIRE

Inspirational Achievements & Delivering SOluTions Every Day

OT Moving & Handling Project Aims: To review customers with moving & handling needs. To deliver savings for WCC To inform the development of a future OT Moving & Handling (M&H) model for customers & carers.

That is NOT the Question Two Care or not Two Care? That is NOT the Question How can I best meet person’s needs and promote their wellbeing?

Achievements – so far Face to face customer reviews addressed immediate risks & planned reviews established Highly skilled workforce Cultural shift across social care – being proactive Improving engagement with care agencies Capturing customer & carer outcomes 1st year savings exceeded Revised OT Assessment, M & H assessment and OT Plan & Handling Plan

Case Study Customer was funded by CHC but at review was deemed not eligible for CHC. SW referred to Amy OT to review customer’s M & H needs. Customer has dementia and is over 65yrs. She lives with son and has had a PA for the last 10 years plus a care package. Amy observed the customer, PA and carers to gain a better understanding of needs and routine. The PA had an excellent understanding of the person and played music etc. to gain the person’s trust and engagement. The M & H was undertaken using a mobile hoist and a standard sling. Amy’s detailed understanding of the situation would perhaps not have been captured if observational visits had not taken place at different times. Outcome: retained PA, installed ceiling track hoist and appropriate sling and reduced agency carers by 50%. (approx. saving 10 hrs per week ( £15 per hour) approx.£7,800 per annum  

The Future: Maintained focus on whole systems approach, quality & cultural change. Developing Business Case to deliver M & H Training to all Care Agencies contracted with WCC incorporating preventative skills. Reviewing OT service delivery model – focus of Personalisation to Long term conditions (LTC) management Drive customer independence, choice & control Reviewing range of M & H equipment in the ICESS service and use of Assistive technology i.e. Apps, Continue savings for WCC

Warwickshire Collaborative Housing Project Housing Assessment & Response Team (HEART) service

An ambitious and challenging collaborative project aimed at creating a new way of delivering HIA and housing adaptations for disabled and older people across the 5 District and Borough Councils and the County Council Strategic drivers:  Integration & Partnership working New legislation – Care Act Safety, Well-being & Prevention Preventing & Facilitating hospital discharges Better outcomes for customers & carers in their home environment Maximising capacity to meet demand within existing or less resources

“To provide customers with the advice and information to help them make the right choice, and provide practical help to deliver the right housing solution when they want it” HEART performance & achievements Pre-project Adaptation provision Performance 150 days was the average One direct number for enquiries in North & South for the service Average cost of an Adaptation £6,220 One practitioner -Housing Assessment Officer with combined skills of OTA and Housing Officer and one contact for customer for all needs A 3.5% drop out rate Delays of over 395 days from customer enquiry to providing an adaptation. Initial customer contact to assessment 22 steps Average cost of an Adaptation £7,396 Two practitioners - OT Assistant (OTA) and Housing Officer and two contact points for different needs A 35% customer drop out as teams struggled to deliver across the organisational barriers of up to 3 organisations in each district and borough locality.

BENEFITS Development of all the team members’ skills to provide housing solutions thus reducing duplication in roles / customer visits and documentation. Development and implementation of a new role of Housing Assessment Officer (HAO) This role enables the functional ability of the person and the conditions of their home environment to be assessed and modified accordingly. This has involved extensive training and mentoring of the HAO’s by OT’s. Single assessment process. Resilience within the service. Portfolio of core interventions that are delivered by all practitioners from advice on specific topics such as falls prevention, home safety through to equipment for daily living, assistive technology (e.g. telecare) and minor and major adaptations. Improved performance. Delivering savings. Improved collaborative working with other teams e.g. Lettings in Districts and Borough, Personalisation within the County. The project is also supporting two PhD students from Warwick Business School.

Case Study Customer was referred by a relative as they were worried about the her going up and down the stairs. Customer has Arthritis and is in her early seventies. Owen Housing Assessment Officer (HAO) observed the customer going up and down the stairs and performing activities of daily living. Outcome: Customer was able to manage the stairs at the present time but required grab rails in the bathroom. Advice and information was given about adaptations (level access shower and stair lift), Disabled Facilities Grant (DFG) process and Benefits check. The discussion on benefits led to the customer saying “I am not entitled to a pension” With the consent of the customer Department for Work & Pensions was contacted by Owen and this led to the customer being paid her pension and deferred payments which had accumulated to £90,000 before tax.

Next steps Developing a future service delivery model around more formal collaboration / integration with implementation planned Autumn 2016 Implementation of a new IT system – Mosaic (Social care) 2016/17 Embed Care Act legislation within the service Consolidate consistent practice across Warwickshire including contractors Maximising opportunities to develop preventative and early interventions

Partnership Integration of Reablement services (WCC) with CERT & Routine therapy south (SWFT) Section 75 Legal Agreement Staff Consultation completed Secondment of WCC staff for 5 years to SWFT Two Operational Hubs – Kings House (WCC) & Heathcote House (SWFT) Service Delivery Model – One integrated Pathway with 3 Flows: Red, Amber & Green Prevention of Admission into Hospital & 24 hr care settings and facilitate discharge from Hospital /D2A & Moving on beds

Customer & Carer Feedback “In this day and age of budget cuts and when it seems common to hear the public services freely criticised, it is a pleasure to be able to offer my grateful appreciation for the service you have provided. Thanks and Well Done”   “I would like to thank you; you were so understanding and helpful” “We thank you all for bringing that bit of comfort and safety into the life of the most important person in our family