Practical Approaches to Human Rights in Health and Social Care - The Wiltshire Story October 15 th V1

Rural county, 470k population Unitary authority 101k people over 65 (2011 census) Eligibility criteria Budget £85m net 4000 older people being supported at home 40% of budget spent on care homes Context

Voice of the Customer

Voice of the customer Ranked ‘top six’ themes

Difficult to know where to get help when it is needed Too many organisations – too much choice Lots of money wasted from duplication Concern about crises at night Importance of “that little bit of help” Loneliness and isolation Same issues for everyone What people told us

What are the Council doing about it? Commission a new service for people at home based on what people want Develop telecare and Response service to help people feel safe Commission a new equipment and practical help service focused on people remaining at home Improve access to information, advice and support Help to Live at Home Service Response Service Community Equipment Service

Telecare and Crisis Response Support when you most need it Call monitoring service Emergency response 24/7 Fall detectors and movement sensors Prevention

Equipment Better access to equipment for everyone Value for money on equipment Community Equipment Service

Traditional model Lots of providers doing different things for the same people Hours based care Assessments based on services rather than outcomes Poorly paid and de-valued workforce Reablement only at the beginning Providers paid by the hour – no incentive to promote independence Assessments and support plans by WC staff Only available to WC eligible customers Help to Live at Home Service

4 providers Outcomes rather than hours Assessments based on outcomes Salaried and professional staff Reablement built in – each support plan is time limited Providers paid for delivering outcomes that are agreed Support plans completed by providers and customers Free initial support available to everyone Help to Live at Home Service

Don’t bamboozle customers with choice Choice about what service they receive – outcomes not hours Person centred planning – important to and important for Choice about direct payment or service Choice, Control and Personalisation

Payable and non payable Payable have to be demonstrable Outcomes written in a way described by the customer Capture what’s important to the customer not the member of staff Only pay for outcomes meeting that meet eligible needs OUTCOMES – WHAT ARE THEY?

I can manage my personal care I can wash I can dress/undress I can manage my hair I can use toilet/commode I can get on/off toilet/commode I can clean myself after using toilet I can manage my foot care I can shave I can manage dental care I can manage continence Personal Care Outcomes - payable

I can make decisions and organise my life I can communicate with people independently I can communicate with people with the use of aids and equipment I can participate in my local community I can use public transport or have access to travel I can access local amenities (shops, faith groups, pub etc) I can visit/receive visits from family and friends when I want More Payable Outcomes

Non Funded Outcome statement ‘ Meeting personal care needs’. Customer had said that “It is important to me that I visit the hairdressers once a week and also have a manicure whilst I’m there”. This is important to the customer but does not meet FACS criteria (non funded) however the provider might support the person with advice and information but the outcome is not an eligible need so therefore is non payable. An important point here is how a provider designs a support plan. There may be an eligible need around personal care that on occasions can be met by supporting this in-eligible outcome. Non Payable Outcome

Talking to people Customer Reference Group Care quality helpline Customer Engagement