Managing demand for Adult Social Care Services Linda Sanders, Corporate Director Social Care, Health & Housing ADASS Spring Conference, April 2012

Strategy To reduce the reliance on long-term residential/nursing placements, enabling people to remain living in their own homes rather than be placed in institutional care. Enabled by effectively mainstreaming TeleCareLine and Re- ablement services, as part of transforming approach to social care.

Transformation targets 3000 new TCL users by the end of 2014/15. Savings target of £8.5m by 2012/13. £4.7m delivered 2011/12 through Telecare, Reablement and reduced care home spend. Comprehensive financial model created to develop and monitor targets.

Anticipated impact of changing care model Combination of: preventing/delaying entry into residential care Preventing people needing on-going care support confidence building during re- ablement process.

LBH new customer pathway All service users referred to homecare re-ablement initially – hospital discharge and community referrals. TeleCareLine part of mainstream offer within Adult Social Care for all clients. TeleCareLine free for over 85s, FACS eligible and first 6 weeks as part of a re- ablement package. TeleCareLine available for self funders, charges from £1.13 to £12 per week. In-house monitoring and installation team. In-house mobile response service (out of hours) for service users without responders.

Impact of change – 2011/12 Reduction in long-term residential and nursing care placements from 8.08 per week in 2010 to 3.57 per week to end Feb Reduction of 112 OPS placements from October Residential/nursing placement headcount at its lowest since April Reablement with Telecare has led to steady reduction in homecare hours purchased of 10% from April 2011 to date, forecast continued year-on-year reduction of 7.8% TeleCareLine installations against a target of 750 for 2011/12.

Early indicators from TeleCareLine evaluation Detailed analysis of sample of new TeleCareLine service users during 2011: 195 clients reviewed – all with enhanced package of support 48% of cases are considered to be assisting in delaying the demand for further services 10% have enabled a delay in residential care placements 42% have facilitated a smaller homecare package.

The recipe Strong strategy and vision. Clear internal process – infrastructure in place. Efficient business processes - clearly communicated. Ongoing PR/communications programme, focusing on all key stakeholders. View internal workforce as key stakeholder – don’t just focus on residents and partners.

“Hearts and minds” Changing the way we engage with service users and the support we provide. Staff and service users – key stakeholders, dedicated activity to engage both for success.

Engagement with Health Successful hospital discharge approach, with TeleCareLine being regularly referred. Increased focus on TeleHealth through NHS Operating Plan, WSD and “3 million lives”.

Got “everybody in the room” Acute hospital PCT CCG CNWLT – (Community Trust)

Business case built around LTC Initial action based around impact on LTC costs. Introduced strategic direction towards a TeleHealthCare service, integrating Health and Social care approach. “Out of hospital care” an increasing focus Aligned with existing Integrated Care pilot.

Lessons learned Compelling case. “Vision” is accepted and understood. Has helped to forge links with NHS. Hard to get coordinated action. Will keep pushing!

Thank you Any questions?