1. Night Care Consultation Providing safe care for residents of care homes during the night Part 1 – Item No:5Appendix 1 Cabinet Committee on the Lancashire County Commercial Group 5 September 2008

2. Night Care Consultation Review by group in 2007/8 Waking Watch- Night Care Assistants2/3 per home Sleeping in-Residential Care Officers 1 per home Volume and nature of Calls to RCOs Role and responsibility of NCAs What is done now Could it be done differently

3. Night Care Consultation Total Cost of Night Care circa £2.25 m Cost of one NCA circa £50,000pa Could this resource be used more effectively or could same service be provided at lower cost

4. Night Care Consultation RCOs awoken when have Fire Alarm, intruder/security issues/access to office needed Accident, Illness, sudden death of resident, escort to hospital missing person Care of dying resident Emergency admission Staff sickness/personal problem

5. Night Care Consultation NCAs role- Physical and Emotional care Safety Checks Hourly checks Drinks/snacks Cleaning building/equipment Laundry Report writing

6. Night Care Consultation Propose Sleep in at own home Take calls from several establishments Be prepared to travel to these establishments if needed Two night staff in all homes Flexible budget to enhance staff numbers when needed More responsive flexible service New rotas for RCOs

7. Night Care Consultation Use of equipment sensors linked to nurse call system Clear procedures and contingency plans Thorough risk assessments Clear roles and responsibilities Mandatory Training Supervision and appraisal

8. Night Care Consultation Carers respond to residents who are ; Wandering, have insomnia, are shouting and disturbing others, have loss of memory or disorientated, have a change of mood, have an accident, need medical care or attention,need turning or pressure relief,need the toilet or have problem with continence need food/drink etc

9. Night Care Consultation Issues to consider Size of Building and number of units, Purpose of unit,Intermediate care,care of people with dementia,respite care Monitoring the quality Monitoring the budget Evidence for CSCI Managing handover

10. Night Care Consultation Residents and Relatives Staff and Trade Unions Commissioners Time Scale How to respond - Either via Registered Manager or direct to Care Services HQ, Marsh Lane, Preston. Tel: 01772 530395 Fax: 01772 530394 E Mail: joe.slater@acs.lancscc.gov.uk

11. Night Care Consultation What do you think about the sleep in duty being off site Covering several establishments Do you think the role should change What autonomy resources training and support does the person on call require

12. Night Care Consulation Do you think the proposals for Night Care Assistants offer more flexibility What training and support do NCAs require Do you think changes need to be made to the role of the NCA if so what are these Do you have any’ What If……?’ questions

13. Night Care Consultation 24 hour integrated staff team/shift pattern 8-00pm to 11-00pm shift 6-00am to 9-00am shift

14. Night Care Consultation Important Issue We will consider all responses Inform people of outcome with reasons for decision.