1. Workforce Change –The Leeds New Type of Worker pilot (Domiciliary Care)

2. New Type of Worker Project in Leeds
Re-designing the role of our Community Support Assistants to enable them to do:-
Low Level Nursing Tasks
Therapy Tasks
Rehabilitation Tasks

3. What Would be ‘New’ About Our New Way of Working?
An improved more seamless service user experience
Staff’s increased confidence and motivation
A service that encourages re-gaining and/or maintaining independence
A workforce with a clear and positive career pathway that can cross sectors

4. Also developing
A programme that workers can obtain NVQ 2 or 3 in 12 weeks
Jointly agreed strategies and clinical governances
The potential to change how social care is delivered in all sectors in Leeds
A model for inter agency working that could be shared and transferred

5. How We Started The Process
Building on previous experience
Looking for consistency
Identified key player’s
Use of Changing Workforce Toolkit

6. Background to the project
The Accelerated Development Programme (ADP) 2003 in the West Leeds area – Local teams/individual workers working well together
Pilot Training Programme for 20 Community Support Assistants by Clinical Leader & ITC Manager in tasks such as:
skin care
maintaining mobility
promoting and maintaining independence
reading blood pressure
blood sugar tests
podiatry
catheter and stoma care
wound care
delegated nursing, therapy and rehabilitation tasks

7. Positives included:
Service users liked the convenience and ‘less people involved’ approach
Workers had the ability and competence to spot where further intervention was needed and enlist the relevant professional
Other professionals saw the CSA’s role in a more positive light
A ‘team’ approach developed across services and sectors

8. Challenges Were
Service delivery was a problem if only certain CSA’s were trained e.g. Morning Workers trained but not Evening Workers
If CSA’s didn’t use these skills regularly they lost confidence
Different interpretation of Moving & Handling guidance and practice between SS and PCTs
A need for joint protocols e.g. Needle stick injury, Hepatitis B and infection control
Management of clinical governance and supervision issues would need to be dealt with

9. Skills for Care Funding
In January 04 using the ADP as a basis, Social Services and West PCT in partnership, secured funding until March 06 to be one of the New Types of Working pilot sites.
Project Manager Zoë Thomas came into post October 04

10. The Project: The Project aimed to:
role out the NTW Training across Leeds
then develop ways of delivering integrated domiciliary or community services
From Skills for Care perspective they wanted to:
learn from our processes and experiences – those that worked as well as those that didn’t! – so that the learning could be transferred to other areas and roles.
Inter-agency working was of particular interest.

11. Key Project Tasks Setting up the inter-agency Steering Group
Creating a jointly agreed Moving and Handling policy
Developing a long term vision
Working towards and gaining high level sign up (via the Modernisation Executive and Making Leeds Better) to implement the NTW role throughout the city

12. Key Tasks continued……
Obtaining agreement to work towards an integrated service – this took far longer than the steering group anticipated but needed to be done for the project to be robust and sustainable
Developing a ‘Fast Track’ model of achieving NVQ 2 and 3 in 12 weeks
Sharing our learning via the Skills for Care pilot sites systems

13. Fast Track Model for NVQ
Developed a “Fast Track” model of achieving NVQ 2 and or 3 within 12 weeks

14. Policy Issues Moving and Handling Needle stick injuries
Infection control
Insurance and litigation
Hepatitis B
Medication

15. Recent multi-agency working developments.
Medication for Adults & Older People in their own homes
Leeds Multi-agency Policy on Assistance with Medication in a Domiciliary Setting (Project lead Angela Mkandla, Strategic Partnership and Development Manager)

16. Leeds PCT & Adult Social Care Funding
Key aspects to implementation:
Adoption of citywide multi-agency policy
3 pharmacy technicians
Production of Medication Administration Record Charts (MAR Charts)
Training

17. Services implemented will;
Assist CSA’s
Ease the capacity issues for District Nurses and CSA’s

18. Objectives include:-
To promote independence wherever possible (enablement)
To prevent avoidable admissions to residential or secondary care
To define the roles and responsibilities of front line staff in Leeds
To improve medication management needs assessment citywide
To provide a clear and single approach
To provide staff with an understanding communication systems

19. Implementation Outcomes
Tangible
Key deliverables – e.g.The National Minimum Standards (NMS), Domiciliary Care Regulations, Medicines & Health Care Standards Act 2000
Expected benefits
Reduction in waste in medicines by use of MAR Charts
Increase in patient/service user safety

20. Questions Averil Rushton Principal Employee Development Officer
Leeds City Council
Adult Services