1. Health and Social Care Facilitator CHC Link Development Officer
Continuing Healthcare in Powys Delivering equitable and safe Tier 1 services
Trish Buchan
Health and Social Care Facilitator
Siobhan Luikham
CHC Link Development Officer

2. What are we doing?
Building capacity of the third sector to provide support so that:
more people in Powys can stay safely in or return safely to their own homes
more people in Powys are connected with and supported by their communities
Focus on “Tier 1” (and some “Tier 2”) activities/services - the type of support you might get from nearby family and friends.
basic information & advice
signposting to other support
befriending
community transport
help with grocery shopping
gardening and DIY help
drop-in facilities for chat
luncheon clubs / coffee mornings
meals-on-wheels

3. How are we doing it? Continuing Healthcare Pilot Projects:
Three “good neighbour” schemes in Ystradgynlais, Crickhowell and Llandrindod Wells led by local volunteer bureaux to support people to stay at home through bespoke care for people at risk of admission.
Extension of Rapid Response Adaptation Service delivered by Care and Repair Powys to support prompt discharge from hospital
Powys Urgent Response Service at Home delivered by Crossroads MWW to prevent avoidable admissions to hospital (Tier 2 - see separate presentation)

4. How are we doing it? Continuing Healthcare Link Development Officer:
Working with third sector organisations to identify who delivers Tier 1 services and what support they need, with a focus on ensuring safety of services and equity across Powys.
Working with third sector organisations to further develop priority services (as identified by service users):
e.g. signposting/ assisted information, befriending, advice (Tier 2), practical support in and around the home, transport (health & social)
Developing effective linking between services and service providers – with a focus on partnership working, including through developing local “hubs” and online database, Info-Engine.

5. How does it help people with complex needs?
People with complex needs want more than just medical care! Tier 1 services help them (and their carers) to remain independent and connect or reconnect with communities.
Person-centred – focus on integrated services and effective partnerships.
Joined-up services – third sector working together with statutory partners to identify complex needs early. Links with other workstreams around health and social care in Powys makes it unique.

6. How does it help people with complex needs?
By providing appropriate support to those with long-term needs and their carers in the home and community, we will reduce the necessity and risk of admission to hospital.
Supporting people to stay in their usual care setting (home).
Proactive discharge planning through volunteer bureau projects and Care & Repair’s Rapid Response Adaptation Programme.

7. What difference does it make?