2. Domiciliary Care Services for Older People

3. Aims  Overview of capacity and trends within care at home  Additional capacity needed  Summary of capacity planning work and service re-design ideas for discussion

4. What drives demand? Increasing number of Older People Changing Population Profile Increasing frailty and health problems Changes in Policy

5. Whole system Capacity Planning

6. Domiciliary Care 2. Edinburgh’s provision since 2012 Significant investment (£11.4M gross since 2012) has enabled a 24% increase in hours

7. Delivered by.......... 27934 hours 66% 1105 hours 2.5% 12000 ours 29% 961 hours 2.5%

8. 4627 hours As at 01 September 2014

9. Opportunities and Challenges Legislative Change Practice Developments Public Expectations Labour Market Challenges Human, Financial and Political Dynamics

10. CEC Home Care and Re-ablement Service Modernisation programme- responding to challenges Market share Re-ablement Specialist Home Care pathways Integration and Personalisation Advanced dementia End of life care Intensive home care

11. Specialist Home Care Pathways Integrated with health colleagues Increase in complex case work- a skilled work-force More complex patterns of provision (Overnight Service) Personalised- choice and control 3 specialist pathways Advanced dementia End of life care Intensive home care Local connections- neighbourhood working Recruitment and retention challenges

12. NEW CONTRACT FOR PURCHASED CARE AT HOME SERVICES Key Characteristics: Reflects the real cost of care Based around Hospitals and Neighbourhoods Personalised Flexible Visible Trusted Supportive of Staff

13. The Fair Cost of Care £15.50 per hour

14. Key Question How can we re engage the voluntary sector in high volume service delivery and...... make the service sustainable in terms of demographic change, labour market conditions and financial pressures?