Council and democracy

Improving services for older people - a best value review

This review Services for Older People was carried out between September 2002 and April 2003 by a joint team from Adult Care Services, Health, District Councils, Voluntary Sector, Residential and Home Care providers.
Five main recommendations have come out of the review. These focus on how Adult Care Services, together with partners in the Health and Voluntary sectors, could apply existing resources better in order to:

• Reduce the long term cost of care packages through providing a more enabling Home Care service that helps people regain and keep their independence for as long as possible.
• Give users and carers more choice and control over the services they receive without increasing the overall cost of services to the county council.
• Ensure existing ACS funded bed based intermediate care services improve people’s independence and that the most successful approaches are identified and adopted across the county.
• Help clients remain independent for longer through using existing information resources more effectively.
• Reduce duplication in Assessment, Care management and Service provision through joint working with local partners.

Home care
We are in the process of setting up a one year project in the St Albans area, targeted at up to 50 users who have the potential and the motivation to improve and to regain their independence. Instead of “doing” things for people, specially trained carers from the Sage Care Agency will work under the supervision of a trained therapist to help clients to improve (over a period of 6 weeks) their skills in everyday living tasks. The impact of the service on individual user satisfaction and dependency will be carefully monitored. It is expected that the scheme will show that an enabling approach could reduce the cost of a person’s longer-term care package. If successful, this scheme could be extended to all areas of the county in a phased way by April 2005.

Choice and Control
We have also set up a six month scheme in the Welham Green and Brookmans Park areas, which started in May, involving up to 19 Home Care users. The scheme is testing ways of making better use of home care hours over a four week period. Home carers are able to make more flexible use of the total hours commissioned. Carers undertake agreed time critical tasks, such as toileting, but then leave and return later to help in a wider range of non time critical tasks. A handyman/woman will be employed on a flexible basis to increase the range of help that the user could call upon. If successful, this scheme could be extended to all areas in a phased way by April 2005.

Intermediate care
In 2002/3 the County Council spent £163,000 on Intermediate Care services. Each scheme has developed to meet the needs of the local people. These schemes will be evaluated and best practice shared across the county.

Information
Older people have complex needs and they need access to a wide range of service providers to meet those needs. Giving clear information when it is needed is an important part of preventing older people entering into crises and helping them remain independent.
As a result of the review we will do the following:

• Develop a common countywide information strategy as part of the strengthening of countywide partnership arrangements and establish a network of local ACS champions to drive forward the information agenda.
• Work with partners at a local level to ensure that:
• a core list of information items is made available in key places to help older people maintain their independence.
• local information is updated and well publicised
• all organisations who have contact with older people identify those users who need to be referred on for an assessment or for more assistance in finding and using the information

Joint Working
The Review concluded that Hertfordshire County Council gets good value for money for the community-based services that it provides. However, in order to improve the efficiency with which we assess and care manage clients, reduce delays and increase choice for users, the Review recommends that joint work between agencies should be strengthened at County, Quadrant and local level. The review recommends that the county council:

• Strengthens existing partnership arrangements between health, the county, district councils and the voluntary sectors.
• Develops joint protocols and processes with our partners in order to deliver single assessment, joint commissioning, integrated care management in an efficient and manageable way.
• Decide at a local level, within a countywide framework, how services could be directly commissioned by other agencies following an assessment.
• Enhance existing arrangements for engaging users/carers and staff in service planning and development.

Questions or comments
• You can write to us c/o Christine Marshall (Project Support Officer) West Green, Woollam Crescent, St Albans, Herts
• You can phone Christine on 01727 755311
• Or email:Christine.marshall@hertscc.gov.uk