Councils can avoid slashing adult care services and improving user outcomes by commissioning a new integrated offer combining home care, telecare and home adaptations, claim the providers behind the initiative.
Domiciliary care and housing repairs provider the Mears Group has joined forces with Tunstall, the country's largest telecare provider, and one of the largest adaptations providers, AKW Medicare, to offer councils an integrated service that they believe will boost efficiency significantly.
The initiative is also backed by Foundations, the representative body for the country's home improvement agencies, which support vulnerable homeowners and private tenants to carry out home improvements or adaptations.
Under the most eye-catching proposal (see below), Mears is offering to purchase telecare for council-funded home care clients it serves at its own risk, so long as commissioners promise to let it share in any resulting savings from reduced care home or hospital admissions for these clients.
Mears executive director Alan Long said the group were trying to offer councils an alternative to raising eligibility criteria and slashing services in dealing with the cuts they are receiving from central government.
"What we will say is that you can take 10% off services, raise eligibility criteria but all you're doing is trying to push water up a hill," he said. "You've got more people coming in; you're not going to get more money; you're going to have to think differently. At the moment 99% of councils are applying a sticking plaster to services."
He said separate commissioning of these services, as practiced by councils, was wasteful. "In my experience as a domiciliary care provider, when telecare goes in, the care plan doesn't change very much and the care worker is not really aware of what telecare can do."
The proposals are to:
• To provide commissioners, self-funders and personal budget holders with a single access point to access home care, home adaptations, telecare and social housing repairs, co-ordinated by Mears.
• Service users to receive integrated assessments and reviews of their needs across all of these service areas, carried out by Mears senior care staff.
• Mears to purchase telecare for home care clients, saving councils money up front, and to share in any savings from reduced care home or hospital admissions.
• Home improvement agencies to provide advice and brokerage to clients in accessing the full range of services.
The group is now approaching commissioners to see if any will agree to test the model.
http://www.communitycare.co.uk/Articles/2011/01/17/116119/providers-prom...
PDF version Adult care directors are seeking "urgent" talks with the Care Quality Commission over concerns that a new ratings system for providers will reduce scrutiny of services, to the detriment of users.
The government has proposed replacing the quality ratings system, under which the CQC graded all registered providers as poor, adequate, good or outstanding, with a voluntary "excellence standard" for the best providers, in consultative plans to overhaul the adult care performance system.
However, the Association of Directors of Adult Social Services warned that the proposed system failed to provide the same degree of "assurance" and transparency as quality ratings.
In its response to the government consultation, Adass said: "[This] could be particularly disadvantageous to self-funders and people using personal budgets to arrange their own support, particularly as this new system does not distinguish between 'adequate' and 'better than adequate' service or between 'good' and 'excellent' service."
It warned that the system may also favour larger providers that had the financial muscle to apply for an excellence rating, and may lead councils to increase their own monitoring processes, increasing costs.
Quality ratings were scrapped last August, but Adass warned: "Further we are concerned that there is no timeline, implementation plan or agreement about how this system will operate."
It called for urgent talks with CQC on the issue.
A CQC spokesperson said: "CQC will be consulting in the first half of 2011 on how to define excellence in adult social care, as part of the development of the information scheme which is referred to in the consultation document.
"CQC will also be producing a public facing provider profile for each registered provider which will provide up to date information about standards of care."
The government's proposed performance framework is also designed to cut bureaucracy on councils by scrapping annual assessments and routine inspections of councils by the CQC.
Instead, councils would produce "local accounts" on the standard of services, which would be reviewed by other councils or user-led groups, and authorities would be inspected by CQC only when risks are identified.
However, Adass said local accounts would fail to cut the bureaucratic workload significantly, nor was such a system costed, while the CQC's triggers for inspections of councils needed to be urgently developed.
The government has also mooted introducing payment by results, under which councils would pay providers on the basis of what they achieved for service users, however Adass warned against introducing this on a national basis.
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http://www.communitycare.co.uk/Articles/2011/02/14/116284/adult-care-pro...
Summary
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Press release
Research shows that older people want and value low-level support - 'that bit of help' - but the benefits of investing in this are realised over many years, making it harder to prove impact and protect funding in the face of severe pressure on spending.
This Solutions provides examples of imaginative, affordable and effective ways of supporting older people’s health, well-being, social engagement and independence. It highlights projects with some local authority involvement whether as lead commissioner, subsidiary partner, or through small grants or seed-funding.
The projects demonstrate the importance of:
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http://www.jrf.org.uk/publications/local-authorities-better-outcomes-old...