24 HOUR COMMUNITY SUPPORT TEAM, Corby, Northants

1KAT/KM MAR 2010

2002 – no purpose built home support service for younger adults with a P.D. But 2 res units choc a bloc with perm. residents

Of the 4 people who moved out, readmission rate was 100%

Trad. Dom care the only choice which set people up to fail

Costly permanent residential care, no process to prevent perm admission

2KAT/KM MAR 2010

Stopped all new perm res care, Res unit closure – C.S.C.I. RequirementsUsed stays as preparation for independent

living Obtained accessible 4 bedded flat, half a

mile from res. UnitObtained “green light” from senior

management to develop 24home care services

Obtained funding for acc. from T.H.B/S.P.

3KAT/KM MAR 2010

Identified not only 4 transitions/ college guys but also existing long standing “hard core” residents who were up for moving out

Worked closely with the borough housing staff on a local level – obtained another 4 bedded flat on the same estate

Inherited 2 services with 2/3 staffing vacancies with a defunct remit giving a base budget of £300k

4KAT/KM MAR 2010

Set up admissions policy, diverting people from perm res care and

setting up spot purchase arrangements with care management and

utilising the 2 community centres and the res unit for prep and cost effective packages

Then team were referred costly agency placements and placements that had failed – 1 customer had 20 diff agencies before team took them on

5KAT/KM MAR 2010

Grew to £1.8 million service, with 3 registered services covering whole county

Excellent “enhanced service” from C.S.C.I.On the verge of acquiring 6 bedded

bungalow to offer prep for independent living in south of county

Delivering 3000 hours worth of service to 55 customers

6KAT/KM MAR 2010

Service started from scratch so could recruit to a staffing structure that worked for the service and the right culture

Introduced new tier of post “community support worker” as well as Manager, Supervisor and Homecarer

Use sleep ins – a lotSpot purchasing made us very efficientTrained in specific issues for the serviceRota’s designed weekly to accommodate

customers and staff requirements

7KAT/KM MAR 2010

Careplans highly specific and full involvement of person Goal setting crucial – working with not for Will give notice on any service where a maid is required

– will support on to P.B. partnership working with others – eg, schools, vol.

Bureau’s children's services, housing, benefits, colleges, travel agencies

Individualised times/cover – expectation that no cover between 10 – 4 – so, employment or day service or other must be sought

Reduced packages in only about 20% of cases – but what we do deliver is the support for a more engaged and fully involved lifestyle of their choice

Of 67 people in total the service has supported 3 moved back into residential care, 3 to other agencies and 9 on to D.P. or P.B. and 3 deaths

8KAT/KM MAR 2010

Currently the service delivers: Client contact hours: 1350 hours weekly Client contact hours we are committed to:1350

hours weekly  Sleep Ins: 350 hours (35 per week) TOTAL HOURS: 1655 a week 4% DOWNTIME 3.2% TRAVEL 4.4% SICKNESS 3.2% MATERNITY LEAVE 

9KAT/KM MAR 2010

Other County Council priorities – L.D. Reprovision

Serious budget problems 2005/6Management restructureDomiciliary Homecare review restructured

P.D. and Dementia as one serviceService lost a significant number of P.D.

Customers in South of County who are now in costlier or residential placements

Very hard to manage in a flexible responsive way

10KAT/KM MAR 2010

Costly packages due to high levels of personal care

Accommodation, accommodation, accommodation – often why residential care exists in the first place

No real drivers to provide specific services – no decent grant funding and serviced usually lumped with older person services where they only get pennies but there are millions of them

11KAT/KM MAR 2010

Small numbers – most res placements are probably cheaper than a single occupancy care package

Majority of service not re able/re hab. Actually enablement

People with high levels of p.c. lose out Classed as long term service not reablement Supporting disabled adults in their parenting role Being part of N.C.C. increases our unit costs –

corporate recharges beyond our control and high – published unit cost is £22.45. Where as our unit costs would be more like £14.58

12KAT/KM MAR 2010