Dudley MBC - Telecare Reablement Pilot Project/Falls Response

Telecare Reablement Pilot Project/Falls Response West Midlands Regional Telehealthcare Network

10 July 2012

Supporting Dignity, Independence and Well Being

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service

DudleyTelecare

The whole

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Pill Dispenser

PilotMaintenance

FaultsTesting visits

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Centre

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Monitor HA

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Children with

DisabilitiesCard

Manage All OOHCouncilRepairs

Just Checking & Interim

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ACCESS


Telecare is part of access –

upstream prevention and signposting

but works closely with intermediate care

and long term care and support teams

OT

Social Workers

Home Safety

Community Care

Emergency Response

TheFalls

Service

OUR FOCUS

• We make huge differences to people’s lives supporting them to live independently in their own homes and improving their quality of life

• The confidence and control over their own lives that our service can give to people is crucial, this also in turn provides carers and family members with reassurance and peace of mind

• Our service offers financial efficiencies


DRIVER - Telecare Reablement Pilot Project

• Bed crisis status in acute hospital settings

• Director asked how many people take up the offer of telecare on discharge from hospital

• Community Care Service Reablement Teams screened for telecare on the wards, their feedback was once you mention the cost, a high percentage of people were not interested

• Hospital social work team generally referred for just a pendant alarm

• Ward staff not aware of telecare

• The Director – May 2010 wanted to offer a free telecare service to people in Dudley on discharge from hospital

• Asked what the telecare package needed to look like to support people on discharge


Telecare Reablement Pilot Project• Desired Outcome

– People were diverted from admission to hospital or

– Experienced a timely, supported or early discharge from hospital or step down setting

• By the provision of a Free Comprehensive Telecare Package for 6 Weeks

– The Pilot ran from September 2010 for 6 months

– We gained Capital funding to support the pilot from the Joint Improvement Partnership, the Directorate provided match funding to purchase a stock of equipment


Background• A revised telecare screening tool for all staff was developed and

launched on 1 June 2010


Background

• Hospital Social Workers, care staff in reablement residential services previously had telecare awareness training to promote the range of equipment available other than the standard community alarm

• Telecare Demo packs were also made available for all Social Work, Community Care and LA reablement residential Staff Teams

• There were some interventions by Hospital Social Workers in promoting telecare to persons in acute settings but no evidence that Telecare was promoted by Hospital Staff

• PCT reablement settings had received no telecare awareness training


Investment

• The Joint Improvement Partnership offered support and £10,000 funding to develop and evaluate the Pilot Project, this was match funded by the Directorate

• Cost of each Telecare Package

– Alarm with pendant £128.00

– Additional Button in the Bathroom £37.47

– Smoke Alarm £40.80

– Pill Dispenser £150.00

– Bed Occupancy Sensor £127.00

– Stand Alone Night Light £4.25

– Total Costs per individual Telecare package: £487.52


Financial Implications

• The telecare team had the capacity to install and monitor five telecare reablement packages each day

• Any further connections over and above the projection would need to be considered against staff costs

• Capital Costs would be phased according to the demand and on going take up of the service

• Initial capital expenditure will be off set by costs being met after six weeks by the Individual

• It was likely that after the 6 week period a number of telecare peripherals may not be needed by the individual or the service terminated and these units could be recycled back into the system


IMPLEMENTATION - Training and Familiarisation

In order to set up the pilot project, training and familiarisation in Telecare needed to be refreshed and extended. This was provided to:

• Staff within step down/reablement settings across health and social care

• Nurse Practitioners; staff on the wards; hospital OT’s and Physios; Discharge Co-ordinators; Continence Advisors

• Hospital Social Workers; Social Work Teams; Falls Co-ordinators

• Reablement Care Providers; Red Cross

• Service Re-design – New Living Independent & Access Teams


IMPLEMENTATION

• All referrals for the Pilot were accompanied with a completed telecare screening tool

• Referrers provided as much notice to the Dudley Telecare Service in terms of the date of discharge for each Service User

• The telecare reablement packages were installed on the day of discharge at no cost for a period of 6 weeks

• Staff rotas were changed to have a fourth person on evenings to accommodate any late hospital discharges usually after 4.00 p.m.

• 6 weekly reviews and outcomes were undertaken and logged by the telecare staff and for Service Users requesting to keep the equipment the monthly charge of £11.00 per month was progressed


Evaluation

• There was no system to record the outcomes and identify the efficiency of the free telecare service.

Screening Tool• The referral for the service, completed by health and social care

professionals• Support a shorter stay in hospital – if yes by how many days• If the Telecare service was not available, detail the likely outcome

for the Service User and their Carer

6 Week Review • Increased reassurance/confidence• Re-admitted to hospital • What services continued to be provided• Signposting activity to other services• Has the equipment been beneficial • Request to keep the equipment• Any comments from Service Users/Carers were captured


Evaluation – Gather Results • Take up of the free service

• Referral Source – across health and social care

• Cancellation of the service after the 6 weeks and the reasons why

• What telecare equipment remains installed post 6 weeks

• More people diverted from admission to hospital

• Shorter Stays in Hospital

• Avoiding re-admission within 30 days of being discharged

• Supporting Reablement Care Providers in diverting people from long term - formal statutory services “Telecare confidence builder”

• Enhancing the range of Universally available resources in the Community

• Future Cost Implications – Staff and Equipment to meet projected future demands


Findings• 102 Referrals for the service

• 8 Service Users refused the Service; 4 undecided; 1 RIP prior to discharge; 1 not required at moment; 2 refused the service

• 79 - 6 weekly reviews have been undertaken

Outcomes

• 57 Service Users want to keep the equipment

• 7 Service Users were admitted to residential care

• 8 Service Users RIP (working closely with Palliative Care Team)

• 3 Cancelled no reason given

• 4 No longer needed/provided reassurance whilst in recovery

• 2 Service Users had been re-admitted to hospital (1 within 8 days and 1 within 43 days)


Referral Source

25

15 15

7

18

13

31 2 3

0

5

10

15

20

25

30

Hospital Social Work Team Community Care Reablement Service

Health Care Professinal Residential Reablement Unit

Living Independent Team Long Term Social Work Teams

Red Cross Community Team Learning Disablitles

Access Team for Social Care NOK

24%

15%

15%7%

17%

13%

3%

1%

2%

3%


Percentages of Referrals keeping Telecare equipment after 6 week review

Percentages of Referrals ,

83%

Percentages of Referrals ,

17%

Private

Council


Telecare Objectives/Outcomes


Health & Social Care Efficiences through the use of Telecare

3 3 1

52

15

63

715 18

0

20

40

60

80

Avoid Hospital Admission

Support Shorter Stay in Hospital

Avoid transfer to step down bed

Avoid 30 day readmission to hosp

No Care Provided / Care cancelled after 6 wks leaving Telecare

Support Hospital Discharge

Discharge from Intermediate Care Setting

Support Discharge from New Bridge/New Swinford

Falls Management

Lessons Learnt

• People are willing to try something if it’s free 83% of people who would have paid initially and may have refused kept equipment after 6 weeks

• All referrals for the pilot were accompanied by a completed telecare screening tool, this provided a vital information source for the evaluation

• Referrers need to give as much notice as possible regarding the day of discharge to meet the target of assessing and installing telecare on the day of discharge

• Work in partnerships with key teams who also have targets to meet e.g. LIT 66% of people return to independence – used telecare as a confidence building in order to proactively work with individuals

• Publish the findings and share with Senior Managers to demonstrate the return on investment

What Happened Next ………….

• Published the findings of the pilot project through the development of a case study with IEWM

• Through the course of the pilot private income increased by £6,478 per annum

• £61,170 efficiencies

• We now offer the “Try Before You Buy” service to all new users of Telecare

Develop Partnerships

• Supporting re-enablement teams in diverting people from long term care “Telecare is a confidence builder”

• Falls Programme - link to falls pathway/responder visits


Falls First Response Service

• The aim of this was to build on the current 24/7 service to train staff to be able to respond to a person in receipt of telecare who is on the floor

• The staff are trained (FPOS) to check the person has no injuries and will then assist them back up using the appropriate lifting equipment

• The overall objective was to develop a community service that will provide greater efficiency by reducing the number of category “C” call outs to the West Midlands Ambulance Service

• To be part of a wider focus to manage patient flows and pathways


Falls Pilot Results (26 January – 29 May 2012)

• 89 Responder Visits

Outcomes

• 4 people got up before we arrived

• 69 people were supported back up

• 9 people paramedic called/checked supported back up (saved a crew)

• 7 people paramedic called/taken to hospital

• £16,500 savings to-date/annual savings of £65,000

Signposting Activity

• 82 Health and Wellbeing follow up visits were undertaken

• 9 referrals were made to the community falls service

• 10 contacts to GP’s

• 2 contacts to District Nurses

• 2 referrals made to OT

• 1 telecare equipment

• 1 key safe

• 1 referral to respite care

Next Steps

• Attending the emergency care board in July 2012

• Initially pilot period – staff volunteers

• Mainstream Service, part of staff JD

• Evaluate all call outs to the ambulance service

• Refresher training - develop skills and knowledge

• Phase 2 residential/nursing homes

• Demonstrating results

Thank You, Any Questions

Further Information/Contact Details

• Dudley Telecare Service – 0300 555 2040

• [email protected]


mailto:[email protected]

Dudley MBC - Telecare Reablement Pilot Project/Falls Response

Health & Medicine

Transcript of Dudley MBC - Telecare Reablement Pilot Project/Falls Response