Monday, 25 September 2017 Overview and Scrutiny Adult Social Care Performance 1
Business Plan Indicator 64 - Qtr 1 Green BPI 64 BPI 64 BPI 64 BPI 64 Increasing the proportion of older people (aged 65 + ) who were Increasing the proportion of older people (aged 65 + ) who were Increasing the proportion of older people (aged 65 + ) who were Increasing the proportion of older people (aged 65 + ) who were still at home 91 days after discharge from hospital into still at home 91 days after discharge from hospital into still at home 91 days after discharge from hospital into still at home 91 days after discharge from hospital into reablement/rehabilitation. reablement/rehabilitation. reablement/rehabilitation. reablement/rehabilitation. 16/17 Outturn 17/18 Target 17/18 Qtr 1 85% 75% 80% What is this for? What is this for? What is this for? What is this for? Measures the effectiveness of reablement/rehabilitation in helping people to live at home for longer and prevent the need for further hospital admission. Why do we use it? Why do we use it? Why do we use it? Why do we use it? In Hounslow we have used it as an outcome measure, to measure the effectiveness of our Community Recovery Service (CRS). The CRS is a joint health and social care service hosted by Hounslow & Richmond Community Healthcare (HRCH). HRCH provide the nursing and therapy staff and ASC is responsible for the personal care support via CRS+. 2
Business Plan Indicator 64 Performance Trajectory BPI 64 BPI 64 BPI 64 BPI 64 Increasing the proportion of older people (aged 65 + ) who were still at Increasing the proportion of older people (aged 65 + ) who were still at Increasing the proportion of older people (aged 65 + ) who were still at Increasing the proportion of older people (aged 65 + ) who were still at home 91 days after discharge from hospital into reablement/rehabilitation. home 91 days after discharge from hospital into reablement/rehabilitation. home 91 days after discharge from hospital into reablement/rehabilitation. home 91 days after discharge from hospital into reablement/rehabilitation. 3
Business Plan Indicator 64 What are the factors influencing performance? Better integrated working Integrated working continues to be embedded which has improved outcomes for residents. This includes: a) Monthly meetings with locality service manager/key managers and the managers of CRS to look at good practice and build on this and improve areas that need development. b) Relevant heads of service along with LBH finance and performance attends performance monthly performance meetings with HRCH 4
Business Plan Indicator 65 – Qtr 1 Green BPI 65 The percentage of people receiving personal care who have a positive outcome from Community Recovery Service (Those with a decrease in care packages) BPI 66 (Those clients closed after short term provision from Community Recovery Service) 17/18 Target 17/18 Qtr 1 16/17 Outturn 39% 50% 61% These two indicators have been combined to create a new BPI 65 The percentage of people receiving a social care service who as a result of CRS+ intervention, had their statutory services reduced or ended What are these for? To measure whether the Community Recovery Service improves independence reducing the need for long term care . . 5
Business Plan Indicator 65 Performance Trajectory BPI 65 The percentage of people receiving a social care service who as a result of CRS+ intervention, had their statutory services reduced or ended 6
Business Plan Indicator 65 What are the factors influencing performance? What are the factors influencing performance? What are the factors influencing performance? What are the factors influencing performance? 1) Better integrated working Integrated working continues to be embedded which has improved outcomes for residents. These include: a) A greater Focus on residents with Double up Care Packages- all CRS staff have been trained in new types of equipment and new ways of manual handling to enable more single handed care for residents resulting in better outcomes for residents. b) Better communication between the first contact team/locality teams and CRS with regular monthly meetings where issues are discussed and resolved. 7
CRS+ Resident Demographic Profile Age Distribution of CRS+ 264 people have passed through CRS+ services in 2016/2017. 98.5% of these we are able to match up to a social care record. 76.5 is the average age of people receiving CRS+ . Most people receiving CRS+ fall into the 80-84 category with a fairly regular standard distribution around it 8 (Based on discharge information received from HRCH)
CRS+ Resident Demographic Profile 9
CRS+ Resident Demographic Profile Ethnicity Distribution of CRS+ When compared with the over age 65 Borough wide average the proportions of people from BAME backgrounds referred to CRS+ are well represented. 10
CRS+ Resident Demographic Profile Informal Carer Relationships within CRS+ Cohort 17.0% of people are recorded as also having an informal carer usually by a family member. 6.3% of people who received reablement from CRS+ were also providing informal care, in most cases to a family member. 11
CRS+ Resident Demographic Profile Impact of CRS 4 weeks after the discharge from CRS, 53 people were receiving Council commissioned personal care, with an average package size of 6.5 hours per week. In comparison the Council-wide average is 15.1 hours per week, which is more than double. The lower than average package size after discharge is an indicator of good practice. 12
CRS+ Resident Feedback Service User Questionnaire The service is now using the service user Friends and Family questionnaire survey. In the month of August, overall satisfaction rating is 96.43%. Previous month July was 96.67%. Compliments significantly outway complaints. 13
CRS+ Resident Feedback Compliments (Examples) Thank you so much for coming every week since I left hospital and for your helping me to go up and down stairs and to walk outside. I am feeling much more confident now and really appreciate all the encouragement you have given to me. Thank you so much for the help and encouragement you have given me through my recovery could do with a friendly nudge every now and again. Thank you for the help and care I have received from you all during the last few weeks. I shall miss your company. . 14
CRS+ Resident Feedback Complaints (Examples) Mrs L is bed-ridden and it quickly became apparent that the bed is significantly narrower than a single bed and there is a risk of Mrs L rolling off. Brother of patient making a complaint about the CRS delay to arrange moving a reclining chair out of his brother's house 15
Business Plan Indicator 67 – Qtr 1 Amber BPI 67 BPI 67 BPI 67 Reducing the number of hospital discharge delays BPI 67 Reducing the number of hospital discharge delays Reducing the number of hospital discharge delays Reducing the number of hospital discharge delays for a social care reason per 100 population (people). Acute for a social care reason per 100 population (people). Acute for a social care reason per 100 population (people). Acute for a social care reason per 100 population (people). Acute and non acute settings) and non acute settings) and non acute settings) and non acute settings) 16/17 Outturn 17/18 Target 17/18 Qtr 1 3.7 3.3 3.5 What is this for? What is this for? What is this for? What is this for? This measure is to encourage the timeliness of Hospital Discharges in support of the NHS driver to reduce length of stays in hospital, and looking at the effectiveness of Social Care support in facilitating residents back into the community. 16
Business Plan Indicator 67 Performance Trajectory (lower is better) The Quarter 1 17/18 rate of 3.5 per 100,000 population equates to 7.5 people per month delayed in their discharge. 17
Business Plan Indicator 67 What are the factors influencing performance? • Better Care Funded Schemes such as Community Recovery Service and hospital Social Work Team • Non-acute delayed transfers of care (West London Mental Health Trust) • Regular monitoring • Challenge process (Monthly meeting) • DToC Action Plans 18
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