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24 HOUR COMMUNITY SUPPORT TEAM, Corby, Northants

24 HOUR COMMUNITY SUPPORT TEAM, Corby, Northants. Context. 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%

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24 HOUR COMMUNITY SUPPORT TEAM, Corby, Northants

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  1. 24 HOUR COMMUNITY SUPPORT TEAM, Corby, Northants KAT/KM MAR 2010

  2. Context • 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 KAT/KM MAR 2010

  3. The journey • Stopped all new perm res care, • Res unit closure – C.S.C.I. Requirements • Used stays as preparation for independent living • Obtained accessible 4 bedded flat, half a mile from res. Unit • Obtained “green light” from senior management to develop 24home care services • Obtained funding for acc. from T.H.B/S.P. KAT/KM MAR 2010

  4. The journey • 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 KAT/KM MAR 2010

  5. The journey • 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 KAT/KM MAR 2010

  6. The journey • 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 KAT/KM MAR 2010

  7. The Service • 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 lot • Spot purchasing made us very efficient • Trained in specific issues for the service • Rota’s designed weekly to accommodate customers and staff requirements KAT/KM MAR 2010

  8. The Service • 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 KAT/KM MAR 2010

  9. The service 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 KAT/KM MAR 2010

  10. What Went Wrong • Other County Council priorities – L.D. Reprovision • Serious budget problems 2005/6 • Management restructure • Domiciliary Homecare review restructured P.D. and Dementia as one service • Service 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 KAT/KM MAR 2010

  11. The Challenges • 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 KAT/KM MAR 2010

  12. The Challenges • 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 KAT/KM MAR 2010

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