2. Integrated Care – The Model
Person centred
Community and Personal network
Core Team – GP, Community Matron, Care Coordinator, Social Worker
Locality Team – OTs, Physios, District nursing teams, re-ablement
team etc.
Specialist resource – Specialist acute – day or admissions
3. Voluntary Sector Contribution to Practical
Wrap-around Support
• Purpose
To increase the ability of people in the Dales to remain independent in their
own homes through the availability of good quality, reliable, ‘wrap around’
services.
• To increase the ability of people in the Dales to regain independence
following discharge from acute services through identifying needs and
securing supportive ‘wrap around’ services that will meet their needs.
• To build community engagement and enable community members to
support their ‘neighbours’.
4. The proposed ‘menu of services’ is as follows:1. Collecting and delivering prescriptions/medication in places where there is
no delivery service offered by the pharmacy.
2. Reminders at the appropriate times of day/evening for people who tend to
forget their medication.
3. Daily communication/telephone call for those who are vulnerable
lonely.
and
4. Collection and delivery, and un-packing if necessary, of fresh produce/basic
shopping.
5. Social visit to lonely and vulnerable people in their own home.
5. (cont) The proposed ‘menu of services’ is as follows:6. Social contact through supported participation in an interest/activity
group, including transport arrangements where necessary.
7. Support with basic house cleaning.
8. Overnight sitting service for people who are worried at night, especially
when returning from hospital.
9. ‘Welcome home’ package of support for people returning from hospital,
including turning on the heating, making sure there are basic provisions
etc.
10. Any other?