Dudley MBC - Telecare Reablement Pilot Project/Falls Response


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Dudley – re-ablement - promoting the benefits of telecare to enhance the range of universally available resources in the community and further promoting independent living. People being discharged from hospital with care needs can benefit from this telecare service in lots of ways. By offering a package of telecare solutions people can get back home earlier, helping to alleviate the bed crisis in acute hospital settings. The Falls First Response Pilot - the aim was to build on the current telecare 24/7 service, to train telecare staff to be able to provide a falls first response service to a person in receipt of telecare who are on the floor and not injured, they will assist them back up using the appropriate lifting equipment as opposed to contacting West Midlands Ambulance Service.
Presentation by Marie Spittle, Service Manager - Telecare

Published in: Health & Medicine, Technology
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  • Slide 26 Referrals can be made directly to the Dudley Community Alarm and Telecare Service. Staff will arrange an appointment to visit and complete the assessment and installation. Or if you want to discuss an individual client further, please contact us
  • Dudley MBC - Telecare Reablement Pilot Project/Falls Response

    1. 1. Telecare Reablement Pilot Project/Falls Response West Midlands Regional Telehealthcare Network 10 July 2012Supporting Dignity, Independence and Well Being
    2. 2. 24/7 Specialist Specialist Monitoring Telecare work Telehealth Centre Installs 24/7 with LD emergency Pill Hub Refs JustMaintenance Responder Dispenser Assessment Checking Faults service Pilot Install & InterimTesting visits Review Dudley Report TSA Telecare Bogus Caller Accreditation The whole Home Safety 2009 Code Partnership Service Manage Host Host Monitor All OOH Corporate Bogus Caller HA Council OOH Line Alerts Repairs Host Host Host Children Emergency Emergency Vulnerable with Duty Team Carers Card Persons Disabilities Card Card Supporting Dignity, Independence and Well Being
    3. 3. ACCESS Social Workers Community Care OT Emergency Response Telecare is part of access – The upstream prevention Home Falls and signposting SafetyService but works closely with intermediate care and long term care and support teams Supporting Dignity, Independence and Well Being
    4. 4. 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 Supporting Dignity, Independence and Well Being
    5. 5. 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 dischargeSupporting Dignity, Independence and Well Being
    6. 6. 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 Supporting Dignity, Independence and Well Being
    7. 7. Background• A revised telecare screening tool for all staff was developed and launched on 1 June 2010 Supporting Dignity, Independence and Well Being
    8. 8. 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 trainingSupporting Dignity, Independence and Well Being
    9. 9. 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: £487.52Supporting Dignity, Independence and Well Being
    10. 10. 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 systemSupporting Dignity, Independence and Well Being
    11. 11. IMPLEMENTATION - Training and FamiliarisationIn order to set up the pilot project, training and familiarisation inTelecare needed to be refreshed and extended. This was providedto:• 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 Supporting Dignity, Independence and Well Being
    12. 12. 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 progressedSupporting Dignity, Independence and Well Being
    13. 13. 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 Carer6 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 capturedSupporting Dignity, Independence and Well Being
    14. 14. 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 Supporting Dignity, Independence and Well Being
    15. 15. 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 undertakenOutcomes• 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) Supporting Dignity, Independence and Well Being
    16. 16. Re fe rral Source30 252520 18 15 1515 1310 7 5 3 2 3 1 0 Hospital Social Work Te am Community Care Re able me nt Se rv ice He alth Care Profe ssinal Re side ntial Re able me nt Unit Liv ing Inde pe nde nt Te am Long Te rm Social Work Te ams Re d Cross Referral Source Community Te am Le arning Disablitle s Acce ss Te am for Social Care NOK Hospital Social Work Team 2% Community Care 1% Reablement Service 3% Health Care Professinal 3% 24% 13% Residential Reablement Unit Living Independent Team Long Term Social Work Teams Red Cross 17% 15% Community Team Learning Disablitles Access Team for Social 7% 15% Care NOKSupporting Dignity, Independence and Well Being
    17. 17. Percentages of Referrals keeping Telecare equipment after 6 week review Percentages of Referrals , 17% Private Council Percentages of Referrals , 83%Supporting Dignity, Independence and Well Being
    18. 18. Telecare Objectives/Outcomes Health & Social Care Efficiences through the use of Telecare80 6360 5240 15 15 1820 7 3 3 1 0 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 Supporting Dignity, Independence and Well Being
    19. 19. 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
    20. 20. 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 TelecareDevelop Partnerships• Supporting re-enablement teams in diverting people from long term care “Telecare is a confidence builder”• Falls Programme - link to falls pathway/responder visitsSupporting Dignity, Independence and Well Being
    21. 21. 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 Supporting Dignity, Independence and Well Being
    22. 22. Falls Pilot Results (26 January – 29 May 2012)• 89 Responder VisitsOutcomes• 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
    23. 23. 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
    24. 24. 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
    25. 25. Thank You, Any QuestionsFurther Information/Contact Details• Dudley Telecare Service – 0300 555 2040• marie.spittle@dudley.gov.uk Supporting Dignity, Independence and Well Being