Sheffield, Doncaster, Rotherham and North Lincolnshire Transforming Care Partnership Kelly Glover Strategic Lead/Programme Director What are we trying to achieve In the broadest sense and what we are being measured on, is to discharge people from hospital and stop people going into hospital (LD/MH hospitals)
Improving quality of life Improving quality of care Reducing reliance on inpatient settings Ensuring all people live a meaningful and fulfilled life Sounds easy, doesnt it? Why is it such a challenge?
Discharged the people who are easy to discharge Too complex Too risky No Accommodation No provider market Workforce issues
No community infrastructure i.e. Enhanced Community Teams/Forensic Outreach Too expensive We have never done it like this before Well thats the way we have always done it Who should be involved?
People and their families Commissioners CCG/LA/NHS England Hospital Providers Care Providers Housing Providers Independent Clinical Advisors Experts by Experience We are all in it together!
When should we be doing it? NOW! Valuing people 2001 Valuing people now 2009 Mansell 2 Winterbourne View
The list goes on.. Transforming Care is not new!!! How do we achieve it? Short term Accept that we have a legacy issue to resolve which can be expensive. This is the systems problem, not the persons! Accept that commissioners do not always know the answers, families and providers have a vast wealth of experience and knowledge Acknowledge we need to do things differently if you keep doing what you are doing, you will keep getting
what you are getting Be creative, Be brave, what would it take to achieve? How do we achieve it? Think more strategically, not affordable or viable otherwise, thats why we are moving to integrated care systems Get the right people involved earlier, can take 12 18 months to discharge someone, why are we waiting until clinically ready for discharge to start planning Change the relationships, trust and good communication between commissioners and providers are essential Collaborative working with all stakeholders is the key to success, no point in saying its your responsibility, now get
on with it everyone has got to share the risk and responsibility to ensure success Developing a Bespoke Solution Jubilee House Janine Strange Development Director Jubilee House Elysium Healthcare working with TCP Yorkshire and Humber to develop new service Transforming Care priorities: community based services for people with learning disabilities / autism who
display challenging behaviour and who may have mental health problems) Hard to place groups Partnership working case managers and commissioners Agreeing service model and property specification
Early discussion around fees Regular visits to site throughout build Identifying individuals early on Early discussions about legal safeguards issues around S37/41 and capacity Detailed reports and proposals provided by Elysium Property specification High specification, robust service, low arousal Six single apartments lounge/ diner, bedroom, en suite wet room, low arousal Private and large shared garden with sensory features
Communal space lounge, dining area, kitchen, sensory spaces, laundry Staff offices and meeting rooms Assistive technology Large car park Service Model Meeting needs of those with ongoing challenging behaviours and risks Small with low numbers of service users -Registering the Right Support Own apartment to ensure as ordinary living setting as possible High staffing ratios A focus on positive behavioural support, where
every service user has a positive behaviour support plan working dynamically to support them. Staff trained in TMVA equips them to manage violence, aggression or other challenging behaviour. Delivered in capable environments and staffing where individuals may display changing levels of behaviour that pose a risk to themselves or others, but can be managed safely. Care and support is tailored to the individual developed in partnership with the Service User, their MDT, family/carer and ICATT/other health professionals. Care is offered in the least restrictive way providing appropriate Deprivation of Liberty safeguards. Communication plans are in place to support effective communication.
Health needs are met in line with the persons Health Action Plan, Hospital passports and actions taken to reduce premature mortality. Transport is provided which enables the individual to access daytime activities and foster or maintain personal relationships and use of public transport, encouraged. Bespoking the service Assessments at early stage prior to build Replicating existing design / spec hospitals Replicating staffing ratios at least initially Regular meetings with builders to adapt plans Examples:
Washing machine in apartment to mitigate behaviours Larger than normal panels in doors to be able to see staff Private garden Very sparse apartment Transition Effective collaborative communication Training from existing service provider
Work on a timescale that suits service user Regular and consistent visits from a skilled staff team with specific goals for each visit Staff Team and service user would work together to establish his needs and build a positive relationship Include Family and Commissioners in the transition process Elysium Staff Team to spend time with service users current team Thank you, any questions?
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