Domiciliary Care Services for Older People

Aims

Overview of capacity and trends within care at home

Additional capacity needed Summary of capacity planning

work and service re-design ideas for discussion

What drives demand?

Increasing number of Older People

Changing Population Profile

Increasing frailty and health problems

Changes in Policy

Whole system Capacity Planning

Domiciliary Care2. Edinburgh’s provision since 2012

Significant investment (£11.4M gross since 2012) has enabled a 24% increase in hours

Delivered by..........

27934 hours 66%

1105 hours 2.5%

12000 ours 29%

961 hours 2.5%

4627 hours As at 01 September 2014

Opportunities and Challenges

• Legislative Change•Practice Developments•Public Expectations• Labour Market Challenges•Human, Financial and Political Dynamics

CEC Home Care and Re-ablement Service

•Modernisation programme- responding to challenges•Market share•Re-ablement•Specialist Home Care pathways•Integration and Personalisation•Advanced dementia•End of life care•Intensive home care

Specialist Home Care Pathways

• Integrated with health colleagues• Increase in complex case work- a skilled work-force• More complex patterns of provision (Overnight Service)• Personalised- choice and control• 3 specialist pathways

• Advanced dementia• End of life care• Intensive home care

• Local connections- neighbourhood working• Recruitment and retention challenges

NEW CONTRACT FOR PURCHASED CARE AT HOME SERVICESKey Characteristics:• Reflects the real cost of care• Based around Hospitals and Neighbourhoods• Personalised• Flexible• Visible• Trusted• Supportive of Staff

The Fair Cost of Care

Employee Hourly Rate Ω Travel Time and Cost Payments Ω National Insurance Ω Pension Ω Statutory Holiday Pay Ω Training Ω Sick Pay Ω Supervisory Staff Ω Management Fee Ω Profit/Surplus Ω Overtime/Weekend Premium

£15.50 per hour

Key Question

•How can we re engage the voluntary sector in high volume service delivery

and......• make the service sustainable in terms of demographic change, labour market conditions and financial pressures?