The first in this series of three short articles focused on our first point of contact, the CareDirect Plus service. Devon has three CD+ teams for a population of 750,000, receiving 48,000 contacts a year leading to 10,500 service plans. CD+ is highly efficient, resolving 75% of all contacts within two days. It has 45% of care management staffing delivering 75% of care management service plans and being responsible for the majority of service reviews.
Services have to be delivered as quickly as possible after assessment. We adhere to the principle that people know what they need and want a speedy response. A high proportion of contacts are from people who require simple equipment or minor adaptations to maintain their independence. We have enough information in CD+ to switch on those services. We ran three pilots to test rapid delivery of equipment and minor adaptations. About 40% of people contacting CD+ have their needs met in this way.
We piloted three models of equipment delivery with different providers who respond to information from CD+. They deliver the prescribed equipment and check that the person can use it. They also verify the initial assessment, looking for indications of more complex need that may not have been identified.
The rapid equipment service handles 70% of requests for equipment and adaptations the rest go to occupational therapists in the complex care teams. We set a target for 80% of the equipment referrals to be resolved within five working days. All three providers have bettered this, with an average of 87% resolution within five days and 95% within 10. We estimate the cost of service delivery is about half the cost of the in-house service, which had a 16-week waiting time on average.
Another key element in speedily meeting needs is our brokerage service. Social workers and OTs no longer arrange services. Following assessment and agreement of a support plan this goes to brokers who arrange all services. We think we are in the early days of an exciting development with enormous potential, especially in supporting people to design and manage their own care. The “standard brokerage” service arranges care such as home care, day, respite. “Personalised brokerage” provides individually tailored support, mainly at the complex, expensive end.
We have developed a model of personal outcomes, linked to In Control and Supporting People methodology, to describe the outcome expected from a package of care. We e-tender to accredited providers. The responses have been way beyond our expectations. Imaginative, flexible and cost-effective care plans have been presented, tailored to people’s needs. We can extend this model to all service users.
Underpinning the transformation of care management is our information system. Staff input directly into a single care record. We use the OLM Carefirst system at every stage. The information is transmitted instantaneously between staff. The days of service users endlessly repeating their story are over.
The next article will describe how we meet the needs of the people with complex and long-term needs through fully-integrated health and social care teams.
David Johnstone is director of adult and community services, Devon Council
This article is published in 26 June issue of Community Care under the heaidng Speed is of the essence afterservice user assessments