COMMUNITY SUPPORT OVERVIEW GROUP
12 April 2006
DEVELOPMENT OF ASSISTIVE TECNHOLOGY
1. / Purpose of Report:1.1 / To inform Members of the development of Assistive Technology in supporting people to remain in their own homes.
2. / Decision Required:
2.1 / To note the contents of the report.
3. / Background:
3.1 / In July 2005, the Department of Health published ‘Building Telecare in England’. This guidance identified the issues facing health and social care delivery to older people in the future. In summary whilst older people will:
· Be better off;
· Be better educated;
· Have higher expectation; and
· Live longer
3.2 / This will present challenges due to:
· The absence of extended family caring networks
· More complex needs
· Older people seeking to have greater control
· Older people seeking to manage their own risks
3.3 / The DoH views telecare as being ‘vital to unlock the future’ and part of new ways of working that will need to be embraced by Health and Social Care Providers. In particular telecare is viewed as having huge potential to reduce unnecessary hospital admissions.
3.4 / Accompanying the publication of the guidance was the announcement of the Assistive Technology Grant of £60 million over two years to pump prime telecare initiatives.
3.5 / For the Borough of Poole the non-ringfenced Assistive Technology Grant (ATG) amounts to:
£83,000 – 2006/07
£139,000 – 2007/08
The DoH will require CSCi to monitor the numbers of people benefiting from telecare through the use of the new grant allocation, commencing with an estimate for 2005/06. It will be particularly looking for impact upon C32 - Numbers Of Older People Helped To Live At Home.
3.5.1 / Of the £83,000, £20,000 has been utilised to resolve budget pressures in Social Services, leaving £63,000 for Assistive Technology.
3.6 / The grant is expected to increase the number of older people nationally in receipt of Assistive Technology by at least 160,000. For Poole the pro rata figure is 430 older people. The DoH expects the grant to:
· Reduce the need for residential/nursing care
· Unlock resources and redirect them elsewhere in the system
· Increase choice and independence for service users
· Reduce the burden placed on carers and provide them with more personal freedom
· Contribute to care and support for people with long term health conditions
· Reduce acute hospital admissions
· Reduce accidents and falls in the home
· Support hospital discharge and intermediate care
· Contribute to the development of a range of preventative services
· Help those who wish to die at home to do so with dignity
3.7 / On top of the ATG the Borough of Poole has secured a further £92,045 for the year 2006/7 from the Supporting People fund, given the need to assist people in maintaining tenancies and retain independent lifestyles through that programme.
4. / What is Assistive Technology?
4.1 / Assistive Technology is the use of technology to assist a disabled or vulnerable person in retaining their independence within their own homes. Whilst aids and adaptations have commonly been commissioned by Social Services to support individuals, Assistive Technology makes use of the communication afforded by the installation of a phone line into a person’s home. Utilising a wide range of ‘peripherals’, a central call centre can detect if:
· A service user falls on the floor
· There is a build up of carbon monoxide
· The house temperature drops to dangerous levels
· The service user has failed to get up in the morning
· A service user has wandered out in the night
More innovative and exciting uses now also extend into telemedicine by detecting if:
· The service user has taken medication
· The service users blood pressure, sugar levels etc are satisfactory
Upon receipt of an ‘alarm’, a call centre will either contact the person direct, alert a family member or neighbour, request the visit of a specialist rapid response home care team, contact the local surgery or summon emergency services.
Given the advances in technology these devices can operate via wireless and the ability to install and transfer these devices is now immense.
4.2 / Importantly, given the many advances in technology it is perhaps useful to also clarify that Assistive Technology is not linked to hardware or software that contributes to staff management or automated billing.
5. / The Poole Assistive Technology Project.
5.1 / Currently:
· 1,800 service users in receipt of a community alarm provided by BoP Lifeline Service(run by Housing and Community services), not including those living in sheltered housing
· There is an absence of any added assistive technology devices e.g. as at June 2005 only 4 people were using fall detectors
· There is an absence of strong referral relationship between Social Services and Lifeline e.g. in 2005-06 there were just 30 Social Services referrals.
· There is an absence of fall reporting by Lifeline to the Woodlands Falls Clinic.
· There is an absence of telemedicine applications in Poole.
5.2 / So What is the Project going to do?
Given the current poor use of Assistive Technology, the national guidance and the local issues in Poole, the project in Poole will:
i) Develop a high profile customer focussed service which will involve leasing a readily accessible shop facility. In the medium and long term this should be located within the new Fourways Well-being Centre.
ii) Utilise underpinning statistical information to develop targeted work with:
- Carers – through providing low level technology that enables the carer to maintain their level of support at home;
- Medicines Management – working in partnership with Poole PCT’s Medicines Management Team to ensure that medicines are taken appropriately; and
- Telemedicine – identifying a Surgery which has a high cluster of surgery/hospital attendees whose medical checks can be undertaken within the home. Ideally this will work together with Self Care/Expert Patient Programmes which gives older people greater confidence in managing their medical conditions.
iii) Test these approaches over the course of the two year pilot to inform how the service should be promoted and developed when mainstreamed in April 2008.
5.3 / From these interventions the project should lead to:
i) Carers feeling more supported and sustaining their support at home, and therefore potentially reduced residential/respite admissions;
ii) Reduced medicines mismanagement and therefore reduced emergency admissions to hospital;
iii) Reduced attendances at surgeries/hospital admissions, promotion of well-being.
5.4 / Consistent with the need to raise the profile of assistive technology the specialist team (see Appendix 1) will take a proactive approach to case finding. In addition to the traditional referral routes and sources, team members will utilise data which identifies people at risk of hospital readmission and work in partnership with a range of voluntary organisations, including the new floating support service and POPP’s programme for older people to identify beneficiaries of the project. Further to assessment of the unique assistive technology devices needed by the individual, the team members will be responsible for installation and maintenance of equipment.
5.5 / It is anticipated that Lifeline will be a core member of the Project Board in order to ensure effective working between this established service and the new project required of Social Services by the Department of Health.
In particular, further discussion needs to be held with the Lifeline service to determine how the resources of each team can be utilised in a manner which provides good value for the Council. Lifeline for example currently employs officers to undertake installation of community alarms. If the existing staff resource can be utilised in partnership then additional funds can be committed to a larger assistive technology equipment budget.
6. / Charging:
6.1 / Existing users of Lifeline pay £3.02 / week for a Community Alarm. This project however, has clear health and social care outcomes to be attained and it is a pilot to test how the service will be mainstreamed. It is therefore proposed that this is a non-chargeable service. Where a service user needs an assistive technology device but is already in receipt of a hired/purchased community alarm, the assistive technology device will be free.
Where a service user has no community alarm but needs the assistive technology service, both the community alarm and the assistive technology device will be installed at no cost (personal phone calls made via the community alarm will be paid by the service user).
7. / Funding:
7.1 / The Assistive Technology project has funding for two years through the Government’s Assistive Technology Grant and the supporting People programme.. The full project cost is therefore: -
Assistive Technology Grant - £63,000
Supporting People Grant - £92,051
This will enable the creation of a small specialist team , office rental and purchase of equipment (see Appendix 1).
8. / Exit Strategy:
8.1 / The Assistive Technology and Supporting People Grants are both for only two years. The expectation of the DoH is that the use and further promotion of assistive technology will become core to Social Services provision, and will be reinforced through the introduction of a Performance Indicator.
8.2 / The outcomes of this pilot, and in particular the ability of the pilot to impact upon supporting carers, preventing crisis admission to residential care and hospital is therefore critical. The pilot will be managed by a project board chaired by the Service Unit Head(ASCWB)and comprised of representatives from Social Services, Primary Care Trust and Housing and Community Services in order to track the attainment for the project outcomes and determine forward funding streams.
Report By: Charlie Sheldrick, Service Unit Head
Contact Officer: Jeff Russell, Principal Officer (Tel…261029)
Appendix 1
Staff Structure and Functions:Project Board
Project Manager
Pharmacy Technician, Community Pharmacist / Telecare
Officer (Older People Mental Health) / Telecare
Officer (Primary Care) / Admin
Support
Project Manager:
· To promote use of telecare through establishing effective link with Primary and Secondary Care, Adult Social Services, Housing, Carers and relevant others.
· To establish and lead the Project Team.
· To ensure systems are designed and maintained which identifies benefits.
· To ensure the Project contributes to LAA and POPPs programme.
· To ensure the Project Board are informed of all key developments.
Telecare Officers:
· To receive referrals and case find.
· To identify and install appropriate telecare solutions.
· To monitor impact and contribute to Management Information systems.
Admin Support:
· To provide full administrative support to the Project.
Project Board:
· To ensure the Project is linked to other relevant strategies.
· To make recommendations to management team of Adult Social Services.
· To ensure respective agencies own the Project.
Lifeline:
· To provide initial call and agreed responses.
· To ensure that telecare stock is readily available.
Funding:
Salaries* / Supporting People / Assistive Technology Grant
Project Manager
1 FTE, MP1x (SCP42) / £40,311 / £34,147 / £6,164
Telecare Officers
2 FTE, APT 1 (SCP 21) / £43,523 / £43,523
Admin Assistant
0.5 FTE, GEN 2 / £8,381 / £8,381
Pharmacy Technician
0.5 FTE, / £12,000 / £12,000
Non Salaries
Office Costs –rent, heating, lighting, telephones, stationary / £10,000
£2,000 / £5,000
£1,000 / £5,000
£1,000
Publicity / Promotion / £5,000 / £5,000
Telecare equipment and support / £29,101
TOTAL / £92,051 / £63,000
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