I’d like to give you an update following on from your 14 November article about the report on the Help To Live At Home service in Wiltshire.
One of the key advantages of the scrutiny process is that it gives the opportunity for members to hear directly from officers, interested or affected people, and expert witnesses. This process allowed the Task Group to question them and to gain a wider understanding of the issue and hence arrive at informed findings and recommendations.
The task group conducted 5 interviews with service users and received positive feedback from all of them with regards to the service they were receiving, as well as a range of other evidence. The report is not designed to detail all evidence and points considered but to give an overall summary of how the conclusions and recommendations were arrived at.
The Report and its recommendations was endorsed by the Health Select Committee meeting on 17 November and concluded that the recommendations in conjunction with the conclusions, should be referred to the Cabinet Member for Public Health for response. The response is due to be received at the next Committee meeting on 12 January 2016.
It was also agreed that an appendix to the report may be included to summarise the concept of the Help to Live at Home model, the key points are included below:
- Help to Live at Home is about reablement of clients following a period of illness or a stay in hospital – to get them back to where they were before the illness, or as close as possible.
- Support plans are based on the outcomes that the client wants to achieve (e.g. to regain independence in washing, dressing and feeding themselves).
- Performance is measured on progress towards achieving these outcomes.
- The support or care provided in order to achieve the client’s outcomes may be different from day to day. For example, a client may need help getting out of bed and dressing one day, and manage to do this for themselves the next (but still want help with food preparation).
- This does not mean that clients are not getting care when they need it.
- The system requires the support worker to be flexible in the amount of time they spend with a client.
- The ultimate aim is to gradually reduce the overall amount of care needed and increase independence.
- The previous model of “time and task” means the support worker arriving at the same times every day to perform the same tasks, regardless of whether the client needed them. This doesn’t encourage reablement and is wasteful in the long term.
The Task Group strongly feels that the Help to Live at Home model is the right one and that further support and education needs to be provided to customers and their families to understand the model and establish the culture change that is required in order to manage and fulfill expectations, in that the outcome of a call takes priority over the time of day and time allocated to achieve the desired outcome.
For example, it is more important for a customer to be enabled to get out of bed and dressed in a comfortable manner rather than ensuring that this task takes place at precisely 8am every time and taking only 15 minutes.
The final report raises some serious questions about the HTLAH service, but has aimed to keep its recommendations to those that are within the gift of Wiltshire Council to implement or influence.
Chairman of Wiltshire Council’s Help to Living at Home Scrutiny Task Group