Modernising Services for Older People

1
Modernising Services for Older People

• March 2006

2
The Process

• Planning and Evidence Gathering June to September
  2003
• Multi Agency Sign Off
• Staff Profiling
• Consultation events
• Closure of inpatient beds Rapid assessment
• Training programme support
• Formal commencement April 2004

3
Why Change?

• On average 13 of the 16 in-patient beds on Calder
  were occupied by people with a diagnosis of
  dementia in 2002/3
• Of these between 4 and 8 were delayed discharges
• Calder had a 98 discharge rate into 24 hour
  residential care
• Of the people admitted to Calder (with dementia)
  78 had been living independently in the
  community prior to admission and a significant
  proportion (48) had not received community-based
  packages of care before their admission

4
Why Change?

• Chantry Units bed occupancy for 2002 was 99 and
  rose to an average of 102 in 2003
• On average 2 to 4 of Calder inpatient beds were
  occupied by people with functional mental health
  problems
• An average eleven people per month were admitted
  to Chantry 2002/3

5
What are the changes?Support to the whole system

• Rapid Assessment Service  
• Home Treatment Team 
• Crisis Resolution
• Session based Day Treatment service
• Single point of Access 
• Liaison Team Hospital Care Homes
• Development of Integrated CMHT

6

• In-patient Services - 
• Chantry Unit Twenty assessment and treatment
  beds for those requiring in-patient support with
  a presentation of a functional mental illness.
• Saville Park View House 17 beds
• Community Units for Older People to support
  those with complex needs
• Sycamores, Ossett 15 beds 15 day places
• Poplars, Hemsworth 15 beds 15 day places

7
Training Programme

• The aim of the eight day training programme was
  team building and policy development
• Included refreshing skills and knowledge in
  mandatory training areas
• A team evaluation took place on the eighth day

8
Training Programme

• Day 1 Team Objectives
• Day 2 Documentation/Assessment Tools
• Day 3 Crisis
• Day 4 Cultural Competency
  Training/Mandatory Refreshers
• Day 5 Nutrition/Continence Management
• Day 6 PSI
• Day 7 Operational Policy/Policy Awareness
• Day 8 Planning and Evaluation

9
RAS- The First 12 Months865 referrals received

• Admissions 4.96
• Out patient appointment 1.98
• Day Treatment 12.87
• No further input 18.81
• Continued ongoing support 61.38

10
Chantry Admissions

• 1999-2000 acute admissions totalled 184. At this
  time there were 90 beds in Older Peoples Services
• 2003-2004 acute admissions totalled 192. At this
  time there were 84 beds in Older Peoples Services
• 2004-2005 acute admissions totalled 89. At this
  time there were 68 beds in Older Peoples Services
• 2005-2006 acute admissions totalled 104. At this
  time there were 68 beds in Older Peoples Services
• N.B Bed occupancy has dropped from 102
  (2003-04) to 88 (2005-06). LOS and bed days have
  reduced due to the ability to support discharge
  with the home treatment team.

11
Benchmark Audit

• Response time to routine referrals 4 days
• Response time to crisis under four hours
• Majority new referrals
• Decreased out of hours crisis and reduction
  crisis generally
• Satisfaction
• FLEXIBILITY