As an industry, we refer to Technology Enabled Care as our core services, however, it is often fair to say, we are more focused on the ‘Technology’ than the ‘Care’. The technology is undoubtedly important. Without it, the people that we look after wouldn’t be able to summon for help when they need it. But what about the ‘Care’? For many, the care that the technology enables is delivered by the call handler who will reassure them and ensure that the help is on its way. For others, the care comes from their friends and family that are there to attend quickly should they need it.
Doro, like many others, also provides mobile response services. Traditionally these services have comprised of responders on the ground, who will quickly assess the situation within the property, reassuring the service user and acting promptly and sensitively to resolve their issues. The increased use of moving and handling services has prevented thousands of unnecessary ambulance callouts and hospital admissions and delivered clear cashable efficiencies for both health and social care.
We do, however, feel that there is a missing, and often vital, component in the delivery of physical response services and that is the provision of emergency domiciliary care.
What we did in Wigan
Doro has delivered services in partnership with Wigan Metropolitan Borough Council since 2007 to over 2000 service users. As we developed moving and handling physical response services across the Borough, it became increasingly clear that there was often a need for emergency, or unplanned, personal care as a result of a service user falling or another unplanned incident.
Although many of the service users did have a commissioned domiciliary care provision, visits were set at scheduled times and it was incredibly challenging for care agencies to be able to respond quickly to an emergency situation. The result was that staff were often calling for ambulances to administer personal care, as there was a lack of alternative options
When the service was re-commissioned, Doro had expanded its service provision to be able to provide the full end-to-end service of emergency response and personal care, gaining Care Quality Commission (CQC) accreditation for the delivery of domiciliary services around the clock. Our teams now make planned visits with a nighttime personal care requirement, such as assistance with toileting or repositioning, supporting service users when traditional care agencies cannot. This enables them to live independently in their own homes for far longer than they may have been able to otherwise, as often the only alternative solution to night-time care requirements is a residential care setting
This service enhances, and is enhanced by, the physical response service and users often move between the two on a flexible basis, depending upon their needs. The teams communicate with one another continuously, and if the emergency responders have visited an individual throughout the night, then their planned visit may be cancelled for that night or scheduled for later on. The staff are multi-skilled and work across both teams, enhancing the robustness of the service delivery.
Ann Newton, Lead External Provider Manager, Adult Social Care, Wigan Council said “This is a win-win situation for everyone involved, especially the residents of Wigan. It’s an amazing response service, providing a personal service to users’ needs, allowing them to remain at home for as long as possible”.
* Enhanced privacy and dignity for the service user due to only one person being required attend to an incident
* Reduction in domiciliary care packages as a result of carers providing ‘just in case’ support visits, these packages have subsequently been significantly reduced with the introduction of technology and emergency domiciliary care.
* Reduction in ambulance callouts, as the emergency services would be the default if an individual had an emergency personal care requirement with no other care provision
* Seamless, high quality service provision from the service user’s perspective.
Delivering the service has not been without its challenges and there has been a vast amount of effort and commitment by Doro and the Council to ensure that the service is fit-for-purpose and delivering the correct outcomes. There have been considerable issues with service users over-utilising the service and requesting personal care when not an emergency. Or service users cancelling their scheduled care visits, on the basis that we will come out ‘whenever they need them’.
Education for the service users has been key to overcoming these issues, ensuring that is made clear exactly what our service is there for – to provide care in emergency situations only, and that we are not there to take them to the bathroom on a regular basis or to help them with their planned meals.
Stringent reporting and monitoring is carried out on a regular basis, with any service user that is requesting a responder more than four times a month being referred back to the Council for assessment to see if they are in need of additional services or support.
One of the valuable things about the emergency care service is that it often highlights when service users may be in need of additional support and when their current care provision may not be meeting their needs or outcomes. The responders may be the only person that ever visits an individual in their own home, and, as such, it is vitally important that their observations and concerns are highlighted and raised with the Council as appropriate.
We now provide over 700 planned nighttime care visits per month across Wigan and around 100 emergency personal care visits. With an average of 500 emergency response visits carried out in Wigan on a monthly basis, around 20% of those visits require personal care.
Following on from the success in Wigan, we were subsequently able to mirror this service delivery in Oxfordshire when we took over their county-wide service in 2018.
It is our belief that a truly flexible approach to care, utilising the brilliant technology that we have available to us, is the future. This approach would support service users with a varied level of need, to remain living independently in their own homes, for as long as they wished to.
Watch the full presentation on Youtube, including hearing from a Wigan Responder delivering the service .