Agenda item

Purpose: To compare the Service Area’s performance levels in respect of Delayed Transfers of Care between 2011/12 and 2014/15.

The Commission considered a report concerning Delayed Transfers of Care (DToC) in West Berkshire. Tandra Forster (Head of Adult Social Care) reminded Members that the item was previously considered by the Commission due to the concerns raised about the poor performance of the Council in comparison to national statistics.

Tandra Forster explained that, since the previous review, DToC figures had significantly improved with social care delays decreasing from an average of 9.0 to 4.5 people per 100,000 population.

Members heard that section 2 of the report detailed how the Maximising Independence Team had managed the improvements through the focused efforts of managers overseeing the following:

·         In reach hospital link workers based on acute hospital sites could ensure a close dialogue with Health hospital discharge teams before point of referral. This enabled staff to get to know people at an early stage to understand their likely social care needs.

·         Referrals were responded too in a more timely manner. The teams proactively worked to the principle of engaging with patients from the point of admission rather than point of discharge, linking with the Council re-enablement team to maximise rehabilitation opportunities and facilitate safe and timely discharge.

·         Engagement with Health managers before formal notification to the Department of Health to ensure that data on delayed transfers is accurately reported as part of the DToC Situation Report (SitRep). 

Tandra Forster advised that helping clients from rural areas to return home presented challenge due to limited capacity with external homecare providers. This placed the Council’s in-house reablement team under pressure as they were having to hold on to clients for longer than they needed reducing access for new people.

Members heard that Adult Social Care (ASC) was committed to continuing good progress and new ways of working in partnership with health partners. The work would include the development of the Joint Care Provider (JCP) project under the Better Care Fund programme of work. The project involved the Council and Berkshire Healthcare Foundation Trust pooling their resources to avoid duplication of services to support timely hospital discharges.

In addition to this, work was underway to develop a 7 day social care response. The plans were in the early stages and some minor changes had been introduced without making any formal adjustments to staff working patterns. The approach was introduced in June 2015 with a sole focus on the Royal Berkshire Hospital. Since then the scope had widened to include North Hampshire Hospital and Great Western Hospital. The impact had been closely monitored and data collected on a daily and weekly basis. The feedback received so far suggested that the changes were effective; should it continue to prove successful then the service would undertake a formal consultation.

The Commission heard that, given the significant improvements in performance and mitigations in place, it was recommended that the DToC item was removed from the Work Programme. Tandra Forster advised Members that the topic was also considered and scrutinised through the Health and Wellbeing Board and local service plans.

Councillor Alan Macro asked whether the changes had resulted in patients being discharged too early; concerned that the emphasis on reducing delays had created unnecessary panic. Tandra Forster advised that it was the overall decision of the Hospital Consultants to discharge patients – the Council supported the patients upon instruction.

Councillor Paul Bryant asked for information regarding capacity within residential care homes and availability of support staff. Tandra Forster advised that there were no particular issues to report; the service had Commissioned fewer beds last year due to a continued focus on supporting people within their own homes.  It was acknowledged that recruiting staff within the care sector was challenging; the line of work was difficult and not particularly attractive to many. Adult Social Care aimed to avoid using agency staff within Council owned care homes. Tandra Forster was unable to comment on the percentage of agency staff in private care homes. It was agreed that Tandra Forster would report back to the Commission with the percentage of agency staff used within Council owned care homes.

Councillor Ian Morrin asked whether the services collected information regarding the readmission rate of patients. Tandra Forster advised that such data was not collected by the Council but she would discuss the request with Health Partners and try to provide a response back to the Commission.

Resolved that:

1)    Tandra Forster would confirm the percentage of agency staff versus permanent staff used within Council owned care homes.

2)    Tandra Forster would discuss the availability for readmission statistics with Health Partners and report her findings to the Commission.

The item would be removed from the Commission’s work Programme