Redesigning Overnight Care: Enhancing Quality through Technology
Experience-based redesign of overnight care services, focusing on assessment, monitoring, and implementing change to meet individual needs. Use of technology-enabled care like Canary and I.Care for efficient service delivery and improving outcomes for adults. Analysis and adjustments made following reviews to ensure better support provision.
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Redesigning Overnight Care Based on the experience of a Review Officer. By Scott Maurice Hurnauth
In 2016 review of over night activity undertaken. 21 adults have Overnight care in clacks. 2 share a house (Alloa) 2 share a house (HMO) 7 supported living (1 Vacancy) 7 reside in own tenancies. 3 core and cluster Review of each adult undertaken. Outcome focussed assessment complete. Monitoring visits for each adult/service provision.
Implementing change Implement Change Evaluation Meet adult/family/ provider for Assessment of need. Telecare assessment Redesign of Package of Care Monitor overnight activity. Home visit and regular contact. Be responsive to change. What impact has this had on adults using service. Lessons learned? Discuss with providers, families, adults, professionals. Agree timescale for change and phase out. Assessment Monitoring/Review
Technology Enabled Care Meet with Telecare Assessor and Discuss requirements Undertaken joint assessments, bring out equipment to show family/adult/provider. By doing this able to resolve any concerns. Implement Technology Enabled Care eg; Just Checking, Canary, I Care, door contacts, smoke, gas, bed monitors, epilepsy monitor. Arrange for home fire safety visit to take place.
Range of Technology Utilised Canary System -Hub, movement sensors and visitors card. -Records light level and temperature. -Charts easy to read and in colour. -Motion sensors and activity sensors -Chart information is well presented. I Care -Sim card, no land line required -Motion sensors and activity sensors -Chart information is complex, gives a lot of detail, through different steps. -MECS alarm with add on Tynetec equipment.
Review Activity After review of Just Checking, Canary and I Care I was able to determine that individuals had on the whole a settled night, indicating some movement however no associated risks identified. Technology in place reviewed and it was found that some technology was working well and some needing to be replaced with alternative. -Epilepsy Monitor too sensitive for adult, replace with Bed Monitor.
Outcome of Reviews 3 adults supported in core and cluster, assessment complete (No sleepover required) 2 share a house and not assessed as required. 1 adult out of area moved to Supported Living. 1 adult in own tenancy no assessed need. All other adults utilising sleepover/nightshift had an assessed need. This continues to meet individuals needs. Gather information and implement Just Checking/Canary/I Care for Technology Enable Care provision.
Redesigning Support Packages Assessment complete for each adult. Existing care reviewed and discussion on best use of individual Self Directed Support Budget. Package of care for each adult has changed to reflect their needs and desired outcomes. Review changes ensuring support remains appropriate. I have care managed adults during this period and afterwards.
Implementing Change Partners Manager discuss outcomes and actions. Contracts and Commissioning to determine contractual compliance. Community Learning Disability Team Providers Discuss overnight care and outcome of assessment. Agree on implementation & timescales for change. Family/Adult Meet at home to discuss overnight support. Introduction of Telecare equipment, Just Checking
Timescales Ongoing monitoring of telecare equipment. Regular home visits, communication. Be responsive to change, any issues that arise during this process, respond to needs. Reduced overnight care over a 4 week period Gradual Reduction and ongoing monitoring. New package of care and technology in place and continue with monitoring.
Over view of activity Good conversations with Adult, Family and Provider -All adults reviewed and assessment complete and agreed. -Monitoring visits undertaken at different times in the day. Some of these visits planned, some unannounced. -Find out what alternative support is available. -Telecare Assessment. Use of Just Checking, Canary to determine activity overnight. -Technology Enabled Care, review existing provision and look at other technology available. Evidence based practice, assessment information, case notes, overnight check sheets, Agree period for phasing in new support and reducing overnight support Inform manager of change and provide new care plan Feedback on outcomes and agree on new support plans
Evaluation Assessment and range of tools to provide outcome focussed assessment. Individual needs being met. Implement change and work with team to achieve this. Care management response to changing needs.
Providing a Quality Service National Health and Wellbeing Outcomes.
Outcome 2: People, including those with disabilities or long term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community Adult Outcomes Live where I want Have support when I need it. Access support when I need it. Package of care and use of Technology Enabled Care to meet outcome Care Outcome focussed assessment. Management, respond to change and review.
Outcome 9. Resources are used effectively and efficiently in the provision of health and social care services Outcome Adult choice increased. SDS budget utilised to full potential. Working within existing adult SDS budget, adult leads in what provision/service is required. Individual has greater choice and maximises independence. Outcome focussed assessment.
Summary of Overnight Reviews Reduction of Sleepover for 3 in core and cluster was 39.836.16 annual Saving. (rate increase 44,611.84) 1 overnight and POC redesign Direct Payment 21,793.20 1 Adult moved into vacancy in Supported Living. 25,566.36 Total - 87,195.72 To be achieved 25,509 To be achieved 24,537.24 21 adults have sleepovers in clacks. 2 share a house 2 share a house 7 supported living 7 reside in own tenancies. 3 core and cluster
Sharing Experiences Assessment Realising Change -Identify adults utilising Over Night care. -Care Management- all adults utilising Over Night care need Outcome focussed assessment complete. -Evaluate outcome of assessment Implementing Meet with wider team and discuss outcome of assessment, Contracts/Commissioning, Telecare assessor, adults, families, provider. Utilise Technology Enabled Care for further assessment. Review Agree on timescale for implementing change. Continue care management role to ensure any change in need is met. Review Technology Enabled Care to ensure this remains appropriate. Monitoring overnight activity using Records of contact, Telecare Assessment. Install Technology/Peripherals.
