Blackburn with Darwen Borough is experiencing significant changes in the population structure over the coming 20 years with increasing complexity of care needs impacted by deprivation and the number of people over 90 almost doubling, writes Steve Tingle. Financially the picture isn’t any brighter. We’ve done some work across Pennine Lancashire and the combined gap across health and social care in the next five years is in the tens of millions… 

WITH INCREASING DEMAND, more people becoming dependent earlier on in their lives, much more complexity of need in the people who come forward for support, and cases which take a lot longer for social workers to organise than five years ago, coupled with significantly less money, we knew we had to do things differently.

One of the main constraints of traditional provision is the intrusive nature of care delivery, particularly in the form of many people being chaperoned 24 /7. If you live in your own home as an older person with social care needs, it can mean a dozen or so different people across your doorstep over a period of time. 

Institutional based models of care can be particularly intrusive and generic, not person centred or flexible and revolve around the needs of the service and not the person. It is also a costly model, with packages from £450 to £3000 per week. 

Cultural issues around traditional care and support are also a challenge in terms of risk aversion and a prevailing belief that “more care is better care”, meaning that some people, through the best of intentions, get more help than they might actually want or need.

Why we had to make a change…

For us, what prompted us to think differently was the fantastic piece of policy making that was Putting People First followed by Think Local Act Personal. It brought with it an emphasis on prevention and in particular on telecare and Reablement.

So our starting point was not just to look at the financial necessity but also the desirability of keeping people out of care institutions. Managing needs in the community was preferable. Using evidence from North Yorkshire we began our journey to telecare and have gone from strength to strength – as this previous blog explains.

The perception we had to overcome was a belief that telecare replaces human contact, but that is not so, and we get more positive user feedback for this service than any other. It wasn’t so much about savings originally, but how to improve services and outcomes. The issue for me comes back to improving outcomes for people and making care and support more empowering so that they have control over their own lives and the environment in which they live.

So we contracted a new development - Moorgate Mill, which was officially opened on July 7 2015 and consists of 20 apartments adapted to meet the needs of adults with complex needs including physical and sensory, learning disabilities, and some with behaviour that challenges. The innovative complex has been fitted with cutting-edge adaptive technology including telecare sensors, telehealth systems and access control, so that tenants can benefit from state-of-the-art care solutions to support them now and in the future.

Everyone has a personal budget that is split 3 ways:

  •          First element is common background support for everyone. Staff are there 24/7 in the background and can be called on when needed.
  •          Second is the personal care package – individual one to one personal care tailored to individual needs and based on a support plan.
  •          Third element is for the advanced assistive technology.

The outcomes for residents and the council

This great blog by Liz Crook explains some of the fantastic outcomes residents have faced, and I was lucky enough to be at the launch party for Moorgate Mill and the smiles on people’s faces was the greatest memory I took away.

 

Moorgate Mill is an exciting mix of care, accommodation and technology designed to create an environment that supports independence and is more cost effective than traditional provision. Not only empowering, the financial benefits of the concept will, it is envisaged, over time allow us to save around 20% on care and support costs.

We are still developing our ideas for the future and looking at the mix of proactive preventative services, coupled with empowering and re-abling for those with greater need. We have increased the use of complex telecare packages several fold over the last nine months as part of a change program, and which shows that complexity of need is growing all the time. We are looking to do more in mental health with technology and we are exploring better options for dementia care with advanced technology as part of our new purpose built extra care facilities.

The traditional approach of supported living with three-to-four people living together is no longer the best approach and its financial viability is in serious question given local government cutbacks. Moreover, people in small group homes often have little or no choice with whom they live, whereas Moorgate Mill allows a better balance of individual living with the choice to have communal living when tenants want.

Moorgate Mill has proven not only that it is a more financially viable model but the residents absolutely love it. We are planning similar schemes for young adults with autism and as part of the likely outcome of a review of the 32 existing supported living schemes in Blackburn with Darwen, where some properties may well no longer be fit for purpose in the medium to long term 

We are absolutely focused on helping transform the care for people with complex needs and believe ever developing technology solutions are helping us deliver on our goals of choice, control and increased independence.

New draft guidelines to help transform the care of people with learning disabilities 

See other ADASS Better Care Technology blogs:

* Tony Zaman, London Borough of Hillingdon

* Linda Sanders, ADASS telecare lead and Wolverhampton

Steve Tingle is Director of Adult Services, Blackburn with Darwen Borough Council