Ruth Lake, Director of Adult Social Care, Leicester City Council. Ruth's slide from the presentation at the East Midlands #7dayservices event on 12th June 2014.

1. Ruth Lake
Director of Adult Social Care and Safeguarding
Leicester City Council

2.  To share a view
 To explore 2 initiatives
 To consider future opportunities though the
integration agenda

3.  Closely linked to the sub-region though NHS
provider trust arrangements
 A challenged health and social care economy
 Long history of joint work on acute care
agenda – focus on ‘flow’
 Low social care delays from acute settings
 Lots and lots of actions; no sustained
improvements

4. Integrated Crisis Response Service (ICRS)
 Social care and health services providing
24/7 rapid response to crisis
 2 hours response time
 Cases held up to 72 hrs
 Hand over if ongoing need
 Virtual integration social care provider staff,
community health services including OPMH,
AT, handypersons, community alarms
 Focus on community cases, A&E diversion

5.  Provider –led initiative
 Developed in response to operational
challenges
 Addresses service gap noted by users / carers
and professionals
 10pm to 7am gap; weekend ‘assessment
capacity’ gap
 Coordinated provider-led bids for funding
 Use of reablement monies initially
 Future funding via BCF / health transfers to
LA

6.  Operational since November 2012
 2 813 referrals – majority seen within 1 hour
 Main referrals source community alarms
(80%) with others spread across acute,
community health, primary care, EDT
 Top 3 issues:
◦ Falls
◦ Personal care
◦ Inability to transfer

7.  470 packages provided during the72 hour
period
 26% requiring no further services
 36% referred into reablement
 24% requiring maintenance package (at same
or higher level)

8.  Routine follow up by DN
 Medication review
 Falls assessment
 Community equipment
 OPMH involvement

9.  Very high levels of satisfaction
 Falls – evident reduction in ambulance call
outs and reduced conveyances
 Resultant comprehensive assessment has
preventative benefit - independence
 Ability to respond to 7 day services agenda
 Route for hospital diversion that didn’t
previously exist
 Reduced duplication and improved flow
 Systems savings

10. ‘Super weekends’
 Proof of concept event
 Whole system step up to business as usual on
Saturday and Sunday
 2 weekends in January 2014
 Sponsored by the Urgent Care Board to test a
theory on reducing acute pressures

11.  Well-established additional working days to
support peak / holiday periods
 Existing provider led response (ICRS /
Reablement) for simple discharges
 Social worker assessment capacity usually
limited
 Input of small care management team on
super weekend dates
 Full duties – new referrals, action on existing
discharge notifications

12.  The whole system did step up
 Busy 1st weekend with work that could be
progressed
 Focus on known discharge cases rather than
newly referred
 Flushed out gaps – pharmacy, equipment,
independent sector preparedness, knowing
what is available
 If one part is missing, overall impact is lost
 Maintaining Saturday working

13.  ICRS a keystone in Better Care Fund plans
 Links to new primary care Clinical Response
Service
 Good early outcomes
 BCF to build ICRS and assessment capacity to
support acute to community shift and 7 day
services