Purpose

To ask Cabinet for approval of preferred
option for the future spend of Better Care Fund monies in this
service area.

Content

That Cabinet:

 

1)   
Approves the delivery of the Urgent Care at Home and Telecare
Response Service to Wiltshire Council in-house services from the 1
August 2024 at an annual cost of £1.665m, to be funded from
the Better Care Fund.
 

2)   
Delegates to the Director Adult Social Care in consultation with
the Cabinet Member for Adult Social Care, SEND and Inclusion to
finalise operational matters to ensure a safe transfer of the
services. This will include the TUPE transfer of eligible staff and
the purchase of the necessary resources such as uniforms, laptops,
phones, equipment for service deliver and the use of fleet
vehicles.
 
Reason

The transfer of the services from Medvivo to the Council was due to take place 1 May
2025, however accelerating this to nine (9) months earlier than
expected has required the Council to act quickly to ensure
vulnerable people are not left without support. The three (3) month
extension period has been agreed to allow for staff eligible for
TUPE transfer(s) to be identified, alongside putting other
operational requirements in place.
 
The service in
scope consists of:
 

Urgent Care at Home; when a situation is moving into crisis, it can
often be stabilised with some domiciliary support. Through the
timely provision of experienced carers who can respond to
presenting issues, risks can be managed to safeguard the situation.
An example would be a carer who helps and supports a partner with
dementia being admitted unexpectedly to hospital. Urgent Care could
provide 24 hour support to look after
the person at home until their partner returned home or alterative
arrangements were made. Telecare Response; Wiltshire Council
commissions a telecare call response service with Apello. When a personal alarm is triggered, for
example because of a fall, Apello call
the person and find out how to best support them through a
conversation on the phone system. The telecare response service can
provide a physical response in the form of a community visit when
it is deemed safe and appropriate to do so, for example when an
alarm has been triggered and the person cannot be contacted. In
some circumstances it is not appropriate to use this service, for
example when the risks require a medical emergency response.

 

The telecare triage service at Apello
carefully manage these risks to ensure they are referring onto the
most appropriate service.

 

Bringing the service in-house was the preferred option (to start 1
May 2025) but the inability of the parties to agree terms for a
further twelve (12) month extension has forced an earlier
timetable.

 

We are confident that the service can be delivered through the
Council’s Wiltshire Support at Home (WSAH) Service. WSAH is
currently commissioned to provide a domiciliary support service
working with Homefirst and Reablement
to support hospital discharges. This expansion will support the
Urgent Care Response Service (UCR) - the Wiltshire Health and Care
Service commissioned to provide clinical response within 2 hours.
Wiltshire Support at Home urgent support service will work with
Wiltshire Health and Care and  provide complimentary wrap around support to
stabilise crisis and prevent hospital admission. This service will
be short term and is commissioned for up to 72 hours. WSAH will
also be able to return to supporting Carer breakdown as this
funding was removed in March 2024. Wiltshire Support at Home is an
in-house service part of the established Reablement Therapy and
Community Service it supports health and social care across
Wiltshire, operating 7 days a week 7am-10pm. There is a structured
registered provider in place and this
can be expanded, and the existing staff group utilised within the
service to provide a seamless transfer of services. We have a
service with trained staff already providing an urgent response to
crisis situations and there is experienced and skilled leadership
and management who can support this transfer.

 

This decision was published on 18 June 2024 and will come into
effect on 26 June 2024.