Agenda item

Consideration was given to a report presented by Dominic Blaydon in relation to the Strategic Review of Intermediate Care Services. 

It was proposed that Day Care, Community Rehabilitation and Residential Teams be merged and co-located.  A new multi-disciplinary health and social care team would be set up to support service users through the intermediate care pathway.  The service would adopt the Common Assessment Framework and deliver integrated health and social care plans.

Millennium would become a dedicated hub for intermediate care services in Rotherham providing day rehabilitation, a Single Point of Access and a focal point for all service delivery.  There were significant benefits to this service model.  It would establish a clear service identity with a range of services being delivered from the same site.  Co-location of staff would facilitate effective communication and peer support.  Greater integration would improve efficiency and help develop a person centred approach to rehabilitation.

The Strategic Review recommended that a programme of refurbishment was carried out on Millennium to make it fit for purpose and proposed that capital grant was transferred from the NHS Rotherham Operational Plan to Rotherham MBC to pay for the necessary works.

It was proposed that Rothwel Grange was decommissioned as an intermediate care facility and that a new residential unit be developed at one of the new local authority residential units.  The plan was to convert one wing of 15 beds into intermediate care provision by December 2009.  This was dependent on vacancies becoming available during this timeframe.  Vacancies were being held at present, and used for respite provision in order to maintain bed occupancy.

The new-build homes were fully compliant with National Care Standards and the Disability Discrimination Act.  Bedroom sizes were spacious, en-suite facilities were provided, doorways and corridors had been widened for the use of disability and bariatric equipment. There was also ramped access to the building.

It was proposed that Fast Response beds were decommissioned and that the savings made were reinvested to improve performance, outcomes and quality elsewhere in the service. There were a number of reasons why it was appropriate to decommission the service:

The unit cost per patient was prohibitive.

There was capacity in the intermediate care residential units to fill the gap left by loss of beds

The intermediate care residential units could meet the needs of people referred into the service

Reducing bed capacity would help improve performance on bed occupancy across the service

Decommissioning would release savings that could be reinvested

It is proposed that the maintenance service was reconfigured so that it delivered time-limited rehabilitation and community integration programmes. The service would continue to provide day care services to current service users for up to 6 months. There were also 4 service users who originally attended the Crinoline House day centre in 1998.  Upon closure of this centre, Elected Members promised that anyone who still wanted to attend in a social care capacity would be allowed to do so. Commissioners were fully supportive of honouring this agreement. 

            The new service would deliver time limited community integration and rehabilitation programmes, which focussed on; improving physical function, training and support on healthy lifestyle, development of mental well-being, reducing social isolation, condition management  and maintaining independence 

It was proposed that the intermediate care team was enhanced so that it could deliver a broader range of health services. The service would introduce nurse practitioners, speech and language therapy and health support workers to support the residential service and those working in the community. The health support workers would deliver low level nursing and rehabilitation support.

It was felt that there needed to be more linkage between the community and hospitals and district nurses as communication was found to be weak.

Resolved:- That the recommendations set out in the Strategic Review and the positive impact this would have on service user outcomes and performance be supported.