Presentation on
Services for Older People Dublin North East by
RoisĂn Maguire, Area Specialist, Services for Older People on
Monday, 24th June, 2013
Strategic Policy of Department of Health & Children & Health Service Executive
“To maintain older people in their own home for as long as possible and where this is not possible, to provide high quality residential care, appropriate intermediate step up / step down and respite beds�.
Population of Older Persons DNE
DNC
17,092
DNW
18,239
DN
28,087
CM
16,677
Meath
17,218
Louth
14,008
2013 Total 111,321
Regional Priorities as per Dublin North East 2013 Service Plan
Clinical Care Programmes
Service Model - Work with the clinical programmes and consultant geriatricians to develop a geriatric service model. Continue to participate in the Frail Elderly Project in 2013 in relation to Home Care Packages, Rehabilitation, Transitional Care, Re-ablement packages and development of integrated case management pending confirmation of 2013 funding. Continue to engage in a pilot project with the Special Delivery Unit to examine the provision of additional hospital egress options including additional intermediate care beds. Frail Elderly Project DNE -funding received, targeted at acute hospital discharges and utilized for HCPs, transition care beds and rehab beds. Additional consultant posts are due to be funded Q4 2013. Community and Hospitals working together to facilitate discharges on an integrated case management basis
Regional Priorities as per Dublin North East 2013 Service Plan
Primary Care Teams PCT – Continue the development of links with the primary care service to ensure optimal use of available resources particularly in relation to HCP Reviews. Implement Recommendations from National Primary Care /Services for Older People Audit when available
Regional Priorities as per Dublin North East 2013 Service Plan
Residential Care Provide an agreed level of public long stay residential beds for 2013 Continue to progress the re-alignment of Skill Mix in Public Long Stay Units to ensure appropriate staffing is provided to meet needs of residents while also reducing 2012 Cost of Care and increasing efficiencies. Reconfiguration of Public Residential Facilities Agree a reconfiguration plan for public long stay facilities as a result of the output from the National and Regional Viability Plans and have an implementation plan in place for 2013 – 2014 Review and determine short term bed requirements for rehabilitation (12 months)/respite, short stay, step up/step down and assessment beds.
Provide high quality residential care for older persons who cannot live at home
ď Ž 2012 Viability Report for Dublin North East submitted December to the Department of Health ď Ž January 2013 request to develop Viability Action Plans re the proposed development of Residential Infrastructure against 4% national norm for Long Term Residential Care and a 20:80 public to private rate of provision -submitted June 2013-await response
Provide high quality residential care for older persons who cannot live at home
Residential Capacity DNE -Viability Report 2013 DNE Public Bed Capacity – 967(NHSS) DNE Private Bed Capacity – 4306 DNE Total Residential Beds - 5273
Public Bed Provision DNE – Bed Types DNE Total Number of Long Term Care Beds – 967 DNE Total Number of Other Type Beds (assessment, rehab, respite) – 123 DNE Total Number of Residential Beds – 1090
2013
Long Term Care
Other Bed Types
Total Residential Care
DNC
85
20
105
DNW
216
55
271
DN
187
7
194
Louth
177
8
185
Meath
92
2
94
CM
210
31
241
Access to Long Term Care-Fair Deal Process • • • • • • • • •
Fair Deal Application completed CSAR –clinical assessment –need/ dependency Financial Assessment Submission to Local Placement Forum –consideration & decision by multi-disciplinary group National Chronological Waiting List Place approved Finance assigned Client choice Resident moves to unit
Long Term Residential Care-Norm Requirements – 4%
Pop 2013
4%
Public 20%
Private 80%
NHSS
Surplus/ Deficit
ISA
DNC
17092
684
137
547
85
-52
DNW
18239
730
146
584
216
70
18
DN
28087
1123
225
898
187
-38
-38
CM
16677
667
133
534
210
77
77
Meath
17218
689
138
551
92
-46
19
Louth
14008
560
112
448
177
65
DNE
111321
4453
891
3562
967
76
76
Long Term Residential Care-Norm Requirements – 4%
Pop 2016
4%
Public 20%
Private 80%
NHSS
Surplus/ Deficit
ISA
DNC
22019
881
176
705
154
-22
DNW
24348
974
195
779
188
-7
-29
DN
37376
1495
299
1196
145
-154
-154
CM
22183
887
177
710
170
-7
-7
Meath
23503
940
188
752
92
-96
-121
Louth
18679
747
149
598
124
-25
DNE
148107
5924
1185
4739
873
-312
-312
Home Care -2013 Service Plan Home Care Implement the National Quality Guidelines for Home Care Support Services as per national implementation plan-awaited Home Care Packages Continue the implementation and monitoring of National HCP Guidelines – ongoing Implement reviews of HCP’’s in line with National HCP (ongoing) and Quality Guidelines (awaited) Ensure all new HCP’s are provided through approved providers in 2013 –in place Implement and monitor Service Level Agreements with all approved providers. – ongoing
Home Support Service –continued Home Help Services - Implement the National Home Help Guidelines as per national implementation planawaited Implement regular reviews of home help clients in conjunction with PCT’s to ensure optimal use of available resource –on-going Examine home help delivery model with a view to value for money (VFM) and service improvement. –on-going Discharge initiatives between community and acute services will continue in 2013
Current Provision DNE HH and HCP’s
DNE Total Number of Home Helps Hours 1.66m DNE Total Number of Home Help Clients 3731 DNE Total Number of HCP Clients 8451
Access to Home Support Application for: 1. Home Help 2. Home Care Package -dependent on level of need Complete application Clinical assessment –usually by Public Health Nurse Assessment submitted to Home Support Panel/Co-ordinator Application approved/rejected Approved application –level of service to be provided confirmed Review date given in letter of confirmation Review –takes place –service level revised/maintained. This process continues for the duration of service provision Case closed-hours recycled and reassigned
Elder Abuse Service to increase awareness of elder abuse & respond in a timely manner to allegations of abuse
Regional -Dedicated Officer to: receive reports of abuse Provide awareness and training Senior Case Workers –one in each of the former LHO areas To follow up on cases of alleged abuse in the area.
Statistics Elder Abuse 2012 2012
No. of Referrals
Louth
89
Cavan/ Monaghan
133
Meath
104
North Dublin
78
Dublin North Central
31
Dublin North West
97
Totals
532
Elder Abuse Data for DNE from 2012 PMR
37% male 63% female Alleged abuse categories: Psychological (31%) Financial (23%) Neglect (16%) 150 of 2012 cases remain ongoing
National Falls Prevention & Bone Health Project
Implementation of National Falls Strategy -Joint Initiative Primary Care & Services for Older People Will build on work to date to prevent falls among the older population Focus on prevention-involving multidisciplinary teams in–Primary Care, Acute Hospitals, Residential Care. Regional Implementation Groups to be put in place Q4 – Joint Chairs Primary Care & Services for Older People
Questions?