An update on progress made since a local system review of health and social care was carried out in York in November 2017. The original review looked specifically at how older people move through the health and social care system, with a focus on how hospitals, community health services, GP practices, care homes and homecare agencies work together. The progress review, carried out in November 2018 found some improvements in services for older people in York. This report identifies progress and impact made against key areas for improvement across the following themes: governance and alignment with the STP; relationships; joint commissioning; managing social care capacity; communicating with people who use services; the high-impact change model and multi-disciplinary working; medicines management; continuing healthcare; and digital interoperability. It found improved relationships between system leaders, with evidence of stronger partnership working at operational level, a focus on implementing high impact changes for managing transfers of care, and increased evidence of disciplinary working around individual people’s needs. The review found that engagement with independent care providers had also improved.
(Edited publisher abstract)
An update on progress made since a local system review of health and social care was carried out in York in November 2017. The original review looked specifically at how older people move through the health and social care system, with a focus on how hospitals, community health services, GP practices, care homes and homecare agencies work together. The progress review, carried out in November 2018 found some improvements in services for older people in York. This report identifies progress and impact made against key areas for improvement across the following themes: governance and alignment with the STP; relationships; joint commissioning; managing social care capacity; communicating with people who use services; the high-impact change model and multi-disciplinary working; medicines management; continuing healthcare; and digital interoperability. It found improved relationships between system leaders, with evidence of stronger partnership working at operational level, a focus on implementing high impact changes for managing transfers of care, and increased evidence of disciplinary working around individual people’s needs. The review found that engagement with independent care providers had also improved.
(Edited publisher abstract)
Subject terms:
older people, integrated care, hospital discharge, leadership, multidisciplinary teams;
An update on progress made in Oxfordshire since a local system review of health and social care was carried out in November 2017. The original review looked specifically at how older people move through the health and social care system, with a focus on how hospitals, community health services, GP practices, care homes and homecare agencies work together. This report identifies progress against Oxfordshire’s action plan, grouped into the following themes: strategic approach to meeting the needs of older people; culture and collaboration; winter planning; market shaping; workforce; review of pathways, points of access and services; housing– equipment and adaptations; carers; and people who fund their own care. It found that, since the initial review: system leaders had made progress to reset the culture of their organisations and develop relationships; there were examples cross-system relationships had improved outcomes for people, for example in reduction in the numbers of people who remained in hospital unnecessarily; and evidence of improved winter planning. The progress report also identifies areas requiring continued improvement, which include greater involvement of the voluntary sector, development of advice and brokerage services for self-funders, and development of the ‘discharge to assess model’.
(Edited publisher abstract)
An update on progress made in Oxfordshire since a local system review of health and social care was carried out in November 2017. The original review looked specifically at how older people move through the health and social care system, with a focus on how hospitals, community health services, GP practices, care homes and homecare agencies work together. This report identifies progress against Oxfordshire’s action plan, grouped into the following themes: strategic approach to meeting the needs of older people; culture and collaboration; winter planning; market shaping; workforce; review of pathways, points of access and services; housing– equipment and adaptations; carers; and people who fund their own care. It found that, since the initial review: system leaders had made progress to reset the culture of their organisations and develop relationships; there were examples cross-system relationships had improved outcomes for people, for example in reduction in the numbers of people who remained in hospital unnecessarily; and evidence of improved winter planning. The progress report also identifies areas requiring continued improvement, which include greater involvement of the voluntary sector, development of advice and brokerage services for self-funders, and development of the ‘discharge to assess model’.
(Edited publisher abstract)
Subject terms:
older people, integrated care, interagency cooperation, hospital discharge, leadership, planning;
...areas for improvement; leadership and governance; strategy and commissioning; information and data sharing; performance and outcomes; workforce; service improvement. Improvements identified included: improved relationships, more effective communication, and a shared across the system; improvements in the quality of care in the independent social care market and how commissioners worked with providers
(Edited publisher abstract)
Updates on progress made in Stoke-on-Trent following on local system review in September 2017. The review focused on how older people move between health and social care services, including delayed transfers of care. This progress report shows there has been significant improvement in the health social care system for older people living in Stoke-on-Trent. The report outlines progress against six areas for improvement; leadership and governance; strategy and commissioning; information and data sharing; performance and outcomes; workforce; service improvement. Improvements identified included: improved relationships, more effective communication, and a shared across the system; improvements in the quality of care in the independent social care market and how commissioners worked with providers; and evidence of improved joint planning in relation to winter 2018/19. Suggestions of areas for further improvement included better involvement of the voluntary, community and social enterprise (VCSE) sector in health and social care and better information and data sharing across health and social care organisations.
(Edited publisher abstract)
Subject terms:
older people, integrated care, hospital discharge, leadership, communication, local authorities;
Findings from a review of the way approved mental health professionals (AMHP) services are being delivered across the country. The review identified the main factors that support the effective delivery of AMHP services, including: leadership – most AMHPs described good peer support, supervision and training arrangements; recognising the value of the AMHP role – across most services, AMHPs felt
(Edited publisher abstract)
Findings from a review of the way approved mental health professionals (AMHP) services are being delivered across the country. The review identified the main factors that support the effective delivery of AMHP services, including: leadership – most AMHPs described good peer support, supervision and training arrangements; recognising the value of the AMHP role – across most services, AMHPs felt that their skills, expertise and knowledge base were recognised in their local area teams; innovation and partnership – AMHPs reported that reduced access to partner agencies could create delays when organising assessments; and crisis and prevention – AMHPs shared positive examples of how improved access to crisis services helped them deliver least restrictive alternatives for patients. The review also examined the challenges and barriers to the AMHP role, focusing on: acute care system capacity – AMHPs reported that a national reduction in beds affected their ability to complete assessments in a timely manner; workforce: AMHPs talked about an inability to recruit and retain AMHPs; variation in health and social care integration – integration of services varied across areas and services; and mental health commissioning – AMHPs recognised the importance of good, integrated, local commissioning arrangements to their role.
(Edited publisher abstract)
Subject terms:
professional role, approved mental health professionals, mental health services, health professionals, leadership, joint working, mental health law;
Interim report summarising key findings from six local system reviews, carried out to examine how health and adult social care work together. The report looks at the planning, commissioning and delivery of health and social care services across the areas of: system leadership; maintaining the wellbeing of a person in their usual place of residence; care and support when people experience a crisis
(Edited publisher abstract)
Interim report summarising key findings from six local system reviews, carried out to examine how health and adult social care work together. The report looks at the planning, commissioning and delivery of health and social care services across the areas of: system leadership; maintaining the wellbeing of a person in their usual place of residence; care and support when people experience a crisis; and step down services, return to usual place of residence and/or admission to new place of residence. Based on the first six reviews, the findings show a strong commitment from organisations and staff working across health and social care services to provide seamless services for older people needing care and support. However there are still too many examples where care is fragmented and people are often uncertain about who is coordinating their care. The report identifies three themes that could act as a barrier to integration: how providers and commissioners work together; capacity, market supply and workforce issues; and, the need to look beyond delayed transfers of care in isolation to resolve the problems that local systems are facing. It also highlights areas for priority action and emerging themes that should be address at a national level.
(Edited publisher abstract)
Subject terms:
adult social care, older people, health care, integrated care, leadership, prevention, delayed discharge;
One of 20 targeted local system reviews looking specifically at how older people move through the health and social care system, with a focus on how services work together. The review looks at how hospitals, community health services, GP practices, care homes and homecare agencies work together and whether services are safe, effective, caring, responsive and well led. The review found that older people living in Stoke-on-Trent sometimes have poor experiences of care and do not always have access to the right care, in the right place at the right time because the health and social care system, led by Stoke-on-Trent City Council and Stoke-on-Trent Clinical Commissioning Group, is not working in a joined up way that is meeting their needs. The reviewers found that organisations and individuals designing and delivering services in Stoke-on-Trent were not working to an agreed, shared vision and that there was a lack of whole system strategic planning and commissioning with little collaboration. This resulted in people finding it difficult to access GP appointments, older people being delayed in hospital, and needs and care packages in the community not being reviewed as regularly as they should be. The review also identifies areas for improvement.
(Edited publisher abstract)
One of 20 targeted local system reviews looking specifically at how older people move through the health and social care system, with a focus on how services work together. The review looks at how hospitals, community health services, GP practices, care homes and homecare agencies work together and whether services are safe, effective, caring, responsive and well led. The review found that older people living in Stoke-on-Trent sometimes have poor experiences of care and do not always have access to the right care, in the right place at the right time because the health and social care system, led by Stoke-on-Trent City Council and Stoke-on-Trent Clinical Commissioning Group, is not working in a joined up way that is meeting their needs. The reviewers found that organisations and individuals designing and delivering services in Stoke-on-Trent were not working to an agreed, shared vision and that there was a lack of whole system strategic planning and commissioning with little collaboration. This resulted in people finding it difficult to access GP appointments, older people being delayed in hospital, and needs and care packages in the community not being reviewed as regularly as they should be. The review also identifies areas for improvement.
(Edited publisher abstract)
Subject terms:
older people, integrated care, health care, social care provision, local authorities, interagency cooperation, leadership;
One of 20 targeted reviews of local authority areas looking specifically at how older people move through the health and social care system, with a focus on how services work together. The review look at how hospitals, community health services, GP practices, care homes and homecare agencies work together and whether services are safe, effective, caring, responsive and well led. The review found that there was a strong commitment and a shared vision across local health and social care partners, including Hartlepool Borough Council and NHS Hartlepool and Stockton-on-Tees Clinical Commissioning Group, to serve the people of Hartlepool well. There was effective involvement of people using services, their families and carers. Local priorities were focused on keeping people well in their normal place of residence by providing them with preventive services and support. Some of the key findings of the review were: a multidisciplinary, integrated approach to delivering a number of services including the single point of access improved people’s experiences; an active voluntary, community and social enterprise (VCSE) that played a positive role in supporting older people to remain at home and to be socially included; good access to direct payments for older people; good support placed at ‘front of house’ in A&E to prevent avoidable admissions; and use of an integrated discharge team had a positive impact on preventing people staying hospital longer than necessary. The review also identifies areas for improvement.
(Edited publisher abstract)
One of 20 targeted reviews of local authority areas looking specifically at how older people move through the health and social care system, with a focus on how services work together. The review look at how hospitals, community health services, GP practices, care homes and homecare agencies work together and whether services are safe, effective, caring, responsive and well led. The review found that there was a strong commitment and a shared vision across local health and social care partners, including Hartlepool Borough Council and NHS Hartlepool and Stockton-on-Tees Clinical Commissioning Group, to serve the people of Hartlepool well. There was effective involvement of people using services, their families and carers. Local priorities were focused on keeping people well in their normal place of residence by providing them with preventive services and support. Some of the key findings of the review were: a multidisciplinary, integrated approach to delivering a number of services including the single point of access improved people’s experiences; an active voluntary, community and social enterprise (VCSE) that played a positive role in supporting older people to remain at home and to be socially included; good access to direct payments for older people; good support placed at ‘front of house’ in A&E to prevent avoidable admissions; and use of an integrated discharge team had a positive impact on preventing people staying hospital longer than necessary. The review also identifies areas for improvement.
(Edited publisher abstract)
Subject terms:
local authorities, health care, social care provision, integrated care, interagency cooperation, leadership;
...and social care system in Bracknell Forest was working effectively and using an integrated approach that was having positive outcomes for older people. Most older people were receiving good quality health and social care services in a timely way. Reviewers found evidence of strong strategic leadership between Bracknell Forest Council, Bracknell and Ascot Clinical Commissioning Group and providers
(Edited publisher abstract)
One of 20 targeted local system reviews looking at how older people move through the health and social care system, with a focus on how services work together. The review consideres how hospitals, community health services, GP practices, care homes and homecare agencies work together and whether services are safe, effective, caring, responsive and well led. The review found that the health and social care system in Bracknell Forest was working effectively and using an integrated approach that was having positive outcomes for older people. Most older people were receiving good quality health and social care services in a timely way. Reviewers found evidence of strong strategic leadership between Bracknell Forest Council, Bracknell and Ascot Clinical Commissioning Group and providers, with a well-established, collaborative approach to designing and delivering services. Bracknell Forest service priorities included helping older people avoid unnecessary admissions to hospital, offering older people support to stay well, and improving the capacity of homecare agencies and care homes to manage the recruitment challenges. As a result, there had been reductions the numbers of people remaining in hospital while they waited for their ongoing care to be arranged. Performance had improved and was better than comparator and national averages. The review also identifies areas for improvement.
(Edited publisher abstract)
Subject terms:
integrated care, older people, health care, social care provision, interagency cooperation, leadership, local authorities;
...and documentation of DoLS procedures, and good leadership in place to provide a focus to staff understanding of DoLS and how to apply it. There is variation in the effective application of DoLS both between providers and within individual providers across the different core services that were inspected. This could lead to individuals not receiving care that is in their best interests. The report finds
(Edited publisher abstract)
Assesses current practice in the use of Deprivation of Liberty Safeguards in health and social care in England. DoLS provide a legal process to ensure that, where it is necessary to deprive a person of their liberty, it occurs in the person’s best interests. The DoLS ensure that people who lack capacity and are deprived of their liberty have a representative voice, access to advocates and the chance to challenge whether their liberty should be deprived. Drawing on the findings from CQC inspections, the report highlights examples of good practice in all sectors, including individual providers who have improved after the CQC had taken enforcement action. Providers who applied the Deprivation of Liberty Safeguards (DoLS) well had a culture of person-centred care, robust policies and documentation of DoLS procedures, and good leadership in place to provide a focus to staff understanding of DoLS and how to apply it. There is variation in the effective application of DoLS both between providers and within individual providers across the different core services that were inspected. This could lead to individuals not receiving care that is in their best interests. The report finds that not enough providers are applying capacity assessments effectively, with many providers making assumptions that individuals lacked capacity without having carried out or documented assessments. Some providers used the ‘blanket approach’ to capacity assessments, which suggests that their focus may be more on managing organisational risk than delivering person-centred care. The report also suggests that lack of staff training remains a problem. Although many staff showed good understanding of the DoLS and wider Mental Capacity Act 2005, there were many other services where training and staff understanding were not good enough.
(Edited publisher abstract)
Subject terms:
Deprivation of Liberty Safeguards, Mental Capacity Act 2005, good practice, person-centred care, leadership, mental capacity;
Designed to help Care Quality Commission’s inspectors rate residential adult social care services, these characteristics set out what safe, effective, caring and well-led care looks like. A description of the characteristics is provided for each rating level, including good, outstanding, requires improvement and inadequate.
(Edited publisher abstract)
Designed to help Care Quality Commission’s inspectors rate residential adult social care services, these characteristics set out what safe, effective, caring and well-led care looks like. A description of the characteristics is provided for each rating level, including good, outstanding, requires improvement and inadequate.
(Edited publisher abstract)
Subject terms:
residential care, adult social care, inspection, regulation, safety, evaluation, leadership;