Schemes/projects:
Introduction
This service directory has developed from the "Putting the Jigsaw Together" directory of schemes. Since the original directory was put together a number of the schemes have ended and new ones developed. "Putting the Jigsaw Together" was a set of four meetings held between December 1998 and March 1999.
The attendees represented health providers, social services commissioners and social services providers at an operational management level.
The meetings aimed to establish a common understanding between those present of the various projects/innovations/developments that were being established across North Lincolnshire in response to a reduction in hospital beds.
The group agreed to provide information on the various schemes for wider dissemination.
Maintaining independence and working within a rehabilitative framework was a constant theme during the deliberations and which now ties in with National policy.
It is intended that this directory will inform both health and social care staff of the initiatives and schemes that have been developed within the respective areas or jointly.
The information was correct in 2000 and is now in the process of being updated.
Karen Fanthorpe, General Manager NLPCT, Disability Service
Peter Lenehan, Assistant Head of Adult Social Care, North Lincolnshire Council
Type of scheme: Local initiative to enable older people with a disability to live relatively independently in the community
Purpose: The scheme involves setting up a care team to enhance existing levels of support. This team will provide support to older people of a higher dependency level so that they can live relatively independently in supported accommodation rather than entering long-term care.
Access: Following assessment by Care Management team.
Resources: April Lodge is in Scunthorpe. It has two specifically adapted bungalows for people with a physical disability and four flats suitable for people with either a learning or physical disability.
Timescale: The scheme is funded from the five-year allocation of money (£125k) transferred from SHHA to NLSSD to support the Strategic Review.
Contact: Linda Millar, Care Co-ordinator, on 01724 841763.
Type of Service: The provision of two additional days, Wednesdays for Older People with Early Onset Dementia, Physical and Age related disabilities and Fridays for Older People with more severe Organic Mental Health problems. The specific aim of the service is to provide social, therapeutic support to help maintain people in there own homes for as long as possible.
Purpose: The provision of a specialised service for people residing on the Isle of Axholme, which will offer respite and support to Carers.
Access: The service can be accessed through the Care Management Team following an assessment with The Lancaster Day Hospital, or an appropriate mental health worker.
Resources: One centre co-ordinator, two days per week and two programme workers, two days per week
Timescale: The scheme was initially funded utilising the Carers Grant Funding for a three year period up to March 2002.
Cost: No cost implication for the service user.
Contact: Carol Powell, centre co-ordinator, Burnham Day Centre 01427 873709.
Type of scheme: Local initiative to promote management of patients at home and reduce demand on hospital beds.
Purpose: This is a project to establish the effectiveness of this change in service delivery. Its objectives are to:
- Ensure patients with COPD are treated in the most appropriate environment
- Ensure effective utilisation of acute medical beds
- Promote patient empowerment to monitor and actively contribute to their condition management through education and rehabilitation
- Create positive link between primary and secondary care teams in the management of COPD
Eligibility: All patients admitted to the medical assessment unit with exacerbations of COPD are eligible for assessment for home management within the confines of a medical and nursing inclusion/exclusion criteria.
Access: Referral is via medical assessment unit by either GP or hospital consultant. Patients involved in the scheme will have an eight-week follow up clinic visit by the Respiratory Physician if needed.
Resources: The team consists of two respiratory nurse specialists and is supported by community nurses.
Medical assessment will be provided on the medical assessment unit. The service will operate Monday – Friday (9am to 5pm) with weekend nursing support for patients on the scheme.
Contact: Andrea Gough, respiratory nurse specialist, telephone 01724 282282 extension 2739; bleep 6578 or 01724 387817
Type of scheme: Emergency telephone with pendant alarm, which, when pressed, will automatically dial through to the control centre which is manned 24 hours a day, 365 days a year.
Purpose: The community alarm can be installed, on request, for either elderly people or those with special needs, in both the public and private sector, within North Lincolnshire Council area. The installation of an alarm can enable some people top remain longer in their own home, and maintain their independence.
Access: Staff within the welfare services section installs the community alarm.
Resources: Grant money has been made available to purchase 55+ community alarms.
Contact: Brumby Resource Centre 01724 297979.
Type of scheme: Joint funded scheme between Social Care and Housing Services - prevention fund monies and rural development fund aimed at reducing the social exclusion and preventing deterioration of the independence of older people by developing a range of community initiatives. Originally centred on Crowle the project now covers all of North Lincolnshire.
Purpose: To develop a range of initiatives that will improve the quality of lives of predominantly older people in North Lincolnshire, such as luncheon clubs, fitting of window and door locks, home maintenance schemes, home gardening schemes, and befriending schemes.
Access: Via self-referral to Scheme Organiser or via referrals made by other agencies to scheme organiser. People are also welcome to contact the scheme direct through the Independent Living Office in Barton 01652 636208.
Resources: Scheme organiser based at an equipped office in Barton with an outreach office in Crowle.
Timescale: Scheme organiser commenced November 1999.
Cost implications to service user: Voluntary charges are made to cover the cost of some fittings of window and door locks, gardening equipment etc.
Contact: Scheme organiser via Barton Office 01652 636208.
Introduction:
The Community Care (Direct Payments) Act 1996 gives local authorities the power to make cash payments for community care direct to individuals who have been assessed as requiring community care services.
Purpose: Direct payments aim to improveme the quality of life of people who would like to manage their own support. They promote independence, and they aid social inclusion by offering opportunities for rehabilitation, education, leisure and employment for people in need of community care.
The local authority makes the payment instead of arranging the services it has assessed the person as needing. The person then uses the payment to secure the relevant services by employing their own staff either employed by them or self employed or using the services of independent providers.
Eligibility criteria:
The scheme is available to new and existing service users over 18 years who need:
- Home care support (including intensive home care)
- Respite care
- Day care
The Act authorises local councils to make direct payments only with the consent of the person concerned. With this consent users take on the responsibilities for buying the services which the payments relate.They must be able to manage the payments (alone or with help)
Access: Access onto the scheme is on request from the service user.
Resources: Penderels Trust has been contracted to provide the support service for scheme users and potential users. It employs a direct payments support worker and direct payments support service administrative assistant based within the North Lincolnshire area.
Timescales: In July 1999 committee approved a permanent scheme following on from the pilot scheme the previous year.
Contact: Support Service - Penderels Trust 01724 860777 at Brumby Resource Centre, East Common Lane, Scunthorpe DN16 1QQ. Contace the reception at Brumby Resource Centre on 01724 297979.
Introduction:
These beds are at The Lilacs Resource Centre in Scunthorpe and Delacy House in Winterton. These are currently four beds set aside - two in each unit for emergency admissions so that assessments can be carried out.
A 14-day period is allowed for a full community care assessment so the needs of the service user can be fully identified, and future management plans considered.
If care is required, a home of choice will be arranged. In the event of no vacancies being available in the aforementioned units, then placement may be made in a preferred provider placement subject to choice and availability.
Access admission criteria:
- The service user must be over 18 and a resident in North Lincolnshire.
- The service users/carer consents and agrees to a referral for an emergency assessment placement.
- It would be unsafe for the individual to be left unsupervised for any period at home.
The assessment process: The focus of the assessment will be on the individual, and if appropriate that of his/her carer. (Undertaken by the care management team).
Specific reasons for the assessment such as confusion, falls, problems at night. These will be recorded by the residential provider and form part of the assessment process and understanding of needs.
Reviews: On completion of the assessment a review will be held and involve all interested parties, for instance service user, carer, relatives who assist with care, residential staff, care management, prior to a care plan being devised. Other providers would only be used if no local authority assessment resource were readily available. The service user will be accommodated in a residential unit (this is not nursing care provision).
Admission(s): Admission would be made to the residential resource, if the main carer(s) were hospitalised, with a treatable illness. Planned hospital admissions of a carer will be accommodated under the normal admission process via care management teams.
Service specification: The specification for this service is as per residential specification – with additional oversight to take into account.
- Establish any unknown factors for the emergency admission.
- Record all relevant information.
- Liase with relatives and Carers, to re-establish individual’s independence.
- Provide support to the individual to promote independence.
Cost - charges: Assessed charges following a financial assessment.
Type of scheme: Local initiative to support discharge of patients from hospital.
Purpose: To facilitate a good quality hospital discharge and enable earlier discharge/prevention of admission or readmission/minimise the need for alternative care.
Eligibility: The service is preplanned, not based on crisis intervention. The individual must have a healthcare/nursing need, be on a district nursing/health care professional case load and require more intensive support than the district nursing service can normally provide. The individual must be able to be cared for at home, have a high level of dependency, and need rehabilitation and/or basic nursing care. The individual must be able to benefit from short-term intervention (maximum six weeks).
Access: Referrals can be made by district nurses, GPs, health visitors, social services and other health care professionals, for example occupational therapist and physiotherapist. Referrals can be made to the team during normal office hours 8.30am to 5pm via the service co-ordinator/facilitator.
Resources: The team comprises nine workers who provide a seven-day service (8am- 10pm) covering the North Lincolnshire PCG.
Timescale: The service is funded by continuing care challenge fund monies.
Contact: Marie Girdham, continuing care co-ordinator, SCHCT. / Amanda Kirk, home health care team facilitator, SCHCT. Telephone 01724 282282, extension 3952.
Purpose: To provide an integrated community Occupational Therapy service by bringing together the functions of NHS and Social Services in North Lincolnshire. The partners in this development are NLPCT and North Lincolnshire Council (as the purchasers) and NLPCT (as the provider).
Eligibility: Referrals are accepted for people who require occupational therapy as part of their rehabilitation to achieve/maintain maximum independence in daily life. This includes those requiring therapy and those requiring changes to their environment either through the provision of aids/equipment or adaptations.
Resources: The service is managed by a jointly appointed head occupational therapist (OT).
The service comprises the services for adults, children, wheelchair and joint projects. There is also a professional advisory link for OTs in the specialist rehabilitation medicine team and Learning Disability Service. This includes qualified, support and administrative staff other than OT assistants employed by NLSSD who retain their pre-existing terms and conditions but are operationally responsible to the Integrated Service.
Timescale: The head OT appointment was made in 2000.
Contact: OT advice clinic, Brumby Resource Centre 01724 298206
Type of scheme: Local initiative to promote management of patients who reside in nursing homes, thereby reducing demand on hospital beds.
Purpose: This is a pilot project to establish the efficiency of this change to service delivery. The objectives of the project are to:
- Ensure all patients are treated in the most appropriate environment
- Ensure effective utilisation of acute medical beds
- Promote effective communication between SGH and local Nursing Homes
Eligibility: The scheme is now available to 14 nursing homes. Any resident from these homes with the following diagnosis can be assessed for the outreach medical/nursing team, the aim being to manage the person in the Nursing Home.
- chest infection - deep vein thrombosis
- urinary tract infection - cellulitis
- mild/moderate COPD - extension of CVA/TIA
- mild/moderate heart failure
Access: Referral is via medical assessment unit by either GP or nursing home matron.
Resources: The outreach team consists of medical and nursing staff experienced in the care of the elderly.
The assessment service operates Monday to Friday (9am to 5pm) with weekend nursing support for patients on the scheme.
Timescale: Ongoing service
Feedback: The pilot is being audited by the project manager and the audit department using control groups and questionnaires.
Contact: Kathy Dawson, project manager 01724 282282, extension 2318.
Introduction:
A £28,000 project, started by a £10,000 successful bid by Mark Sherwood based in housing. Improving access was paid for by Client Services, along with the ramp and disabled toilet facilities. Chippendale Kitchens, Jacksons, B Line Industries, ASM Medicare, DMA, Huntliegh Healthcare, Chiltern and Bison Bede provided the fixtures and fittings in the centre free of charge.
Access: Access is available by appointment arranged by a therapist. The centre can be used for small groups of 15 or less for meetings and training.
The store is at Cupola Way Scunthorpe, there is no general public asccess to the store as it only for professional use. However, the OT Demonstration Centre is now at Brumby Resource Centre and access is via the OT Advice Clinic (01724) 298206.
The Demonstration Centre is not open to unattended public.
Resources: The resources at the centre are:
Assessments
- Kitchen areas
- Bathroom areas
- Bedroom area
- Information
- Venue for equipment demonstration by manufacturers
Timescale: The Demonstration Centre was opened summer 2000 and then moved to Brumby for greater accessibility.
Contact: Joint Demonstration Centre, Brumby Resource Centre, East Common Lane, Scunthorpe DN16 1QQ Tel. 01724 297979
OT Store, Cuploa Way, Normanby Industrial Estate, Scunthorpe 01724 280273.
Type of scheme: Mobile warden for North Lincolnshire, visiting elderly residents living in council designated properties as well as other adults as requested by social services, including those living in private dwellings.
Purpose: The role of the mobile warden is to act as a good neighbour, to access/liase with various services, agencies and other directorates on behalf of the resident they are visiting.
As well as carrying out mobile warden duties, the warden will also install community alarm equipment in client’s homes.
Access: Via the Principle Housing Manager 01724 296654.
Resources:
Timescale: Ongoing service
Contact: Via the Principle Housing Manager 01724 296654.
Type of Scheme: Local initiative to prevent admission to hospital and to facilitate early discharge.
Purpose: To provide Occupational Therapy assessment and therapy / equipment in order to prevent admission to main hospital wards at SGH.
Eligibility Criteria: Service is available to patients admitted onto the admissions ward who have the potential to be discharged. This service is available for A&E, the medical assessment unit and the diagnostic and treatment unit at SGH.
The types of people who are expected to benefit are:
- elderly people who have fallen
- people with upper limb fractures
- people with minor injury / soft tissue injury
- acute crises of chronic conditions, e.g., rheumatoid arthritis, Parkinson’s Disease, Diabetes
- people admitted for social reasons
Access: Referrals are made by medical and nursing or other health professionals. The service gives a rapid response and works closely with other agencies, especially social services and in particular ICS.
Resources: Occupational Therapist able to respond on an ‘as needs’ basis.
Time-scale: This is ongoing.
Contact: Anne Bontoft, Operational Head of Occupational Therapy and Orthotics (SGHT) 01724 387715.
Type of Scheme: To provide services that are aimed at preventing admission to hospital and to ensure a return home safely with necessary support. The scheme works in conjunction with the hospital discharge team.
Purpose: To provide a short-term period of home support that prevents hospital admission. To maximise the service users independence and enable them to remain independent. The service user will be deemed medically fit for discharge and able to return home with the provision of social and health care packages. All service users will have a risk assessment completed by the Rapid Response Team
Access: The scheme will be accessed by the Out of Hours Service who will complete a standard assessment. Service users will be residents of North Lincolnshire who are identified as needing a period of home care and will remain on Rapid response up to, and not exceeding, 7 days before moving on to a longer term home care rostered service.
Resources:
Overview of the scheme is through a senior care officer based at Brumby Resource Centre. The care officer carries a mobile telephone which enables them to respond to risk assessments, medication issues and emergencies.
Timescale:
The scheme commenced in December 1999 and is ongoing.
Contact:
Out of Hours Service 01724 296555
Type of Scheme:
To prevent admission to hospital or long term residential care. The scheme is available to vulnerable frail older people age 65 and over who have experienced a change of circumstances in their lives that prevent them from functioning at a desired and appropriate level.
Purpose:
To work with service users who have lost their confidence to carry on living at home and can be assisted to regain skills by undergoing a period of recuperation.
Access:
There are two single rooms at The Lilacs residential home that are accessed by referral from Adult Social Care Teams. The service users must be motivated to return home and their medical prognosis must indicate that they have the capacity to do so.
Resources:
The scheme is serviced by key workers who will work in both the recuperation suite and the service users own home.
Costs - Charges:
Assessed charges following a financial assessment.
Timescale:
The scheme was inaugurated in December 1999. The period of recuperation may vary but a return home within 6 weeks is envisaged.
Contact:
Brumby Resource Centre 01724 297979
Type of Scheme:
Local initiative to provide a rehabilitation facility.
Purpose:
The Unit will provide an integrated rehabilitation service for in-patients (based on 21 beds) and day patients (based on 30 half-day patient sessions).
Eligibility Criteria:
Patients must be sufficiently fit to respond to an intensive multi-disciplinary rehabilitation programme. Inpatients will be transferred to the Unit from other wards – there is no direct referral route.
Patients will be assessed against criteria before admission to the Unit.
The Day Unit provides ongoing rehabilitation on an outpatient basis. It provides for a range of other services such as specialist clinics for people with Parkinson’s Disease and transient ischaemic attacks . It is hoped to develop other specialist clinics such as Falls Assessment Clinic and Multiple Sclerosis.
Access:
Access to the In-patient beds will be via the multi-disciplinary team.
Access to the Day Unit will be via the multi-disciplinary team, GPs and Community Health Professionals.
Resources:
The building was opened in July 2000.
Time-scale:
The Unit opened 1 July 2000 and is funded on a recurrent basis.
Contact:
(SGHT) 01724 282282
Type of Scheme:
The Travelling Day Service provides support to older people in rural North Lincolnshire. The service is provided in local village halls etc. and ensures that those who need day support do not have to travel vast distances to access it.
It is available to:
- People over 65 years with organic mental illness.
- People over 65 years with chronic mental health problems compounded by
- age related disorders.
- Working age people (50-65 years) with organic mental illness.
Purpose:
The Travelling Day Service provides day support that meets the needs of the identified client group by providing social, therapeutic and rehabilitative activities. It seeks to promote the independence of the service users and ultimately provide day respite for their Carers.
Access:
The service can be accessed through the Care Management Teams or direct by contacting the Travelling Day Service Co-ordinator. Referrals that come direct to the Co-ordinator will be logged with the relevant Care Management Team.
If it is felt that the referral is appropriate an initial 6 week period of attendance at the Travelling Day Service will be offered during which time the person's needs and suitability for the service will be assessed. At the end of the 6 weeks a review will be called to which all parties involved will be invited. This review will then decide whether the Travelling Day Service can meet the needs of the person, and a long-term place will be offered or a suitable alternative suggested.
Resources:
The staffing structure consists of:
1 x Service Co-ordinator
1 x Registered Mental Nurse
2 x Care Workers
Timescale:
The Travelling Day Service is run in partnership with North Lincolnshire Council and NLPCT.
Contact:
Julie Collingwood
The Bungalow, The Lilacs
Warwick Road
Scunthorpe
North Lincolnshire
Tel: 01724 847972.
Type of Scheme:
Local initiative to reduce length of stay in hospital.
Purpose:
To provide weekend physiotherapy support to patients on the Orthopaedic Ward at Scunthorpe General Hospital to ensure continuity of treatment for patients, and to contribute to further reducing length of stay in hospital.
Eligibility Criteria:
Patients on the Orthopaedic Ward requiring physiotherapy input.
Access:
The qualified Physiotherapist working on the ward identifies suitable patients.
The Therapy Assistants continue the physiotherapy programme with the patients identified.
Resources:
Two physio technical instructors working together on Saturday and Sunday, with one working Monday and Tuesday, one working Thursday and Friday, a total of 15 hours each.
The Assistants have ‘back up’ from the ‘on-call’ Physiotherapist if necessary.
Time-scale:
The scheme commenced in November 1998. It is funded by Waiting List Initiative Monies and is on going.
Contact:
Linda Batt, Physiotherapy Manager (SGHT) 01724 282282, ext. 2385.
Type of Service:
Provided one-to-one as required.
Purpose:
To provide an advice and casework service for clients referred from Care management.
Access:
By appointment only, made via clerical support team at Brumby Resource Centre.
Resources:
Time Scale:
Ongoing
Contact Point:
Income Advice and Collection Officer 01724 297979.
Type of Scheme:
National Wheelchair Scheme for the local implementation.
Purpose:
The aim is to give disabled people more choice of wheelchair within the NHS by offering three options:
- accept the wheelchair prescribed as normal
- contribute to the cost of a more expensive chair from a range offered by the service. The NHS retains ownership and is responsible for repair and maintenance – the partnership option
- contribute to the cost of a more expensive one chair of their choice. The person owns the chair and is responsible for maintenance/repair – the independent option.
Safeguards are in place to ensure the chosen chairs meet the person’s clinical requirements.
Eligibility:
The scheme is available to people newly referred to the service and existing wheelchair clients if they require a reassessment of provision.
Access:
A GP referral is required for all new clients and those requiring a reassessment.
Resources:
The voucher issued to the client represents the cost to the NHS of providing a new wheelchair that meets the person’s clinical need.
Timescale:
The scheme was established in April 1998; the first voucher was issued in June 1998.
Feedback:
Good local take up of scheme although this is not reflected nationally.
The take up rate is increasing as the scheme becomes more established.
- The vast majority of vouchers (98%) are issued on the partnership option
- The scheme has required additional staff time as more than one appointment is needed if people choose to enter the scheme
- For those able to afford to "top up" the voucher value, there is greater satisfaction in having a chair which meets both "needs" and "wants"
- For those people unable to pay the difference, the voucher scheme has introduced a two-tier system, some people may however, be getting assistance from charitable sources.
Contact:
Karen Fanthorpe Tel. 01724 290074, Cathie Hobbs Tel. 01724 290082.