Angela Hibbard – Director of Finance and Performance visited the Devon Cares team at their office recently, see below the response received by the team from Angela.
I recently spent some time with the Devon Cares team, a part of the Trust that I am not very familiar with.
Devon Cares has been in existence for around two years and is a service where we broker packages of care on behalf of Devon County Council (DCC) and Northern, Eastern and Western Devon Clinical Commissioning Group (NEW Devon CCG). By this I mean that we receive referrals directly from DCC or the CCG for customers who need supportive care at home (either for a health need or a social care need) and then source the necessary care package from a number of care providers who have signed up to the Devon Cares framework.
The term customer is used rather than patients because the individuals are not in a care setting. I finally got used to this terminology by the end of my visit!
By having this brokering service, we are able to streamline processes to establish care packages for customers as soon as possible and are also developing strong relationships with the care market.
This is a vital service for our population and for the Trust – for those who need a little extra support at home, Devon Cares can help discharge patients from hospital and can help to avoid them being admitted to hospital unnecessarily.
At the start of the service, Devon Cares had seven providers on their framework. Now, they are working with over 40 providers, which has really opened up the domiciliary market.
However, there are significant challenges that we are experiencing in northern Devon, along with the rest of the country. This is an area of increasing demand but reducing capacity due to the difficulties in attracting workforce. The nature of domiciliary care has changed, with a higher complexity of health and social care needs (including more mental health conditions) leading to a higher level of care needing to be provided. However, this higher level of skill required has not been reflected in the offer to the workforce.
The increasing complexity of care needs and the increasing demand for services have led to these roles becoming more stressful for our carers, and jobs in the care market are therefore becoming increasingly unattractive. In northern Devon, we are competing with other industries in the area, particularly tourism in the summer, where jobs can be more lucrative with less responsibility.
But, it is clear that this is a wider problem than just northern Devon. With the care market becoming more essential as our population ages, we need a national response to create an attractive career pathway in the care industry so we recognise these roles for the contribution they make to the health and care system.
Locally, we need to continue to do what we can to acknowledge this workforce and ensure they feel valued as part of our system. I was heartened to see a recent letter to members of our domiciliary care workforce from our chief executive Suzanne Tracey, thanking them for the contribution they make. These small gestures can make a difference to individuals.
Despite the workforce challenges, the Devon Cares team continue to work hard to broker the packages of care needed to alleviate the pressure on our system. They want to continue to work with our inpatient wards and share the message that they are here to support the hospital and are hoping to get out and about soon to help communicate this more widely. They have built up a good working relationship with the discharge coordinators, but need to extend this to other ward staff to ensure they are fully integrated with the discharge process at all times.
The team aren’t just responsible for brokering packages. They also have a role in assuring the quality of the provider market, maintaining strong relationships with social care, trying to stimulate the market and dealing with customer complaints. This is a further area of growth driven largely by the capacity issues, but also because of the different relationship between customers and carers. Many individuals contribute for their care through the social care mechanisms and therefore may have different expectations and demands regarding what the care market can provide.
I left with a story from one member of the team which resonated with me. I was told about a patient who had been in hospital for some time and was at the end of his life but desperate to go home. A fast-track referral was put to the team through the Continuing Healthcare pathway. The individual lived in an area where the geography meant there was a particular shortfall in the care market, and all efforts had to be made to get the package of care to facilitate the discharge. Eventually it happened, which allowed the individual to get home, where he sadly passed away a few days later, but in the environment he wished to be. The emotion as this story was shared with me said it all. Working in the team to broker the right packages of care makes a real difference to very vulnerable people when they need help and support.
Once again I am humbled by the work we do and the efforts we go to