Domiciliary Care (Personal Care as regulated by the CQC)

It is expected that, the numbers of older people using non-residential care will rise by 102% from 1.5 million to 3.1 million in the next 20-30 years. The population for elderly people in the UK is growing rapidly. This is set to continue and is going to present major challenges. When you factor in that people are living longer, with more complex medical conditions you can see the potential impact of what lies ahead. As a result, Access24 Health Medical Services Ltd’s domiciliary care service has included the support for people with mental health (including dementia and brain injury, learning disability/difficulties, physical disabilities on both the young and the elderly, in residential or supported living or in the comfort of their homes. The service includes personal care, shopping, live in care, respite care, hospital rapid response etc.

Supported Living

Access24 Health & Medical Services Ltd presents, The Prevention and Recovery Care & Support (PARCS) project, which is divided into 2 models of care.

The project aims to provide supported living to health and social care clients, in community and help service users regain life in a less restrictive but supportive environment. We use a shared care model, where referring teams remain involved.

How will this project help with service user recovery?

1. Promote Social Inclusion by supporting service users to participate in community based activities.
2. Provide service users with the best possible support services in collaboration with the client, their family and their treating team
3. Clients remain under the care of the treating team, with the PARCS supporting clients to attend their medical reviews, CPAs, Physical Health clinics and GP appointments
4. To help our partner organisation to allocate or re-allocate scarce resources to efficiently meet their organisational needs
5. To promote first class health and wellbeing service for our partners by recruiting qualified and experienced staff who share the same vision and values as ours.
6. Specific and indvidualised care and support will be delivered under

Model 1

Our Supported Living model means supporting people in a shared housing, where each person has his or her own room but shares the living room/kitchen and other amenities. The staffing and skill mix is dependent on the needs of the clients using the service at the time, i.e. either working night, sleep over etc, but there is staff on site 24 hours a day, supported by an on-call or duty manager, who will help promote each service user recovery by prompting and encouraging them to engage in day time activities. With staff acting as facilitators, each individual client will be supported to be independent and do more for themselves. We offer support with; 

Mental Health

• Offer 1:1 work with clients to monitor mental state examination, Risk Assessments, Care Planning and Evaluation/reviews and help develop coping strategies
• Medication Supervision and management, monitor side effects & repeat prescriptions
• Liaise with Care Co-ordinator and treating team to support client with attending OPA, CPAs, Tribunals, Physical Health Clinics and other appointment with his/her team, e.g. clozapine clinics 

Physical Health Needs

• Maintain Personal Hygiene (including clothes launder)
• Support with GP or Dental appointments to support with Managing existing health condition, e.g. blood sugar levels, Blood Pressure
• Food Shopping and Cooking – support or prompting with buying and preparing meals

Social Care Needs & Day Time Activities

• Work in collaboration with voluntary sector in preparing clients for work experience and access for education and training
• Support, and encouraging clients to attend Leisure and learning courses
• Explore hobbies interests and social activities in the community
• Maintain contact with family – Assisting and encouraging service users to keeping in touch with their family
• Forming/maintaining friendships – Does the service user require support to form and maintain friendships?
• Religious/Spiritual/Cultural beliefs-All service users will be encouraged to take part in their wishes and develop and maintain their spiritual beliefs, which will help with their recovery

Finances

• Assess if client would benefit from budgeting for day to day expenses and savings
• Pay debts – Does the service user need support to manage debts and support with setting up direct debits or standing orders.
• Support with Accessing financial advice – Would the service user benefit from financial advice (e.g. seeing an advisor at the Citizens advice bureau or setting up an appointeeship service)?

Model 2

Step Up and Step-Down Service

The aim of this model is to provide a half-way house, to help reduce health and social care costs related to hospital admission.  It is a short-term recovery focused support for service users who would benefit from a 24-hour support to avoid hospital admission, by giving service users, a chance to recover before a full mental health relapse or recover from a hospital admission and continues to receive intensive support from their treating team. This would provide an alternative to acute inpatient admission. 

Step Up Service (Diversion)

Prevents service users from going into hospital by providing them with short term admission to the PARCS and continue to receive support from their treating team, e.g. admission for clozapine initiation, close supervision of their medication to aid concordance and avoid relapse. The referring team/clinician will accompany the client to the PARCS to ensure a smooth transition, continuity of care and an official handover takes place to initiate a care plan.

Step Down Service

PARCS provides vital care for people who no longer need to continue to stay in hospital at the same time, not fully recovered to return home but can receive treatment in a less restrictive environment. The client is from hospital), the hospital only gets the client ready for picking up and official handover takes place. The PARCS will arrange to pick up the client from the hospital, thus the start of efficient savings. 

Care Planning

As part of service user involvement, PARCS operates a need led service, working in partnership with clients, families and partner organisations. Each care plan will be developed with the servicer users and they will have this copy of the care plan, specific to their needs. The care plan is centred around the practice, principles and values of the recovery process, in a person-centred approach, clearly showing client’s goals, wishes, dreams, hope and will include a discussion around early warning signs, relapse prevention strategies and crisis plans. 

What does it mean for clients or Service User?

• Easy access to a supported environment
• Stay in a less restrictive environment more than necessary
• Continuity of care, because the referring team will remain closely involved
• Reduced stress related to out of county placement

What does it mean for Health and Social Care?

• Continuity of care to the service user
• Reduction in costs associated with hospital admission
• Reduction in costs associated with out of county placement
• Reduced travel time by clinicians 

Other Services

Recruitment and Temporary clinical staff supplies

Access24 Health and Medical Services Ltd offers temporary staffing solutions by working as a recruitment agency for health staff. It aims to help organisations with short-term staffing solutions by recruiting and supplying dynamic staffing requirements that will impact your business strategy for the long term. 

Placement reviews

Around £690 million was spent on mental health out of area placements in 2009/10.1 Nearly half of out of area placements in the independent and voluntary sector are made by local authorities (48.6%), one quarter by NHS commissioners (24.3%) and roughly one quarter jointly funded (25.7%) (Ryan et al, 2007). Nearly two thirds of the funding for these placements (62.6%) comes from NHS commissioners (Ryan et al, 2007).

Access24 Health and Medical Services Ltd will help organisation to audit and see which service users had been placed out of area and see if there are no local services that can meet the intended goals for the organisation, service user and their carers money.

Mental Health Advocacy & Appropriate Adult Services

There is an increase in the need to safeguard vulnerable people in our society. As this need increases, we work with organisations within the framework of the Mental Health Act 1983 and the MCA 2007, to support people to understand their rights under the Act and participate in decisions about their care and treatment. There are several organisations that offer advocacy services, but our organisation is well positioned to work even out of hours. 

Corporate Services

Service Performance and Improvement

Successful quality service delivery starts with the people on the floor, with top management making quality, performance and improvement part of their organisational strategy. We use different improvement/quality methodologies to ensure and support organisational quality improvement. We have helped organisations to:

• Comply with the Care Quality Commission (CQC)
• Help local teams operate above the NHS’s minimum standards, as required by the Quality, Innovation, Productivity and Prevention initiatives (QIPP)
• Help implement the local Clinical Governance requirements by conducting clinical audits, SUI investigations, present the findings to senior management and offer training to staff
• Clinical Auditing/Analysis of performance indicators and ensure that the teams followed the minimum recording standards and key performance indicators
• Local stakeholder consultations and engagements for change initiatives

Change Management

Why do we need change?

In our everyday working lives, change happens all the time or should happen all the time. All those who have an experience of using the NHS, will agree that, there is constant and continuous change, but the NHS remains the same. Why?

There is need for specialist and experienced professionals with considerable skills and knowledge to ensure that change is successful. This is where we come in. We use different change models/tools and techniques that suite your organisation and staff.

Project Management

Our Team of project managers are experienced in setting up and leading projects. Like change management, in project management, organisations need to know the best methodology to employ when considering a project, managing and delivering successful projects. This is where we come in as professionals with specialist knowledge and skills. We have delivered projects in time and within budgets. We are experienced in service re-design, health systems management and strengthening, payment by results, HR support functions and policy formulation, reviews etc.