North Yorkshire County Council

Health and Adult Services

Executive Member Meeting

14^th October 2022

REPORT TO Corporate Director of Health and Adult Services (HAS) in consultation with Executive Member for Health and Adult Services

Care Rooms Pilot- Continuing Proof of Concept

1.0 Purpose Of Report

1.1 To consider extending the Selby Care Rooms Pilot across South Hambleton, Ryedale, Whitby, Scarborough & Richmond for a period of 24 months.

2.0 Executive Summary

2.1       This paper sets out proposals to extend the Selby Care Rooms pilot scheme across wider areas of North Yorkshire, to support and facilitate discharge from hospital and provide respite opportunities for adults with assessed care needs.

2.2      Care Rooms is a community based short-term bed provision that operates out of people’s homes, known as Hosts. As well as offering short stay bed provision for those requiring support following discharge from hospital due to elective surgery, falls or illness, Care Rooms also acts as a respite option for those wanting to stay in a more family environment. It offers a unique and innovative approach to addressing ongoing pressures in the care market by harnessing the strengths, assets and resources that exist within local communities.

2.3       To evidence proof of concept on a wider scale, the pilot would be extended across the localities of South Hambleton, Ryedale, Scarborough, Whitby and Richmond, while maintaining provision in Selby District.

These areas would be targeted as they have been identified as areas with limited care provision. There are also limited options for short break/ carer respite in these localities. As a result, this impacts on the ability of the Discharge Hub teams to discharge people back into their local communities. The pilot would support short breaks for struggling carers, and develop additional options and approaches to facilitate Hospital discharge.

The 24-month timescale would allow for recruitment of Hosts into the identified locality areas, build awareness of the service, and facilitate integration of the referral process into the internal locality teams. Once embedded, referrals through additional pathways could be explored.

2.4       Extending the Care Rooms Pilot across other localities in the county would provide further care options for Hospital Discharge teams to utilise, improving the system flow of people to a home first option. Extending this approach to other people and communities countywide could unlock community assets and resources, as well as providing needed respite options in areas that are limited for this type of provision.

3.0 Issues for consideration

3.1       Recruitment of Hosts

In order for the Pilot to run effectively Hosts need to be recruited from the community. As was found at the start of the original Pilot in Selby District, this can take a significant amount of time and involves linking into local networks and resources to raise awareness of the opportunity and the support that the public can provide to those needing care and support. To mitigate this, early awareness raising and networking with local community and media groups would be needed to generate interest and allow the Provider to interact with potential Hosts, to bring them on-board or address any queries.

3.2       Take up of the provision

Referral rates have begun to steadily increase through working with the locality teams to raise awareness of the offer and how to refer in. The referrals received have led to a positive outcome for the individuals, with a significant reduction in ongoing packages of support once the person has returned home, allowing the individual to maintain and build their independence with support to integrate into their own community support networks.

Awareness raising of the Pilot would need to be undertaken in order to embed the service into the teams working in different Hospital Trusts, Brokerage teams and Reablement services.

3.3       Market Pressures

There are ongoing pressures in the Care Market, which are impacting ongoing sourcing of packages of care following discharge from Hospital. This could have an impact on exit planning from Care Rooms back home. However, this can be mitigated through working with the Provider and a third party contracted domiciliary care provider, who would be contacted to continue any ongoing care needs in the first instance if this support is assessed as being needed for the person to return home. It should be noted that Care Rooms itself offers a new and innovative approach to addressing the ongoing pressures in the care market,

4.0 Performance Implications

4.1      The proposed extension for the proof of concept pilot into South Hambleton, Ryedale, Scarborough, Whitby and Richmond has been developed based on engagement with Hospital Discharge teams, care and support teams and knowledge of the current provider marketplace in those areas. These areas have been identified as lacking sufficient care provision to enable people to be discharged from Hospital into a safe and local care setting. Similarly, there is a lack of respite provision in those areas to allow individuals to receive respite in their local community without travelling outside of their local area.

4.2       A performance and outcomes framework will be developed alongside a service specification for the extended Pilot. This will enable us to review the outcomes of the service and work with the provider to identify areas for development over the course of the Pilot. It is recommended that a transparent performance and outcomes framework is adopted should continuation or extension of the Pilot across North Yorkshire be approved.

5.0 Financial Implications

5.1 The extension of the pilot would require investment from North Yorkshire County Council and funding has been identified to cover the cost of this pilot. This is a new and innovative provision that needs investment to allow expansion and identify if the concept is a viable and effective method of supporting hospital discharge on a wider scale, while offering an alternative option for respite care.

6.0 Legal Implications and Governance compliance

6.1       Advice has been received from NYCC Procurement and legal services, indicating the requirement of a waiver to directly award the pilot contract to the existing provider.

NYCC Procurement have advised that a full service review is undertaken prior to the end of the 24 month pilot to gauge interest in delivery of the service longer-term and to assess whether  the pilot represents the best way forward (strategic relevance and stakeholder feedback, quality, value for money etc.) The review would also include a market engagement exercise analysing the market’s appetite/ability to provide this service across a countywide or individual locality patch.

7.0 Equalities Implications

7.1 It is the view of officers that the proposals should not have significant adverse impact on any groups of people with protected characteristics identified in the Equalities Act 2010.

9.0       Recommendations

9.1      To note the contents of this report, and to recommend

(i) Extending the Care Rooms Pilot across South Hambleton, Ryedale, Whitby, Scarborough & Richmondshire for 24 months.

Author Tilly Skeels

Date 03/10/2022