CHILD & ADULT SERVICES DEPARTMENT

PART B

SERVICE SPECIFICATION FOR THE PROVISION SPECIALIST DOMICILIARY CARE VIA AN INDIVIDUAL SERVICE FUND

CRN 678: SPECIALIST DOMICILIARY CARE VIA AN INDIVIDUAL SERVICE FUND

SECTION A - INTRODUCTION

1.Service Aims and Objectives

The objective of the Service is to support and facilitate the Service User to meet their Individual Outcomes around well-being and independence.

The Service Specification sets out the Authority’s requirements in relation to the provision of domiciliary care and support services for Service Users aged 16 through life living within the community.

It is applicable to adult Service Users living in their own home

The Council requires that:

  • Service Users have a strong sense of being in control of the nature and delivery of the Service in order to meet their Outcomes.
  • The Service is able to respond flexibly to individual Service Users changing needs and issues on a day-by-day basis.
  • The Service must comply with the

Health and Social Care Act 2008

Care Quality Commission (Registration) Regulations 2009

Health and Social Care Act 2008 (Regulated Activities) Regulations 2010

Care Standards Act 2000

The Care Quality Commission’s Guidance about Compliance – Essential Standards of Quality and Safety forms an integral part of this Service Specification.

The first two of the aboverequirements are key to what Hartlepool wants to see explicitly reflected in the design and execution proposed by the Provider. This approach is fundamental as the basis for Hartlepool’s strategy for the future provision of all care services in demanding a shift towards an `Outcome' based model of care delivery. Outcome based care delivery is designed to ensure that people receive a personalised service. Outcome based care puts the Service User at the centre of their service and focuses service delivery on working towards specific Outcomes defined by the Service User

Hartlepool wishes to work in partnership with all providers in delivering a high quality of care to its Residents. The aim is to maximise the use of available resources by establishing longer-term, more integrated relationships with service providers.

By signing up to a “partnership approach”, Hartlepool and all providers are making a commitment to:

  • Share key objectives.
  • Collaborate for mutual benefit.
  • Communicate with each other clearly and regularly.
  • Be open and honest with each other.
  • Listen to, and understand, each other’s point of view.
  • Share relevant information, expertise and plans.
  • Avoid duplication wherever possible.
  • Monitor the performance of both/all parties.
  • Seek to avoid conflicts but, where they arise, to resolve them quickly at a local level, wherever possible.
  • Seek continuous improvement by working together to get the most out of the resources available and by finding better, more efficient ways of doing things.
  • Share the potential risks involved in service developments.
  • Promote the partnership approach at all levels in the organisations (e.g., through joint induction or training initiatives).
  • Have a contract which is flexible enough to reflect changing needs, priorities and lessons learnt, and which encourages Resident participation.

2.Service Values and Principles

The Council has adopted a set of values to characterise all contact with Residentsand the public at large. These values are:

privacythe right of individuals to be left alone or undisturbed and free from intrusion or public attention to their affairs;

dignityrecognition of the intrinsic value of people regardless of circumstances by respecting their uniqueness and personal needs and treating them with respect;

independenceopportunities to act and think without reference to any other person including a willingness to incur a degree of calculated risk;

choiceopportunities to select independently from a range of options;

rightsmaintenance of all entitlements associated with citizenship;

fulfillmentrealisation of personal aspirations and abilities in all aspects of daily life

The principles which underpin the service values are that:

  • everyone has equal rights, entitlements and access to services;
  • everyone has access to information, advocacy and assessment reflecting individual needs;
  • service users and carers are fully involved in planning care packages;
  • services reflect differing lifestyles, minimise dependency and develop individual potential and, where possible, are offered within the community;
  • standards of service continue to be raised;
  • all statutory and non-statutory organisations work together in the development and delivery of services;
  • the views of service users, carers and representative organisations are incorporated in the planning process.

3.General Core Principles and Deliverables

This set of principles should apply to all contact with Residents and their Carers and the following sets out what will be required to deliver them

  • To treat people as individuals and promote each person's dignity, privacy and independence.
  • To acknowledge that all care and support workers are visitors in the Service Users home and should act accordingly.
  • To acknowledge and respect people's gender, sexual orientation, age, ability, race, religion, culture and lifestyle.
  • To maximise people’s self care abilities and independence.
  • To recognise people’s individuality and personal preferences.
  • To provide support for Carers, whether relatives or friends, and recognise the rights of other family members.
  • To acknowledge that people have the right to take risks in their lives and to enjoy a normal lifestyle.
  • To provide protection to people who need it, including a safe and caring environment.

CRN 678: SPECIALIST DOMICILIARY CARE VIA AN INDIVIDUAL SERVICE FUND

4.Service Outcomes

The Specification requires the Provider to ensure that people have better lives through more choice and control over the support they use. The Think Local Act Personal group, believe that services and support should be:

  • More personalised according to the needs and wishes of the people who use them
  • Provided in ways that help people to be active and contributing members of supportive communities.

In addition the Specification requires the Provider to meet a range of agreed and shared Outcomes which should ensure people, irrespective of illness or disability, are supported to achieve those broad Outcomes contained in Putting People First: A shared vision and commitment to the transformation of Adult Social Care 2007:

  • live independently
  • stay healthy and recover quickly from illness
  • exercise maximum control over their own life and where appropriate the lives of their family members
  • participate as active and equal citizens, both economically and socially
  • have the best possible quality of life, irrespective of illness or disability
  • retain maximum dignity and respect.

and also reflects the priorities for Hartlepool Joint Strategic Needs Assessment and the Hartlepool Council and the general direction as outlined in Child & Adult Services Departmental Plan:

  • A greater focus on the prevention of ill health and the promotion of well being
  • More personalised care
  • Services closer to peoples homes
  • Better co-ordination and integration with health services
  • Increased choice and control
  • Focus on prevention.

More specifically, the Provider is required to meet a range of service Outcomes which are contributed to and determined by the achievement of individual Service User Outcomes. The design of the Service should be knowledge based around what are the factors that are most likely to maintain somebody in their own home and the way in which Service Users want and expect their services to be delivered. This could mean that the Service is not always delivered in the Service User’s property. The Service will need to be delivered in a holistic manner to achieve the following Outcomes:

The Service will:

i.Contribute to the initial reduction of the levels of care and/or support previously received by the Service User before commencement of the Service

Examples of individual Outcomes that the Service will need to deliver for include:

a.Improvement in being able to undertake daily living function.

b.Improvement in undertaking the ability to self care.

c.Improvement in mobility function.

d.Improvement in confidence and independence in own home.

e.Improvement in health or the capacity to sustain health – both mental health and physical health.

ii.Support the on-going care and support needs of its Service Users and reduce the likelihood of admission to long term care

Examples of individual Outcomes that the service will need to deliver for include:

a.Ongoing improvement, maintenance or minimised deterioration in ability to undertake daily living functions.

b.Ongoing improvement, maintenance or minimised deterioration in ability to self care.

c.Ongoing improvement, maintenance or minimised deterioration in mobility function.

d.Ongoing improvement, maintenance or minimised deterioration in confidence and independence in own home.

e.Ongoing improvement, maintenance or minimised deterioration in health – both physical and mental health.

f.Continued involvement and support for family and Carers.

g.Reduced anxiety about ill health by individual and their families.

h.Ability to remain in own home for as long as possible.

i.Service Users improve their access to preferred social company, contact and social stimulation to avoid isolation.

j.Improved access to interesting and stimulating social and/or recreational activities.

iii.Contribute to the prevention of hospital admission, re-admission and enable early discharge

Examples of individual Outcomes that the service will need to deliver for include:

a.Prevention of ill health.

b.Ongoing improvement, maintenance or minimised deterioration in health – both physical and mental health.

c.Prevention of hospital admissions and readmission.

d.Reduced stay in hospital.

e.Ability to return to a suitable home environment following hospital discharge.

The individual Outcomes detailed above are not an exhaustive list. All Service Users Outcomes will be different and so an individual Care and Support Programme may not include all of the Outcomes all of the time.

5.Description of Service

5.1.The purpose of the Service is to enable the Service User to use their Personal Budget to take control of their own life and to self direct their care and support arrangements by providing:

5.1.1assistance, if needed and chosen by the Service User, to enable Service Users to develop their own Support Plan

5.1.2support to enable Service Users to manage and implement their Support Plans using their Personal Budget, which will be held and managed by the Provider in the form of an Individual Service Fund.

5.1.3flexible personalised direct care and support services to meet the outcomes agreed within the Service User’s Support Plan

5.1.4support to Service Users to access universal services and informal support with clearly understood accountabilities on the parts of the Service User, the Provider and the Council

5.1.5support to officers of the Council to review the Service User’s support arrangements and the outcomes of the Services against their Support Plan within the Councils statutory review process.

5.2Under this Agreement, Providers may provide some or all of the above component Service parts set out under Section 5.1 above and is specified by the Council and/or chosen by the Service User.

5.3The Provider will only use monies held within each Service Users Individual Service Fund on their support only, in accordance with the individuals agreed support plan.

5.3The Service will be available for people who are ordinarily residents of the Borough of Hartlepool and aged 16 and above whose assessed primary need is learning disabilities.

5.4Service Users will make an informed choice regarding their choice of providers from a list of Preferred Providers with the assistance of their Care Manager and family and friends if required.

5.4The Service is available to Service Users living in their own homes either by themselves, or with families, friends or co-tenantswho have opted to self-direct some (or all) of their support through a Managed Personal Budget which they have chosen to be placed with the Provider in the form of an Individual Service Fund.

5.5It is assumed that Service Users have capacity to make their own decisions and choices about their Support Plan, delivery of day to day support and the use of their personal Budget. However, if it is established that a Service User lacks capacity to make some or all of the decisions, then any decision(s) or action(s) carried out on their behalf must be in accordance with the Mental Capacity Act 2005.

5.6The Provider will at all times remain accountable to the Council for how the Individual Service Fund is spent and must manage the Individual Service Fund in accordance with the requirements of the Agreement.

5.7The Provider will provide direct care and support identified within the individuals Support Plan in a flexible and person centred way to meet the Support Plan outcomes.

CRN 678: SPECIALIST DOMICILIARY CARE VIA AN INDIVIDUAL SERVICE FUND

SECTION B - Service DELIVERY

The Provider will at all times meet the requirements of the

Care Standards Act 2000

Health and Social Care Act 2008

Care Quality Commission (Registration) Regulations 2009

Health and Social Care Act 2008 (Regulated Activities) Regulations 2010

The Service shall meet the outcomes identified in the Care Quality Commission’s Guidance about Compliance – Essential Standards of Quality and Safety as set out below.

INVOLVEMENT AND INFORMATION

Outcome 1 – Respecting and involving people who use services

(Health & Social Care Act 2008 (Regulated Activities) Regulations 2010 - Regulation 17)

People who use services should:

1.1Understand the care, treatment and support choices available to them.

1.2Express their views, so far as they are able to do so, and are involved in making decisions about their care, treatment and support.

1.3Have their privacy, dignity and independence respected.

1.4Have their views and experiences taken into account in the way the service is provided and delivered.

Examples of how this may be demonstrated in practice are set out in the prompts to Outcome 1 of the Care Quality Commission’s Guidance about Compliance – Essential Standards of Quality and Safety.

The provider must also meet the following requirements:

1.5The Council expects Service Users to be encouraged to remain as independent as possible. The balance of encouragement and assistance given to each Service User should be discussed with the Service User on a regular basis as needs may vary from day to day. The Provider must ensure that Service Users receive the level of support and encouragement needed to maintain, regain or develop such skills.

1.6Service Users must be able to make decisions in relation to their care, support and lifestyle and the Provider must recognize that they have the right to take risks. Where a Service User’s decision or any consequential actions or behaviour raise concern for the health, safety or comfort of the Service User or other people, the Provider must discuss those concerns with the Service User. If the Service User persists in continuing with their actions and the Provider remains concerned for the well-being of the Service User or other people, the Care Manager or, in their absence, another representative of the Council, must be informed immediately.

Outcome 2 – Consent to Care and Treatment

(Health & Social Care Act 2008 (Regulated Activities) Regulations 2010 - Regulation 18)

People who use services should:

2.1Where they are able, give valid consent to the examination, care, treatment and support they receive.

2.2Understand and know how to change any decisions about examination, care, treatment and support that has been previously agreed.

2.3Can be confident that their human rights are respected and taken into account.

Examples of how this may be demonstrated in practice are set out in the prompts to Outcome 2 of the Care Quality Commission’s Guidance about Compliance – Essential Standards of Quality and Safety.

Outcome 3 – Fees

(Health & Social Care Act 2008 (Regulated Activities) Regulations 2010 - Regulation 19)

People who use services or others acting on their behalf, who pay the provider for the services they receive should:

3.1Know how much they are expected to pay, when and how.

3.2Know what the service will provide for the fee paid.

3.3Understand their obligations and responsibilities

Examples of how this may be demonstrated in practice are set out in the prompts to Outcome 3 of the Care Quality Commission’s Guidance about Compliance – Essential Standards of Quality and Safety.

PERSONALISED CARE, TREATMENT & SUPPORT

Outcome 4 – Care and welfare of people who use services

(Health & Social Care Act 2008 (Regulated Activities) Regulations 2010 - Regulation 9)

People who use services should:

4.1Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

Examples of how this may be demonstrated in practice are set out in the prompts to Outcome 4 of the Care Quality Commission’s Guidance about Compliance – Essential Standards of Quality and Safety.

4.2Prior to referral to the Service a potential Service User will agree a Care and Support Plan with the Care Manager which details the Outcomes which have been agreed as being required by the Service User. The Outcomes will address the Service User’s support needs and identify the Service to be provided.

4.3The Council will provide a copy of the agreed Care and Support Plan to the Provider and will agree whether the Service Users needs are Profound and Multiple or Complex and Severe using the Needs Descriptions outlined in Appendices B and C to this Specification (Where a Service User presents with ‘Complex and Severe Needs’ in any one of the domains listed in the Appendices then their care package will automatically fall into the higher banding of care needs (Complex and Severe)).who shall, within 2 (two) working days of receipt, assess the situation within the estimated budget to meet the Outcomes in the initial stages. The Provider will work to the principle of providing the minimum amount of Service required to meet the Outcomes specified. This should minimise dependency and maximise self reliance and make best use of the total amount of resource available to meet the needs in the community.