To review the performance of the Home First service one year on from its commencement and to discuss progress.

The committee received a report concerning the Home First service, as attached to the agenda. Amy Pitt, Head of Partnerships and Integration (HoPI) introduced the report and provided the presentation in appendix. Justine Bennett, Operational Service Manager (OSM) and David Farnsworth, Wye Valley Trust (WVT) were also in attendance to provide detail on the work of the home first service. The HoPI explained that the service was part of integrated working in Herefordshire to reduce admissions to hospital, address delayed transfer of care through reablement and contribute to the strengths based model. 

The committee made those points below in the discussion that followed:

·         The challenge in providing two carers to clients who required support was queried. The recruitment of staff who did not drive was questioned. The OSM provided an update on recruitment to the service with staff now numbering 31. It was confirmed that it could be struggle to allocate 2 carers to attend to clients particularly if they did not drive. People who were suitable to join the service were employed even if unable to drive.

·         The committee questioned those clients who did not need the level of service provided by Home First but were unable to access services of need from alternative providers. The OSM explained that some clients did not want to leave the service and some private providers were unwilling to take on clients with complex needs.  

·         The link to nursing services was also raised. Mr Farnsworth, WVT, explained that there was a clinical interaction with the service with nurses and therapists. It was outlined that some clients would require the support of a district nurse.

·         It was queried whether recruitment was a problem for the service. The OSM confirmed that there was no problem in the recruitment of carers to the service.

·         The committee queried whether the service would utilise the electronic appointments facility used by WVT. Mr Farnsworth explained that the WVT were in discussions with a company to develop a new facility for appointments. The OSM confirmed that currently the Home First service used a paper based appointments facility but there was potential to link to the new system being developed in future.

·         The committee considered the performance of the service against the 91 day checks required. The use of written letters was suggested to increase the level of response by elderly clients. It was queried whether attempts were made to contact next of kin in the event of an absence of response by the client. The OSM explained that under the performance measures clients must respond within three attempts at contact by the service. It was confirmed that next of kin were approached if their contact details were held. There was contingency planning in place for clients who did not respond to attempts at contact.

·         The committee queried how the service took account of winter pressures and prioritised discharges during visits to clients. The OSM confirmed that a planning group regularly looked at cases entering and leaving hospital and used indicators to identify when someone could be supported by the Home First service.

·         The committee queried the role of the service to hand over clients to private providers, where they would be a cost implication, once reablement had been completed. The OSM explained that the service facilitated transfer to alternative providers and in some cases paid-for services.

·         The committee requested details of the training undertaken for employees of the service and the previous experience of members of staff. The OSM explained that there were 8 mandatory training modules that new staff had to undertake and most had previous experience. A new initiative was underway to offer a two week induction for members of staff with no previous experience but who possessed an aptitude and desire to work in the care sector.

·         It was proposed that work in the service should be publicised to looked after children as a potential opportunity if they were interested in work within the care sector.

Resolved – that:

1.    The committee would like to see additional steps being taken, to the current phone call clients receive, in connection to the 91 day checks.  For example, writing letters or utilising local ward or parish council members to visit clients and to ensure that links are made to local ‘good neighbour schemes’.

2.    The committee would like to see children/young people who have been through the care system being offered care training opportunities

Councillor DW Greenow left the meeting at 12.19 p.m.