Decision details

That Cabinet:

1)    Approves the delivery of the Urgent Care at Home and Telecare Response Service to Wiltshire Council in-house services from the 1 August 2024 at an annual cost of £1.665m, to be funded from the Better Care Fund.

2)    Delegates to the Director Adult Social Care in consultation with the Cabinet Member for Adult Social Care, SEND and Inclusion to finalise operational matters to ensure a safe transfer of the services. This will include the TUPE transfer of eligible staff and the purchase of the necessary resources such as uniforms, laptops, phones, equipment for service deliver and the use of fleet vehicles.

Reason

The transfer of the services from Medvivo to the Council was due to take place 1 May 2025, however accelerating this to nine (9) months earlier than expected has required the Council to act quickly to ensure vulnerable people are not left without support. The three (3) month extension period has been agreed to allow for staff eligible for TUPE transfer(s) to be identified, alongside putting other operational requirements in place.

The service in scope consists of:

Urgent Care at Home; when a situation is moving into crisis, it can often be stabilised with some domiciliary support. Through the timely provision of experienced carers who can respond to presenting issues, risks can be managed to safeguard the situation. An example would be a carer who helps and supports a partner with dementia being admitted unexpectedly to hospital. Urgent Care could provide 24 hour support to look after the person at home until their partner returned home or alterative arrangements were made. Telecare Response; Wiltshire Council commissions a telecare call response service with Apello. When a personal alarm is triggered, for example because of a fall, Apello call the person and find out how to best support them through a conversation on the phone system. The telecare response service can provide a physical response in the form of a community visit when it is deemed safe and appropriate to do so, for example when an alarm has been triggered and the person cannot be contacted. In some circumstances it is not appropriate to use this service, for example when the risks require a medical emergency response.

The telecare triage service at Apello carefully manage these risks to ensure they are referring onto the most appropriate service.

Bringing the service in-house was the preferred option (to start 1 May 2025) but the inability of the parties to agree terms for a further twelve (12) month extension has forced an earlier timetable.

We are confident that the service can be delivered through the Council’s Wiltshire Support at Home (WSAH) Service. WSAH is currently commissioned to provide a domiciliary support service working with Homefirst and Reablement to support hospital discharges. This expansion will support the Urgent Care Response Service (UCR) - the Wiltshire Health and Care Service commissioned to provide clinical response within 2 hours. Wiltshire Support at Home urgent support service will work with Wiltshire Health and Care and  provide complimentary wrap around support to stabilise crisis and prevent hospital admission. This service will be short term and is commissioned for up to 72 hours. WSAH will also be able to return to supporting Carer breakdown as this funding was removed in March 2024. Wiltshire Support at Home is an in-house service part of the established Reablement Therapy and Community Service it supports health and social care across Wiltshire, operating 7 days a week 7am-10pm. There is a structured registered provider in place and this can be expanded, and the existing staff group utilised within the service to provide a seamless transfer of services. We have a service with trained staff already providing an urgent response to crisis situations and there is experienced and skilled leadership and management who can support this transfer.

This decision was published on 18 June 2024 and will come into effect on 26 June 2024.