Service Delivery Objectives. 3.1 The Allocated / Pooled Fund will support a seamless range of Services that reflect the needs of the local population, in line with the agreed policies and the Services commissioned by the Partners. Within the defined scope it will fund the care for the residents of the Locality who present with health and social care issues by ensuring that the right care is provided at the right time, in the right place and at the optimum cost. 3.2 Early assessment will be delivered through an appropriate single process to assess the needs of Service Users. Where possible, interventions will be provided to people in their home for people who meet the prevailing eligibility criteria. The preference will be for time limited interventions, with publicly funded longer-term support (outside the scope of these Intermediate Care services) only where necessary. 3.3 Intermediate care services will be planned and delivered according to a single model across providers so that the clinical and social care needs of the Service User are met in the most effective way. 3.4 The Partners will ensure that the access pathway into specialist services is made easier for people with intermediate care needs including referral pathways to allied services and those provided by the Third Sector. This will include a rapid mobile response to respond to Telecare activations. This will complement other community-based services that assist timely discharge from hospital. 3.5 The arrangements will allow more effective service planning as the traditional barriers between health and social care definition and funding can be overcome by the Allocated / Pooled Funds and a single management structure. This will make the most efficient and effective use of public service and Third Sector resources together with carers in the community. 3.6 The integrated care operational manager shall maintain an awareness and knowledge of the Council and Health Board’s policies and procedures so far as they relate to the Service and ensure that the Service complies. 3.7 An effective Community Resource Team will have the following positive knock-on effects in other parts of our health and care system: • reduced unscheduled hospital admissions through enhanced rapid response and more focus on reablement; • reduced occupancy of hospital beds by residents of the Locality utilised for post-acute recuperation or step up; • reduced number of placements in residential and nursing homes because more people are supported to remain living at home; • reduced need for ongoing domiciliary care packages through increased reablement and right-sizing care (regular objective reviews of needs and eligibility); and • reduced hours of support that were provided at commencement of enabling intervention when leaving short-term enabling services intervention. Schedule 1.5 provides detailed performance measures for the Community Resource Team.
Appears in 2 contracts
Sources: Regional Partnership Agreement, Regional Partnership Agreement