New Bollington, Disley and Poynton Care Home Community
Community
New Bollington, Disley and Poynton (BDP) is a care community within the Cheshire & Mersey footprint, made up of several providers across Health and Social Care that deliver services to the Care Homes in the area. The providers that serve this community extend from both Greater Manchester and Cheshire and Merseyside footprints.
BDP has the highest rate of admissions from Care Homes into secondary care. There are differing admission methods between each provider. In addition, due to the geographical split between Cheshire & Merseyside and Greater Manchester, there seems to be a high rate of Out of Area admissions.
Throughout the patient journey, there are multiple patient contacts by different health and care services that could be streamlined.
High turnover of staff in Care Homes is also a known and observed issue.
WRaPT helped in translating the challenge to a goal which was to develop an effective workforce model using the WRaPT tool to enable the Bollington, Disley and Poynton neighbourhood to deliver a more person centred approach to care in Care Homes (therefore minimising the rate of admissions) and understand the impact of this across all services in scope in the area.
The initial stage of the project was to develop an understanding of:
• how the practitioners currently operate (i.e how much time is spent on what?)
• what tasks are undertaken and the skills required for each task
• scope for skill mix re-distribution
In early 2019, the WRaPT team worked closely with key leads from the different teams providing care in the care home community in scope and agreeing a data collection mechanism to support the development of a baseline model.
The Challenge
Care is delivered by a number of different practitioners from a number of teams working in different organisations. It was important to understand who was doing what, how much time they spent doing it and how this equated to an overall WTE picture for the care homes in scope. In total there were 28 roles involved in the delivery of care across six teams, equating to a total of 18.29 WTE. Having a platform to capture data, bring data together to get a cross organisation picture with the ability to model across those teams in the future was important for this project.
Of the findings from the initial analysis however, it was apparent that the activities for the community nursing team did not fully reflect the level of activity that was being undertaken, this was considered to be due to the way data had been gathered and would require some further validation and also required additional investigation around the way the team operated due to a combination of factors, i.e. data quality: staff not completing the review, staff working part time or staff off sick. In addition, the earlier review had a strong focus on the Safeguarding Practitioner role rather than the Admin team.
Our Approach
The WRaPT Team worked with key leads in the care community to design a data collection exercise whereby staff could record their activity for work they had done within the care homes in scope. The aim of this was to understand the contribution of the different roles and teams providing care which would help identify duplication/overlap and scope for improvements. The team were also keen to understand the workforce WTE associated with care delivery for the eight care homes in scope.
Data was collected from GP Practices, Community Teams, Adult Social Care and the Mental Health Liaison team.
Following the data collection exercise, the WRaPT team undertook detailed analysis of the data to produce a workforce and activity baseline and load this into the WRaPT tool. This was presented at a meeting with the project leads where next steps were discussed. Due to some changes in contacts, data from the community nursing team was considered out of date and would require further collection/analysis for the baseline to accurately reflect the current state. The meeting provided a good opportunity for the representatives from the different teams and organisations to discuss the options around updating the baseline and next steps that would support the leads in modelling future state changes.
Recognising the value in using the WRaPT approach and modelling tool the need for dedicated resource to undertake the work locally was identified and a business case would be submitted.
The Outcome
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