Wakefield District: Enhanced health in care homes vanguards

The programme aims to tackle loneliness and fragmented care by joining up services for older people in supported living schemes and care homes, to help people live longer, healthier lives at home and within their communities. This example of a local initiative forms part of our managing transfers of care resource.


The approach is currently implemented in 15 care homes and two extra care facilities within the vanguard and in 2017/18 will be expanded to take in 12 more homes.

The programme is a collaboration between health, social care, housing and the voluntary sector with a focus on the wider determinants of wellbeing – ‘somewhere to live, someone to love, something to do’. It includes reablement and rehabilitation services and the development of community assets to support resilience and independence, and enable people to live in the most independent setting for as long as possible.

Assessment and care planning is proactive and multi-disciplinary, involving GPs, community nurses, therapists, pharmacists, voluntary workers and care home staff. Enhanced primary care support (working with 25 out of 40 GP practices in Wakefield) allows access to a consistent, named GP and wider primary care services, and a coordinated support package helps to keep people socially connected to activities in the wider community (via Carers Wakefield, Age UK). 

This holistic approach helps to reduce the risk of deterioration and dependence. It also helps build the confidence, capability and continuity of staff working in care homes through continued training, overall reducing the frequency of emergency call-outs. For residents and their families it means they stay in control of their care while maintaining optimum health. Every resident has an end of life plan, enabling people to die in their place of choice instead of experiencing the distress of being transferred to hospital in their last hours.

Additionally, the approach is:

  • reducing accidents and health deterioration which result in urgent GP calls and hospital attendance or admission
  • reducing the number of people choosing to go from independent living into care settings to escape loneliness
  • enabling couples to be supported to stay together in independent living schemes.

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Connecting care in Wakefield 

Contact

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