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The project also identifies optimising Multi-disciplinary Teams (MDT) working through the adoption of the MDT best practice guidance and the appointment of a generic Occupational Therapy/Physiotherapy (OT/PT) technician who attends all MDT meetings and accepts referrals to undertake low levels assessments.
Offer 3: Ongoing support
The third level of support includes services for people whose conditions or circumstances mean that they need longer-term specialist or substitute care or support. The route into this level of care and support is usually through an integrated assessment and multi-disciplinary professional support; a care and support plan is based on the question ‘what matters to you’ and an outcome plan delivered accordingly.
Services include:
• Domiciliarycaresupport,directpaymentsandresidentialplacementsincarehomes for assessment, respite or on long-term basis
• Social support and day opportunities are provided through accessing community based services, direct payments or day centre provision
• Health led services include community nursing and hospital services, continuing healthcare and end-of life care. Over 60% of the £37,602,320 spent in 2014-2015 on continuing healthcare in HDUHB was spent on older adults, which included both domiciliary and residential nursing care (Hywel Dda University Health Board, 2016b)
• Residential and nursing care. Across the region, several residential options are available which range from extra care to EMI nursing. Approximately 668 residential care beds are registered for older people with dementia and 645 EMI nursing home beds, with 1,257 residential placements and 673 nursing ones; as well as currently having 254 units of extra care accommodation across the region
• A significant proportion of older people who live in a residential setting in West Wales currently fund their own placement but may need financial support at a later date. The Local Government Information Unit (LGiU) estimated that an average of 41% of people entering residential care each year self-fund, and of those, 25% will run out of money during their stay. Estimating the precise numbers of self-funders in the area is difficult, however a market survey of care home providers in each county suggests that Carmarthenshire and Pembrokeshire have a similar rate of self- funders (34% and 33%) while Ceredigion has a lower number (23%). Another calculation which estimates numbers of self-funders, and considers the number of beds funded by NHS continuing health care provided similar results for Ceredigion at 21.5%, but higher for Carmarthenshire (43%) and Pembrokeshire (41%). (Mid and West Wales Health and Social Care Collaborative, 2015)
• Safeguardingservicestoprotectagainstabuseandneglect.
• Comprehensivetelecaresupport
West Wales Population Assessment March 2017 Older people