Over £2 million extra a year to support people to recover at home

Published: 20 October 2016

From October 2016 Torbay and South Devon NHS Foundation Trust (TSDFT) is investing £2.31m a year in Intermediate Care services. This will mean that people right across South Devon as well as Torbay can benefit from the service.

Intermediate Care is a key service for providing the care people need to stay at home, preventing them from needing to go into hospital unnecessarily.

The Intermediate Care services in South Devon are also gradually being made available during weekends and Bank Holidays – the people of Torbay already benefit from this cover.

This means that all people living in Torbay and South Devon who would benefit from short-term care and support at home will be able to receive Intermediate Care services – no matter which part of the area they live in.

A key enhancement of the service includes the Intermediate Care team having medical support from a GP and a pharmacist, helping to ensure patients can receive timely medical care when they need it. The GPs are dedicated to the Intermediate Care service, so GPs are not being taken away from their normal surgery hours. This £2.31 million a year is part of a wider investment in developing a new model of care for local people.

Jane Viner, Chief Nurse from Torbay and South Devon NHS Foundation Trust said: “This kind of care is really effective and is what our local people increasingly want and need. With our extra investment this year, we will be able to provide all local people with Intermediate Care services, wherever they happen to live – whether it’s in the Torbay catchment of towns, or further afield within our other South Devon localities.

“We are working hard to make these services available during weekends and Bank Holidays too, as we know people are needing help and support at home seven days a week so our services need to reflect that. This is now starting to happen and by March 2017 we will have a seven day a week Intermediate Care service throughout all of Torbay and South Devon. And it’s fantastic that we now have GP and pharmacist support within our Intermediate Care teams – this is a further step in our integration agenda to provide a truly joined-up health and care service to our local people, it just makes so much sense for us to be doing that.

“So this is great news for our patients and their families, and is a major achievement of our Trust since we formed our integrated care organisation last October.”

Patient stories to illustrate Intermediate Care

Mrs Doreen Graham, aged 87 lives with her family in Paignton. After she had fallen several times, resulting in her being quite unwell, her GP referred her for Intermediate Care services: she needed physiotherapy to assess her mobility and help her rebuild her confidence; she also needed some equipment delivered to her home to minimise the risk of her having any more falls. Her family work during the day, so the Intermediate Care team did what they could to support both Mrs Graham and her family, so she could remain safely at home and the family would not need to worry.

One of the adaptations and equipment include a trolley [as seen in the picture] which Mrs Graham uses to safely and easily transport her things around her home. The Occupational Therapist, Juliette Kite [pictured with Mrs Graham] also installed a bed lever so that Mrs Graham can get in and out of bed without needing anyone to help her. “It was a pleasure helping Mrs Graham,” says Juliette. “It is always great when we can make a difference and keep people independent at home by providing simple pieces of equipment, therapy and advice.”

Sarah Paviour, the Physiotherapist who visited Mrs Graham comments: “It’s so important that Intermediate Care teams and others like us across Torbay and South Devon are here to visit people at home at times of real crisis for them and their families – as in the case of Mrs Graham, who had fallen several times and was at risk of injury resulting from a fall or a long lie. We were able to stop things escalating and offer the equipment and support necessary for Mrs Graham to remain safely at home. Being able to attend Mrs Graham at home meant she was assessed promptly in the appropriate environment. At the time of assessment Mrs Graham would have been unable to attend physiotherapy outside of her home. Mrs Graham’s mobility returned to her baseline within a short space of time, and during the week of our Intermediate Care involvement she had no further falls. We are very pleased to hear she’s doing well!”

Here is what Mrs Graham has to say about the Intermediate Care service she received: “Everything was put in motion and I had everything I could have asked for. They even offered for me to have someone come the next day to get me my lunch, but I said they didn’t need to worry because I had my grandson coming round to do that! I couldn’t have asked for anything more.”

Mrs Elizabeth Crawford aged 78 lives in Torquay with her husband who is in his 80s and has Parkinson’s. Recently after a fall, Mrs Crawford’s GP arranged for her to have an x-ray at Torbay Hospital, where it was confirmed her foot was fractured. She was given a special boot to wear and was admitted overnight. To ensure her husband would be all right, Mrs Crawford agreed for the Rapid Response team – who provide temporary personal care and support such as help with washing, dressing, shopping and preparing meals – to visit her husband the next morning. When Mrs Crawford returned home, she managed over the weekend but on the Monday, she was struggling so she telephoned her GP who then referred her to the Intermediate Care team. Early the next morning Laura Boak, Occupational Therapist arrived at Mrs Crawford’s home to assess how she could help her, including deciding on what equipment could be provided to ensure Mrs Crawford’s safety and independence. Laura says:

“Mrs Crawford not only has a broken foot, but she is also managing other medical conditions, and on top of that, she is caring for her husband who is in his 80s and has Parkinson’s. My assessment showed Mrs Crawford was struggling with mobility and transfers – such as getting up and down from a chair, or in and out of bed – so I provided her with some equipment to make transfers easier and safer. I also noticed that Mr and Mrs Crawford are unable to leave their property due to the step access, so I’m helping them to try and get more equipment – a ramp – which they can trial and hopefully, they will then be able to safely get outside, out into their community.

“The central ethos of Occupational Therapy is the holistic treatment of the whole person. Working in the community enables our team to treat people in their own home environment focusing on what is important to them, setting realistic goals and supporting them to work towards achieving those goals. I am so pleased that we are able to address the difficulties that Mrs Crawford and also her husband have been having with getting outside to access their community, as this is an important goal for her and her husband to achieve.”

Physiotherapist Carla Tucker who also visited Mrs Crawford says: “I find my job immensely satisfying – it is always a privilege to be allowed into someone’s home, and hopefully make a difference at times of crisis. Sometimes it’s the simplest of equipment or advice that makes the greatest difference. With Mrs Crawford I have prescribed exercises to help her stay mobile.

“As we are able to see our patients as frequently as we feel is necessary, we build up a great rapport with them, so they trust in us to help them work towards the goals we set with them.”

“It’s been really marvellous,” says Mrs Crawford. “They came round in the morning and the equipment was with me a few hours later in the afternoon. You can’t ask for better than that, can you?”

Su Skelly is the Operational Manager for Intermediate Care, Torbay and South Devon NHS Foundation Trust: “Thanks to the swift intervention from our Intermediate Care services, many people avoid being admitted to hospital, which is usually a big relief both for them and their families. People like Mrs Graham and Mrs Crawford who have had falls can receive exactly what they need to help regain their mobility and independence in the comfort and familiarity of their own home, without being exposed to the risks that we know exist once they are admitted to hospital as an inpatient. And as we all know – there’s no bed like your own bed!”