SPECIFICATION FOR DOMICILIARY CARE
Glossary of terms
Time and task:
the process by which a provider is paid where the time taken and task needed is
calculated on a rate per hour basis
Outcomes:
where the Provider and adult with needs agree what they want to achieve from
the help they are receiving, which are focussed at enabling the adult
Providers:
Current providers who have contracts with Swindon Borough Council
Tenderer:
Companies who are submitting a bid for the requirement
Authority:
Means Swindon Borough Council
Master Vendors:
Mean those tenderers who are awarded a contract as a result of the tender for
master vendors for domiciliary care
1
Introduction
The number of older people in Swindon are projected to rise faster than the national average
whilst life expectancy is also increasing in line with the national average. In Swindon we have
seen an increase in the number of older people contacting adult social care and an increase in
those being supported both at home and in residential and nursing homes. At the same time
admissions to hospital of older people are also rising as is the number of those with three or more
long term conditions.
2
The aspirations of the Authority
The Council are committed to building a simpler, stronger approach to adult social care that
improves the lives of the people we work with.
In order to achieve this we want to actively work with the market to:

To deliver agreed sustainable outcomes whilst ensuring the quality of the services. In
doing so we will need to:
o maximise the independence of adults with needs for as long as possible
o to promote and achieve a good quality of life for those being supported
o To meet the increasing demand for services, within our financial budgets.
o Build on the support of family and community networks to promote older people’s
independence and reduce their isolation
Using outcomes as a method of service delivery is a major change from the traditional care
delivery model where a rate per hour is agreed to perform a task.
Outcomes can be set at a service and individual level: At service level the outcomes
achieved could be for example, % reduction of readmissions to hospital, % of adults with
1
needs reporting improved well- being. At an individual level the outcomes may be directly
linked to overall service outcomes, for example, being able to manage my long term condition
effectively in the community, not feeling isolated as a result of an increased network of
support.
For the adult with needs the achievement of outcomes is about their aspirations for their care.
For commissioners it is about the difference the service makes as a whole, and also how it
meets (and reduces) the needs of the individual; the ‘so what?’ question.
There are Provider(s) in Swindon currently who are able to demonstrate that they are making
a difference to adults with needs through the delivery of individual outcomes in the existing
time and task payment system. The real issue is that this is time limited and that there may
not be sufficient time to really achieve the outcomes so that they are sustainable (with a
reduction in the number of overall service interventions). Equally the outcome may have been
met more quickly and the package of care could have been reduced down or indeed ceased;
the longer that the package of care remains in place then the greater the risk of dependency
developing and the sustainability of the outcome reducing. We also need to ensure that in
meeting the needs of older people provider build on the strength and networks of support of
the individual
3. Purpose of this tender
The purpose of this tender is to procure services from prospective providers who have a track
record of delivering quality services to adults with needs. They will need to provide relevant
and timely care interventions to meet the assessed needs, which responds either in the short
or longer term.
We are looking to award the domiciliary care master vendor(s) contract to one or two
tenderers; the borough will be split in two with a master vendor each taking either the north or
the south of the borough. The boundary between north and south is the railway line which
runs from the west (Bristol and beyond) into London. The borough boundary forms the overall
boundary.
4. A two master vendor strategy and the need to work together
We recognise that there will be a need for all the involved parties to work together. The
nature of the services between the North and South of the Borough cannot be substantially
different and there will be a need for a common performance framework against which
services can be developed and monitored. We prefer a two Provider(s) strategy so that we
reduce our risks. We are cognisant of the impact of this contract on the local market and subcontracting will be encouraged, but this will not be with intervention from the Authority. The
Providers will be responsible for managing the relationships and performance of the subcontractors.
2
We are open to having a sole master vendor, however we would only award to one tenderer if
there are significant and sufficient advantages in doing so.
The long term aim of this contract is to move from time and task to outcome based
commissioning where there is an agreement on the total budget for the achievement of the
outcomes for that individual. The aspiration of commissioners, working with the master
vendors would be to achieve a wholly capitated budget across the delivery of service and
individual outcomes
We wish to go on an improvement journey with the Provider(s) starting from a place of proven
performance. The basis of this would be a strong, open and challenging relationship, for all
parties that creates honesty, innovation, and guaranteed delivery of all required services and
the meeting of individual customer outcomes.
Swindon Borough Council’s Adult Social Care have not had a contract such as this previously
and therefore recognise that there will be challenges on the journey. As a result of this we
have put formal contract review points at years three, five and eight of the ten year contract.
5. Current Provision and Market Supply
A Domiciliary Care Framework has been commissioned starting on 1st July 2017 which has a
number of Provider(s) who have complied with the quality standards required. The Provider(s)
are mixed with a range from small local Provider(s) to larger national ones. The Framework
will pick up the service need from 1st July 2017 up to the award of the master vendor(s)’
contract(s). The packages of care that the Framework Provider(s) are supplying will continue
beyond the start of the master vendor(s)’ contract(s); this will result in there being no need for
any TUPE of staff or packages. This will primarily prioritise the continuity of care for the adult
with needs and will continue until those packages come to their natural end. There is a
possibility of the care package being handed back in particular circumstances and in this case
it would transfer to the master vendor(s) or if appropriate move to a direct payment.
The Domiciliary Care Framework provides a state of readiness for any potential bidder should
they wish to subcontract from the existing market. It also ensures that market stability is
maintained, even in the event of non- award of the contract.
6.
Current Model of Delivery
The current model of delivery by Provider(s) in Swindon is that of time and task where
Provider(s) are commissioned to deliver specific tasks in a given time slot. These are based
on assessed need, however are primarily about doing the task for the person rather than
enabling and supporting them to achieve the task or achieve an outcome for themselves. This
has often created dependency on the service and not fostered greater independence and
overall improvement of well-being.
3
As a consequence of moving from time and task service delivery and payment method there
are likely to be defined phases of the contract. We recognise that these phases could be
shorter or longer for Provider(s) depending on a number of considerations, including
experience.
Phases of Domiciliary Care Contract Development
Phase 1 – Transition Phase - recognising a time and task based approach to care at the
start of this contract which will be followed by the Development Phase (phase 2)
The service provision in Phase 1 will be a combination of time and task domiciliary care and
home from hospital bridging services. The Provider(s) will be required to deliver services
under packages of care commissioned by the Authority following the conclusion of the
mobilisation period. Any existing care packages will remain with existing Provider(s) in the
framework and will not transfer to the master vendor Provider(s) except when a change in
Provider(s) is required for whatever reason.
Packages of care are based on the needs identified through the assessment process and an
indicative budget based on those needs. Outcomes are able to be demonstrated and
achieved. The master vendor(s) notify commissioners when packages of care are able to be
reduced or ceased.
Phase 2 – Development Phase – reflecting an outcomes based way of working that is to
be implemented early within the contract and through further innovation throughout the life of
the contract.
Phase 2 follows Phase 1. It builds on the specification and the service delivery requirements.
The master vendor Provider(s) will transition the services from a time and task model to an
outcomes-based model during Phase 2.
This is considered an outline specification which articulates the direction of travel to which all
parties are committed.
7. Key features of this procurement and its resultant contracts
We are committed to fully understanding the bids provided by the tenderers and ensuring
there is absolute clarity about



Those providers who have an ethos of ensuring that their work is of the
best quality and that this can be demonstrated through past experience (
questions in the selection questionnaire and in the ISOS)
Those providers who have adult care at the centre of their business and
who are passionate about adult care
How the tenderer anticipates providing the services for the term of the
contract, in particular moving from payment by the hour to payment for the
4
outcome: Specifically through the dialogue sessions we will be seeking to
understand
 Realism and practicalities
 Expected obstacles and opportunities
 Risks and the management of these – both for the providers and for
the Authority
 More detail about the “ how “
o
o
o
We want to explore, through dialogue the bids received and understand better
those proposals who we deem, through the evaluation criteria, to be the best.
We accept that at the Invitation to Submit Outline Solutions (ISOS) stage a
proposal may not be fully developed- and there is an opportunity to finesse (not
change) the bid at final tender stage. We accept that there needs to be a lot of
thought and commitment, not only to bid but to want to win the work. We will be
holding an open day during the tender process when bidders may come and seek
answers to their questions ( in addition to the normal clarification process)
There is a payment gain share during phase 2 (and for the remaining life of the
contract) when payment is by outcome alone. Any underspend of an outcomes
budget is shared between the provider and the authority. How this works in
practice needs discussion.
This specification is intentionally not specific as tenderers should know best how to
provide care to adult with needs.
We are looking to the market to explain how they can deliver these main drivers for this
contract:
1. Changing the way care is provided to enable greater independence and better
quality of life for those adults with needs
2. Ensuring in a time of decreasing budgets and increasing demand that value for
money is achieved by significantly altering the way care is delivered.
3. Providing equality of care for the North and South of the Borough, irrespective of
provider. Ensuring that the care market in Swindon remains viable and vibrant The
Provider(s) will be expected to meet the demands of the system and the needs of
the clients by collaborating and building strong links with other Provider(s) in
Swindon. Sub-contracting is seen as a key element of the structure of service
delivery in Swindon. Building a vibrant care sector is a requirement of the
Provider(s). The Provider(s) is likely to need to manage the sub-contractors,
ensuring capacity and quality in the market as well as delivering services directly.
It may be possible for the commissioner to provide the Provider(s) with a suite of
incumbent Provider(s) from whom it will be required to access a level of care, and
who will provide capacity for the Provider(s) as a result of the Domiciliary Care
Framework being in place.
5
8. Technical aspects
In September 2016 we commissioned 9,800 hours of domiciliary care for the over 65
population per week. This had risen from 9,100 hours in September 2015 and peaked at
10,200 hours in December 2016. Our expectation through this tender is that there will be a
reduction in the amount of hours required per week due to the efficient use of technology and
community support.
Most services are required and can be delivered between from 7.00am until 10.00pm, every
day of the year.
The master vendor(s) will need also on some occasions to support people between 10:00pm
and 7:00am. This will not necessarily be through a ‘live in care’ arrangement but may be part
of a more flexible approach where short visits are scheduled e.g. to help adults with needs with
toileting or pressure relief.
9. Quality standards

The master vendor(s) will be required to develop and agree care plans for each adult with
needs

The master vendor(s) will be required to comply with the Mental Capacity Act 2005,
including Deprivation of Liberty Safeguards, with appropriate use of mental capacity
assessments and best interest decision making

The master vendor(s) will be required to use an enabling approach to service delivery

The master vendor(s) will be required to manage challenging and difficult behaviour

The master vendor(s) will be required to Comply with the Care Act 2014

The master vendor(s) will be required to Identify, support and work with carers and links
to community networks

The master vendor(s) will be required to monitor and review the care plan and provide
regular and formal feedback to the Authority

The master vendor(s) will be required to Increase the use of voluntary and community
sector organisations which result in a decrease of care packages

The master vendor(s) will be required to provide staff training and development in line
with CQC standards
6

The master vendor(s) will be required to keep records and provide these to the Authority
on matters concerning staff attraction, retention, attrition and training, complaints against
staff and the service, and other staff related issues.

The master vendor (s) are required to meet best practice and quality standards of a good
and excellent service as defined by CQC
Typical domiciliary care services currently comprise: 1

Supporting and working with people with dementia, particularly those who have complex
needs. We would expect providers to work in line with the DoH 2009 Dementia Strategy.

End of Life care and support

Enabling approach to service delivery

Administering medication, application of creams and dressings ( liaising with Health
professionals as appropriate)

Rehabilitation of people discharged from hospital

Supporting people with long term conditions

Support for discharge and step down cases with input for 2-4 weeks

Support for complex needs
Currently the following services are out of scope:







Telecare
Management of Equipment /Wheelchairs
Rapid response (including night service)
Wider voluntary sector services (wellbeing coordination)
Homeline and control centre
Re-enablment – it is expected that all new packages of care will start with a reenablment focus as described within Section 4 below.
Housing Support, Extra Care Housing and Live in Care.
The services delivered will be jointly developed with the master vendor(s) within the term of
the contract. It is the intention of this tender to build on the experience and innovation of
successful master vendor(s) and to further test these within the collaborative nature of this
contract. It is expected that as a minimum the master vendors will be required to:
1
Please note this list is not exhaustive
7

Accept all referrals made to them and provide care within 72 hours, unless the Provider(s)
can demonstrate that the Adult with needs should be referred to a specialist service
following a process of risk assessment

Take referrals and provide care for patients discharged from hospital the same day 7 days
a week and for those in crisis where social care makes a request for immediate care

Develop initial Support Plans within indicative amounts

Monitor progress of outcomes against agreed targets

Review Adult with needs outcomes, leading to a revised indicative amount which will be
referred to the Commissioner for authorisation.

Develop Support Plans for future phases of support within revised indicative amount

Ensure Adult with needs satisfaction and engagement
The process for how services are currently commissioned can be found in the Appendix of
this document- along with two draft processes which will be used for discussion and should
be considered when tenderers make their submissions.
10. Outcomes and related performance indicators
CARE COHORT
SERVICE OUTCOMES
Short term recovery
 The proportion of older people who
enter residential care after receiving
domiciliary care - <20%
 Percentage of people who completed
short-term reablement who were
assessed as still requiring a service after
8 weeks – less than 33%
 Percentage of people who are admitted
to hospital within 2 years of receiving the
service – less than 15%
Longer term recovery

The proportion of people receiving
longer term care whose care needs have
decreased – >15%
8

The proportion of older people receiving
longer term care whose needs have
increased – <25%
The proportion of older people who
enter residential care after receiving
domiciliary care - <20%

Helping a person to live/ manage with a long
term conditions

The proportion of people with a long
term conditions who are supported to
remain at home and who do not enter
residential or nursing care - >75%
 Percentage of people whose needs are
reduced within first year of receiving the
service – over 20%
 Percentage of people whose needs
either remain the same or reduce over
time 70% (do not increase)
Helping a person to live with / manage memory
dementia

The proportion of older people with a
diagnosis of dementia who are
supported to remain at home and who
do not enter residential care - >75%
Helping a person receive end of life care

Supporting a carer who is helping any of the
above

Percentage of people who died in the
place of their choice – over75 %
Percentage of people who have to visit
GP? Less than 20%
These are the service outcomes and individual outcomes will be agreed and set with the
individuals. Performance will measured against the key performance indicators.
The Tender Guide forms part of the suite of documentation and this lays out the process and
provides a useful guide. The submission documents should be used to make your submission
where the Selection Questionnaire and the ISOS should be completed
9
Data Annexe
Annexe
Living healthy and independent lives - Swindon
A briefing and data outline
Swindon has an ambitious Vision for growth and increased prosperity; our priorities
include:
 Well managed housing growth
 Improved infrastructure for a rapidly growing city
 Developing a workforce that meets the needs of business
 Transforming public services to meet the increasing needs of a growing
population
As the latest Centre for Cities report (which included Swindon albeit a town not a city)
highlights, we are:




The town with the third highest population growth in the UK (more than double the
national average)
The town with the fourth highest growth in the number of businesses
The town with the second highest growth in the number of homes
The town with the third highest employment rate and the second highest
proportion of private to public sector jobs.
Over many years, Swindon has consistently delivered high growth in terms of both
housing numbers and economic output. The Council has supported this through the
strength of its relationships with the private sector companies who have made their home
here.
Swindon is a fast growing town with main developments at Wichelstowe (3,500 homes)
which is due to be followed by the UK’s largest urban extension, Swindon’s Eastern
Villages (9,000 homes). We are also committed to ensuring that, through new house
building, we can continue to support elderly and vulnerable members of our community,
with the greatest possible dignity and independence.
The overall population of Swindon is forecast to rise to around 250,000 by 2030. As with
any predominantly urban area there are challenges around inequality and disadvantage.
Swindon has a younger population but the number and percentage of older people is due
to grow faster than the national and south west average. In addition, there are extremes
of high and low levels of deprivation. A number of areas score in the bottom 10% in the
Index of Multiple Deprivation which highlights significant levels of deprivation in
comparison to other parts of the Borough. There are also areas of Swindon that feature
in the least deprived 10% nationally.
The Swindon Borough Council (SBC) resident population was estimated at 215,000
people in 2014. 32,900 people were aged 65 years or more (14.2%), including 15,500
10
aged 75 years or more (6.8%). Swindon older population and births are both forecast to
rise at a rate above the national average from 2016.
Swindon has a diverse and growing population of Black and Minority Ethnic families.
School census figures show an increase of BME pupils of 20% in January 2014.
Swindon has been a dispersal area for Asylum Seekers for several years and this has
had an impact on a number of local schools as well as some public services. The 2011
census shows the number of people reporting themselves as White British as 84.6%
compared to the average for the South West of 91.8% and the South East as 85.2%. The
largest single nationality among the BME population is Goan but there are also significant
populations from China, India, Bangladesh and Pakistan. (Appendix 2 for Swindon
profile. Full details of the Joint Strategic Needs assessment are on
http://www.swindon.gov.uk/info/20024/health_and_wellbeing/220/swindon_joint_strategic
_needs_assessment
Health and Social Care integration
Our joint vision for people in Swindon is enshrined in the Health & Wellbeing Strategy
To ensure that everyone lives a healthy, safe, fulfilling and independent life and is
supported by thriving and connected communities
We have aligned our joint resources to support the health, wellbeing, mental health,
education and care of children, families and adults in the community to achieve the
mission of both organisations.
We have a long history of integrated commissioning and integrated service delivery for
health and social care. This was outlined in detail in our bid ‘Shoulder to Shoulder’ to
become an integration pioneer. Our vision for the Better Care Fund builds on our
successful integration and the Five Year Strategic Plan for Swindon.
We are a single unitary local authority (Swindon Borough Council), one CCG (Swindon
CCG, representing 26 member practices in Swindon and Shrivenham), a single acute
Trust in the Town (Great Western Hospitals NHS Foundation Trust) who also provides
community health services, one mental health Provider(s) (Avon and Wiltshire Mental
Health Partnership NHS Trust, who have established a clinical directorate that just serves
Swindon), one emergency patient transport Provider(s) (South Western Ambulance
Service NHS Foundation Trust) and one network of voluntary sector organisations
(Voluntary Action Swindon or VAS).
Our track record in providing integrated commissioning and delivery has been recognised
in Swindon becoming one of 10 members of the national Public Service Transformation
Network Areas. This work has now been joined with the Integration Health Pioneers in
the recognition of the work that is taking place in Swindon.
We have jointly commissioned services through National Health Services Act 2006
Section 75 Agreements since 2008. The Agreement renewed in 2011 comprises a total
aligned fund of £16m CCG and £55m Swindon Borough Council (SBC), a total of £72m.
Services are commissioned through commissioners reporting to both the Accountable
Officer in the CCG and the Director of Adult Social Care/Director Children’s Services. All
services are commissioned against agreed commissioning intentions set out in the ~Joint
Commissioning Intentions 2016/17 and the forthcoming Better Care Fund Plan 2017 - 19
and monitored by a Joint Commissioning Group. Our joint commissioning of services has
achieved savings of £5m in 2014/15, £6m in 2015/16 and £3.8m in 2016/17
he The Better Care Fund Plan 2016/17 and 2017 - 19.has a strong emphasis on
prevention, maintaining your health and wellbeing and self-management of managing
11
long term conditions. We are committed to working with the voluntary and third sector
and have established an advice and information website and market place
www.mycaremysupport.co.uk.
Adult social services is the provider of all social work and commissioning services for
older people. We also provide Reablement, discharge to assess and rehabilitation beds
and two care homes.
We require Provider(s) who are able to demonstrate a commitment to integrated working
and the development of services that push the boundaries of quality care and support.
We are particularly interested in Provider(s) who help deliver our vision, build on people’s
strengths and ability and works closely with communities and the voluntary sector.
The requirement is for a Provider(s) for each zone of Swindon (Swindon North and
Swindon South), who will coordinate, manage and deliver both directly and indirectly,
domiciliary care and community support in Swindon, working with us to overcome
barriers and deliver a new model of care and support. The present levels of care in
Swindon are included in Appendix 2– Better Care Fund population projections
Further information about the Swindon Population and the Health Being Priorities can be
found in the links below:
Document or
Synopsis and links
information title
Health and
Statutory Plan to improve the health and well-being of the people in
Wellbeing Strategy Swindon
2017 - 2022
JSNA 2013-2022
Joint Strategic Needs Assessment for Swindon
http://www.swindonjsna.co.uk/
One Swindon
The Community Strategy and Vision for Swindon
http://www.oneswindon.org.uk/cs/Pages/default.aspx
Adult Care
Our strategy for managing demand for adult services
Strategy
http://ww5.swindon.gov.uk/moderngov/mgConvert2PDF.aspx?ID=4
6045
CCG One Year
Operational Plan
2016/17
Joint
Commissioning
Intentions and
update 2016/17
NHS Swindon
Policies and Plans
NHS Swindon 2
year operating
plan 2017-19
Better Care Fund
Plan 2016/17
Swindon CCG Operational Plan 2016/17
http://www.swindonccg.nhs.uk/index.php/list-of-events/attend-agoverning-body-meeting/governing-body-papers
http://www.swindonccg.nhs.uk/index.php/about-us/download-ourplans-and-publications
The final d Better Health Care Plan is on the Health & Wellbeing
Board website of Swindon Borough Council
12
http://swindonjsna.co.uk/strategy/Better-Care-Fund
13
Appendix 1
Budget information
Domiciliary Care
Domiciliary care
estimated budget for
20117/18 for older
people.
CHC funds
£9.7m
£4.5m
The type and cost of services which are an option for possible inclusion in future years
are listed in the table below. There are currently no plan or estimates on timing for these
future inclusions. The purpose is to allow us greater flexibility in the delivery of our
services via 3rd Party Provider(s)s.
Telecare
Residential and nursing care budget for older people
Rapid response (incl night service)
Wider voluntary sector services (wellbeing coordination)
Social work, Occupational therapy and physiotherapy
Homeline and control centre
SBC funded
£109k
£16.3m
£423k
£45k
£2.6m
Break even traded
service
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DOMICILIARY CARE DATA
Mainstream Homecare Clients who moved to Placements during 16/17
Age Band
18Client Category
65+
64
Mental Health Support
1
2
Physical Support - Access & Mobility
2
Physical Support - Personal Care Support
4
82
Sensory Support - Support For Hearing Impairment
1
Sensory Support - Support for Visual Impairment
1
Support with Memory and Cognition
14
Grand Total
5
102
Grand
Total
3
2
86
1
1
14
107
Mainstream Homecare Clients who moved to Placements during 16/17
Age Band
18Client Category
65+
64
Learning Disability Support
2
Mental Health Support
2
Physical Support - Personal Care Support
47
Sensory Support - Support for Dual Impairment
1
Support with Memory and Cognition
7
Grand Total
2
57
Grand
Total
2
2
47
1
7
59
Total Number of New Homecare Clients Split by Age Band, Category and Number of hours per week. Period 2016/1
Less
Greater
Greater
Greater
than 5
than 5 - 11 than 11 than 18
Client Category
Total
Hrs per
Hrs per
18 Hrs per
Hrs per
Week
week
week
week
Personal Care Clients aged 18-64
10
30
8
4
52
Personal Care Clients aged 65+
116
170
80
63
429
Mental Health Support /Memory & Cognition 1864
3
1
3
1
8
Mental Health Support /Memory & Cognition 65+
2
6
3
2
13
Total
131
207
94
70
502
15
Map showing Borough – Boundaries and North /South Boundary
16
Typical hourly and cost profile for North and South Swindon
Area
Week 7/3 - 13/3/16. 65+ age band
No.
Sum of Total Cost
Clients
North
324.00
South
multiplied
by 13
weeks for
13 week
cost
Sum of
Total
Duration
in
HOURS
multilplied
by 13 for
total
hours for
13 week
hours
used
Sum of
No of
Visits
no of visits x 13
for 13 week
period
77106.33
1002382.33
5175.77
67284.97
7373.00
95849
251.00
57140.36
742824.68
3736.40
48573.20
5833.00
75829
Out of area
2.00
630.11
8191.43
39.50
513.50
8.00
104
Grand Total
577.00
134876.80
1753398.44
8951.67
116371.67
13214.00
171782
multiplied
by 13
weeks for
13 week
cost
Sum of
Total
Duration
in
HOURS
multilplied
by 13 for
total
hours for
13 week
hours
used
Sum of
No of
Visits
no of visits x 13
for 13 week
period
Week 6/6/16 to 12/6/16. 65+ age
band
Sum of Total Cost
Area
No.
Clients
North
335.00
78588.36
943060.30
5053.02
60636.24
7396.00
88752.00
South
268.00
61306.78
735681.38
3847.40
46168.80
6230.00
74760.00
out of area
2.00
661.68
7940.16
39.50
474.00
8.00
96.00
Grand Total
605.00
140556.82
1686681.84
8939.92
107279.04
13634.00
163608.00
multiplied
by 13
weeks for
13 week
cost
Sum of
Total
Duration
in
HOURS
multilplied
by 13 for
total
hours for
13 week
hours
used
Sum of
No of
Visits
no of visits x 13
for 13 week
period
Week 5/12/to 11/12 /16
Sum of Total Cost
Area
No.
Clients
North
372.00
89842.57
1167953.41
5722.02
74386.22
8504
110552.00
South
306.00
73513.91
955680.87
4584.90
59603.70
7199
93587.00
out of area
1.00
645.26
8388.38
38.50
500.50
7
91.00
Grand Total
679.00
164001.74
2132022.66
10345.42
134490.42
15710
204230.00
multiplied
by 13
weeks for
13 week
cost
Sum of
Total
Duration
in
HOURS
multilplied
by 13 for
total
hours for
13 week
hours
used
Sum of
No of
Visits
no of visits x 13
for 13 week
period
Area
No.
Clients
Week 5/9/ to 11/9 /16 . 65+ age
band
Total Cost for Period
17
North
362.00
88290.81
1147780.55
5637.77
73290.97
8086.00
105118
South
280.00
69742.45
906651.85
4352.40
56581.20
6680.00
86840
Out of Area
2.00
661.68
8601.84
39.50
513.50
8.00
104
Grand Total
644.00
158694.94
2063034.24
10029.67
130385.67
14774.00
192062
no of visits x 13
for 13 week
period
TOTALS FOR YEAR BY AREA
Area
North
No.
Clients
Total Cost for Period
multiplied
by 13
weeks for
13 week
cost
Sum of
Total
Duration
in
HOURS
multilplied
by 13 for
total
hours for
13 week
hours
used
Sum of
No of
Visits
324.00
77106.33
1002382.33
5175.77
67284.97
7373.00
95849
335.00
78588.36
943060.30
5053.02
60636.24
7396.00
88752.00
324.00
77106.33
1002382.33
5175.77
67284.97
7373.00
95849
372.00
89842.57
1167953.41
5722.02
74386.22
8504
110552.00
totals for year
1355.00
322643.59
4115778.37
21126.57
269592.39
30646.00
391002.00
South
251.00
57140.36
742824.68
3736.40
48573.20
5833.00
75829
268.00
61306.78
735681.38
3847.40
46168.80
6230.00
74760.00
280.00
69742.45
906651.85
4352.40
56581.20
6680.00
86840
306.00
73513.91
955680.87
4584.90
59603.70
7199
93587.00
1105.00
261703.50
3340838.77
16521.10
210926.90
25942.00
331016.00
totals for the
year
18
Service requests process – please click on PDF to open
As is
AS IS - Domicillary
Care Provision - Provider Perspective.pdf
Proposed – version 1 and version 2
TO BE - Domicillary TO BE - Domicillary
Care Provision - Provider
CarePerspective.pdf
Provision - Provider Perspective (Option 2).pdf
19
1. Swindon and its people, the vision for Adults with Needs
The joint vision of Swindon Borough Council and Swindon Clinical Commissioning Group
for people in Swindon is enshrined in the Health & Wellbeing Strategy.
To ensure that everyone lives a healthy, safe, fulfilling and independent life and is
supported by thriving and connected communities
Swindon is a single unitary local authority (Swindon Borough Council), one CCG (Swindon
CCG, representing 26 member practices in Swindon and Shrivenham), a single acute Trust
in the Town (Great Western Hospitals NHS Foundation Trust), one mental health provider
(Avon and Wiltshire Mental Health Partnership NHS Trust, who have established a clinical
directorate that just serves Swindon), one emergency patient transport provider (South
Western Ambulance Service NHS Foundation Trust) and one network of voluntary sector
organisations (Voluntary Action Swindon or VAS).
Swindon Borough Council is the Local Housing Authority.
Swindon will have grown substantially by 2020 with a population of over 250,000 by 2026
(including Shrivenham) from a current population of 220,000.
Living in Swindon in 2020 will mean that you can expect to live longer than the English
average, with less risk of avoidable death, in better health and with the support of your
neighbourhood and community.
We recognise the ongoing cost pressures on Older People services, especially in relation
to nursing home placements. Despite more people requesting services, and people over
85 years of age suffering from complex and multiple health problems, we aim to deliver
£1.2m through more preventative care and finding new ways to meet people’s needs.
Local analysis of need has identified:

The most deprived areas of Swindon have the highest prevalence of chronic
conditions (such as heart disease, diabetes and cancer) in the local population, the
highest rate of emergency hospital admissions (after allowing for age), and the
highest rate of death before 75 years of age

12,123 people are living with diabetes in Swindon which is projected to be 13,422
people by 2020, which represents a 10.7% rise (1,299 people). Currently there are
2,000 people in Swindon with dementia and the prevalence is projected to increase
with age being the biggest risk factor. In 2014/15, there were 6,301 people with
diagnosed Coronary Heart Disease in Swindon CCG (2.75%) and 3,372 people with
diagnosed stroke.
20

Over 120 languages are spoken in schools in Swindon and an increasing number of
children are arriving from minority ethnic communities who will have parents and
grandparents with increasing needs for health and social care. This also means that
our advice and information needs to be in simple language and staff need to be well
trained to provide a service to diverse communities. Given the number of languages
spoken, we access services such as language line to offer a wide range of translation
services.

Geographical mapping has shown that an increased number of older people, who are
financially supported by the local authority, live in areas of deprivation. Currently
there are people living in areas of Swindon such as Penhill, Pinehurst, Parks, Toothill,
Gorse Hill and Moredon with high levels of poor health and needs with little access to
advice and information. From our data we know that many people in those areas
prefer information given to them face to face. We know that the number of older
people with long term conditions will rise substantially from 35,000 now to
approximately 40,000 by 2020.

An annual survey of service users gives us data about user satisfaction with local
services. In all areas Swindon scores better than the national average.

Swindon has an increasing number of people from minority ethnic communities and
backgrounds. 25% of school age children are from BME backgrounds. Citizens Advice
Bureau reports that 24% of its customers and service users are from BME
backgrounds.

Population estimates in Swindon show numbers are increasing and are currently
around 220,000 of which 14.9% (32,237 people) are aged 65 or older. Projections
indicate that almost half (25,900 people) of the population growth between 2011 and
2031 will be in the 65 plus age group. The increase in population is being driven by
people living longer and (net) internal migration.
We understand the population of Swindon at a locality/ward area and at GP practice
level. We have some preventative and self-help services in place such as a third phase of
community navigators and befriending support for a small number of older people.
The growth in people from BME Communities to 15% places even greater emphasis on
the development of approaches to healthcare design and delivery that reach out to and
are guided by our new communities. The greatest growth has been in communities who
are also vulnerable to diabetes and cardiovascular disease in the Asian community,
By 2020 preventative and self-help integrated services will be in place locally to engage
and support individuals. Swindon is in the process of developing an Accountable Care
system. Accountable Care sits across several organisations: Swindon Clinical
Commissioning Group (CCG), Swindon Borough Council (SBC), Great Western Hospital
NHS Foundation Trust (GWH) and Avon and Wiltshire Partnership Trust and Primary Care.
The aim is for everyone to work together to provide high-quality care for patients.
Accountable Care makes the system less complicated, less fragmented, and reduces
21
hospitals delays. Each organisation providing care to the local community will pool
resources to support the joint commissioning and delivery of health and social care for
everyone. This is to benefit both patients and staff, as well as make better use of
resources across the health and social care system.



Our vision is to support Adults with Needs to live life to the full within the
community despite long term conditions thus avoiding institutionalised care in a
community setting.
We will offer a genuine choice of care setting for those whose mobility,
functionality or health is impaired or for those with serious and terminal illness who
are preparing for death.
Home will mean people’s own home, where we will be using new practice and
technology that enables people to be and remain at home.
2. Social Care and Health Integration
We have a long history of joint commissioning and integrated working for health and
social care. Our future plans have now been revised in light of the Five year Forward plan
next Steps and the Sustainable Transformation plan as well as the refresh of the Health
and Wellbeing Strategy 2017 - 2022
Our track record in providing integrated commissioning and delivery has been recognised
in Swindon becoming one of 10 members of the national Public Service Transformation
Network Areas.
We have aligned our joint resources through a section 75 agreement to support the
health, wellbeing, mental health, education and care of children, families and adults in
the community to achieve the mission of both organisations.
We have jointly commissioned services through National Health Services Act 2006 Section
75 Agreements since 2008. The Agreement renewed in 2015 comprises total funding of
£47m from the CCG and £89m Swindon Borough Council (SBC), a total of £136m. Services
are commissioned through the Joint Commissioning Group with representation of the
Executive Nurse of the CCG, the Director of Adult Social Care and Director of Children’s
Services. For 2017 – 19 services are commissioned against the Better Care Fund Plan and
monitored by the Joint Commissioning Group reporting to the Health & Wellbeing Board.
The Better Care Fund Plan is a summary of jointly agreed areas of priority and serves as
our plan for integrated working and joint commissioning.
Service users stated that their priorities are:




Improved advice and information about services for carers and parent carers
A simplified assessment process for service users and carers
Community support for people discharged by specialist mental health services and a
seamless link between voluntary and third sector providers and specialist services
Support for older people who are isolated
22

Improved patient flow within the hospital discharge process
We recognise that our demographic challenges as an expanding town with an ageing
population. Following a detailed diagnostic by Newton Europe in 2015, the community
health services and community equipment services were tendered in 2016 with the aim
of improving independence, reducing emergency admissions and improving the health
and wellbeing of the population. The contract was successfully awarded to Great
Western Foundation Trust who we are working with to develop a new model of care in
line with the Five Year Forward View.
On 1 October 2016, 400 staff that had previously provided care services in Swindon on
behalf of SEQOL (the independent employee-owned social enterprise company)
transferred to the Council following financial difficulties experienced by SEQOL. A new
management structure has been established and we have successfully recruited to a
Head of Transitions post, Head of Commissioning, Head of Social Work and Regulated
Services Manager. In light of the strategic direction and the Special Educational Needs
Reforms, Swindon Borough Council transferred Learning Disability social work services
from SEQOL to the Council in October 2015.
There are strong links between the provider of integrated community health and social
care services and all partners, particularly the local hospital, care homes, voluntary sector
and primary care. We have invested in My Care, My Support website at
http://www.mycaremysupport.co.uk/ giving advice and information about health and
social care as well as a community based advice service. We have also worked to improve
urgent care, however there is more to do.
Our vision is that by 2020 everybody in Swindon will work together with a common set of
values and principles based on respect, giving people choice, collaboration and
innovation, where people are encouraged to think what they can do themselves, what
help they have within their family and community and what they still need help with.
When people need help it will be personalised, offering choice and control.
Outcomes for Adult with Needs will improve by 2020 in line with the Better Care Fund
(BCF) and Swindon’s vision for integrated health and social care:



Emergency hospital admissions will be avoided for specific groups of patients,
particularly those suffering from diabetes and heart conditions
More patients will be able to leave hospital without delay and three or more long
term conditions
Fewer older people will be admitted to residential care, through support provided at
home and flexible housing with care, reducing isolation amongst older people.
23


Reablement will be an integral part of all domiciliary care and will mean that fewer
patients will be re-admitted to hospital
More people with a learning disability will be able to find employment through
support commissioned from the voluntary and third sector and in partnership with
our Skills for Employment.
Our Commissioning Intentions
Swindon’s commissioning intentions are covered in The Better Care Fund 2017 which
includes a detailed action plan. The Better care Fund for Swindon is also seen as
Swindon’s commissioning strategy.
Also see Bath and North East Somerset, Swindon and Wiltshire’s Sustainability and
Transformation Plan (STP) A short guide: http://www.wiltshireccg.nhs.uk/wpcontent/uploads/2016/04/STP-short-guide.pdf
3. Older People
Population Profile
Population
Projection
People aged 65+
2011
2016
2021
2026
2031
29,069
34,009
39,504
46,458
54,976
Source:
SBC population projections: http://swindonjsna.co.uk/Files/Files/Population-Projections-to-2031.pdf
The largest increase in persons in the population growth will be in the 65 to 74 age group,
projected to be 12,900 more by 2031. However, the 85 plus age group will have the
largest growth rate at approximately 136%. By 2031 the population aged over 65 is
projected to grow by 25,900 persons to reach a total of about 55,000 by 2031, accounting
for 46% of total population growth.
In Swindon, in 2013-15, life expectancy is 79.6 years for males and 82.8 years for females,
which is similar to England. Males in Swindon will spend 80.5% of their lives in good
health, around 64 years, whereas women will only spend 74.4% in good health, around 62
years. At age 65, life expectancy for males in Swindon is an additional 18.5 years
compared to 20.9 years for females. However, there is little difference between sexes in
the remaining length of time spent in good health (12.2 years compared to 11.2 years).
Causes of premature mortality in Swindon are changing. In 2001-03, 36% of deaths under
75 were from cancer and 30% from cardiovascular disease (CVD) but by 2012-14, 41%
were from cancer and 23% from CVD.
24
Meanwhile, the gap in life expectancy between the least and most deprived has reduced
significantly amongst the female population but risen slightly amongst the male
population. In the most deprived areas of Swindon, men die on average 9.7 years earlier
and women 4.0 years earlier than those in the least deprived areas.
Based on national population projections, which show less growth in Swindon’s elderly
population because they don’t take new housing into account, the following projections
of the number of over 65s projected to have certain conditions or limitations have been
calculated. These numbers can be regarded as conservative estimates if the prevalence
of these conditions remains unchanged in future years. Many elderly people will have
more than one of these conditions or limitations.
Number of over 65s in Swindon projected to have certain conditions or limitations
2015
2020
2025
2030
% increase
2015 to
2030
2,280
2,727
3,259
3,979
75%
766
890
1,042
1,228
60%
A long-term illness limiting day to
day activities a lot
7,745
9,005
10,694
12,653
63%
An admission to hospital because
of a fall
677
792
957
1,124
66%
A BMI of 30 or more
8,683
9,927
11,398
13,272
53%
Type 1 or Type 2 diabetes
4,135
4,787
5,525
6,494
57%
Dementia
A long standing health condition
caused by stroke
Source: Projecting Older People Population Information System (POPPI
Demand and supply profile
Care Home Provision
Admissions to residential and nursing care have being effectively managed and remain
below target for both younger adults (aged 18-64) and older adults (aged 65 and
over). During 2016/17, 192 older people have been admitted to permanent care: 102 to
a nursing home placement and 90 to residential care. Amongst these first time
permanent admission to care, 21 people were admitted with mental health needs, one
with a learning disability and 170 people with personal care/physical support needs
(older people). The target for the year was to admit no more than 228 older people (a
rate of 689.52 per 100k population). Current performance is 580.65 per 100k
population aged 65 and over which puts us ahead of our year-end target. During
2016/17, nine younger adults were admitted to permanent care: two to nursing care
25
placements and seven to residential care. Amongst these new admissions to permanent
care, three are people with physical care needs, three people have mental health needs
and three people have a learning disability. Our rate for first time permanent
admissions for younger adults is 6.66 per 100k against a target of 8.89.
Dementia Care
Dementia is a key priority for Swindon in the context of an increasingly older population
and likely demand on health and social care services. It is estimated over 2,300 people
in Swindon have dementia (based on the Joint Strategic Needs Assessment) and most
people wait on average 3 years before reporting symptoms to their GP. People live on
average 7-10 years with dementia once diagnosed but this varies by person. Different
types of dementia produce different symptoms, depending on which part of the brain is
affected and services and support need to reflect an understanding of this. The latest
published data (2015/16) records prevalence for dementia in Swindon is 0.62% for all
ages and 4.04% for age 65+. This compares to 0.76% and 4.31% for England. March
2017 data for NHS Swindon CCG shows an estimated diagnosis rate of 62.5% compared
to a national estimate of 67.6%.
Projected growth in numbers of People aged 65+ in Swindon Borough with dementia:
Swindon
2011
2016
2021
2026
2031
2036
Borough
People
107
131
138
166
194
215
aged 65-69
People
183
220
273
288
346
386
aged 70-74
People
330
351
431
537
568
628
aged 75-79
People
517
557
614
760
955
1064
aged 80-84
People
532
600
687
775
985
1099
aged 85-89
People
353
514
718
943
1198
1409
aged 90+
Total
2022
2372
2861
3469
4246
4802
population
aged 65+
Source: Family Resources Survey 2015/16 available at:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/600465/famil
y-resources-survey-2015-16.pdf
Work continues to develop a clear community pathway for dementia led by the
Dementia Steering Group. Great Western Hospital launched a dementia strategy in
2017 and held a successful event in Steam on 18th May to coincide with National
Dementia Awareness Week which SBC were involved with. A Dementia Friendly
26
Swindon Co-ordinator (funded by One Swindon) started on 24th April to work with
businesses and others in the community to make Swindon dementia friendly. Swindon
has guidance for dementia friendly housing provision and is drafting specialist housing
supplementary planning document (SPD) which is relevant for dementia care.
Extra Care and Day Support
There are currently four Extra Care settings who have commissioned care provided by
Swindon Borough Council; there are a number of private Extra Care settings in Swindon
run by housing providers. Some of the care packages are privately funded. The four
Extra Care settings include one where the building is owned by Swindon Borough
Council; the other three are owned and supported by three different housing providers.
There is day support provided on all four Extra Care sites providing a range of support.
Maple Court
The Ridings
Newburgh
Harry Garrett
No of flats
51 with 21
receiving
care/support
30 with 14
receiving
care/support
47 with 32
receiving
care/support
41 with 25
receiving
care/support
% /no of
residents
with
general
needs
%/
residents
with
medium
needs
%
residents
with high
needs
% residents
with
diagnosed
dementia
% residents
with signs
of
dementia
without a
diagnosis
0%
29%
31%
0%
83%
64%
53%
60%
17%
7%
16%
40%
23%
21%
9%
27%
29%
36%
31%
36%
27
4. Domiciliary Care and Care at Home
Population Profile
Domiciliary care plays an important part in the enablement of adults with needs
particularly in the discharge from hospital and in the avoidance of delayed discharge. The
link of domiciliary care with occupational and physiotherapy is crucial in the delivery of
sustained outcomes.
Total Number of New Homecare Clients Split by Age Band, Category and Number of hours per week.
Period 2016/17
Client Category
Personal Care Clients aged 18-64
Personal Care Clients aged 65+
Mental Health Support /Memory &
Cognition 18-64
Mental Health Support /Memory &
Cognition 65+
Total
Population
Projection
Total
population
aged 65
and over
unable to
manage at
least one
domestic
task on
their own
Less than
5 Hrs
per
Week
10
116
Greater
than 5 - 11
Hrs per
week
30
170
Greater
than 11 18 Hrs per
week
8
80
Greater
than 18
Hrs per
week
4
63
3
1
3
1
8
2
131
6
207
3
94
2
70
13
502
2010
2015
2020
2025
2030
13,011
13,323
15,541
18,269
21,623
Total
52
429
Source: www.poppi.org.uk (based on national not local population projections).
Tasks include: household shopping, wash and dry dishes, clean windows inside, jobs
involving climbing, use a vacuum cleaner to clean floors, wash clothing by hand, open
screw tops, deal with personal affairs, do practical activities
Demand and supply profile
There will be a new domiciliary framework in place from 1st July 2017 which will develop
the journey further with providers to move to outcome focused, person centre delivery.
28
This will be built on in the commissioning of master vendor(s) for the north and south of
Swindon in 2017 which will move from time and task to outcome focused delivery.
5.
Physical Disabilities and Sensory Impairment
Population profile
Using the provisional outturn 2014/15 data, Swindon is spending £508.55 per older
person on Physical Support and Sensory Support (PS&SS) 65+ social care. This is in line
with the South West average of £508.38. The actual proportion of Adult Social Care
(ASC) spend on PS&SS in Swindon at 25% is lower than the South West average at 31%
but this is due to Swindon having a smaller 65 plus population. The actual amount we
spend per person on the 65 plus population is in line with the average.
Population Projection
People 18-64 predicted to
have a moderate physical
disability
People 18-64 predicted to
have a serious physical
disability
2015
2020
2025
2030
10,592
11,258
11,650
11,751
3,093
3,347
3,511
3,542
Source: Source: www.pansi.org.uk (based on national not local population projections).
Population Projection
People 18-64 predicted to
have a severe visual
impairment
2015
2020
89
92
People aged 65+
predicted to have a
moderate or severe visual
impairment
2,891
People 18-64 predicted to
have a moderate or
severe hearing
impairment
People 65+ predicted to
have a moderate or
severe hearing
impairment
2025
2030
94
95
3,341
3,957
4,652
5,259
5,780
6,059
6,075
13,805
16,084
19,291
22,752
Source: www.pansi.org.uk (based on national not local population projections).
29
Demand and supply profile
During 2016/17, nine younger adults were admitted to permanent care: two to nursing
care placements and seven to residential care. Amongst these new admissions to
permanent care, three are people with physical care needs. Our rate for first time
permanent admissions for younger adults is 6.66 per 100k against a target of 8.89.
6.
Mental Health
Population Profile
Mental health is an essential component of a persons’ health and has an impact on every
aspect of life, including how people feel, think and communicate. It impacts on physical
health, lifestyle choices, and behaviour. It enables people to manage their lives
successfully and live to their full potential. Mental ill health is the largest single source
of ill-health in the UK. No other health condition matches mental illness in terms of
prevalence, persistence and breadth of impact. In Swindon it is estimated that between
22,600 and 29,000 individuals have a common mental health disorder such as anxiety,
depression, phobias, panic and Post Traumatic Stress Disorder. The number of people
with mental health conditions looks set to rise over the next couple of decades. Much
of this is to do with demographic changes rather than a particular expected increase in
prevalence.
Population Projection
2015
2020
2025
2030
People aged 18-64 predicted to
have a common mental disorder
22,084
22,819
23,302
23,584
9,896
10,220
10,436
10,565
People aged 18-64 predicted
to have two or more
psychiatric disorders
Source: www.pansi.org.uk (based on national not local population projections).
Population Projection
2015
2020
2025
2030
People aged 65+ predicted to
have depression
2,853
3,277
3,791
4,446
People aged 65+ predicted to
have severe depression
905
1,036
1,229
1,445
Source: www.poppi.org.uk (based on national not local population projections).
Swindon GP registers indicate that Swindon’s population has slightly higher rates of depression
than the national and regional average. Particularly pertinent is the expected increase in the
numbers of those over 65 years expected to develop depression. Planning for later life and
initiatives to ensure that older people protect themselves from depression should be developed
30
7.
Support for Carers
Population profile
National evidence shows that carers providing regular and substantial care are at greater
risk of poverty, poor health and loss or inability to secure or maintain work. Carers UK
report that people caring for more than 20 hours per week are twice as likely to have
poor mental health.
Current demand and supply
Population profile
National evidence shows that carers providing regular and substantial care are at greater
risk of poverty, poor health and loss or inability to secure or maintain work. Carers UK
report that people caring for more than 20 hours per week are twice as likely to have
poor mental health.
Demand and supply
We recognise carers provide regular and substantial support for service users and it is
encouraging that we are exceeded our annual target of 70% with over 82% of carers
(1342) having an assessment or review of their needs. It is particularly pleasing to see
improved access for learning disability carers to annual reviews which suggest long term
planning and carer needs around ageing well are becoming embedding in support
planning. 130 carers of clients with a learning disability have received a review of need
compared with 103 at the same point last year. We have not met our annual targets for
the proportion of carers with self-directed support and the proportion of carers
receiving support through direct payments. 32% of carers have personal budgets (177
carers) against the annual target of 36%, and 30.9% (170) have a direct payment against
the annual target of 34%. Swindon continues to be an outlier compared to the 15/16
England average (77.7%) and South West average (55.4%). We will continue to work
with the Swindon Carers Centre to address the shortfall in personal budgets and
progress will be monitored regularly.
Although the recent survey we have undertaken has shown more carers are reporting
satisfaction with their quality of life and social contact, it has also identified a number of
areas for improvement. Compared to the previous survey in 2015/16, recent findings
have highlighted a slight reduction in the overall satisfaction of carers with social
services, there were fewer carers reporting that they have been included or consulted in
discussion about the person they care for, and there was a reduction in the proportion
of carers who reported they find it easy to find information about services.
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8.
Prevention and the Voluntary and Community Sector
Population Profile
We currently have a diverse sector of voluntary and community groups which may not
have been as effectively coordinated as we would like. This means that we have a gap in
offering individual support for those recovering after specialist mental health support, a
gap in services reducing isolation and a gap in offering employment support for those
with a learning disability.
There are currently 18 voluntary and community sector organisations commissioned to
deliver services to support adults in the community. Current contracts are outcome
focused with an emphasis on promoting greater independence and reducing isolation
for the people organisations work with. The new contracts require greater engagement
with local communities, community based activities and a focus on encouraging adults
into employment.
Swindon both sees and recognises the value of the contribution that the voluntary and
community sector have to make to support the increasing demand on service provision
for adults in need both in providing preventative services and in the step down support
they provide. There is an opportunity to improve the links between social care and the
voluntary sector so that more older people receive advice and support from community
based agencies and carer support improves. We will be continuing to work through our
commissioning and with partners to strengthen and develop this.
Demand and Supply
Sanford House, a central building in the Town Centre, has been open since June 2016,
and offers a wide range of services from the voluntary sector. There has been an
increase in footfall of over a 1000 people since its opening. This approach continues to
demonstrate the added value of co-locating key voluntary sector providers.
 CAB continued to support people seeking advice on a variety of different issues
and have supported over 9,116 people during 2016/17. As in previous years, the
biggest area of work was supporting residents with debt and finance issues.
 Healthwatch Swindon is provided by Care Forum, this contract began in April
2016, and has during 2016/17 focused on priorities including; a new community
health service procurement, children and young people –mental health and re
procurement of services, and Diabetes and healthy weight.
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 The Harbour Project has dealt with an increasing number of asylum seekers and
refugees over the past year and has, at the same time, engaged more women
and children in their support plans.
 Swindon Carers Centre continues to raise the profile of and provide support for
Adult Carers, and had 2322 carers registered at the end of 2016/17. The Centre
has worked in partnership with SBC to ensure it is Care Act compliant.
 Swindon Advocacy Movement (SAM), deliver an Advocacy Service that
encompassed Independent Mental Capacity Advocacy (IMCA)/Independent
Mental Health Advocacy (IMHA) and Care Act statutory requirements.
 Swindon MIND - SBC is working in partnership with MIND on a Pilot programme,
to deliver 1-2-1 therapeutic intervention and support for people with learning
disabilities and care leavers who have low level mental health issues. The MIND
1- 2- 1 support workers actively engage and support the service users to prevent
deterioration of their mental health and escalation into crisis.
 The Home from Hospital provision provided by Red Cross and Age UK has
supported service users who are discharged from hospital. This work is
designed to give a much more holistic and responsive service to individuals
needing support to return home. The pilot is designed to engage early with
patients during their stay in hospital, and provide support to avoid hospital readmission and ensure reintegration into their community.
Number of service users/clients worked with in Q4 2016/17
Name of Provider
Age UK
Alzheimer’s Society
Cruse – Bereavement Care
DHI (Developing Health &
Independence)
Harbour Project
Headway (head injuries)
Open Door
Red Cross
SAM ( Swindon Advocacy
Movement)
Swindon MIND
Stroke Association
Service Users/Clients worked with or supported
in Quarter 4 2016-17
(January-March 2017)
173
112
71
573
337 current registered clients
65 in Swindon 23 from surrounding areas
93
31
222
423
27
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Swindon Carers Centre
TWIGS (Therapeutic Work in
Gardening in Swindon)
2322 adult carers registered
230
NB As the monitoring of the above services is gathered in a rolling year there may be duplicates in any
quarter
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