Better Care Fund Scheme Evaluation
Evaluation Ref:
Name of scheme
Provider(s)
Evaluation completed by
2015/16 Budget (£)
2015/16 Spend projection (£)
13
Resource Centres
WCC
Steve Brotherton
2,528,000
2,197,896 (330k underspend)
Purpose of scheme
The County Council Resource Centres at Howbury House in Malvern and The Grange in
Wyre Forest provide an in-patient step up and step down rehabilitation service. Service
users are generally admitted for a period of time for rehabilitation where there are
identified rehab goals. The admission may, however, be for a period of assessment
where someone's future needs / goals need to be identified. Goals may be set around
many areas but common ones are: mobility, meal preparation, personal care,
management of medication and confidence building. The aim of the services is to enable
services users to return home wherever possible. The services have social work, social
care and therapy, all working in an integrated way and able to progress with
achievement of goal and discharge planning in a timely way. All patients are assessed
by a therapist within 48 hours of admission and an individual planned programme of
rehabilitation put in place. Therapists attend all MDT and discharge planning meetings to
facilitate discharge and improve patient flow.
Note – this scheme is within scope of the Integrated Recovery projects currently ongoing
in the three Clinical Commissioning Group (CCG) areas. Howbury is within the SW CCG
project, and The Grange in the WF CCG project.
Activity - what intervention is involved and how much of it – what is the unit cost?
Type of Place
Grange
28
IC (Rehab/Assessment)
Howbury
16
Respite (Respite Beds)
0
Respite (Dementia Unit)
Step Down
Urgent/Unplanned
6
22
Permanent
28
TOTAL Beds
Occupan
cy
Apr15
May15
Jun15
Jul-15
Aug15
Sep15
Oct15
Nov15
The Grange
91.5%
93.8%
84.9%
93.2%
91.1%
93.6%
87.2%
91.7%
Howbury
House
77.9%
73.4%
94.2%
97.7%
94.7%
95.3%
94.9%
92.3%
Average Length of Stay by month
2015-16
IC beds only
Average of LOS (Days) at discharge - Analysis on a month by month
basis
Home
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-15
Nov-15
Grange
16.2
22.0
21.2
21.7
19.3
21.7
23.8
22.3
Howbury
17.8
25.6
17.8
42.5
35.8
37.8
42.9
27.2
Contribution to BCF outcomes
Reduction in non-elective admissions
Reduction in admissions to
residential care
In a similar way to UUPS beds, the Resource
Centres can offer a destination for people who
require an immediate intervention, alternative to
an acute setting. Of the 450 new admissions to
the Resource Centres during the period April
2015 – December 2015, 364 were from a
hospital setting, and 86 people came from
another setting, such as their own home (62
people), or from a long-term nursing or
residential home placement (18 people). It is
reasonable to assume that a large percentage of
those 86 people would have required either a
hospital bed or an UUPS placement, if a space
in the Resource Centres were not available.
There were a total of 454 discharges from the
Resource Centres for the period April 2015 –
December 2015. A relatively small percentage
(9% - 43 patients) were discharged to a longterm nursing or residential placement, compared
to 340 people (75%) that were discharged to
their own homes.
Increase in people still at home 91
days following hospital discharge
Rehabilitation and Therapy Programmes are
designed to maximise independence and a
return to independent living, which should mean
more people remaining at home following
hospital discharge. There is no specific data
available.
Reduce emergency admissions for
falls >75
Rehabilitation and therapy programme are
designed to maximise independence and a
return to independent living, which should mean
a reduction in emergency admissions. There is
no specific data available.
Customer experience
There is a high level of customer satisfaction
across these services.
Risks if the scheme were to be withdrawn or reduced - quality, financial, reputational?
Risks to all BCF outcomes linked to the Resource Centres
Insufficient residential rehabilitation resource to offer a response to hospital discharges
Recommendations to HWB for 2016/17
 Budget to be maintained at 2015/16 level for 2016/17, with the recommendations
of the Integrated Recovery projects still to be released.