These two reports from the 2000’s. These were written by Deidre Wild, Sara Nelson and Ala Szczepura at the University of the West of England.
Short overview – Report One
An Evaluation of an In Reach Model of Care in LA Care Homes
In 2004, The University of the West of England, Bristol (UWE) was invited by Bath and North East Somerset Local Authority (B&NES LA) in partnership with B&NES Primary Care Trust (PCT) to submit a proposal for an evaluation study of the efficacy of an in reach team’s (IRT) provision of nursing and physiotherapy to support up to 15 ‘virtual’ beds in a group of LA residential care homes. Over time, these beds provided IRT care for a total of 131 residents. The IRT project was funded from a successful bid to the Office of the Deputy Prime Minister (ODPM). In addition, the evaluation study’s remit included a monitoring of the IRT members’ support for designated IRT support ‘new role’ care staff undertaking health training to the National Vocational Qualification (NVQ) level 3, funded by Skills for Care.
Short overview – Report – Two
Audit of In-Reach Nursing Team for Residential Care Homes: Activity, Costs, Benefits & Impact on Long-Term Care
The quantitative results presented in this report can be compared with the findings presented in the previous qualitative evaluation report (The In Reach Model Described from the Perspectives of Stakeholders, Home Managers, Care Staff, and the In Reach Team, May 2007) in order to draw conclusions.
The analysis of audit data presented in this report indicates that the joint NHS-Local Authority initiative to provide a dedicated nursing team to group of residential care homes with 131 residents in Bath and North East Somerset was able to avert between 81 and 197 potential hospital admissions between July 2005 and June 2007. Examination of hospital stay also shows some decrease in longer admissions (greater than 48 hours) and some increase in those of less than 48 hours. This suggests a positive impact of the in-reach nursing team both in preventing longer admissions and in facilitating early discharge. However, the time span of the study was too short to demonstrate a meaningful trend in either type of hospital stay.
Interview evidence presented in the previous qualitative evaluation report suggests that enabling residents to stay in their home during an illness episode was preferred by care staff, managers, and most importantly by residents.
Audit also indicates that the nursing and physiotherapy expertise from a dedicated in-reach team (IRT), in combination with new type of worker (NToW) development of care home staff, has been successful in preventing 20 (or possibly up to 28) residents from being transferred to a nursing home. Total saving to the Local Authority and PCT will vary depending on whether these represent a delaying mechanism or a longer-term maintenance measure. In total, delays in transfer to nursing homes resulting from IRT activity during the period July 2005 to June 2007 produced a saving of £207,598 plus an additional £103,798 for each extra year’s delay. It was not possible to prevent some avoidable transfers during the period of major home closures, so numbers might have been higher in a more stable context.
Leave a Reply