London Borough of Havering Council's homecare process has moved away from a traditional paper driven process. This frees up care managers to add value and properly assure the quality of care. The Council introduced a unique 'end-to-end' solution to improve the efficiency of how domiciliary care is provided, managed and paid for.
The Council worked with software partners PCCL and CM2000, and used Visa Card settlement from the Royal Bank of Scotland (RBS). By making all home care providers Visa compatible the Council was able to prepare the platform for the delivery of individual budgets through pre-loaded Visa cards. Each recipient of a pre-loaded Visa card has the option of 'shopping' for a variety of services from locally delivered and Care Quality Commission registered providers. This has transformed how home care is provided and provided efficiency savings of almost £500,000.
Previously, home care budgets were being overspent and the process required updating. In response to this, the Council initiated a full scale homecare consultation. This resulted in a two scale approach to the delivery of home care services. The first was a strategic shift toward the provision of re-ablement home care provision to be provided within the first six weeks of services. Second was a modernised electronic solution to back office functions to allow more resources to be devoted to front line delivery.
The Council uses a paperless five step process for the planning, commissioning and payment of home care. The system applies to external provision whilst in-house home care services use the system which is connected directly to payroll.
Step 1 - The first six weeks
A care plan is created in a system called SWIFT that has been reconfigured to track budget on a real time basis. The care plan is forwarded to the commissioning team who immediately refer to an in-house re-ablement service. The in house services use CM2000 call monitoring to track their involvement, this feeds directly into payroll to eliminate time sheets.
Step 2 - External provision
If the service user still requires home care following re-ablement it is commissioned through an external provision with one of 15 care agencies operating in the borough. Each of these agencies uses CM2000 call monitoring and the Council has full access to all information.
Step 3 - Transaction data matching
Once the service has been delivered it is automatically matched against the commissioned hours. This means that the Council can check that the service they commissioned is being delivered fully. If there are no anomalies or queries an electronic invoice is created.
Step 4 - Approval
The electronic invoice is viewed by the Commissioning Manager who approves it online.
Step 5 - Payment
The reconciled payment is made within seven days of delivery to each provider on a virtual Visa card. The financial information is then linked to Oracle and automatically updates the Council’s financial information system.
Part of the agenda for transformation was to manage the quality issues for service users. The system allows service users access to their own quality information via a web site, as well as allowing the Council to monitor overall quality standards as indicated through the call monitoring data.
The borough is now moving away from bricks and mortar day centres to day opportunities allowing more people to choose from their own interests and needs. The call monitoring system is being adapted to allow people to register for the day opportunity of their choice rather than rigidly send them to the same day centre on a set day.
As a result of implementing the new processes in home care the Council has achieved efficiency savings of £469,000 in 2008/09.