What is being done?
Nottingham Home Care provides specialist home care support for people with complex care needs.

The team supports the most severe dementia cases transferring users to non-critical care services providers when and where appropriate. Members of the team describe it as being ‘without demarcation’ and the members plan together, work together and learn together.

• Nottingham Home Care was developed in response to the need for more appropriate, person-centred home-care for people with complex care needs.
• It was first introduced into a district of Nottingham and has since been rolled out across the city.
• The multi-agency members of the Nottingham Home Care service share a clear and collective vision focused on service users’ and carers’ needs

New role and function
Nottingham Home Care is a specialist multi-agency home care service for people with complex care needs that was established in 1999. Home care workers work with service users to provide person-centred care which maintains individual abilities and prolongs independence. Following referral, an initial assessment is carried out by a social worker, followed by a visit from a community liaison nurse and occupational therapist. Dependent on the outcome of the assessment, a care package will be arranged in consultation with the care manager, the Jack Dawe service will then be commissioned.

Staff at Nottingham Home Care include home care workers, community psychiatric nurses and Occupational Therapists, all with a specific interest in people with dementia and specifically trained to work in this area. The team provides a service to approximately 300 people in the Nottingham City area

The Service objectives are:

• To provide people with complex care needs with the appropriate services to help them remain at home as safely as possible for as long as possible.
• To support carers by providing practical help and information.
• To link with voluntary agencies, such as the Alzheimer’ Society, to provide independent specialist support.
• To work as a multidisciplinary team, including care workers, community liaison nurses (mental health) and occupational therapists, with carers seen to be a key part of the extended team

The support provided by team members includes where necessary personal care, assistance with activities of daily living such as shopping and collection of pensions/benefits and paying household bills.

Senior and Home Care workers are given a detailed induction which includes information on their role and responsibilities, health and safety, the nature of dementia and the provision of personal care support. All Home Care workers are expected to complete (if not already achieved) the NVQ Level 2 in care.

What has been achieved?
Nottingham Home Care achievements include:

• The whole team, including administrators, are trained in person-centred care and understanding dementia.
• There is a high degree of integration of health and social care staff across professional boundaries, and a high quality of team-working.
• All team members are engaged in care planning and review.
• Members of the Jack Dawe service share a clear and collective vision for the service, focused on the needs of both the service users and their carers.
• Teams regularly review the results of customer surveys, service user feedback and performance data to identify opportunities for service improvement.
• Feedback from service users and carers has shown that they experience a more appropriate, focused, co-ordinated and responsive service.
• There is a ‘passion for Jack Dawe’ amongst the team.

The team regularly review the results of customer surveys, service user feedback and performance data to identify opportunities for service improvement.

In 2008 an evaluation of the service found the following benefits:

• Increased time with service user means additional needs can be met and care workers adapt their working routines to clients requirements
• The breadth and quality of the care package enables users to stay at home longer
• Staff expressed increased job satisfaction from the development of long-term relationships with users
• The service reduced the amount of residential home placement required