Domiciliary Care Rapid Response Service – Discharge to Recover then Assess (D2RA)

Cardiff Council commissioned 3 providers to deliver the original D2RA Winter pressures contract and due to the increased numbers in patients being discharged ready and some changes with the awarded Domiciliary Care Providers.

This was part of the original pilot as a second Framework arrangement to ensure sufficient capacity is available to support the safe discharge of individuals back home.

All partners deemed the model an extreme success and wish to secure the service for 23/24. The timeline for the initial period is governed due to Regional Integration Funding (RIF) being agreed, although we do anticipate Partners confirming future RIF funding 2024/2025.

The Directorate is now seeking to commission up to a further 4 Domiciliary Care Providers to deliver more Rapid Response Discharge to Reablement Assessment (D2RA) Domiciliary Care Services across the City.

Cardiff Council is seeking to commission up to 4 Domiciliary Care Providers to deliver a Rapid Response Domiciliary Care Service across the City following a pilot service, with a new Framework arrangement. These packages of care will support individuals who are medically fit and discharge ready to leave hospital but require a period of assessment to take place in their own home to determine their long- term level of need.

It is intended that the hours of care purchased within the package of care, will be used to support individuals who have been assessed as requiring support to return home following a period in hospital. These are people whose needs would be assessed as requiring a Domiciliary Care package of care There is the expectation that the initial level of care for some people may be over prescribed, with possibly double handed care being provided initially, in order to safeguard the individual whilst they are assessed in their own home.

The Rapid Response Domiciliary Care services will be provided to meet the outcomes of the individual in their own home environment. Within the first 10 working days a review of their care needs will be undertaken by an Occupational Therapist/ Social Worker/Assistant, from within our community teams, they will right-size the package. If the package requires double handed care, the review will take place within the first 3 working days.

The proposed model is a City-Wide scheme that will be delivered for a period initially of 4.5 months (with a further 12 months, subject to funding being agreed) that will address the demands by:

Implementing a framework model of service by commissioning a framework of up to four domiciliary care providers to deliver a Rapid Response Team.

The Rapid Response Care Team supporting the Discharge within 72-hours of a referral from the integrated Discharge Hub (IDH)

Taking the hospitalised person when they are discharging ready home.

Ensuring clear communication between the Care Coordinators & Integrated Discharge Hub (IDH), the person would settle for a couple of days and the Multi-Disciplinary Team (MDT), along with the provider and the citizen would right size the care & support package within 10 days of discharge.

The Rapid Response Team would take on next discharge ready person.

The service being provided by Domiciliary Care Provider(s) will be for 7-days a week.

The person, after 10-days support, would go through brokerage to identify a provider to meet the assessed longer-term care & support package if required.

Providers who wish to bid to join the framework will already be approved on to the Domiciliary Care Dynamic Purchasing System (DPS) and not in Escalating Concerns.

It is expected the demand, at any one time, would be 10 people, needing potentially 4 x double handed calls per day.