CareRooms for Local Government
PROJECT OVERVIEW & APPROACH
The health and social care system is challenged with predicting care capacity in an environment of intense demand, stress and the understandable lack of predictive data on the evolution of the COVID-19 pandemic. In parallel, the technical revolution in the health and care sector has led to a disconnect with the physical and social interaction that we require to recover well and flourish.
CareRooms have spent the last 3 years developing a new care model and associated technology platform, which embraces the positive aspects of the sharing economy married to the challenges of an ageing population. It uses local, screened ‘Hosts’ with spare rooms, to provide safeguarded care for a range of step up, step down and respite capacity. Rooms can also provide accommodation for NHS elective surgery patients. Key to this project is that the approach already has a significant proven track record of reducing readmissions and a positive impact on community health services.
The side effect of sharing income and resources is to prevent loneliness for both the host and the guest during the stay and as a result to extend their independence and “happiness”.
CareRooms utilise technology and spare rooms in carefully screened homes where the owner is keen to provide a calm recovery space. We then add care by a Host who is a retired healthcare professional or a local care partner and this unlocks new care capacity in our communities, which is a theme that many councils are keen to develop.
This model looks to expand the options around domiciliary care and to provide an alternative form of “home first” which places positive mental health at the forefront and provides fast, safe and accessible alternatives when the patient’s home or domestic circumstances are delaying their “home first”, or next stage of their care journey.
Over 60% of CareRoom hosts are retired healthcare professionals, who, as we have seen in the past few months, are keen to continue to help their communities. The CareRooms platform, safely selects, screens and onboards hosts as part of the overall model and actively supports them throughout the guests stay. Over the past two months, CareRooms have been approached by a number of local authorities and NHS England, to repurpose hotels – and other settings – for COVID-19 negative and positive patients.
CareRooms have built a platform that includes the utilisation of world-leading technology, to offer remote vital-signs monitoring, falls detection, remote room metrics collection (for both comfort and security) and more. This results in an environment which feels like home, but without the loneliness. It has the intelligence of a healthcare facility, combined with the safeguarding elements to support the Guest during their stay and protect the Host.
With the possibility of a second wave of COVID-19, the release of safe, elective surgery capacity and the next winter flu season, the aim is to explore this model in a local authority context, to provide resilience and flexibility to the health and social care system, that will be needed later this year and beyond.
Having had a variety of conversations with local authorities and ICS’s and NHS partners, we now have a dedicated FAQ document we are happy to share on request, covering safeguarding, regulation, equipment, monitoring, pricing, COVID-19 questions and more – please request this by email here.
This programme of work will explore how the CareRooms model can improve mental health (by reducing social isolation) and physical health outcomes, through 1:1 care and interventions. This will enable local authorities to create community care capacity; whilst at the same time giving clients the best possible chance of a supported recovery. The model will help to reduce the number of A&E visits, provide a safe space for those leaving hospital, and alleviate the ever increasing pressure on existing care settings.
Working with CareRooms, co-funders will help uncover how the model can be adapted to reflect council and partner needs, as well as to be scalable within different communities. Including providing additional care capacity, the approach seeks to positively build on COVID-19 generated community cohesion and support local economies. The model removes the need for investment in capital intensive projects by the Local Authority, by redeploying community owned assets of people’s one homes and resources.
As we enter the next phase of COVID-19, the restart of surgery in the NHS and the flu season, the squeeze on community beds is likely to become substantial. Back in May 2020, 16,000 patients were in hospitals in England with COVID-19. In July we saw this drop to just over 2000. Some experts predict a second wave could be worse than the first. In addition, current assumptions are that there are over 8m delayed surgical interventions leading to a combined need for 1000’s of extra community beds. This demand will exceed NHS capacity, as acute trusts try to get through the backlog of delayed demand.
Provision of extra capacity to facilitate the flow of patients away from COVID-19 sites to safe sites, will also mitigate the COVID-19 infection risk. This is required more now than ever, due to the growing waiting list of an estimated 8 million patients.
Whilst CareRooms has a model to offer the safe care of COVID-19 patients, it will be the decision of the co-funding authorities as to the make-up of the patient cohort to focus on.
CareRooms approach to the safety of patients/guests and Hosts with respect to COVID-19 infection risk, has been to follow the NHS guidelines but to add in extra safeguards to minimise transfer risk from the community or hospital settings. Testing for COVID-19 within 12 hours prior to discharge, is the first step. This is followed by appropriate PPE for the Host, deep cleansing of the rooms and a controlled visitor process with track and trace, which are all components in minimising infection risk. This is a moving target of best practice and CareRooms intend to continue to be at the leading edge of best practice.
Under the traditional domiciliary care model, the first 6 months of care costs around £5,500 per patient. This is based on 3 visits per day for the first 6 weeks, and then 1 visit per day for the remainder of the 6 month period; with an average cost per visit of £20.
Under the proposed model, the first 6 months of care would cost around £2,300 per patient, which equates to a ~60% saving. This is based on the patient being placed with a CareRooms host for up to 2 weeks, and then receiving continued ‘at home’ monitoring support for the remainder of the 6 month period.
This project will look to thoroughly test the above hypothesis and document any secondary, soft and unpredicted benefits partners experience. On top of this, CareRooms would be able to provide significant data to help local authority teams undertake a social care assessment that might typically follow a 6 week period of initial reablement. We would look to quantify these savings as part of this project.
This project seeks help from local authorities and NHS partners to explore and evidence that the combined model of local spare and care room capacity combined with appropriate technology is a compelling new model. We want to evaluate how we can leverage community assets to deliver a new approach to care in the community, improving the potential for independent living for as long as possible – whilst saving substantial costs to the local health and care economy (more figures below).
Councils involved in this project will help to shape and develop a range of dashboards to allow them to have a full view of all care capacity and patient progress. By introducing Hosts and Guests in their communities, we want to assess how this can reduce social isolation, improve health and reduce reliance on the current, strained health and care system.
The CQC has offered to support with this project to review the process needed for appropriate levels of governance and we would look to further develop the technology platform and its integration into the NHS NoE CSU Care Capacity Tracker (with 12,012 users representing 190 CCGs and 152 local authorities), work that is already completed (more on Regulation below).
- To identify the right cohort of patients to support via CareRooms (100 nights included) and drive host engagement
- To build local authority specific management information dashboards
- To scale the model through the NHS Care Capacity Tracker and/or local platform
- To develop the proof of concept (POC), data and evidence
- Business case/model/ROI validation
- Proof of replication & scaling
- CQC test bed for new model
The project requires five council partners who, in addition to the funding, are able to contribute:
- Subject matter expertise to help shape the development of the required dashboard(s), which will allow councils to manage care capacity and insights within their geography. All development will be undertaken by the delivery partner, however each council will help to steer the solution through active, remote co-design.
- Testbed environment which can support strong evidence based research over a 6 month period; helping to form a proof of concept and evaluate the associated benefits and outcomes of the model.
It’s important that councils feel incentivised to participate in this project as co-funders. Involvement in the co-design process will offer councils the chance to help shape the dashboard development and ensure it aligns to their operational realities. Once these dashboards have been developed, co-funding partners will be offered a discounted license which seeks to return their initial investment in developing the technology.
£30,000 fixed contribution per partner.
TOTAL PROJECT COSTS (6 MONTH PROJECT)
Total project cost of £150,000 shared between five partners co-funding the project. This will cover:
- End-to-end technical development of dashboards to allow local authorities to manage care capacity, insights and morbidity planning of patients who have gone through the CareRooms process within their geography.
- £13,500 worth of CareRooms credit for each co-funding partner, which is equal to 100 nights of “step up/step down”, respite, reablement care or discharge to assess care. Alternatively for those rooms where IV services are provided, this will cover up to 38 nights of care.
CareRooms has applied for the following CQC regulation: Clinical Care and Accommodation (TDDI).
During this project, we will be working with the CQC to establish the new care models and to develop new approaches to governance through the use of dashboard data. The insights derived from this data will drive increased efficiencies for the CQC and the LA’s around the regulatory and governance process.