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Help to live at home service: an outcome-based approach to social care

Report, case study | April 2012

This case study report by Professor John Bolton of the Institute of Public Care describes the development over three years by Wiltshire Council of its new `Help to Live at Home Service` for older people and others who require help to remain living in their own house rather than going into residential care.

The council`s approach has focused on the outcomes older people wish to gain from social care, and hence involved a complete overhaul of both the care management and the contracting functions of the social care system. Accordingly, the paper - based on interviews with stakeholders - discusses the theoretical underpinnings of outcome-based care, sets out how assessments for outcomes were performed with customers, and also explains how the new goals were reflected in tendering and payment arrangements with providers.

The study includes details of the origins and principles of the new service design, how transition from old to new was effected, and reasons for choosing new providers for the service, and the rationale for retaining relatively limited numbers of providers, contrary to the prevailing wisdom on wider customer choice. Problems encountered are also reflected in the report, particularly the number of people initially electing to stay with old providers and take a Direct Payment.

Professor Bolton`s conclusions reflect on both the successes achieved and the continuing challenges faced, and a series of key messages are intended to promote discussion among other local authorities on how outcomes-based, personalised support can best work in social care in England in the future.

For further information please contact Keith Moultrie at IPC


Tel: 01225 484088