Project title: Adult Social Care Services: Help to Live at Home

What was required

Engaged by Wiltshire Council to provide guidance and support for a business change programme to make drastic cost savings in four core areas of expenditure, aiming to save £33m a year from a £172m budget with minimal negative impact on service provision and without unacceptable increases in self-funding of essential care of the elderly and other vulnerable adults. This involved an entire department of over 950 full-time and part-time employees and influenced a wide range of people working across other council departments as well as partner organisations such as the NHS and the voluntary sector.

What we did

Our engagement was carried out in eight stages:

1. Organised and managed a series of workshops and investigative interviews, involving employees from all levels and areas of the department.
2. Analysed the outcomes of these sessions and compiled detailed diagrams and reports on the council’s “AS-IS” processes.
3. Helped the council to communicate the benefits of change to employees, senior executives and partners.
4. Worked with the Council’s staff, including managing in-house business analysts, to design new “TO-BE” processes for Adult Social Care.
5. Facilitated a series of workshops and guided employees to consider what the best processes might be from a customer’s perspective.
6. Designed a new structure for the department.
7. Guided the Council in bringing partner organisations on-board, gaining buy-in with the new structure and in implementing the new structure.
8. Developed a new model of care for the elderly and disabled called “Help To Live at Home” (HTLAH) to satisfy their preference to be cared for at home and to allow the Council to dispose of part of its property portfolio.

The end result (how this helped the client)

• Created a new role of customer coordinator to provide a single point of contact for customers and to coordinate the delivery of all of the services and equipment they need, across all community services teams.
• Changed the physical location of teams to group professionals with multiple skill sets together according to customer needs.
• Rebalanced the roles of Council, NHS and voluntary sector to reduce the financial exposure of the Council.
• Simplified the Council’s existing processes by removing a level of technology dependency, leading to further cost reductions and to speeding up delivery of community services.
• Having designed the HTLAH structure, supported the Council in identifying and appointing its outsource partners. Later re-engaged to review and to problem-solve before the pilot of HTLAH began.

Client’s assessment

At the end of the trial period, the Council’s project steering group committee reported that average productivity savings of over 30% were recorded right across the department, with 50% savings in assessments alone. These savings totalled £8.6m in money terms in the first year (including income from property disposals) and £6m a year thereafter. Additional contributions from those requiring care were minimised.Further: the quality of care improved overall. Figures provided by Shaw Healthcare indicated that HTLAH increased the life-expectancy of the elderly going into care from 18 months (average longevity in a care home) to an estimated 8 years (assisted living at home). These efficiency gains also allowed the council to invest in more preventive measures, reducing the demand for long-term palliative care.

Wiltshire Council’s recommendation led to an engagement to manage a channel shift programme for Worcestershire County Council which required cheaper and more efficient ways to communicate with the elderly and with the other vulnerable adults it supports to provide 24/7 contact.