Models of Care

What is a “model of care”?

A model of care describes how a service is delivered to ensure an individual receives the right care, at the right time, in the right place, from the right people – those with the values and skills to provide safe high quality care and support.

The White Paper recognises there is no ‘one size fits all’ solution.

That is certainly true in terms of many dimensions of care, such as the setting in which the care and support is provided. Different models will be needed in different places and geographies.

It is important that the people who draw on care and support, and their family members, are able to make informed choices about the models that work for them.

Core elements for all models of social care

That said, Reinventing Social Care believe there are some core guiding principles, rooted in the ethos and guiding principles for social care, that should be built into all models of social care.

Models of care should have a relentless focus on advancing quality of life, purpose and meaningful individual occupation. They should be designed around the reasonable wants and needs of individuals and communities, not the convenience of organisations.

All models of social care should be:

  • Person-centred and person-led – the whole person should be the focus (not a set of symptoms or issues) and the individual should identify their priorities and objectives.
  • Strengths based – people are able to live as independently as possible with services recognizing individual’s strengths and building upon their personal assets Strengths-based approaches | SCIE. Reliance on Social Care is minimised to the right level and involves both formal and informal support networks.
  • Integrated so that the individual experiences a seamless service, and services are integrated and embedded within communities
  • Social-value oriented – so people accessing care and support and their families are equal stakeholders alongside providers and commissioners in defining what outcomes and changes are important and valued.

Models of social care and support

Social Care models need to be developed to reflect the needs and aspirations of local populations and individuals. These will be diverse and need to be co-produced with people who access services, their carers and relatives, providers and commissioners.

Models of care can be designed around a range of characteristics, for example:

  • The physical setting and location in which care is provided
  • The intensity of care and how care is provided: “Care” includes the right combination physical and mental health, personal care and social care and support an individual needs to achieve the best quality of life
  • The duration of care – whether it is for the long term, flexible and adaptive, or time limited supporting recovery and convalesence
  • The stage at which care is provided – whether that is early in someone’s journey and preventative in nature, or towards the end of someone’s life

People may need and use care from across the spectrum of provision and models of care need to be able to flex and adapt. It is important that a diversity of provision and models is maintained:

Where Highly specialist accommodation (e.g. nursing home) Extra Care / Supported Living Own home (with adaptation incl. digital tech where needed) Community
Intensity In person (high staff:person ratios; 24/7) In person (daily) Hybrid in person and virtual delivery Virtual / remote delivery
Duration Long term & ongoing Recurrent / fluctuating needs Time limited Short term / one‑off
Timing / stage End of Life Maintenance of level of independence Re-ablement Early intervention & prevention

Toby is 57 and suffered a stroke. He chose to enter a nursing home rather than stay in hospital and he received intensive care and reablement support whilst his own home had adaptations including a digital call system fitted.

Where Highly specialist accommodation (e.g. nursing home) Extra Care / Supported Living Own home (with adaptation incl. digital tech where needed) Community
Intensity In person (high staff:person ratios; 24/7) In person (daily) Hybrid in person and virtual delivery Virtual / remote delivery
Duration Long term & ongoing Recurrent / fluctuating needs Time limited Short term / one‑off
Timing / stage End of Life Maintenance of level of independence Re-ablement Early intervention & prevention

Jane is 29 and has mental health needs and type 1 diabetes. Her selfcare and management of her long term physical health condition can be affected by her mental health. Her smart medication dispense alerts her support worker when meds are missed and she can be contacted via her smart phone and a visit arranged if there’s no answer or she indicates one would be helpful.

Where Highly specialist accommodation (e.g. nursing home) Extra Care / Supported Living Own home (with adaptation incl. digital tech where needed) Community
Intensity In person (high staff:person ratios; 24/7) In person (daily) Hybrid in person and virtual delivery Virtual / remote delivery
Duration Long term & ongoing Recurrent / fluctuating needs Time limited Short term / one‑off
Timing / stage End of Life Maintenance of level of independence Re-ablement Early intervention & prevention

Models of Care: holistic & inclusive approaches

We believe models of care should be designed so people can thrive and achieve, living their best possible lives. Whilst it has been around since the 1940s, Maslow’s Hierarchy of Needs remains a useful framework.

Currently, too many models of care are commissioned to meet the basic needs levels with insufficient consideration being given to self esteem and self actualization. Reinventing Social Care is about models of care that move away from maintenance and towards fulfillment, choice and opportunity.

Models of care examples:

The Big Life Adventure (BLA) – Peak 15

The BLA provides full guide training through their in-house Positive Behaviour Support Lead. This equips staff (the guides) to support an individual’s journey. The BLA uses technology tools to plan, record and share a person journey and promote digital inclusion for people with learning disabilities. They include assessable tools to plan and guide a person’s journey, multimedia tools to record and a secure social media platform for people to share their journey and give people social opportunity

Peak 15’s Big Life Events uses the guides to facilitate opportunities and experiences for people with learning disabilities to empower them to have the opportunity to experience exciting social, leisure and learning events just like other citizens.

The aim is to support people to be more independent and reduce support hours and deliver great outcomes for people, and for society as a whole.

The virtual & extended care home – Birtley House

Birtley House invests in developing and maintaining string connections to the local community to create inter-generational opportunities and beneficial outcomes for the wider community. A local charity for people with learning disabilities uses the grounds and gardens to develop horticultural skills and work alongside the home’s chef to learn cooking and catering skills, with the products being enjoyed and sold to raise money for the charity. Mindfulness activities are offered to residents and local employers through Forest Bathing sessions.

The virtual care home model harnesses digital technology to improve information flow, reduce overheads and provide better access and communication for all parts of the system so the individual has a seamless and enhanced experience of care. Centred on the care home, step-down from hospitals is enabled sooner – the home acts as a virtual ward, with digitally facilitated input from GPs and community matrons. Domiciliary care services can get to know the individual in the home and be part of the virtual team around the person, as well as using the care home as a base in more rural areas. The more sociable and community-centred environment leads to faster recovery and return home

Once home, people can continue to stay in touch with friends in the home and join in social and creative activities using digital technology to maintain social contact, over and above any domiciliary care package. The knowledge that there is a skilled staff team that knows and understands the individual close by even out of hours gives people confidence at home. If they need additional help or care for a period, this can be identified early – whether through the GP, domiciliary care service or referral) and delivered from the care home team they already know and trust. Step-up support can be through short breaks/ respite stays or coming into the home on a day-basis for therapeutic interventions and social activities. Digital (and in person) social activities and support from the home can also be offered as a preventative measure for local people, supporting them to stay independent for longer.

The extended and digitally enabled care home provides people with confidence and choice, enabling them to maintain their independence and benefit from belonging to a community.

 

Current Issues & Problems

text here

Our Proposal

text here

Commentary on ‘People At The Heart Of Care’: The Adult Social Care Reform White Paper (published 01/12/21)

text here

Best Practice Share

text here

Our Key Takeaways

text here

TOGETHER OUR COLLECTIVE VOICES CAN MAKE A DIFFERENCE.
HAVE YOUR SAY ON EVERYTHING YOU’VE READ.
GET IN TOUCH WITH THE REINVENTING SOCIAL CARE TEAM HERE.

Provider?