The Sheffield Ageing Well Programme

Sheffield Ageing Well Programme: 1. Collaboration 2. Personalised Care 3. Shared Aims 4. Co-produced & inclusive 5. Coordinated Partnership Working 6. Iterative 7. Focus on Delivery 8. Promote Equality 9. Resourced 10. Integrated

Background

The NHS England funded Sheffield Ageing Well programme continues to make good progress. The programme is a collaboration of place partners with identified Senior Responsible Officers and clinical leadership.

Background to the Sheffield Ageing Well Programme.

Programme structure including local workstreams are outlined below:

What we have done so far?

  • Joined up the elements of the work into an Ageing Well programme with a well-supported and attended multi agency collaborative driving and delivering the work.
  • Presented the work to various stakeholders including the HCP Primary Care Board and nationally.
  • Building on the success of the programme, have made applications to national awards.
  • Acknowledged the interdependencies/connections to other areas of work in the city and worked to align these.

Visit the three Sheffield Ageing Well Programme workstream pages below to read in-depth progress updates.

Urgent Community Response (UCR)

Enhanced Health in Care Homes (EHiCH)

Anticipatory Care

What this means for the people of Sheffield?

Urgent Community Response (UCR)

  • In 2022 the Urgent Community Response team supported 871 people in crisis, avoiding admission. Community Nursing UCR response data will also be captured from April 2023, thus demonstrating city’s UCR offer in full.
  • Care home patients can access specialist UCR clinical support, potentially reducing conveyences to the Emergency Department.

Team Around the Person (TAP)

  • Since 2019, TAP received 722 referrals.
    • On a cross section of closed cases:
  1. 98% of cases referred were individuals with 2 or more long term health conditions (including mental health and substance misuse)
  2. 41% of cases referred were for those with Frailty
  3. 58% of cases were for individuals living in areas of deprivation
    • TAP has lead to an estimated 4000 less police call outs, reduced Emergency Department visits by 847, saved 3069 hospital bed days, and avoided 1470 ambulance call outs.

Falls awareness and prevention training

  • The citywide falls prevention leaflet has been distributed to staff working at Sheffield Churches Council for Community Care, the South Yorkshire Housing Association and lunch clubs. Plans to share with Community Support Workers, Independent Living Coordinators and TAP, linking to Age UK and with Voluntary Care Organisations.
  • Partnership working with the Council to establish the anticipatory care needs of clients. 17 clients interviewed in one housing retirement complex.
  • Upskilled community therapy staff to screen for malnutrition as part of community falls prevention. Developed competency framework for staff and updated system 1 to support appropriate management and referral to dietetics.
  • Ontago training for the city planned in September, which delivers strength and balance training to reduce risk of falls.

Enhanced Health in Care Homes

Care Home Workforce Development

  • Training regarding caring for the immediately fallen resident has been delivered to 7 care homes.
  • There has been 16 weekly Speech and Language & Dietic drop-in Zoom sessions delivered.
  • Dysphasia links training has created 28 dysphagia link staff within care homes.
  • So far, 34 care home staff have training regarding nutrition and hydration, with positive staff evaluation.
  • iStumble training has recently been commenced and so far has resulted in 7 care home managers being upskilled in the use of iStumble.
  • 38 care homes, who look after 1924 residents, received full RESTORE 2 training, with 18 care homes being signed off as competent.

Technology and Equiptment

  • 17 Riazer Chairs have been purchased and will be implemented alongside iStumble technology.
  • A RITA device costing £8000 has been purchased to be tested within a care home setting.
  • Sheffield City Council have purchased 180 Aquarate Hydracare smart cups, that identify volume of drinks consumed, and will work with the Ageing Well Specialist Dietitian to implement good hydration! This project is in conjunction with testing this smart technology.

What are the priorities for 2023/24?

Following review of our achievements so far, and in recognition of current operational challenges, whilst we continue to deliver on the workstreams identified, there will be a specific focus on the following topics in 2023/2024:

  • Mental health support for care homes
  • Urgent community response pathways that include:
  1. Care homes
  2. Immediately fallen individual
  3. 999/111
  • ReSPECT citywide implementation.
  • Management of the deteriorating individual, providing RESTORE2mini training to care homes.

The programme also aims to:

  • Continue to build a partnership network in Sheffield, to deliver ‘what matters’ to our population and the workforce who serve them, ensuring an embedded structure for delivery of Sheffield’s key strategic priorities today and into the future.
  • By doing this we will realise the ambition to create a city collaborative that enables greater integration and therefore efficiency and effectiveness, aiming to build capability and capacity in the community across health and social care, the Voluntary Community Sector and the independent sector, in order to deliver improved quality and better outcomes for people in Sheffield.
Page last reviewed: 22/12/2023