Changes proposed to overnight care service in Borders

The proposals are part of an ongoing review of the Adult Social Care service which is currently provided by five staff teams, one in each locality across the Borders.

As part of the review, two month-long pathfinder pilots were held with Night Support Service users in the Tweeddale and Berwickshire localities.

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The Tweeddale Pathfinder was undertaken in January and February while the Berwickshire Pathfinder took place during July and August 2023.

In each of these localities, service users received a reassessment of their care package which included being assessed as to their suitability for their overnight visit to be moved to a dawn (6am-12.00noon) or twilight (6pm-12midnight) shift.

The provision of Assistive Technology/TEC solutions such as alarms, movement sensors, bed sensors and door activation monitors were also considered as in many cases this meant that a face to face visit was not always required. A Rapid Response team was available locally to respond to any alarm activations.

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Any changes were closely monitored and undertaken following full consultation and agreement with service users and their family carers. Anyone who was assessed as not being suitable to take part in either pathfinder continued to receive the Night Support Service as per their existing care package.

Evaluation in Tweeddale found that service users experienced no adverse impact or increased risk as a result of the changes, whether that was through an adjustment to the timing of their visit or the use of Assistive Technology/TEC solutions.

Many reported that they benefited from not being disturbed throughout the night which also promoted better sleep. A number of those who were provided with Assistance Technology/TEC felt a greater sense of safety from the constant monitoring this provided, compared to a time-limited face to face visit. Families were also supportive and raised no concerns.

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A similar outcome was experienced by service users who took part in the Berwickshire pathfinder, with many able to have the timing of their visit moved to the dawn/twilight shift with no adverse effect.

In three cases, it was found that service users required the ongoing and planned support of the Night Support Service, due to individual level of need and not meeting the criteria for Assistive Technology/TEC solutions.

Full evaluation of both pathfinders has concluded that there continues to be an overnight support requirement for a small number of service users with critical needs across the Borders.

However, this could be provided by fewer teams who would provide both planned support to those assessed as critical need and act as a responder service to any Assistance Technology/TEC alarm activations. The teams would be staffed by two support workers who would each have access to a vehicle.

The Council is now seeking feedback on the proposal that this model is adopted throughout the Borders.

The consultation is open from Monday 30 October to Sunday 3 December 2023. The survey can be accessed online at: night-support-service consultation Oct 23

Paper copies are available by emailing: sbc.surveys@scotborders.gov.uk.

A letter is being sent to all existing service users to ask for their feedback. Engagement is also being held with staff likely to be affected.

Councillor David Parker, Executive Member for Health and Wellbeing, said: “The pathfinder pilot undertaken in the Berwickshire area has given us a further opportunity to assess the potential impact on service users of changes being proposed to the overnight care service.

“It was encouraging to see that service users who were assessed as being suitable for the dawn/twilight shift pattern responded well to the adjustment, experiencing no adverse impact. Similarly, those who were suitable for Assistive Technology/TEC experienced a number of benefits when this was made available to them. There was no change for those who continued to require the Night Support Service.

“Now that a robust evaluation of both the Tweeddale and Berwickshire pathfinders has been undertaken, we are confident that the model that has been trialled in these localities would be equally effective if rolled out across the Borders. I would therefore encourage people to consider the proposals outlined in the consultation and provide us with their feedback. All comments will be taken into account before any final recommendations are made.”

There will be no change to the service provided to anyone receiving the Night Support Service in other localities until the results of the consultation are known and the outcome shared with the Council and Integration Joint Board to determine the next steps. Integrated Impact Assessments have also been completed.