Hertfordshire County Council spends around £26
million a year on home care providing 45,000 visits a week to
around 6,000 clients through 49 approved private home care
providers. As a part of their contract with the County Council most
private home care providers are required to have an electronic
monitoring system in place.
The main driver for introducing electronic monitoring in
Hertford-shire was the need for greater transparency and protection
of vulnerable service users. Guy Pettengell, contracts manager,
Adult Care Services, recalls, "Before monitoring was intro-duced
the only information we had about what services were actually
provided was based on our commiss-ioning information. Greater
transparency has enabled us to think about more flexible ways of
commissioning care because the system deals with the issue of 'how
long did the care actually take' we can now start concentrating on
flexibility to benefit the service user".
Three years ago Guy and
his team tendered for a range of 'block' contracts. Part of the
requirement of that tender was for providers to introduce a form of
electronic monitoring of service provision. Hertfordshire County
Council had initially looked at a range of home care monitoring
systems. "Real time monitoring with an alarm facility was
critical", says Guy. "A working party was set-up, and we did a
trawl of the systems available. In looking at what was best for
Hertfordshire we decided to let providers choose their own system,
one that suited their needs best whilst meeting our contract
require-ments. This gave them ownership and got over any potential
problems associated with imposing a system".
Guy continues, "Through the tender we gave providers the
opportunity to choose a system which would best suit their needs.
In the end providers decided to adopt for one of two different
systems - CM2000 or HET Software Solutions, with the county council
supporting providers in implementation."
The block contracts let in 2001 included the remit to start
electronic monitoring. Providers were all piloting their preferred
system during 2002 and by April 2003 everyone was up and
running.
Electronic monitoring has now been in full use for over a year.
The biggest challenge has been supporting providers from a
technical viewpoint in a market where there is little technical
expertise. Guy remembers, "at the beginning some providers didn't
even have an e-mail address so there was a lot of support needed,
with both CM2000 and HET investing a significant amount of time and
energy."
"We have been very pleased with CM2000's support for both us and
our providers. They've been very open in providing us with
information, support and ideas and we get good feedback from the
providers."
So, has electronic monitoring met all the original objectives
and the business case for introducing it? "Absolutely", says Guy,
"we have the opportunity to improve service user safety with the
'alarm function' and greater trans-parency has been achieved and
this means Hertfordshire can now say categorically "we only pay for
the amount of care we have received."
Block providers are also now seeing the benefits with
improvements in the available management information. "We even have
some providers who are using the information to enhance the way
they pay staff based on not just what they are actually doing but
how well they are doing it", says Guy.
Guy is also proud of the fact that Hertfordshire is the first
local authority to generate invoicing direct from data gathered
through electronic monitoring. This has had a significant effect on
process cost reductions for both the authority and the
provider.
Finally, the Audit Commission has been so impressed with
Hert-fordshire's model for the monit-oring of care that they have
included it in the best value toolkit for use by other local
authorities. As Guy says, "The Audit Comm-ission recognise the way
we monitor as a key integral strategy for managing care".