Faringdon & the South West Locality (OCCG)
Needs Analysis
Background
1. In May 2013 Oxfordshire County Council (OCC), with support from the Oxfordshire
Clinical Commissioning Group (OCCG), started a competitive tendering process to
identify new suppliers to deliver intermediate care beds (ICBs) in care homes.
2. Unfortunately, the Council received no bids from nursing home providers in Faringdon or
the surrounding area (despite writing to all care home providers in the county and across
the county boundary to alert them to the forthcoming tender) and was therefore not in a
position to award a contract to a local provider.
3. At the meeting 19th December 2013, the Council and OCCG agreed to carry out a needs
analysis to help inform decisions about what action might be taken to mitigate the loss of
the 6 intermediate care beds at Ferendune Court in Faringdon following the termination
of the contract 31st March 2014.
Approach
4. OCC & OCCG officers worked together to produce a framework for needs analysis which
was shared with stakeholders at the meeting at the White Horse Surgery, Faringdon on
28th January 2014.
5. The framework is based on the structure of the National Audit for Intermediate Care,
2013. The concept of intermediate care is a helpful foundation for the needs analysis
because intermediate care services aim to:



Help people avoid going into hospital unnecessarily
Help people be as independent as possible after a stay in hospital
Prevent people from having to move into a residential home until they really need to
6. Intermediate care services take many forms, of which bed-based intermediate care is
only one. There are several services in Oxfordshire that have some form of intermediate
care function including Community Hospitals, the Crisis Response Service, Hospital at
Home, the Emergency Multi-disciplinary Units, the Oxfordshire Re-ablement Service and
the Community Therapy Service.
7. The framework is structured as follows:



Population - what do population levels, trends and characteristics tell us about the
need for intermediate care services
Supply - services that are available in or accessible to the locality / area
Service activity - as a possible indicator of need and demand
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

Performance - how well existing services perform against national benchmarks
Funding - the total investment in aspects of intermediate care
8. Because OCC and OCCG commission at a county and locality based level it is
necessary to look at the needs of the Faringdon area in the context of the OCCG South
West Locality / OCC Vale Locality. The findings are as follows:
Location & transport
9. Faringdon is a small but growing market town in the Vale of the White Horse District
Council area. It is surrounded by a rural hinterland and a number of local villages have
historically used Faringdon as a market town and local service centre.
10. Faringdon is located 11 miles from Wantage, 12 miles from Witney, 13.5 miles from
Swindon (Great Western Hospital), 14 miles from Abingdon, 22.5 miles from Oxford
(John Radcliffe Hospital), 21 miles from Didcot and 23 miles from Chipping Norton1.
1
Distances as measured by AA Route Finder
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11. The Oxfordshire Local Transport plan which was revised in April 2012 states that
"Faringdon has a relatively good range of bus services for the size of the town".
12. The Traveline online journey planner http://www.travelinesoutheast.org.uk/se/XSLT_TRIP_REQUEST2?language=en&timeOff
set=15 - states that there are half-hourly buses direct from Faringdon to Swindon and
Faringdon to Oxford on weekdays (the number 66 service). Services may be less
frequent in the evenings.
13. Local stakeholders feel that in general buses to Abingdon, Wantage and Witney are less
satisfactory and can involve lengthy journeys.
14. Oxfordshire Dial-a-Ride provides a door-to-door service for those who are mobility
impaired and unable to use, or do not have access to, conventional public transport. The
service can be used for shopping trips, attending appointments (but not hospital), days
out and visiting family and friends.
15. There are a number of other community transport services in the county. The
Oxfordshire Travel Advice Line (Oxtail) offers free impartial advice on a range of
transport options for older people or those with a high level of support needs and can be
contacted on: 0845 310 1111, Monday to Friday, 9am-5pm, email:
oxtail@oxfordshire.gov.uk
16. Oxfordshire County Council has developed a transport strategy for Faringdon as part of
the third Local Transport Plan (LTP3) which runs from 2011 to 2030. The strategy for
Faringdon is linked below, however there is currently no funded action plan for its
delivery:
http://www.oxfordshire.gov.uk/cms/content/faringdon-area-transport-strategy
17. The area transport strategy includes commitments to:



Work with local bus companies, developers and other partners to improve the
frequency and attractiveness of the bus services in Faringdon, thus increasing
patronage.
Work with local bus companies, developers and other partners to improve and
develop bus services on certain other routes to increase the accessibility of
Faringdon to/from other key locations particularly the surrounding villages.
Retain the existing local bus services in the area.
Population - what do population levels, trends and characteristics tell us about
the need for intermediate care services?
18. Oxfordshire is overall a relatively wealthy and healthy county. It is in the top 10% of
authorities for both health and a low level of deprivation (2010 Index of Multiple
Deprivation). This means that compared with the national average, most people in
Oxfordshire enjoy:



Longer life expectancy and a lower mortality rate
Fewer early deaths from cancer and coronary heart disease,
Better levels of mental and physical health.
19. The population of Oxfordshire increased from 607,300 to 654,800 between 2001 and
2011. This is an increase of 8%.
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20. The number of people aged over 65 increased by 19% between 2001 and 2011. The
rate of growth was much higher in the predominantly rural districts (over 20%) than
Oxford City where there has been a 5% fall in the number of people over 65. This is true
of the Faringdon area including Great Coxwell and Little Coxwell where the number of
people aged over 65 is forecast to increase at a higher rate than in the county as a
whole. See graph below.
21. Somewhat surprisingly, the position is reversed for people aged over 85 where this part
of the population in the Faringdon area is expected to grow at a slower rate than for the
county as a whole.
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22. The Faringdon Neighbourhood Plan - Evidence-based Review, 2014 notes that currently
there is "a comparatively lower population in the 45-84 age group, but higher numbers of
the very elderly".
Age structure at the 2011 census
25
20
%
15
Great Faringdon
10
5
Vale of White Horse
South East
England
0
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Fig. 5: Comparative age distributions by region at 2011 census (KS102EW)2
23. The population of Faringdon is estimated to be 8,0003, though this is forecast to increase
significantly and at a rate that is higher than for the county as a whole.
2
Faringdon Neighbourhood Plan - Evidence-based Review, 2014
3
Faringdon Neighbourhood Plan - Evidence-based Review - Allies and Morrison Urban Practitioners March
2013, revised by MJ Wise for Faringdon Town Council, 2014
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Population figures for the county and OCCG South West Locality are as follows:
Indicator
Oxfordshire
SW Locality
Faringdon
Total adult
population
680,000
138,000
8,000
Total
population
65+
16%, 103,742
people, 2011
24,005
1,1474
Population
65-74
60,513
13,004
Population
75-84
36,871
7,895
Poplulation
85+
15,814
3,156
Over 65
(growth to
2020)
25,599 - 24.5%
Over 85
(growth to
2015)
85+ population
growing at a faster
rate than nationally.
(growth to 2015)
2351 - 15.8%
24. The percentage of population that is over 65 is in line with other areas in the south and
south east of England:
4
Faringdon Neighbourhood Plan - Evidence-based Review, 2014 - shown as 65-90
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25. Over the next 20 years, the over-85 and over-90 populations in Oxfordshire are
expected to more than double. As the population ages the demand for support
will increase. It is estimated that more than eight out of ten people aged 65 now
will need some care and support in their later years (Caring for our Future white
paper, 2012).
26. Eight wards in Oxfordshire (5 in the City and 3 in Banbury) show particularly poor
outcomes across a range of indicators including child poverty, low skills, low income,
poor attainment, higher crime and poor health. The wards are Blackbird Leys, Greater
Leys, Littlemore, Rose Hill & Iffley, Barton and Sandhills, Banbury Ruscote, Banbury
Neithrop and Grimsbury & Castle Page.
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27. Prevalence of long term conditions

The number of people with Dementia in the county is forecast to increase by 28%
from 2012 to 2020, from 7,800 to 10,000.

The number of people over 90 with Dementia is forecast to rise by 48% in the same
period - from 1736 to 2565.

The prevalence of Diabetes is lower in Oxfordshire than the national percentage
(OCCG) 2011/12 is 6.5% countywide, and 2.1% in the SW Locality. Over 26,000
people aged 17 years and over diagnosed with Diabetes in Oxfordshire GP practices,
representing almost 5% of that age group

Cancer - increasing rate of incidence countywide, higher than national level but not
clear whether due to better recording / identification

Circulatory diseases - significantly lower prevalence than rest of country
28. Living well and independently





The number of referrals to adult social care has grown at a higher rate than that
which would be expected through the effects of an aging population.
62.2% of clients in Oxfordshire received self-directed support in 2011/12. This is the
18th highest proportion of all local authorities.
29% of people aged over 65 were living alone at the time of the census. Across
districts, it is estimated that this rate is highest in Oxford City, at 36% of the
population.
At 30.2 per 1000 people, the rate of people claiming disability living allowance in
February 2012 in Oxfordshire was well below the national rate (50.4). Districts range
from 25.9 in South Oxfordshire to 33.8 in Oxford City.
However, when only mental health related conditions (Psychosis, Psychoneurosis,
Personality Disorder, Dementia) are considered, the rate for Oxford City (8.4 per
1000 people) is above the national rate (7.4)
Life expectancy in Oxfordshire and Districts (at birth,
2008-10)
Female
Male
Oxfordshire
84.1
79.9
Cherwell
83.6
78.9
Oxford
83.2
78.9
South Oxfordshire
84.6
80.3
Vale of the White Horse 85.2
81.1
West Oxfordshire
83.8
80.0
South East
83.5
79.7
England
82.6
78.6
29. People with chronic health problems and early death


Life expectancy for both men and women in Oxfordshire is higher than the England
average.
Estimates for 2011/12 suggest that the number of adults participating in physical
activity is higher in Oxfordshire (27.4%) than in the South East (24.7%) or England
22.9%.
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


Oxfordshire contains below average prevalence of most of the diseases in the quality
outcomes framework. Out of 20 diseases recorded measured by General Practice
the following conditions were more prevalent than the UK average in 2011/12:
Cancer, Depression, Asthma, Atrial Fibrillation, Chronic Liver Disease
These figures may reflect the thoroughness of our GP services in identifying disease
early rather than high disease rates in the population.
The diagnosis and early recognition of dementia is increasing across the county and
is particularly high in West Oxfordshire.
30. Disability

The percentage of residents who reported their health to be very bad or bad in the
June 2011 Census was lower than the regional and national average. Oxfordshire
contains a lower proportion of households with at least one adult with a long term
health problem or disability (21.7%) than the South East region (23.6%) and the
country (26.0%).

46.3% of the Older People in Oxfordshire say that their day to day activities are
limited due to a health problem or disability to some level and 21.6% were affected a
lot, 2011 Census. The following table suggests that the prevalence of disability as
measured by this indicator is similar in the SW Locality to other parts of the county.
People who find their day-to-day activites limited due to a
health problem or disability
16
% of population
14
12
10
8
6
4
2
0
Cherwell
Oxford
South
Oxfordshire
Limited a lot
Vale of White
Horse
West
Oxfordshire
Oxfordshire
Limited a little
31. Approximately 61,500 people have identified themselves as carers in Oxfordshire in the
2011 Census - Carers Strategy, 2013-16. This includes at page 15 a breakdown of
carers by district.
https://www.oxfordshire.gov.uk/cms/sites/default/files/folders/documents/socialandhealth
care/carers/CarersStrategy.pdf


Oxfordshire county council supports 4,500 people to provide unpaid care to another
person.
The proportion of people who reported that they provide some form of unpaid care is
much higher at 61,130.
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
There appear to be higher proportions of people providing unpaid care in rural areas
compared with urban and suburban areas.
Supply - what services are available in or accessible to the locality / area?
Hospitals & EMUs
32. Oxfordshire is served by a wide range of hospital and community-based health and
social care services. There are 2 acute hospitals with A&E facilities (John Radcliffe,
Horton). People living in the SW Locality may also access acute hospital services at
Great Western, Swindon and the Royal Berkshire Hospital, Reading.
33. OCCG has commissioned Emergency Multi-Disciplinary Units (EMUs) in both
Abingdon and Witney which are designed to provide access to emergency medical
assessments and diagnostics and prevent unnecessary admissions to hospital. The
Abingdon EMU is open from 8 – 8 weekdays and 10 – 4 at weekends. Witney is open 8
– 6 weekdays and closed at bank holidays and weekends. These facilities provide an
assessment and diagnostic service and will set up a package of (health and social) care
for people (which may include a short spell in a bed on the site) to support people at
home. EMUs can be accessed on referral by an in-hours or out-of-hours GP.
Community clinical services
34. A wide range of community clinical services are provided on a countywide basis,
including district nursing, podiatry, dietetics and pharmacy services. In the SW
Locality a Continence Clinic is held locally in Faringdon Health Centre (delivered by
Oxford Health NHS Foundation Trust) and there is a South West pilot collaborative
project on Dementia Diagnosis.
Community rehabilitation and crisis services
35. The following services are commissioned by OCC and OCCG on a countywide basis:
a) Oxfordshire Reablement Service - Countywide re-ablement service, operates 7am
to 10pm across the county, provides enabling care and support including therapy
inputs for a maximum period of 6 weeks. Available to prevent unnecessary hospital
admissions and facilitate hospital discharges. Free at the point of delivery.



In 2011/12 there were 1851 episodes of reablement, but the reablement strategy
target is for an increase of almost 90% over the next two years.
In 2011/12, 71% of those commencing reablement completed the course, and of
these 47% needed no on-going care within the year.
In December 2013 68.1 % of the people who completed reablement needed no
ongoing care, in November this was 56.1%. (The target is 55%)
b) Crisis Response Service - 24/7 social care crisis response service which provides
emergency support to people in their own home, on a 4 hour response basis
countywide. Service has been effective in preventing unnecessary hospital admission
since its inception in January 2012 with over 80% of people being supported without
admission. Free at the point of delivery.
c) Community Therapy Service - provides assessment and therapy from team of
physiotherapists and occupational therapists to address a range of needs, including
recovery and rehabilitation following a hospital stay. Free at the point of delivery.
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d) Hospital at Home - provides nursing supported care to people at home to prevent
avoidable hospital admissions and support discharges from hospital. Free at the
point of delivery.
e) Discharge to assess at home - this countywide service provides intensive, short
term care packages to help people with a high level of need for care to return home
from hospital
f) Support at Home - if a person needs on-going care and is eligible for support they
may receive a personal budget from the Council which will enable them to purchase
support from a personal assistant or domiciliary care provider.
g) Carers' services - the Council provides a wide range of services and support for
family carers including information and advice, carers' assessments and carers'
grants and breaks.

In January 2014 15,228 carers were supported by Adult Social Care and 819
people were jointly funded with health for a carer’s break accessed via their GP.
There were 3,124 carers registered with the Carers' Emergency Support Service
(delivered as part of the Crisis Response Service).
Bed-based services
36. Intermediate care beds in care homes. 66 beds will be available from 1st April 2014 in
the following locations. Eligible, adult residents of Oxfordshire can be admitted to ICBs
regardless of where they live in the county.
Location
Number
Type
Step up
Step down
Brooklands Nursing
Home, Banbury
17
Rehabilitation (12) &
recuperation (5)
Yes
Yes
Isis Care Centre, OSJ,
Oxford
20
Intermediate care (New
Service Specification)
Yes
Yes
Watlington, Sanctuary
15
Intermediate care (New
Service Specification)
Yes
Yes
Henry Cornish Centre,
Chipping Norton
14
Intermediate care (HCC
specification)
Yes
Yes
37. In addition there are approximately 200 community hospital beds at various locations
around the county. These also provide bed-based intermediate care. In the South West
Locality there are 40 community hospital beds at Abingdon and 8 at Wantage.
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38. Bed-based respite - OCC currently purchases 22 respite beds in care homes around
the county. Two of these are in the SW CCG Locality (Stirlings residential, Wantage).
Other nearby respite beds are at:






The Meadows residential, Didcot
Madley Park residential, Witney
Mill House Nursing Home, Witney
The Meadows residential, Didcot
Westgate residential, Wallingford (2)
The Grange nursing home, Stanford in the Vale
Extra Care Housing
39. OCC is proactively developing Extra Care Housing (ECH) in the county as an important
resource for older people and an alternative to residential care home placements.
40. ECH is described in various government sponsored reports as: “Purpose-built
accommodation in which 24 hour personal care and support can be offered and where
various other services are shared.”
41. The most important factors that define ECH are:






Purpose built ‘lifetime’ homes for rent, sale or shared ownership
An on-site team of carers providing personal care on a 24-hour basis that
provides an alternative to residential care
Ability to provide a daily hot meal (usually from an on-site kitchen) served in a
communal dining room
Enhanced bathing and toilet facilities and a laundry
Various communal rooms/areas offering a range of therapeutic, health, leisure
and activity functions
An ethos of extra care that promotes independence, not to foster a culture of
dependency. Wherever possible, people are assisted in performing tasks
themselves, rather than having them done for them.
42. Oxfordshire County Council wants to develop ECH countywide at a ratio of 55 places per
1,000 persons aged 75+. This sets a stretch target of 4,300 units of ECH within
Oxfordshire from now (2013) until 2031. A total of 930 flats are on track for development
by 2015.
43. Extra Care Housing will be provided in the newly approved planning application
for Bloor Homes on the South of Park Road (A417), Faringdon. Estimated demand totals
for ECH in the Faringdon and Wantage areas is as follows;
Locality
ECH Demand 2015 (by
flat/unit)
ECH Demand 2033 (by
flat/unit)
Faringdon and surrounding
wards
110
180
Wantage/Grove and
surrounding wards
150
230
44. Potential and planned ECH schemes for Faringdon & Wantage at October 2013 are:
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




Kingston Bagpuize and Southmoor: A speculative planning application for 45 ECH
units at this site was agreed earlier this year. It was agreed these should be a mixture
of affordable and private sale flats. The agents behind this application are trying to
find a housing association (with support from the County Council and the District
Council) to take this proposal forward.
Land south of Park Road, Faringdon. An application has been submitted to develop
380 homes at this site. Both the County and District councils are supporting the need
for 60 ECH flats at this site as part of the affordable housing allocation.
Grove Air Field; An agreement with the District Council to provide 80 ECH flats on
this site has been in place for a long while and has featured in draft master plans.
However the site development has been delayed for several years by its owners
given general concerns over the economic climate (but is now close to being taken
forward).
Land at Crabb Hill, Wantage. An application is being considered for 1500 homes at
this site and the County Council has requested a 60 flat ECH scheme as part of the
affordable housing provision
Stirlings site, Wantage. The County Council currently lease this site to the
Oxfordshire Care Partnership for the operation of a former OCC care home. The site
also contains an older style sheltered housing scheme. In time and subject to further
consultation the site could be re-developed for a modernised service such as ECH.
Service activity - what does this tell us about need and demand?
45. Information of service activity is patchy and generally only readily available at a countylevel. This is what we have:
Hospitals & EMUs
46. Unplanned hospital admissions 65+ - 9,153 countywide, 1,746 SW Locality or 18%
47. Over the past year, the number of referrals from acute hospitals for ongoing care rose by
34% and placements from hospital into care homes increased by 28%, to 229 cases.
48. This means also that a slightly larger percentage of people were placements from
hospital (50%, up from 46%), while a slightly smaller percentage were threshold cases,
i.e. ones where the Council begins to support a client who was previously funding their
own care (28% to 24%).
49. The chart shows the breakdown for 2011/12
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Care homes
50. The number of people who go in to care (nursing and residential) homes after being in
acute hospital is about twice as high as the national average.
51. The breakdown by age and type of care home is shown in the table below, as well as the
percentage by age band of the total number of older people supported at home.
52. Both the number of people in care homes and the percentage supported at home
increases with age. The peak age band for placement in a care home is 85 and older for
both men and women.
53. The number of people placed in care homes has fluctuated over the past few years, but
has been consistently above the target introduced in October 2012 of no more than 400
being placed each year:




2009/10: 596
2010/11: 472
2011/12: 558.
2013/14: 582.
54. In Oxfordshire we make fewer placements into care homes than other counties (14th
lowest rate in the country – 42 people per 10,000 population aged over 65) but have a
higher percentage of older people living in care homes.
55. The average length of stay is 5 months longer than amongst our comparators, is about
twice the national average, and has increased by 10% over the past 6 years (from 2.58
yrs to 2.84 yrs).
Age
Nursing home
Residential
home
65-74
75-84
85+
Total
67
208
484
759
100
284
444
828
Total in
care home
(residential
or nursing)
167
492
928
1587
Percentage
of overall
no. in a
care home
11%
31%
58%
Percentage
supported
at home
17%
32%
52%
Intermediate care beds in care homes
56. Currently information on service activity and the performance of intermediate care beds
in care homes (ICBs) is limited due to inconsistencies in reporting arrangements across
units and service providers. The Council is working to introduce a new countywide
performance monitoring framework which will correct this, from April 2014.
57. Previous analysis5 has shown however that ICBs in care homes deliver good outcomes
for service users with high levels of occupancy (95%) and good service outcomes with 6
in 10 service users returning home following a stay in an ICB.
5
Report on Intermediate Care Beds in Care Homes to the Older People's Joint Management Group, November
2012
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58. There were 33 admissions to the Ferendune ICBs during 2013/14, or 5.5 admissions per
bed compared to a maximum capacity of 13 assuming an average length of stay of 4
weeks. The reasons for people being referred to Ferendune have been:




Rehabilitation following a fall or fracture (majority)
Rehabilitation following a stroke
Treatment for cellulitis
Rehabilitation following a period of treatment for Diabetes, chest infection, urinary
tract infections
Community hospitals
59. Over the past 3 years a considerable change in level of needs of the people being
referred for care to community hospitals has been noted, added to that the number of
people being referred has increased.
60. Oxford Health NHS Foundation Trust has worked hard to change the provision in the
community hospitals in line with the need of people being referred. The larger ones
(Abingdon and Witney) provide sub-acute and rehabilitation, working very closely with
the Emergency Multidisciplinary Units on those sites. The beds on the other sites provide
a range of services that vary from sub-acute to rehabilitation. The plan is for further
adaptation to take place ensuring that the supply of beds fits the range of needs of the
population coming through much more closely.
Crisis response
61. Crisis Response referrals are shown below by district. The figures for the SODC and
Vale Districts are combined here but overall it would appear that referrals are lower for
this area than other districts:
Social care
62. OCC funds 2,400 support at home packages and 1,600 permanent care home
placement annually
Performance
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63. We have not managed to capture information on the wide array of community health and
social care services that provide support to people to help them to remain independent in
their own homes and prevent unnecessary hospital admissions.
Funding
64. Oxfordshire County Council and OCCG invest heavily in a range of community-based
intermediate care services which are generally commissioned on a countywide basis as
described in the following table.
65. A further £2.6M p/a is invested in the Discharge to Assess at Home service which
provides intensive care and support packages for people with complex needs to get
home, and the Supported Hospital Discharge service.
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IC function
Crisis response
Setting
Community based services provided
to service users in their own
home/care home
Aim
Assessment and short term interventions to
avoid hospital admission
Oxfordshire
Crisis Response
Service
Home based
rehabilitation
Community based services provided
to service users in their own
home/care home
Intermediate care assessment and
interventions supporting admission avoidance,
faster recovery from illness, timely discharge
from hospital and maximising independent
living
Hospital at Home
£2,000,000
Bed based
Service is provided within an acute
hospital, community hospital,
residential care home, nursing home,
standalone intermediate care facility,
independent sector facility, Local
Authority facility or other bed based
setting
Prevention of unnecessary acute hospital
admissions and premature admissions to long
term care and/or to receive patients from acute
hospital settings for rehabilitation and to
support timely discharge from hospital
66 x ICBs in care
homes
£3,451,485
200 x Community
Hospital Beds
£19,000,000
Community based services provided
to service users in their own
home/care home
Helping people recover skills and confidence
to live at home, maximising their level of
independence so that their need for on-going
home care support can be appropriately
minimised
Oxfordshire Reablement Service
£5,000,000
Community Therapy
Service
£6,400,000
Re-ablement
Budget 2013/14
£620,000
£36,471,485
Investment in intermediate care services and functions, 2013/14
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Summary of key findings and conclusions
1. This needs assessment has demonstrated that Oxfordshire is a relatively wealthy and
healthy county. The general population enjoys longevity and there are low levels of
deprivation and mental health issues.
2. Although the population is ageing and demand for health and social care services is
expected to increase as a result, a wide range of community clinical and rehabilitation
services already operate in Faringdon and the South West Locality as in other areas of
the county to help meet this demand.
3. If a person needs bed-based intermediate care in a nursing home setting we will
endeavour to provide this as close to their home as possible. If this is not possible and
community transport options including dial-a-ride do not provide a reasonable alternative,
we will have available, for those who have insufficient means, a discretionary fund to pay
for that need.
4. This needs analysis has not identified any significant gaps in the range of provision of
health and social care services in the South West Locality though it has noted that
transport may be a barrier for some who use health care services that are not provided
or available in the locality.
5. Health and social care services have developed significantly since the intermediate care
beds at Ferendune Court Care Home were first commissioned.
6. There is now substantial investment in a wide range of services that deliver some form of
intermediate care function to help vulnerable adults and older people to avoid
unnecessary hospital admissions and get home quickly following a stay in hospital. Our
challenge is now to develop and optimise the performance and effectiveness of these
services.
7. The Older Peoples Joint Commissioning Strategy 2013/16 and the blueprint for Priority 2
in the strategy, ‘Healthier at Home’ focuses on the transformation of community services.
Subsequent developments and publications including OCCG's consultation on Improving
the Health of Oxfordshire and NHS England's recent guidance on delivering care for
older people6 emphasise the need to deliver care which is at the right level and quality
and at home or as close to home as possible.
8. Locally and nationally the emphasis is shifting from delivering healthcare services in bedbased settings to one of providing ‘spells’ of the right, integrated care for that person at
the right time. This may include a short period of time in a bed-based setting however the
evidence is showing that older people who spend too long in emergency departments
and hospital beds can suffer harm.
9. During 2013/14 considerable progress has been made by the Council and OCCG in
increasing the care available at home and ensuring it is the right care. Details of these
services are noted in the needs assessment. The focus has been on providing a
countywide spread and equity of services across the county. At times it has meant that
people getting the right care in an appropriate setting comes before that care being close
to the person’s home.
6
Safe compassionate care for frail older people using an integrated care pathway - NHS England,
2014
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10. Health and social care services are, and will remain, available to support at home people
who live in the Faringdon area. Our strategy is to deliver better support to people who
live in Faringdon and elsewhere in the county through the development and optimisation
of our range of intermediate care services, not just bed-based services.
11. We will continue to monitor and develop all our services to ensure that they meet the
needs of people in Oxfordshire, and make changes as required.
12. There will be a specific focus on the provision of intermediate care beds in line with the
recent changes that have taken place. OCC and OCCG are actively considering future
procument of intermediate care beds to ensure that sufficient supply is maintained
across the county, and any further tender is likely to be preceded by market development
activity.
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