Case study: Housing trust provides integrated and sustainable services

Peaks and Plains Housing Trust and Tunstall Healthcare collaborate to offer sustainable health and wellbeing support

This article explores how Peaks and Plains Housing Trust (PPHT), a Cheshire-based, not-for-profit organisation, is using its TrustLink service, in collaboration with Tunstall Healthcare, to offer a wide range of integrated and sustainable health and wellbeing support services

About Peaks and Plains TrustLink

PPHT’s TrustLink team helps people of all ages and abilities to live safely, securely and confidently in their own homes by providing them with technology-enabled care and assisted living solutions. The TrustLink team consists of three interlinking groups of professionals:

    Independent Living: A dedicated team with specialist knowledge of how technologies can be used and tailored to individual circumstances to give independence, safety and security. Independent Living Advisors identify customers’ concerns and recommend solutions that will provide maximum benefit, including for people with more complex needs such as dementia, epilepsy or learning disabilities
  • Control Centre: Delivering services 24 hours a day, every day of the year. Highly-trained advisors established the customer’s needs and react accordingly, contacting a family member, friend, TrustLink Responder or the emergency services depending upon the circumstances
  • Response: available throughout Cheshire East, the highly-trained response team will attend the homes of customers following an alert received at the control centre, where this is appropriate and the customer has chosen this service

Since March 2016, the Supporting People funding has been withdrawn, affecting various TrustLink services such as activities to reduce loneliness and isolation and added value services such as birthday cards and calls.

As a result, TrustLink remodelled its service delivery to focus on a private customer service model and Housing Benefit eligible services, such as Intensive Housing Management tasks, signposting to referrals and support, assistance with rent and tenancy queries, tenancy sign up visits, checking and reporting repairs.

The communications challenge

TrustLink undertook an eight-week intensive customer communications programme that involved one-to-one visits with individuals affected by the withdrawal of Supporting People Funding and their families. These visits explained how the funding change would affect them and highlighted the benefits of the TrustLink services. As a result, 63% of people chose to continue with the service, funding it themselves, 60% chose the two-star service which includes a response service if required.

Dianne Hutter, TrustLink service manager for PPHT, said: “The key to our success has been working in partnership with other agencies to provide integrated care.

We have a wealth of information about the communities we work in and the services available, and we can act as a lynchpin between the two, identifying underlying needs and signposting to other agencies.

This collaboration means we can take a more preventative approach, which delivers better outcomes for the people we support and is more cost effective.”

The Falls Project

Launched to combat winter pressures and part funded by NHS Eastern Cheshire Clinical Commissioning Group Systems Resilience Fund, the falls project has seen TrustLink successfully forge partnerships with health, social care and the third sector.

The service is aimed at patients who have fallen and require an ambulance response. Whereas often these patients would be referred to hospital for observation only, they can now remain at home and be referred, following clinical assessment, to TrustLink following a falls pathway.

Following a referral, a TrustLink Falls Advisor will visit the client - usually within 24 hours - any day of the week to undertake a falls risk assessment, identifying and addressing issues that might be contributing to the risk of falling. They will also signpost to other services that may support the patient to live safety such as:

  • Community Rehab Physio Team
  • Community Outreach Pharmacy
  • Feedback to GPs
  • Activities and exercise classes
  • Telecare services

From April 2015-March 2016, TrustLink assisted a total of 2,176 patients. Of these, 1,941 patients were able to stay at home with only 235 taken to hospital (10.8%).

Assuming a cost of £110 per A&E visit – not taking into account any further assistance required – this has saved up to £213,510.

Assuming the average cost of a stay for an emergency admission is £1,179, if only half these users had been admitted (970), the saving could be as much as £1.1m over 12 months.

Life Links: Early intervention and prevention

Commissioned through the Better Care Fund and delivered through PPHT and Age UK Cheshire East, Life Links is a free service designed to help people in the community live life and stay well. A team of eight wellbeing co-ordinators work in the community to reduce the need for statutory healthcare services by co-ordinating support packages and signposting to appropriate agencies. Advice is offered over the phone, or home visits can be arranged if appropriate.

Life Links provide information on home adaptions and equipment, such as telecare, to help people live independently at home and works with them to prevent minor health conditions from becoming a major problem. The team is also tackling social isolation by helping people get involved in local groups and activities in the community.

Life Links also has a team of trained community volunteers working from community hubs helping people get online, teaching basic ICT skills such as Skype to help them keep in touch with loved ones.

Chris Twomey, assistant sirector of housing services at PPHT, added: ““As a charitable organisation and not-for-profit company, the goals of Peaks and Plains are different from our commercial competitors.

“We continually reinvest funds to improve services and ensure we are offering value for money, using our in depth knowledge of our communities to interact with other services to work collectively to provide preventative support.

“Long-term, the aim is to support behavioural and cultural change; giving people the information and tools to make good choices about their own health and help commissioners deliver interconnected and sustainable services which meet the real needs of the individual.”

Companies