Integration: Commissioning home care for older people

For good home care to respond properly to the needs of older people with complex needs, it should be well integrated with health care and other support services, including those in the voluntary sector. [16]

Integrated and joint working, where health and social care staff work together, can be difficult to organise. Also, each organisation will have its own ethos, roles and responsibilities and these may clash. [17]

If health and social care staff are located in the same place, or there are other ways in which their organisations are integrated, this does not necessarily lead to professionals from different background working much closer together. So the emphasis should be more on the processes of team working at the personal level. [3, 19]

There are some successful models of integrated care for older people with complex needs. Features of these include:

• single shared assessments
• care management and intensive care management
• home care reablement
• intermediate care, such as hospital discharge teams and admissions avoidance schemes.

There is no ‘best’ way of providing integrated care as providing such care is a dynamic and complicated process. [18]