Pembrokeshire Council - Case Study

In a pioneering and bold move, Pembrokeshire County Council is the first Council in Wales to roll-out a standard system for monitoring the quality and efficiency of all their homecare services delivered by independent providers.

Implementing care monitoring

This method of implementing care monitoring is different to other Councils in Wales as Pembrokeshire owns their independent Providers’ monitoring data and has 24/7/365 access to it. This dramatically reduces administrative boundaries that can hinder or delay delivery and waste much needed resources. This model gives the Council the greatest quality control and the potential to achieve savings.

Following a competitive tender process, the Council chose CM (now Access CM) solutions with the aim of improving the transparency and accountability of homecare services.

Speaking at the time the contract was awarded, Cllr Simon Hancock, Cabinet Member for Adult Services, Health and Well-Being and Equalities for Pembrokeshire County Council said:

“CM will allow the Council to monitor services delivered by a wide range of Domiciliary Care providers, enabling the Council to monitor quality indicators such as punctuality, duration of visit and care worker continuity that will provide visibility on service delivery for vulnerable older people. At the same time it will ensure more effective and transparent payments to providers.”

The introduction of electronic care monitoring is part of a wider change management programme, including a new Provider framework. This is a big programme of work which inevitably takes time to bed in.

With 60% of Providers up and running with CM monitoring the system is already delivering impressive results.

Ian Randell, Strategic Commissioning Manager, explains the benefits and learnings to date.   

Service visibility drives improvements 

“The system is delivering a new level of transparency which we didn’t have before. Having factual data helps us with service reliability and invoice accuracy.”

Pembrokeshire now have much of the information they need to review Provider performance and spot issues. This brings new levels of safety and reassurance to help reduce risks. In the past if they had concerns over missed visits they had no timely, reliable evidence – now Pembrokeshire County Council staff are empowered with all the service delivery information they need, whenever they want it.  

Service User’s don’t just benefit from the safeguarding features of the system, ensuring visits aren’t running late or missed. One of the drivers for change was incorrect billing and those who contribute towards the cost of their care now have the reassurance that the bill is based on correct, real-time actual delivery.

For some Service Users that means the cost has gone down. If someone has a query, it’s now much easier to resolve as the Council have immediate access to the service delivery and invoice information. 

Savings and improved payment process

Pembrokeshire also purchased CM (now Access CM) Finance Manager invoice arbitration tool which will be fully implemented shortly. Despite this, they are already making significant savings due to only paying for actual care delivered.

Ian explains: “In year one of the contract, the Council has achieved an efficiency saving of £413k, and of course there is future cost avoidance which helps to protect the public purse in the longer term. We’re also seeing staff efficiencies by reducing some of the duplication of effort within the brokerage team.”

Further efficiencies are anticipated once Finance Manager is in place and all Providers are using CM monitoring, in particular in relation to the effective use of staff resource within the Council’s commissioning and payment and financial assessment teams.

Another one of the objectives of implementing the system was to reduce the invoice turn-around time for Providers. Progress has already been made in this area too. Providers are now empowered with the ability to reconcile and submit their invoices online, which are often paid by the Council the week following receipt.    

Powerful business intelligence

For the first time the Council can run a variety of reports giving a wide range of service information using dynamic data. This is particularly helpful for evidencing things such safeguarding issues.  

The Access CMBI business intelligence tool will allow them to run their own KPI dashboards showing important quality indicators such as punctuality, missed calls, continuity of Care Worker and information recorded in real-time (indicating proper use of the system).

Early progress with more to come

Pembrokeshire County Council are committed to driving innovation through their use of technology. Understandably, large scale projects like this which require significant change take time to achieve.

Ian is pragmatic about the Council’s progress to date:

“At this stage we’re still embedding our vision. We’ve had to work hard to bring all our Providers along the journey and it’s important to make sure they understand the benefits. The results to date demonstrate that moving to electronic monitoring was a positive investment and absolutely the right thing to do. Based on the progress so far we expect the benefits to continue to increase. We now have greater visibility of services to vulnerable people, Provider invoicing has been improved and we’re already generating savings and efficiencies.”