Bath and North East Somerset Council shares mental health services with Avon and Wiltshire Mental Health Partnership NHS Trust. Team Leader, David Leveridge, wanted to test if activity monitoring could postpone the need for residential care. He calculated that Just Checking would pay for itself if residential care was postponed for just 2 weeks. He purchased 10 systems, and allocated them to the two community mental health teams in the Bath area.
The systems were used for assessment, with some remaining in place for many months. Data was shared with family carers if they were involved in supporting their relative at home. After 6 months a review was made of 7 cases in which residential care was being considered when Just Checking was installed. Of the 7 cases, 4 continue to live in their own homes, 2 went into residential care, and 1 died at home.
Although difficult to quantify how many weeks of institutional care had been prevented, the professionals in 2 cases felt that the equipment had definitely prevented a placement from being made. In both cases the equipment had been in situ for approximately 26 weeks. The authority calculated that the savings from these two cases alone, covered the entire expenditure on 10 Just Checking systems. A further 3 suggested that the equipment has “probably” averted a placement although it was not possible to attribute this solely to the use of the equipment.
The community mental health teams are convinced that Just Checking not only supports people in their own homes for longer, but also helps them to carry out their job more effectively. With clearer information about how a person with dementia is behaving, the team can make adjustments and see the effect of changes to care or medication, while the person remains in the familiarity of home, avoiding admission to hospital or respite care. Staff install Just Checking themselves. The wireless sensors are fixed using Velcro pads, and the system all works automatically.
“Just Checking made a huge difference to the quality of life for one of our service users. It enabled us to see his behaviour at night and to make adjustments to medication and support.”
Pam Jenkins, Community Mental Health Team.
Annual cost of Just Checking = £664 = £12.77 a week
(based on 1 system, writing off capital cost over 3 years)
Average weekly cost of residential care to Bath & North East Somerset in 2007 = £310
Two cases judged to have prevented residential care for 26 weeks: 26 x £310 x 2 = £16,120
Cost of using Just Checking for 26 weeks = 26 x 12.77 x 2 = £664.04
Net savings £16,120 – £664.04 = £15,455.96
Updating these figures and using national unit costs, if a person with dementia was supported at home with Just Checking and a home care package of 1 hour visit or 2 x half hour visits a day
Weekly cost of Just Checking is £12.77
Average hourly cost of home care is 14.60*
Average weekly cost of residential care = £498.00*
*Source: NHS Health and Social Care Information Centre. Personal Social Services Expenditure and Unit Costs 2008-2009, NHS Health and Social Care Information Centre (2010)
£12.77 + 7 x £14.60 = £114.97
Total weekly savings = £498.00 – £114.97 = £383.03 Total annual savings = £19,917.56
The cost of purchasing and running a Just Checking system for a year is covered if residential care is postponed for just 10 days.