Assessment of the service user’s needs for integrated Sample Clauses

Assessment of the service user’s needs for integrated home care This step focuses on assessing the individual service user in relation to any home care needs they may have. This will usually be a systematic process which relies on pre-defined assessment criteria / procedures. These enable identification of health related needs as well as needs for other forms of home support. Implementation of this process is thus likely to require involvement of multi-disciplinary expertise. Generally, it should focus on client-specific risk factors and service outcomes that can be realistically anticipated from relevant professional perspectives for the individual service user.
Sample 1
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Assessment of the service user’s needs for integrated home care: The call centre does a brief initial assessment of the reason for referral. If level of intervention required is likely to be very low they will pass to social care rather than the Integrated Care Team (ICT). ICT comprises district nursing, occupational therapy, care managers and social workers. ICT accepts the referral and contacts referrer to get further details regarding the nature of the referral and more background information. • If hospital referral: check on-line records to ascertain if person is already in receipt of any services. Discharge meeting arranged involving ICT Care Manager, hospital social worker (SW), patient, family / carer (if possible) and xxxx staff. Hospital SW provides the pre-discharge Multi-Disciplinary Team (MDT) assessment. Currently they do not use eNISAT (electronic Northern Ireland Single Assessment Tool). • For all non-hospital referrals: ICT meet with client and possibly their family / carer and a community social assessor if applicable. eNISAT process starts with core screening. GP is contacted to provide NISAT medical assessment. Dependent on outcome the person will either be: • referred to a care facility; or • remain at/return home with a package of care. Care packages are people centred, and designed around the assessed needs of patients and clients. Services available in a care package may be: • Domiciliary Care: may be provided by HSC Trust, private provider or voluntary / community organisation: • Personal care. • Meals. • Medication. • Occupational Therapy: • Telecare (Telemonitoring NI service). • Aids and adaptations. • District nursing. • Physiotherapy. • Speech therapy. • Podiatry. • Specialist nursing services. • Telehealth (TNI service).
Sample 1

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