About this toolkit
CSED has put together this toolkit to help councils looking to introduce a new homecare re-ablement service or extend or improve an existing service.
It has been developed as a practical project support to councils and builds on extensive work done by CSED in:
-
compiling a body of evidence on how homecare re-ablement services are helping to appropriately reduce the level of ongoing homecare support required
- working actively with councils to identify successful approaches, learning points and best practice
Toolkit contents
Organised into nine main sections, the toolkit tackles each of the critical aspects of designing and implementing a successful homecare re-ablement service. It covers both the rationale, benefits and different approaches, as well as project and service management, including tips, templates and case study examples to give practical help to council teams.
There are eight project steps that help lead to successful homecare re-ablement services:
- Setting the vision for a homecare re-ablement service
- Building a business case for homecare re-ablement
- The high level pathway - designing the optimum customer route through social care services
- Applying process design to homecare re-ablement services
- Developing the team and skills
- Establishing an effective performance management system to track and measure the service
- System and form design
- Implementing the new service - change and project management
- In-house versus outsourced provision
The eight project steps follow a logical sequence from setting the initial vision through to project managing the implementation. Users of the toolkit can choose to follow the sections in sequence or access individual sections as required. Each section includes cross-references and links to other content where appropriate.
In-house services versus outsourced provision
A new Section 9 added to the toolkit in March 2011 looks at the outsourcing of homecare re-ablement services and sets out the issues for councils to consider when adopting this approach.
More about homecare re-ablement
Homecare re-ablement complements the work of intermediate care services, focusing on skills for daily living. It is a key policy priority for health and social care, as one of a range of re-ablement services that, through short term intervention, help people recover skills and confidence to live at home after an episode of poor health, admission to hospital, or bereavement. (see A Vision for Adult Social Care: Capable Communities and Active Citizens, DH, November 2010).
Additional funding is going to the NHS between 2010/11 and 2012/13 for re-ablement as post-discharge support. Following an acute hospital episode recovery may involve homecare re-ablement together with other services such as physiotherapy, intervention by a dietician, etc - whatever the person needs following acute care to get them back to or improve upon the position they were in before the acute hospital phase. (see Appendix 3 of Dear Colleague letter, NHS Support for Social Care, 13 January 2011/123463).
Speaking at the 5th International Carers' Conference in July 2010, Secretary of State for Health Andrew Lansley said "We must place renewed emphasis on keeping people as independent as possible for as long as they feel able, not least by providing earlier support... We have to maximise the potential of re-ablement, telecare and other innovations which can dramatically improve people's lives while also being highly efficient... We need to accelerate this change so that these services and this approach is the norm".
You can find more information on the background to homecare re-ablement and CSED's detailed research and discussion papers via the following links.
- For a definition of homecare re-ablement, see 'Intermediate Care and Homecare Re-ablement; what's in a name? Homecare Re-ablement
- See CSED's retrospective longitudinal study
- See CSED's prospective longitudinal study
PDF version Over the next two decades, the number of people aged over 80 is set to double in Britain. Public services must adapt to the challenge that this poses, central to which is the need to deliver social care to older people. Home-based care has the potential to reduce the pressure on more costly public services such as hospital beds and care-home places.
refer http://www.ippr.org/publications/55/7688/home-care-in-london
Reablement services must be made more personalised if they are to improve and promote clients' independence, consultants said today.
Currently, reablement remains a service that is largely "done to" the service user, the consultancies Ambrey Associates and Helen Sanderson Associates warned. "People face too many, uncoordinated assessments and staff are under pressure to meet short-term goals before they "move people on", their paper added.
The warning is timely given the importance being placed upon reablement services by government, the NHS and local authorities as a way of cutting the costs of long-term care and support. The Department of Health has allocated £150m to the NHS this year and £300m next year to spend on reablement, which involves the provision of short-term support to help people regain independence following a crisis, to help minimise their future care costs.
However, the paper, A New Reablement Journey, found reablement was focused on helping people carry out personal care tasks, rather than meeting social needs, and people who needed support after a period of reablement were often inadequately prepared for the transition to other services.
It said reablement should be reshaped around 10 principles to maximise independence, choice and control, including that:-
• Reablement can be just as appropriate for a younger person with a physical or learning disability as an older person in need of help with personal care tasks.
• People should be able to self-direct the support available to them to achieve the outcome of maximised independence.
• People should have information about the resources available to them and support to plan and make decisions for when their reablement programme ends.
• Relevant information about a person should only be collected once and with their full involvement and consent.
"Maximising independence becomes something that should underpin all social care support and not be confined to age or disability, or to the first few weeks of a person's journey," said Jenny Pitts, one of the authors from Ambrey Associates.
The approach is being piloted in Walsall whose executive director for adult social care and inclusion, Paul Davies, said: "More people should have the chance to maximise their independence and have choice in how that is achieved. Reablement is not just about practical self-help; it's about living life as fully as we can; we have to work holistically to achieve that and have a person centred approach."
The paper will be available online from Ambrey Associates or Helen Sanderson Associates later today.
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