Reablement within the Independent Sector Pilot Project

What is reablement ? Reablement is emerging as a pivotal service within health and social care. It focuses on prevention and enabling clients to return to independent living through a short therapy led outcome programme. The majority of service users supported by adult social care receive care from externally contracted independent home care providers. As part of Putting People First, reablement enables people to receive care and support whilst continuing to live independently and have more say over what they what to do for themselves

Desired outcomes of the pilot 1.Greater independence for those reabled to live at home and with an improved quality of life. 2.Increasing people’s self reliance, leading to reduced hospital admissions caused by falls and accidents 3.Potential to use financial savings on homecare for more universal services that prevent health and mobility deterioration 4.Assess the independent sector ability to respond to people’s individual needs, capable of reabling people as well as providing traditional homecare. Pilot Project Aim To assess whether providing reablement with independent home care providers will improve client’s outcomes and reduce the overall need for homecare in East Sussex.

Set up of the project Work was undertaken internally to identify the best geographical area to operate the pilot (Hastings) Two independent home care providers agreed to participate within the pilot Partnership working was developed with ASC Occupational Therapists, Social Workers and assessment staff A reablement training programme provided by ASC to 39 care staff across both companies

Delivery The pilot launched in October 2011 with existing clients assessed for reablement potential but it was found that current care packages were effective The Project Board extended the pilot to new cases and added to the geographic area to include all of Hastings, Rye, Bexhill and Battle The pilot is unselective - all clients are offered reablement services (after professional assessment for suitability) There is ongoing monitoring of how well the desired outcomes are being met

Case study – Mrs M 86 years old, widowed and lives with her daughter who provides support with daily living including shopping, housework, laundry, meals, drinks and snacks. History of agoraphobia and incontinence. Became bed ridden, due to loss of confidence, after a fall Assessed as needing an ongoing Package of Care was for hours per week Keen to maintain her own independence and avoid too much reliance on others. To rebuild her confidence she instead opted for reablement. The reablement programme, worked on increasing confidence and activities. Longer term limitations were identified and a revised ongoing Package of Care developed. The new package was for 2½ hours per week. Benefits: personalised approached to delivery of care promoting independence home care resources released to provide support services elsewhere

Feedback from providers Responses include: –“ This is a real partnership between the Council and providers with everyone able to contribute to the development of the service”. –“The pilot has worked effectively for both their clients and carers, with an excellent rapport with all ESCC departments enabling excellent working relationships”. –“Our carers have benefited from the extra involvement in the decisions and planning of client care. Our clients have received a service to meet their changing requirements and have seen the result in hours rather than days or weeks.” –“We already have a workforce who have always been proactive in enabling clients as the main care goal”. Participating providers were both asked to give their views on the effectiveness of the pilot and how it has impacted upon their businesses

Feedback from clients What can we do better in future? –“Nothing, everything was very good” –“Happy with all help given” Any further comments on your experience? –"Happy to be walking without stick indoors." –"I am happy to be completing all of my daily tasks / routines by myself now." –“Glad to be doing things myself”

Going forward We will roll out to other areas of the county and to facilitate this we are: –Developing plans to support independent sector reablement capacity –Developing a programme of training –Revising internal processes (to rely on the abilities of providers to deliver services while having a OT resource available to assist when necessary)