Parvaneh Rabiee Caroline Glendinning, Hilary Arksey, Kate Baxter, Karen Jones, Julien Forder, Lesley Curtis What Works: Putting Research Into Practice Institute for Research and Innovation in Social Services (IRISS) Workshop Series, Edinburgh, 30 th April 2010
Policy context and the rationale for the project Aims and methods The key findings Success factors Conclusion Implications for practice
Re-ablement a priority for adult social care A decade ago: Recognising the need for greater investment in preventative and rehabilitation services 2000: A wide variety of intermediate care services established More recently: Development of home-care re-ablement services Restated in the recent Green Paper on future options for adult social care Reduced needs for on-going home care support But how long does this last? Which groups are likely to benefit most? How best can re-ablement services be organised? Prospective study SPRU (York) and PSSRU (Kent) Investigating the longer-term impact of home care re-ablement services
Provide research evidence on the immediate and longer term benefits of home care re-ablement Identify the factors that affect the level and duration of benefits for service users Identify any impact on and savings in the use of social care and other services Describe the content and the costs of home care re- ablement services
A comparative design 5 councils offering home care re-ablement services 5 councils offering standard home care services Using quantitative and qualitative approaches
How are home care re-ablement services organised and delivered? Factors contributing to the success of re- ablement service Interim report Research Works
Five established services Interviews with re-ablement service managers Observations of re-ablement service visits Focus group discussions with front line staff
From selective to inclusive intake Multiple roles Re-ablement Intensive short-term intervention Short-term home care support Extended assessment Transforming in-house home help services Transferring staff to new specialist services - retraining staff Volunteering to join the scheme Voluntary redundancy and early retirement
Eligibility criteria: Adults over 18 newly referred for home care support Exclusions: people at last stages of their life and people with severe dementia Duration of re-ablement Charging policies
(Re) assessment and care plans Flexibility about length of visits
Staff rotas to enhance continuity Case recording and communication within team Supervision and shadowing Formal reviews Onward referrals
Personal care (e.g. washing and dressing) Practical support (e.g. meal preparation) Prompting medication Psychological / emotional support Advice and information (e.g. falls prevention) Rapid access to equipment Problem solving
Service users characteristics User support needs User motivation Staff attitude, commitment and skills Training and supervision Flexibility and prompt intervention High quality assessment Consistent recording system Rapid access to equipment and specialist skills (OT/physio/mental health/dementia)
Family/informal carer support Wider environment Strong/shared vision of the service Capacity within independent sector providers
Re-ablement as an intake service and implications for measuring ‘success’ Organisation of services Training, skills and supervision Factors external to the re-ablement service
Be clear about the aims of the service and the conditions under which they can be achieved Using appropriate performance measures Need to adopt a ‘whole system approach’
Reflections of what has been presented? What are the likely implications for staff and service users of what you have heard? What issues does what you have heard create for you, your work and your organisation? What do you think you/your organisation needs to do or change as a result?
Parvaneh Rabiee Caroline Glendinning, Hilary Arksey, Kate Baxter, Karen Jones, Julien Forder, Lesley Curtis Download from: