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HOMECARE RE-ABLEMENT

HOMECARE RE-ABLEMENT . Gerald Pilkington Care Services Efficiency Delivery Housing, Home Care and Community Health Services – Enabling People to Stay at Home 2 nd December 2008. HOMECARE RE-ABLEMENT: Objectives of this Presentation. To provide:

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HOMECARE RE-ABLEMENT

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  1. HOMECARE RE-ABLEMENT Gerald Pilkington Care Services Efficiency Delivery Housing, Home Care and Community Health Services – Enabling People to Stay at Home 2nd December 2008

  2. HOMECARE RE-ABLEMENT: Objectives of this Presentation To provide: • a summary of the ‘body’ of evidence in England • how CSED supports development of re-ablement services • Questions

  3. HOMECARE RE-ABLEMENT: CSED’s role • To support CSSRs to achieve their cashable efficiency targets within adult social care in England during CSR07 • Working through 10 programmes • Transforming Community Equipment • Referral, Assessment and Care Management • Homecare Re-ablement • Care Pathway Planning • Support Related Housing and Technology • Better Use of Information • Crisis Response • Commissioning (including Better Buying) • Planning • Personalisation of Social Care, Engaged with CSSRs through programme leads and regional teams

  4. HOMECARE RE-ABLEMENT: CSED Proposition

  5. Homecare Re-ablement: What is it ? – a definition* (1) Prevention • Services for people with poor physical or mental health • To avoid unplanned or unnecessary admissions to hospital of residential care • Can include short-term and longer term low-level support Rehabilitation • Services for people with poor physical or mental health • To help them get better Re-ablement • Services for people with poor physical or mental health • To help them accommodate their illness by learning or re-learning the skills necessary for daily living * Definitions from an evaluation report by De Montfort University

  6. Homecare Re-ablement: What is it ? (2) Common principles and features: • helping people ‘to do’ rather than ‘doing to or for’ people • outcome focused with defined maximum duration • assessment for ongoing care packages cannot be defined by a one-off assessment but requires observation over a defined period Objectives are: • to maximise users long-term independence, choice and quality of life • to appropriately minimise ongoing support required and, thereby, minimise the whole life-cost of care

  7. HOMECARE RE-ABLEMENT: Does it work ? (1) * Leicestershire De Montfort study 2000

  8. HOMECARE RE-ABLEMENT: Benefits

  9. HOMECARE RE-ABLEMENT: Does it work ? (2) *1= FACS applied at entrance to homecare re-ablement *2 = FACS applied at exit from homecare re-ablement

  10. HOMECARE RE-ABLEMENT: Retrospective Longitudinal Study – Duration free from homecare

  11. HOMECARE RE-ABLEMENT: Retrospective Longitudinal Study -Changes in level of need since re-ablement for > 65s Exit = users transferred to long-term care or died

  12. HOMECARE RE-ABLEMENT: Comparing Conventional and post Homecare Re-ablement packages Comparing the results of the De Montfort study and Retrospective Longitudinal study over a 24 month period.

  13. HOMECARE RE-ABLEMENT: CSED Documents As a result of its work with CSSRs, CSED has produced a body of evidence which is available via its website: Executive Summary and Discussion Document:published January 2007 containing information from 5 case studies and 13 additional information sites, supporting documents: evaluations, evidence of benefits, example documents. Assessment tools and satisfaction surveys: published August 2007 7 examples of functional assessment tools used within CSSRs Summary of outcome measures / standardised assessment tools 8 examples of satisfaction survey tools Retrospective Longitudinal Study: published November 2007 working with four CSSRs, tracks 2,441 people that underwent a phase of homecare re-ablement for 24 months and quantifies the duration of benefit CSSR Status Directory Update: published May 2008 provides an update on 137 CSSRs

  14. HOMECARE RE-ABLEMENT: Outline of Direction for 2008/09 Focusing on 4 projects • Continued roll-out of the Homecare Re-ablement model • CSSR Homecare Re-ablement Scheme directory - completed • Benefits of homecare re-ablement - underway • Outsourced services • Clients with mental health, physical, sensory and learning disability needs • Prospective Longitudinal Study – underway Working with nine CSSRs • to identify the features of an effective and cost efficient service • to maximise both outcome and duration of benefits and reduce variability between services • to understand and reduce the demands on other formal care, including • other social care services e.g. delay or prevent admission to residential care • other council services • delay or reduce demands on health • Homecare Re-ablement for those on ‘maintenance’ packages • seek to provide evidence through case studies and supporting information of the benefits of homecare re-ablement for those who have been in receipt of a maintenance homecare package. • Post initial phase homecare re-ablement • seek to provide evidence through case studies and supporting information of the benefits of additional phases of homecare re-ablement for those whose needs increase at subsequent reviews following an initial phase of homecare re-ablement

  15. HOMECARE RE-ABLEMENT: Social Care in England (1) • Department of Health has policy responsibility • Delivery is responsibility of councils with social service responsibility (CSSRs) • Councils report to Communities and Local Government department NOT Dept of Health – locally responsible to elected councillors • Gross spend on adult social care 2006/07 - £16.5 bn (plus £5.6 bn on children and families services, and asylum seekers)

  16. HOMECARE RE-ABLEMENT:Supporting Development (1) Slide 16 National • CSED to provide national platform and subject matter focus • CSED involvement to develop generic skills • Promote joint work with other efficiency and change ‘programmes’e.g. Regional Efficiency Improvement Partnerships (REIPs), Care Services Improvement Partnerships, etc. Local • Champion • Dedicated and skilled project manager • Project board • Clear statement of vision • Develop ‘as is’ and ‘to be’ models, prioritisation • Consider capacity for change

  17. HOMECARE RE-ABLEMENT: Supporting Development (2) CSED can support CSSRs in a range of ways Input to strategic thinking about nature of service Advice on key areas for consideration in pre-planning and implementation phases Subject matter advice based on work with CSSRs across England Linkage to other CSSRs: at similar stage or advanced stage of service implementation / maturity Generic project management skills by regional team Slide 17

  18. HOMECARE RE-ABLEMENT: Contact with CSED Gerald K Pilkington CSED Lead Homecare Re-ablement gerald.pilkington@dh.gsi.gov.uk www.csed.csip.org.uk Telephone: 020 7972 4161

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