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Parvaneh Rabiee

The Organisation and Delivery of Home Care Re-ablement Services - factors that promote successful outcomes for service users. Parvaneh Rabiee Caroline Glendinning, Hilary Arksey, Kate Baxter, Karen Jones, Julien Forder, Lesley Curtis What Works: Putting Research Into Practice

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Parvaneh Rabiee

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  1. TheOrganisation and Delivery of Home Care Re-ablement Services - factors that promote successful outcomes for service users 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, 30th April 2010

  2. Structure of presentation • Policy context and the rationale for the project • Aims and methods • The key findings • Success factors • Conclusion • Implications for practice

  3. Policy context and the rationale for the project • 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

  4. Aims of study • 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

  5. The overall study design • A comparative design • 5 councils offering home care re-ablement services • 5 councils offering standard home care services • Using quantitative and qualitative approaches

  6. Focus of this presentation • How are home care re-ablement services organised and delivered? • Factors contributing to the success of re-ablement service • Interim report • Research Works

  7. Methods • Five established services • Interviews with re-ablement service managers • Observations of re-ablement service visits • Focus group discussions with front line staff

  8. Organising home care re-ablement services • 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

  9. Organising home care re-ablement services – Cont... • 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

  10. Day to day operation • (Re) assessment and care plans • Flexibility about length of visits

  11. Day to day operation – Cont… • Staff rotas to enhance continuity • Case recording and communication within team • Supervision and shadowing • Formal reviews • Onward referrals

  12. Re-ablement interventions • 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

  13. Success factors • 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)

  14. Success factors – Cont… • Family/informal carer support • Wider environment • Strong/shared vision of the service • Capacity within independent sector providers

  15. Conclusion • 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

  16. Implications for practice • 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’

  17. Questions for discussion • 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?

  18. TheOrganisation and Delivery of Home Care Re-ablement Services - factors that promote successful outcomes for service users Parvaneh Rabiee Caroline Glendinning, Hilary Arksey, Kate Baxter, Karen Jones, Julien Forder, Lesley Curtis Download from: http://php.york.ac.uk/inst/spru/pubs/1223/

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