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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

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


Structure of presentation

Structure of presentation

  • Policy context and the rationale for the project

  • Aims and methods

  • The key findings

  • Success factors

  • Conclusion

  • Implications for practice


Policy context and the rationale for the project

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


Aims of study

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


The overall study design

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


Focus of this presentation

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


Methods

Methods

  • Five established services

  • Interviews with re-ablement service managers

  • Observations of re-ablement service visits

  • Focus group discussions with front line staff


Organising home care re ablement services

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


Organising home care re ablement services cont

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


Day to day operation

Day to day operation

  • (Re) assessment and care plans

  • Flexibility about length of visits


Day to day operation cont

Day to day operation – Cont…

  • Staff rotas to enhance continuity

  • Case recording and communication within team

  • Supervision and shadowing

  • Formal reviews

  • Onward referrals


Re ablement interventions

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


Success factors

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)


Success factors cont

Success factors – Cont…

  • Family/informal carer support

  • Wider environment

    • Strong/shared vision of the service

    • Capacity within independent sector providers


Conclusion

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


Implications for practice

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’


Questions for discussion

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?


Parvaneh rabiee

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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