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

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:

http://php.york.ac.uk/inst/spru/pubs/1223/