SCIE media statement
Reablement – what we know
14 April 2011
New SCIE research briefing and Social Care TV film
It’s amazing. I don’t have to think now: ‘What am I going to do?’ It’s important to me to be independent, because I always have been.Margaret, on Social Care TV
SCIE has published a research briefing, reviewing the evidence underpinning reablement. The publication focuses on how reablement can achieve better outcomes for people, and can be cost effective. It comes on the same day that a Social Care TV film about reablement is also launched. The Social Care TV film brings the subject alive by looking at the work of START in the London Borough of Sutton. ‘START’ stands for Short Term Assessment and Reablement Team.
What is reablement?
Reablement is usually designed to help people learn or re-learn the skills necessary for daily living. Those skills may have been lost through deterioration in health or increasing support needs. Reablement is usually a six to 12 week intervention, focussing on skills such as washing, dressing, cooking and climbing stairs. It is distinguished from conventional home care by a more ‘hands off approach’ to supporting people. Instead of doing things for people, care workers need to stand back and encourage them to relearn the ability to do things for themselves.
The publication is one in a series about preventative care and support for adults. It looks at issues such as why reablement is important, what people think about reablement and the implications of reablement for service providers. It also examines evidence about the cost effectiveness of reablement.
Findings in the research briefing include:
- Although no single leading delivery model has yet been identified reablement is generally designed to help people learn or relearn the skills necessary for daily living. These are skills which may have been lost through deterioration in health and/or increased support needs.
- People using reablement welcome the emphasis on helping them gain independence and better functioning, although evidence on user and carer views needs to be strengthened.
- Reablement significantly improves outcomes, particularly in terms of restoring people’s ability to perform usual activities and improving their perceived quality of life.
Social Care TV film
In the film, 85 year-old Margaret is shown living at home, six weeks after returning from hospital. The 85 year-old has had a stroke and says:
Always having things done for me in hospital made me worry that I wasn’t even going to be able make myself a pot of tea when I got home. However, her care worker, from Sutton’s START team, encourages Margaret to do things like open a milk bottle and wheel a tea trolley into the living room. A traditional domiciliary care worker may have opened the bottle for her. START workers verbally encourage people to provide their own care.
Margaret now has all the right equipment, for instance, a stool in the bathroom, for independent washing. It is expected that Margaret will need zero hours of home care soon, and START says that this situation is common. Margaret says:
It’s amazing. I don’t have to think now: ‘What am I going to do?’ It’s important to me to be independent, because I always have been.
Cost effective and good for outcomes
From a social care perspective, there is a high probability that reablement is cost effective(p11, SCIE Research Briefing 36).
Reablement achieves cost savings through reducing or removing the need for ongoing support via traditional home care. Among reablement users, up to 60% of savings have been demonstrated in the cost of subsequent social care provision. Combined with the outcome data, one robust evaluation found a high probability that from a social care perspective, reablement is cost effective. However, there is currently little evidence to suggest that it reduces health care costs.
Reablement is significantly associated with better health-related quality of life and social care-related outcomes compared with conventional home care. Research evidence demonstrates that reablement improves independence, prolongs people’s ability to live at home and removes or reduces the need for commissioned care hours (in comparison with standard home care).
Implications from the research
There is good evidence that reablement removes or reduces the need for ongoing conventional home care. There is good evidence that reablement improves outcomes for people who use services. Evidence on user and carer views about reablement needs to be strengthened.
People’s views about reablement
The research briefing concludes that people who use services generally welcome the improved independence that reablement provides. Some carers report that reablement increased their confidence with their own caring responsibilities. Negative views about reablement tend to mirror those often expressed about conventional home care. Managers and frontline staff welcome the opportunity reablement provides to work flexibly and responsively with people.
In October 2010, the Department of Health announced that £70 million would be spent on providing support to people going back into their homes after a spell in hospital. The government Spending Review and 2011/12 NHS Operating Framework have provided further funding to primary care trusts (PCTs) for the financial years 2011/12 and 2012/13 to develop local reablement services, in partnership with councils, in the context of post-discharge support plans. This funding commitment recognises the great potential of reablement although it is more than a hospital discharge service. Reablement is actually becoming the ‘default’ initial response to presenting needs, rather than a service that is restricted to those discharged from hospital.
From 01 April 2011, the NHS has new responsibilities for people’s care needs for 30 days after they leave hospital. Reablement is also part of the Government’s Vision for Social Care.
Steve Palmer | Press and Public Affairs Manager | Tel: 020 7766 7419 | Mob: 07739 458 192 | Email: email@example.com