BONIFACE Gail, et al
This literature review systematically selected, critically appraised, and thematically synthesized the post 2000 published and unpublished evidence on the effectiveness and cost effectiveness of occupational therapy interventions for older people in social care services. Identified themes established: the localized nature of social care services for older people; organizational and policy impacts on services, and factors influencing effectiveness and cost effectiveness. Although occupational therapists are increasingly involved in rehabilitation and reablement, there is a continuing focus on equipment and adaptations provision. A high level of service user satisfaction was identified, once timely occupational therapy services were received. Overall, occupational therapy in social care is perceived as effective in improving quality of life for older people and their carers, and cost effective in making savings for other social and healthcare services. However, the complex nature of social care services makes it difficult to disaggregate the effectiveness of occupational therapy from other services.
UNIVERSITY OF YORK. Social Policy Research Unit
This report provides final findings of a study conducted with ten participating councils to investigate the benefits of homecare re-ablement. The study aimed to identify features of an effective and cost efficient services; maximise outcome and duration of benefits; and to understand and reduce the demands on other formal care, including other social services. The study comprised of three groups of councils: intervention sites which were enablement staff led; intervention sites with mixed staff teams; and comparison sites where service users had not undergone a phase of home care re-ablement. The previous interim study reflected on initial findings from the intervention sites. This report also adds findings from the comparison sites and long term impact from the follow up review stage. Main findings are discussed in the areas of assessment arrangements; discharge and onward referral arrangements; key features of re-ablement services; team skill mix; staff commitment, attitude, knowledge and skill; service users and carer views; and a strong vision of the service.
GERALD PILKINGTON ASSOCIATES
The report ‘Homecare Re-ablement Prospective Longitudinal Study Final Report’ (Dec 2010) commissioned by the Department of Health’s Care Services Efficiency Delivery programme (CSED) has provided further insight and understanding about the nature and beneficial impacts of homecare re-ablement. However, some of the report content has resulted in a lack of clarity. The aim of this paper is to set out some of the background to the report and provide clarity on the learnings that can be gained with regard to the cost effectiveness of homecare re-ablement services. Contrary to impressions set out in various articles, the report does not indicate that homecare re-ablement as an approach has little financial benefits for a council. What it does illustrate is that councils should undertake a baseline exercise to establish an understanding of the local position and then to operationally performance manage their service to ensure that it is and remains cost effective whilst maximising the benefits of independence for as large a number of people as possible.