Reablement

Examples of Practice

The vision for Reablement Services across Glasgow was to:

  • Have an approach that changes the culture of homecare from ‘task and time’ to better outcomes.
  • To ‘do with’ service users rather than to ‘do to’ or ‘do for’.
  • Maximise service users long-term independence and quality of life.
  • Appropriately minimise ongoing support required and thereby, minimise the whole life-cost of care, targeting a 30% reduction.
  • Have service users making the most of their lives.

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Reablement and Crisis Care

Examples of Practice

The re ablement and crisis care service has re-focused its activity to intervene earlier and promote the independence of older people. The new service design has delivered the following improvements

  • 24/7 response to any crisis
  • Fast Track provision of technology and equipment
  • Single point of contact for responding to falls
  • Falls prevention programme
  • Respite for Carers
  • Intensive Re-ablement Programme, building personal resilience
  • Improved alignment of social and health care staff, making better use of resources

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Rapid Response and Resettlement Service

Examples of Practice

This service was developed in response to the fact that older people can often be unnecessarily admitted to hospital, due to there being a lack of readily available transport to take them home, and the risk that the 4hr A&E target may be breached for them.  It was recognised that patients may also be more likely to be admitted especially if they have arrived at A&E later in the day, and there is a lack of family/care support to ensure a safe return home.

In addition to this, a service that would support individuals into their own home, ensuring their safety and comfort, was seen to be beneficial both in terms of direct support to the patient, and potentially picking up on issues which might prevent further deterioration or a  potential readmission to hospital.

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Carers Hospital Discharge Project

Examples of Practice

To improve the experience of carers of older people through the journey of hospital discharge from beginning to end.  Carers expressed views that they felt excluded from the process of hospital discharge and needed to access relevant information and support.

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Anticipatory Care

Examples of Practice

Very few patients had an anticipatory care plan in place should they become unwell and none had a plan should their informal carer become unwell or unavailable.  There were often separate plans in both Health and Social Care and sometimes access to the required information out of hours was difficult or the information just unknown, potentially resulting in short term care home admissions and avoidable hospital admissions.

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