West Dunbartonshire CHCP recognised that the RCOP agenda offered both opportunities and risks to providers of care. In developing a cohort of managers involved in My Home Life we are attempting to support our Managers to embrace the changes which RCOP will bring and also support them to engage with key decision makers in order that they can help direct the future provision of care in order that it better meets the needs of those receiving care. Whilst promoting the delivery of high quality care.
Previously Care of the Elderly clinical pharmacy input would only be available from the hospital setting, not in the community. In this example, patient had problems taking her medicines after being discharged from hospital following a stroke.
Review the council medication policy to ensure robust processes were in place for carers managing and administering medicines.
Due to shifting the balance of care, more patients with complex health needs are being looked after in the community therefore there is a need for specialist pharmaceutical care input, normally only available in the hospital setting.
The reablement approach in homecare offers support and encouragement to individuals to empower them to help themselves and so increase their independence. It supports individuals ‘to do’ rather than ‘doing to’ or ‘doing for’.
Goal setting and review of outcomes achieved are central to the reablement ethos. This means that we work with individuals and their carers to establish what tasks they want to gain confidence in doing or relearn particular skills. By engaging with individuals around an agenda of what they can do and what they would like to do we can develop short term interventions which support them to achieve these goals. These are often around basic daily living skills such as dressing, meal preparation and mobility. It is not uncommon for an individual to have lost confidence around their ability to carry out certain tasks after spending time in hospital.
Our traditional home care approach has been to assess people around what they no longer can do and provide a service to meet these deficiencies. As a result services are embedded into people’s lives, often for length periods of time. While this is perfectly acceptable for a number of people who suffer from severe and complex conditions it has the potential to create a dependency for people who may have had the potential to relearn or regain skills. Reablement focuses on this potential and research suggests that many people who would have received a traditional service leading to risks of dependency can eventually become more confident and lead fulfilling lives when they regain lost skills.
The pro-active identification and assessment of people at a high risk of experiencing an adverse drug reaction leading to hospital admission / re-admission, otherwise known as a polypharmacy medication review.
Supported by improving communications and information transfer between hospitals and primary care with regards to medication.