Homecare Reablement

What was the issue you were addressing or working on?

  • 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.

What you did?

  • Reablement within East Renfrewshire’s CHCP has been introduced in a phased change approach as opposed to a big bang approach. Home care staff have been introduced two at a time, and their existing posts back-filled, using the Change Fund, to continue the parallel running of the home care service.  This approach has allowed lessons to be learned and processes to be tweaked through regular team and management meetings, to ensure the final model when fully implemented will allow for a model that has been tried and tested and is accordingly robust and sustainable. The amount of change was significant and included:

o   New processes.

o   New team structure and roles.

o   New job descriptions.

o   New rotas and patterns of work.

o   New assessment paperwork.

o   Performance measurements and management.

o   Change in culture and practice, based on helping people learn or re-learn skills, and no longer on doing things for them

  • Five 2-day training courses took place in January and February 2012 for staff within the mainstream homecare service and Rapid Response Team led by Gerry Graham of the Scottish Government’s Joint Improvement Team. The training aimed to develop skills they already possessed and introduced concepts such as empowerment, the use of equipment and the skills required for reablement. The evaluation of the training indicated that staff felt valued and empowered and were very positive about the reablement approach.
  • We also arranged briefing sessions for staff in wider CHCP to bring everyone up-to-date on our implementation plans.  For us it was important that everyone was clear about the intended goals and ambitions and what the service will achieve for the people using it.
  • The first phase of implementation began on 23 April 2012, and the second phase has commenced to introduce the reablement approach across the larger Rapid Response Team.

What were the outcomes - benefits or otherwise?

A reablement digital story has been produced and features a service user who has been through the reablement process and a staff member working in the service talking about their experiences, please click here to view it.

Outcomes data is available, click here to view it.

Contacts - to find out more

Tony O’Hare,  Tony.ohare@easterenfrewshire.gov.uk    0141 577 3173