Reablement Services in Wales

1
Reablement Services in Wales
Susie Lunt
Alison Elliott Joanne Williams
Ceri Anne Cartwright Angela Edevane
2
Reablement in Flintshire

• An honest presentation!

3
What is Reablement?

• Regaining
• Enabling
• Achieving
• Building
• Learning
• Empowering
• Maximising
• Expanding
• Nurturing
• Teaching

4
Taking Control
5
Criteria for Reablement Service

• Adults over the age of 18 years
• Resident of Flintshire
• Motivated
• Potential for improvement
• Short term - maximum 6 weeks

6
Raising the Profile
7
Whole System

• Part of a continuum of care
• Wellcheck
• Telecare
• Home care
• Developing extra care
• Carer support

8
What people say about us

•  
•  the team taught me the best way to shower and
  get dressed
•  
• Mum feels much more in charge of the showering
  process and much more comfortable with the less
  hands on approach as she has regained some lost
  autonomy
•  
• I live alone, aged 86 years, and you helped me
  to get around once more after my knee operation
  and took me for short walks to regain my
  confidence

9
Outcomes for Service Users

• Prevention of hospital admission
• Supported to leave hospital sooner
• Increased independence, autonomy and choice
• Enabled to remain living at home
• Keep skills
• Fewer falls

10
Outcomes for Staff

• Skills being used
• Increased self esteem/respect
• Increased job satisfaction
• Some decision making at sharp end

11
Outcomes for Organisation

• Effective targeting of services
• Greater efficiency
• Increased recruitment and retention
• Increased flexibility
• Multi-skilled workforce
• Frees up capacity

12
Challenges

• Preciousness of roles
• Supporting people with dementia
• Keep reablement focus when receiving mainstream
  service
• Proving its worth bed days saved!!!!
• Expectations
• Service users
• Family
• Care staff
• Changing mindset
• - also applies to Carers
• Time

13
Where next?

• Expand the reablement team to support all new
  referrals using in house homecare
• Already begun to train staff
• But will require changes in care management
  functions too

14
ReablementWhy bother?
15
This is why we bother!

• Its better - its obvious!
• People regain skills
• People regain independence
• People regain confidence
• Staff get job satisfaction
• No recruitment issues
• Everyone loves it!
• It saves money and reduces dependency

16
Who is the service for?

• Over 18
• A resident of the borough
• Informed consent to actively participate in the
  scheme
• Underlying physical/sensory condition which will
  improve with therapy and support
• Short term service up to 6 weeks.

17
Who provides the service?

• Team Manager
• Physiotherapists
• Occupational Therapists
• Case Managers
• Administrators
• Reablement Co-coordinators
• Reablement Support Workers
•  

18
Who are the partners?
19
Challenges!

• Existing staff
• Changing thinking
• Taking risks,leap of faith
• Evaluating service
• Convincing Trust therapists that community
  reablement staff had the skills! 
• UAP  - aah!
• Physiotherapy recruitment  
• Budgets!

20
Outcomes

• Nov 06 Feb 07 50 cases diverted from long-term
  dependency
• High levels of service user satisfaction
• Two positive CSSIW Inspections
• Professionals value service

21
What next?

• Bigger and better let more people benefit
• Extend reablement
• Co- terminus with Assessment Teams
• Intake service for all cases except
• life limiting illness
• medical condition will deteriorate over time
• palliative care

22
MERTHYR TYDFIL CBC INTEGRATED ADULT SERVICES

• Initial Response and Re-ablement
• Services

23

• INTAKE MODEL VIRTUAL TEAM

All customers assessed under UAP
Therapy led
Initial Response Service 14 support staff 1
manager
Re-ablement Service 1 physiotherapist 1
occupational therapist 1 speech/language
therapist 2 support staff
5 days a week
365 days
Therapeutic interventions
Personal care
24

• HOW IT WORKS
• Takes all customers
• Every customer assessed
• Pick Mix service options
• Person centred plans -realistic outcomes
• Fit service delivery to meet need
• Customer engagement co-operation from onset
• On going review
• Continual interface with care management
• Identifies how post 6 week need will be met

25

• WHY IT WORKS
• Customers really buy in to it
• Exceptional relationship with care management
• Strong relationship with continuing home care
  service
• Staff with the right skills, knowledge and
  attitudes
• Senior management and elected members commitment
• Commitment to change across the Directorate
• Incremental service growth/development

26

• WHAT IT MEANS TO CUSTOMERS
• BEFORE AFTER
• Traditional home care doing for
  Enabling services working with
• Increasing dependency Increased independence
• Loss of control over their life Increased
  autonomy self determination
• Not maximising potential Support to regain
  skills
• Dependent on carers Potential maximised
• ? home care demand ? home care demand
• ? COT demand focus on aids supply COT provide
  therapy services

27
WHAT IT MEANS FOR THE DIRECTORATE
182
174
147
42
39
38
101
45
58
61
62
55
The following people achieved greater
independence 2003/04 81 people 80 of
referrals 2004/05 123 people 83 of
referrals 2005/06 134 people 77 of
referrals 2006/07 182 people 60 of
referrals
28
What have we learned?

• Keep the faith outcome focused
• Hold the line vision and clarity of purpose
• Can do approach
• - yes if ..
• not no because..

29
TOP 5 TIPS !

• Be ready to change at any point
• Do not expect to have all the answers to begin
  with
• Adapt the model to suit your needs
• Set realistic incremental service development
  goals
• Hold out for the right people for the job