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Reablement and Occupational Therapy in Gloucestershire

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Reablement and Occupational Therapy in Gloucestershire Margot Mason Professional Team Lead, Occupational Therapy, ... Widening role of Occupational Therapy staff. – PowerPoint PPT presentation

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Title: Reablement and Occupational Therapy in Gloucestershire


1
Reablement and Occupational Therapy in
Gloucestershire Margot Mason Professional Team
Lead, Occupational Therapy, Stroud Gloucester
Locality.
2
Presentation outline
  • Integrated Adult Health Social Care.
  • Overview.
  • Our Journey.
  • Challenges benefits.

3
Measuring Outcomes
  • April 2013-March 2014
  • number of people entering Reablement 557
  • 86.6 of these were over 65 years old
  • 43.8 of these did not need ongoing care
  • We are to gather more detail
  • partially reabled
  • needing less/same/more ongoing care
  • reasons for not completing

4
Quality Outcomes
  • Right levels of care Indicative budget
    calculation before after reablement used as a
    measure of the outcome/ benefit. Initial results
    showed a 48 reduction in indicative budget
    following reablement (although it should be noted
    that the sample size was very small).
  • Canadian Occupational Performance Measure
    Occupational Therapists use the COPM, showing
    significant improvement in Service User
    satisfaction and performance of their identified
    Occupational Performance Issues.
  • Experience Countywide Service User Reablement
    satisfaction survey rolled out. Positive results.

5
Identifying Reablement cases
  • Countywide telephone Helpdesk.
  • Local referral centre New referrals screened by
    an Occupational Therapist, Physiotherapist and
    Reablement co-ordinator.
  • Initial assessment by Therapist or Senior
    Reablement Worker.
  • Use of robust Goal Planning.
  • Regular Evaluation.

6
Added Value of Occupational Therapy
  • The COT Position Statement discusses our use of
    evidence informed practice, person centred
    working, thorough assessment and outcome
    measurement.
  • Literature review Benchmarking.
  • We use the Canadian Model of Occupational
    Performance outcome measure.
  • Work within Integrated Community Teams for the
    benefit of Service Users.

7
Occupational Therapy skills
  • New Integrated Community Teams (ICTs) in place.
  • Social Care, Intermediate Care Community
    Hospital backgrounds.
  • All extending core skills.
  • Supervision, CPD sessions, work-shadowing.
  • Use of delegation to Reablement staff.

8
Our journey
  • Literature review completed to inform practice.
  • Competency framework for Reablement staff
    developed.
  • Range of training developed.
  • Reablement goal plan re-designed.
  • Team working Communication.
  • Need for countywide model of Reablement.

9
Assessment
  • High-quality assessment before re-ablement
    started was said to be essential in helping
    re-ablement teams to set up appropriate support
    arrangements.
  • Ongoing assessment during the period of
    re-ablement was also important to enable the team
    to identify new targets as peoples abilities
    improved.
  • Rabiee Glendinning 2011

10
Communication
  • Regular communication is extremely important and
    key to the whole process
  • So, understanding each others roles
  • Discussion with the service user family to
    monitor progress and timescales
  • And liaison between Reablement workers, Nurses,
    Therapists Co-ordinators to regularly review
    and progress goals with the service user.

11
Work completed to date
  • Development and implementation of a comprehensive
    Reablement competency framework.
  • Delivery of an extensive training programme to
    support the framework.
  • Development of Team Working Workshop and
    Workbook.
  • Development of Therapy screening and first
    assessment.
  • Development of outcome based performance measures
    as part of the scorecard.

12
Barriers Challenges
  • Reablement staff change of role, hours rotas.
  • Widening role of Occupational Therapy staff.
  • Service demands.
  • New referral screening assessment-By whom?
  • Need to increase Assessment skills and Clinical
    support of Senior Reablement Workers.
  • Need to further embed Team working, Vision and
    true Integrated working.

13
Leadership
  • South West Clinical Network
  • Benchmarking
  • Leadership Group, Work streams identified
  • Development of alternative reablement pathway and
    pilot.
  • Workforce Development.
  • Development of outcome measures.
  • Increasing contact time.
  • Review domiciliary care in lieu of reablement.

14
Summary
  • Reablement is embedded in the Integrated
    Community Teams.
  • Continue to develop Occupational Therapy at the
    forefront of Reablement.
  • Positive impact on External Care budget spend.
  • Any Questions?

15
References
  • Boniface et al. 2013. The effectiveness of local
    authority social services occupational therapy
    for older people in Great Britain a critical
    literature review. British Journal of
    Occupational Therapy. 76(12) 538-547
  • COT Position statement 2010 Reablement The added
    value of occupational therapists. www.cot.org.uk
  • Rabiee P. and Glendinning C. (2011) Organisation
    and delivery of home care re-ablement what makes
    a difference?, Health and Social Care in the
    Community, vol 19, no 5, pp 495503.

16
Contact details
  • Margot Mason
  • Professional Team Lead, Occupational Therapy.
  • Stroud Gloucester Locality
  • margot.mason_at_glos-care.nhs.uk
  • 01452 427661
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