Reablement should become more focused on helping people re-engage with their communities, Community Care writes.
The Coalition Government has adopted the reablement agenda with zeal – honouring Labour's original commitment to invest £70m in reablement services in 2011-12 and adding to it – with £300m allocated to reablement by 2014-15, and a further £162m announced for immediate use in 2011, generated by central NHS cost savings.
The Government has also introduced a 30-day duty of care on hospitals – whereby hospitals are responsible for those people it discharges for 30 days after discharge, and penalised if they are readmitted to hospital or require emergency treatment. This was warmly welcomed by those in the social care sector, seeing it as the first recognition by a government that the responsibility for those leaving hospital is a shared one between social care and health services.
In spite of this welcome new investment and policy reform, there remains a critical omission in current reablement services – housing support. Reablement is perceived very much as a short term social-care based intervention, led by social care workers and sometimes an occupational therapist, to rehabilitate people to living independently at home. Whilst home adaptations and telecare often form part of this intervention, the wider role a person’s home can play in mental and physical recovery after hospital discharge, and in regaining independence, is usually overlooked. As such, key opportunities to improve outcomes through non specialist home-based support and improvements are missed, and important stakeholders – from housing associations (which provide homes for 5 million people), to extra care, supported housing and retirement village providers – are often left out of commissioning decisions and critical conversations between health and social care services when it comes to discharging someone from hospital and putting in place reablement and rehabilitative support. It also means those with more complex needs – whose reablement may require more than therapy and adaption, but actually re-location to a more suitable home – are often under-supported and vulnerable to readmission to hospital.
With all this in mind, Demos will re-examine the current model of reablement, and in particular, focus on the opportunities for improved outcomes and lower costs by addressing a clear weakness in its current delivery – the omission of housing-related support.
This project will challenge the concept of reablement as a “social care intervention” and explore how better outcomes can be achieved, potentially at a lower cost, through a more integrated approach – one which brings together health, social care and housing support following hospital discharge.
The project has the following aims:
To achieve these aims we will employ the following methodology:
The project is supported by Midland Heart housing and regeneration group.
The Home Cure suggests that there needs to be a greater role for social housing care providers in reablement.