reablement seminar tate gallery liverpool 10 january 2008
TRANSCRIPT
Reablement Seminar
Tate GalleryLiverpool
10 January 2008
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Home Care Reablement – From ‘Specialist’ to ‘Mainstream’ Services
aJane Dabrowska
Service Manager
Older and Disabled People’s Services,
Melton and Market Harborough
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Homecare Assessment & Reablement Teams
Council Profile:• 610.000 population
– 15.7% over 65, 1.8% over 85 (2001 census)
• Rural area, 6 market towns, 6 District Councils
• 4 PCTs now down to 1
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Background:
The Home Care Market in 1999:-
• Mixed Economy - 25% in-house
• Generic Provision
• Purchaser/Provider Split
• Task/time specific commissioning
Homecare Assessment & Reablement Teams
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Triggers for Change:
• Promoting Independence Grant
• Rehabilitation Agenda
• Best Value Review
Homecare Assessment & Reablement Teams
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Home Care Reablement Team:
• Pilot project begun in 1999
• ‘New’ Team in one area of the County
• ‘New’ look
• ‘New’ way of working
Homecare Assessment & Reablement Teams
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What was different?
• Short term
• Time spent to fit service user’s needs
• Not ‘doing to or for’ - doing with
• Working towards set goals
• Adjusting care plan
• Contributing to first review
Homecare Assessment & Reablement Teams
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Homecare Assessment & Reablement Teams
De Montfort University Evaluation
HART MATCHED GROUP
Average Care Package at Start
8 hrs/wk 5.6 hrs/wk
Discontinued at 1st Review 62% 5%
Decreased at 1st Review 26% 13%
Increased at 1st Review 2% 11%
Maintained unchanged at 1st Review
10% 71%
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After the Evaluation….• Pilot never stopped…. rolled out• Some changes made to original design:-
– Staff trained by OT on assessing for minor aids and adaptations,
– Home Care Managers carry out reviews,– Entrance extended to all newly assessed (or re-assessed
following significant change) service users unless clear indication that reablement could not benefit,
– Home Care Managers commission any on-going care packages to independent sector via broker.
Homecare Assessment & Reablement Teams
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Implementation:
All teams across the county have been restructured to ‘specialist’ areas of work:-– HART (37%)– Dementia Teams (45%)– Child Care Teams (14%)– Awaiting Transfer (4%)
(April 2007)
Ongoing success of HART due to……….
Homecare Assessment & Reablement Teams
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OUTCOMESGeneral
2001/2 2006/7
Average hours commissioned/week
28,800 36,577
Households 3,900 4,393
Average Hours/household
7.4 8.3
Homecare Assessment & Reablement Teams
Currently: 13% of activity in-house
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OUTCOMESHART
2005/6 2006/7
Number of Cases 1836 2,216
No Further Services
913 (49.7) 1,102 (49.7)
On-going need
Start – Finish hrs6.61 – 5.1 6.37 – 5.3
Total % Reduction in Hrs/week
41.6% 42.3%
Homecare Assessment & Reablement Teams
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Financial Benefits:In 2006/7,
• Taking account of the cost of HART, average break-even point is approx. 26.3 weeks
• Reduction/week - £85,000
Homecare Assessment & Reablement Teams
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And finally……..Top Tips:-• Trusting relationship between
commissioners and providers• Pro-active management of staff to work in
‘new’ way• Clear, consistent message to service users• Eliminate delays/bottle necks• Effective communication with all
stakeholders
Homecare Assessment & Reablement Teams
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For further information, contact
01664 503900
Homecare Assessment & Reablement Teams