Home First

Reablement is often considered an alternative to traditional homecare for:

• individuals returning home from hospital or other inpatient care setting following a period of illness; or
• individuals where there is evidence of declining independence or ability to cope with everyday living due to deteriorating health.

It is a way of empowering people to do things for themselves rather than having things done for them, as in traditional homecare, which can lead to dependence on a package of care.

The use of a reablement approach, and subsequent interventions, can ultimately result in reducing or preventing the need for traditional homecare. However, homecare still has its place following a period of reablement, but the ethos of reablement needs to be to promote independence & empower individuals for as long as possible.

Broadly, there are two categories of reablement service:

Intake and assessment service

This supports a wide range of users including hospital and community referrals. Intake and assessment services tend to operate a model whereby all those referred for home care undergo reablement unless it is agreed they will not benefit.

Hospital discharge service

Primarily supports people on discharge from hospital for up to 6 weeks and services usually operate on a more selective basis. They support only those people who are assessed likely to benefit from reablement. For example, discharge from hospital of someone who lacks confidence in their abilities following a fall which resulted in injury.

Provider of last resort

If Adult Community Services are unable to source a Care Provider to provide a package of care, Home First will step in to provide the care and support until a provider is found.

Another principle of reablement, which ensures an effective service, is having a reliable team. This is dependent on having the right structure, roles and a fully competent team of people who understand and operate within the ethos of reablement. Research has shown that staff skills and knowledge of reablement principles are regarded as key to successful outcomes.

The reablement team often consists of Independence & Wellbeing Practitioners/Assessors, Team Leaders, Reablement Support Workers and Occupational Therapists. However, in some areas, other disciplines such as physiotherapy may also be included.

Home First Independence and Wellbeing Practitioners / Assessors will carry out the assessment process, which involves measuring the person’s base line in all aspects of activities of daily living.

The care plan will then be developed placing the individual and their support network at the centre of their care, working together to identify the outcomes they would like to achieve.

Evidence from research and practice suggests that the most successful reablement teams have occupational therapy input. There is no single agreed way of involving occupational therapists. They could contribute to the reablement team in different ways:

• as trainers of reablement workers
• as assessors before and after a period of reablement

Occupational therapists are part of a reablement team and their holistic approach supports goal setting to be realistic and achievable. Their expertise is easily accessible to Reablement Support Workers to provide continued advice & support, facilitating the best outcomes for our customers.

Reablement Support Workers are often local authority homecare staff who have received additional training to adopt a re-abling approach.

They work closely with our customers to identify what tasks can be managed independently, what tasks require assistance and what tasks customers would like to return to doing.

This information feeds into the overall assessment and supports with goal setting, to achieve outcomes agreed with customers.