REABLEMENT

      Cynthia Cranston
Head of Occupational Therapy




      www.COT.org.uk
Why change?
• 2nd largest population in NI

• 25% of children’s population

• Fastest growing population

• By 2020, 40% increase in people aged 75+

                 www.COT.org.uk
How do we change?
                                 Proposed Service Model
                                   Living Your Life To The Full - Example
                                             Operating Model


                  Access &         Re-ablement                  Support          Care Bureau                   Monitoring
Prevention       Information       & Assessment                 Planning        Commissioning                  & Review

                                    550 enter
  1000 people          45%          re-              30% are        385people      Professional time released to direct to
    contact         resolution      ablement         re-abled       enter SDS                professional task
                                    people



                    Up to                                                                                         Not passive
  Care                                     30%                    Agree
                                                                                    3rd Sector                     Actively
 Pathways           45%                   No Care               Outcomes
                                                                                     Support                      Challenge
 Planning           Resolution            Required               Required
                                                                                                                    Needs



                                   Crisis Response / Emergency


                Crisis Response / Emergency Procedure /Partnership working


                                                 www.COT.org.uk
What is Reablement?
• Providing support and recovery to help older
  people regain daily living skills, providing
  confidence and independence to live their life to
  the full




                       www.COT.org.uk
Objectives of Reablement
               Service?
• To maximise service users long-term
  independence, choice and quality of life

• Care for older people in their own homes and
  communities for as long as possible

• Empower and support people to manage their
  long term conditions


                   www.COT.org.uk
Key principles of Reablement ?

• Helping people ‘to do’ rather than ‘doing to
  or for’ people

• Outcome focused to appropriately minimise
  on-going support required, and thereby
  minimise the whole-life cost of care



                   www.COT.org.uk
The Team
1WTE Reablement Co-ordinator (Band 7 Trustwide)

Each locality:
•1 WTE Occupational Therapist (Band 6)
•7 WTE Reablement Support Workers (Band 3)


                  Hours of Service
                  Monday – Sunday
                    8 am – 8 pm


                   www.COT.org.uk
Investment in Learning
Reablement Support Workers:
•Minimum of NVQ Level 2 (to complete NVQ Level 3 (QCF) within one year)
•Intensive two week induction

Core Units
   – contribute to the effectiveness of teams
   – promoting communication in health or social care settings
   – promote person centred approaches in health and social care setting

Additional Units
   – Advise and inform individuals on managing their condition
   – Collaborate in the assessment of environmental and social support
   – Adapt and fit Healthcare equipment
                             www.COT.org.uk
The Model
                             Assessment –
         Discharge          (Standardised)


                                               Client centred
                                                Goal setting


Review                                       Reablement plan




                      Intervention

                       www.COT.org.uk
Reablement Service
• Reablement pilot commenced in the Lurgan locality
  in April 2011 and extended to the Portadown locality
  in July 2011

• Extending to Armagh in April 2012

• During the 6 month period from April – September a
  total of 146 users were accepted on the scheme,
  and 135 discharged during this period
                      www.COT.org.uk
Key Facts for the 6 Month Period

• 82% of referrals received were accepted

• 59% of users were discharged from
  Reablement with no service, the same service
  or a decrease in service

• Average number of days on Reablement 9.85
  (£7700 per average care package per annum)


                  www.COT.org.uk
Discharge Pathways
•Client discharged from Reablement with no further
service need

•Client discharged to Conventional Services

•Client referred to Specialist Services

Community & Voluntary Links
Development of a Community Navigator Post
                      www.COT.org.uk
In Addition
• The Patient Client Council have carried out an
  independent patient satisfaction survey due to be
  completed in the coming weeks

• Further research is planned to commence in April to
  demonstrate the effectiveness of Reablement.
  (Currently out to tender)



                      www.COT.org.uk
Future Developments
• The Trust plans to establish a Reablement
  Team in 7 localities

• Each Team will consist of 1 Band 6
  Occupational Therapist and approximately 7
  Reablement Assistants

• Access criteria is inclusive rather than
  exclusive

                   www.COT.org.uk
Future Developments
• To date Teams have been established in 2
  localities with plans for further roll-out between
  now and April 2013

• Work is on-going to further embed a
  Reablement ‘ethos’ across Trust services and
  processes

• On-going evaluation and monitoring is key to
  refining and continually improving the service
                     www.COT.org.uk
User feedback
  “The team possess such a wide range of experience
  and skills and they treated me with such patience and
  encouragement … You are an astonishingly talented
      and caring force for good in our be-leaguered
                    health service”.                Client

    “Staff incredibly kind, well trained and supportive.
Excellent service. Life saver for both patient and relative”.
                                                     Carer

“Very helpful staff helped me to regain my independence”.
                        www.COT.org.uk             Client
User feedback
         The staff explained everything clearly,
        were patient and helpful and helped mum
                regain her independence”
                                             Carer

     “It’s a great service – Staff feel that services are
being reduced and that patients are getting the opportunity
to practice their personal care, toileting, meals etc. So we
   know when they are referred back there is no further
                potential for them to improve” District Nurse

                      www.COT.org.uk
THANK-YOU
     for your attention
paula.haughey@southerntrust.hscni.net

cynthia.cranston@southerntrust.hscni.net



              www.COT.org.uk

Reablement

  • 1.
    REABLEMENT Cynthia Cranston Head of Occupational Therapy www.COT.org.uk
  • 2.
    Why change? • 2ndlargest population in NI • 25% of children’s population • Fastest growing population • By 2020, 40% increase in people aged 75+ www.COT.org.uk
  • 3.
    How do wechange? Proposed Service Model Living Your Life To The Full - Example Operating Model Access & Re-ablement Support Care Bureau Monitoring Prevention Information & Assessment Planning Commissioning & Review 550 enter 1000 people 45% re- 30% are 385people Professional time released to direct to contact resolution ablement re-abled enter SDS professional task people Up to Not passive Care 30% Agree 3rd Sector Actively Pathways 45% No Care Outcomes Support Challenge Planning Resolution Required Required Needs Crisis Response / Emergency Crisis Response / Emergency Procedure /Partnership working www.COT.org.uk
  • 4.
    What is Reablement? •Providing support and recovery to help older people regain daily living skills, providing confidence and independence to live their life to the full www.COT.org.uk
  • 5.
    Objectives of Reablement Service? • To maximise service users long-term independence, choice and quality of life • Care for older people in their own homes and communities for as long as possible • Empower and support people to manage their long term conditions www.COT.org.uk
  • 6.
    Key principles ofReablement ? • Helping people ‘to do’ rather than ‘doing to or for’ people • Outcome focused to appropriately minimise on-going support required, and thereby minimise the whole-life cost of care www.COT.org.uk
  • 7.
    The Team 1WTE ReablementCo-ordinator (Band 7 Trustwide) Each locality: •1 WTE Occupational Therapist (Band 6) •7 WTE Reablement Support Workers (Band 3) Hours of Service Monday – Sunday 8 am – 8 pm www.COT.org.uk
  • 8.
    Investment in Learning ReablementSupport Workers: •Minimum of NVQ Level 2 (to complete NVQ Level 3 (QCF) within one year) •Intensive two week induction Core Units – contribute to the effectiveness of teams – promoting communication in health or social care settings – promote person centred approaches in health and social care setting Additional Units – Advise and inform individuals on managing their condition – Collaborate in the assessment of environmental and social support – Adapt and fit Healthcare equipment www.COT.org.uk
  • 9.
    The Model Assessment – Discharge (Standardised) Client centred Goal setting Review Reablement plan Intervention www.COT.org.uk
  • 10.
    Reablement Service • Reablementpilot commenced in the Lurgan locality in April 2011 and extended to the Portadown locality in July 2011 • Extending to Armagh in April 2012 • During the 6 month period from April – September a total of 146 users were accepted on the scheme, and 135 discharged during this period www.COT.org.uk
  • 11.
    Key Facts forthe 6 Month Period • 82% of referrals received were accepted • 59% of users were discharged from Reablement with no service, the same service or a decrease in service • Average number of days on Reablement 9.85 (£7700 per average care package per annum) www.COT.org.uk
  • 12.
    Discharge Pathways •Client dischargedfrom Reablement with no further service need •Client discharged to Conventional Services •Client referred to Specialist Services Community & Voluntary Links Development of a Community Navigator Post www.COT.org.uk
  • 13.
    In Addition • ThePatient Client Council have carried out an independent patient satisfaction survey due to be completed in the coming weeks • Further research is planned to commence in April to demonstrate the effectiveness of Reablement. (Currently out to tender) www.COT.org.uk
  • 14.
    Future Developments • TheTrust plans to establish a Reablement Team in 7 localities • Each Team will consist of 1 Band 6 Occupational Therapist and approximately 7 Reablement Assistants • Access criteria is inclusive rather than exclusive www.COT.org.uk
  • 15.
    Future Developments • Todate Teams have been established in 2 localities with plans for further roll-out between now and April 2013 • Work is on-going to further embed a Reablement ‘ethos’ across Trust services and processes • On-going evaluation and monitoring is key to refining and continually improving the service www.COT.org.uk
  • 16.
    User feedback “The team possess such a wide range of experience and skills and they treated me with such patience and encouragement … You are an astonishingly talented and caring force for good in our be-leaguered health service”. Client “Staff incredibly kind, well trained and supportive. Excellent service. Life saver for both patient and relative”. Carer “Very helpful staff helped me to regain my independence”. www.COT.org.uk Client
  • 17.
    User feedback The staff explained everything clearly, were patient and helpful and helped mum regain her independence” Carer “It’s a great service – Staff feel that services are being reduced and that patients are getting the opportunity to practice their personal care, toileting, meals etc. So we know when they are referred back there is no further potential for them to improve” District Nurse www.COT.org.uk
  • 18.
    THANK-YOU for your attention paula.haughey@southerntrust.hscni.net cynthia.cranston@southerntrust.hscni.net www.COT.org.uk