Developing a resource to support localities address user and family understanding of, and engagement with, reablement: a development and implementation study

Introduction

Reablement is a core strand of the UK government’s intermediate care strategy. The purpose of reablement is to prevent or reduce demand for social care (including moving to residential care) by enabling people to live as independently as possible in their own homes. Unlike traditional homecare, which does things for individuals, reablement aims to help people resume activities of daily living (e.g. self-care, housework, social activities). This may involve regaining prior skills and confidence, or helping individuals find new ways to do things, sometimes with the provision of equipment. Its approach is intensive, but time-limited. Specially trained reablement practitioners work with individuals to achieve daily living goals identified through an holistic assessment process. It is provided by local authorities (or integrated health and social care localities), free of charge, for up to six weeks.

Increasing frailty or discharge from hospital are key reasons for referring an older person for reablement.

A key barrier to someone benefitting from reablement is a poor understanding of it and what it is trying to achieve. Families’ understanding and/or support for reablement may also affect progress, and whether achievements are maintained after discharge.

Objectives

This study aims to develop a Resource to support localities, led by strategic social care leads and senior reablement managers, to: ‘diagnose’ risk points/windows of opportunity for user or family member understanding of, and engagement with, reablement; and select and implement evidence-informed interventions with respect to these risk points/windows of opportunity. The research team will do this by:

• Identifying and describing the processes and factors that affect user and family member understandings of, and engagement with, reablement
• Identifying points along referral and care pathways where understanding of, or engagement with, reablement is at risk, or which present ‘windows of opportunity’ to improve understanding of, and engagement with, reablement
• Identifying ways to intervene at these ‘risk points’ and ‘windows of opportunity’.

Once the Resource has been developed, they will:

• Investigate how localities view and use the Resource, and its impacts on service delivery and practice
• Collect information relevant to designing a study which evaluates the impacts of a locality using this resource on service user outcomes
• Contribute to theory and understanding of engagement in the context of social care / interventions delivered by social care practitioners, including directions for research.

Methods

There are four stages:

1. The team will work with older people, family members/carers and professionals to: a) develop a theory about how and why older people and family members do, or do not, understand and engage with reablement; b) identify points on referral and care pathways where understanding/ engagement is at risk, or could be boosted (a ‘window of opportunity’); c) identify ‘evidence-informed’ ways to address these risks, or make the most of ‘windows of opportunity’
2. Based on this, and continuing to work with different stakeholder groups, develop the Resource
3. Pilot the Resource in 6-8 localities, and investigate how it is used and its impacts on senior staff, service delivery, service provision and practice
4. Based on findings from the pilot, refine the Resource and its underlying theory.

The Social Care Institute for Excellence will host the Resource on their website and publicise it widely.