Transforming Reablement

Evidence from CSED (Care Services Efficiency Delivery) shows that timely bursts of social care reablement can either prevent hospital admission or post hospital transfer to long term care, or appropriately reduce the level of ongoing home care support required. Reablement complements intermediate care services and the benefits include:

• Maximised independence

• Minimised whole life cost of care

CSED's initial findings also suggest that there is still low take up of homecare reablement nationally and significant scope to accelerate its adoption and expansion.

Extending the benefits of reablement for clients can also bring real benefits for councils. Analysis of councils across the country shows that 2.1% of over 65s could benefit from reablement. For London this equates to an average of 567 people per council per year. Based on some standard assumptions, this could give a council annual savings of £650k in Year 1 and £1.1m in Year 2. A client we have been working with has proved through a pilot that average savings of £10,500 can be made per service user, with 75% of service users ending reablement requiring no further on-going care packages.

While many councils have set up reablement services, most have an opportunity to scale-up their services and begin to realise these projected savings. A number of options exist to scale-up services:

• Introduce reablement early on in the customer journey before the care plan is written-up, making it a core element of the end-to-end service. This means fast and effective routing of users into the service, followed by efficient handover to care planning and to providers for those service users who still require a care plan.

• Making a stronger case for change. Experience shows that it is important to set the right ambition for the service and support it with a strong business case. This means recording baseline numbers and regularly monitoring improvements against best practice benchmarks.

• Putting in place strong management decision making and change management support. Councils who have achieved real benefits have taken some fundamental steps to reshape their service and extend it to larger numbers of service users.

Options for extending to larger numbers of service users include:

• A de-selection model (excluding only limited categories of users) for intake to ensure as many people as possible go through reablement

• Expanded reablement to intake and assessment (normally the default route into social services) rather than just hospital discharge

• Free access to reablement

• Addressed the culture and skills aspects through training and optimum use of specialist support.

The challenge many local authorities are facing is how to translate this learning into a business case. The purpose of a business case is to:

• Obtain agreement from decision makers of the rationale for the service

• Provide a framework to plan the implementation of the service

• Check implementation progress and continued viability

A good starting point for the business case are the Office of Government Commerce (OGC) five areas:

• Strategy and objectives

• Options appraisal

• Commercial aspects

• Affordability

• Achievability

CSED have produced a Business Case Template and Excel model populated with data from the longitudinal studies.