Home care re-ablement services: investigating the longer-term impacts (prospective longitudinal study)

Researchers: Hilary Arksey, Kate Baxter, Parvaneh Rabiee, Caroline Glendinning, Alison Wilde
Personal Social Service Research Unit (Kent): Julien Forder, Karen Jones, Lesley Curtis

Funder: Department of Health

Duration: April 2008 – December 2010

Background

Adult social care services were increasingly developing specialist home care re-ablement teams that worked intensively with new service users to increase their skills, confidence, and ability to live independently. Our previous research, in the project Investigating the longer-term effects of home care reablement services (retrospective longitudinal study) , suggested that the benefits of home care re-ablement may be significant and sustained, possibly delaying subsequent needs for services by up to two years. A major prospective longitudinal study was therefore commissioned by the Care Services Efficiency Directorate.

Aims

The study aimed to:

examine the immediate and longer-term effects of home care re-ablement
identify factors affecting the level and duration of benefits for users of home care re-ablement services (eg features of the service, types of services used subsequently)
describe the content and costs of home care re-ablement services and their relationships to service outcomes
identify any impacts on, and savings in, the use of social care and other services that can be set against the costs of re-ablement services.

Design and methods

The study followed users of home care re-ablement services in four different local authorities with established home care re-ablement services. It compared their outcomes and their use of health and social care services up to a year later with service users in four other local authorities without home care re-ablement services. Data on the unit costs of home care re-ablement services were collected and calculated for the first time. The study included an investigation of the organisation and delivery of home care re-ablement teams through interviews with managers; focus groups with front-line staff; and observations of re-ablement interventions. Small subsamples of re-ablement service users and carers were interviewed in depth about their expectations and experiences of the service.

Findings

Home care re-ablement was associated with a significant decrease in subsequent use of social care services, although any cost savings were almost wholly offset by the initial costs of the re-ablement intervention. Re-ablement had positive impacts on users’ health-related quality of life and social care outcomes; the probability that re-ablement is a cost-effective service was therefore very high.

The study also identified the organisational and wider environmental factors that appeared to contributed to effective and efficient re-ablement services.

Publications and presentations

2012

Home care re-ablement - who benefits and why? Reviewing the evidence base. Invited.
Glendinning, C., Home Care Reablement Roadshow, Birmingham, 1 March 2012.

Home care re-ablement services: What do they do? What impacts do they have? Invited.
Glendinning, C., Hartlepool Borough Council Adult and Community Services Scrutiny Forum Meeting, Hartlepool, 16 January 2012.

Home care re-ablement: who benefits and how? Evidence from research and practice. Invited.
Glendinning, C., Home Care Reablement Roadshow, York, 26 January 2012.

'If they're helping me then how can I be independent?'. The perceptions and experiences of users of home care re-ablement services, (forthcoming)
Wilde, A. and Glendinning, C., Health and Social Care in the Community.

2011

Home care re-ablement services: investigating the longer-term impacts
Baxter, K. and Rabiee, P., Knowledge Transfer Partnership Meeting, York St. John University, York, 16 February 2011.

Home care re-ablement services: investigating the longer-term impacts. Workshop.
Baxter, K. and Rabiee, P., Community Care Live 2011, London, 19 May 2011.

Home care reablement - effectiveness and cost-effectiveness. Invited.
Glendinning, C., Making Research Count Conference, University of Keele, Keele, 17 November 2011.

Home care re-ablement services - investigating the longer-term impacts
Glendinning, C. and Rabiee, P., South East Regional Masterclass on Reablement Services, Winchester, 18 January 2011.

Home care re-ablement services: investigating the longer-terms impacts, 2011
Glendinning, C., Jones, K., Baxter, K., Rabiee, P., Curtis, L., Wilde, A., Arksey, H. and Forder, J., Research Works, 2011-01, Social Policy Research Unit.

Organising home care re-ablement services: what makes a difference? Plenary.
Rabiee, P., Homecare Re-ablement: Making it Work for Everyone Conference, London, 25 May 2011.

Organisation and delivery of home care re-ablement: what makes a difference?, 2011
Rabiee, P. and Glendinning, C., Health and Social Care in the Community, 19, 5, 495-503.

Home care re-ablement services: investigating the longer-term impacts
Rabiee, P. and Jones, K., Bigger Societies, Smaller Governments?, Social Policy Association Annual Conference, University of Lincoln, Lincoln, 4 July 2011.

2010

Executive Summary: Home Care Re-ablement Services: Investigating the longer-term impacts (prospective longitudinal study), 2010
Glendinning, C., Jones, K., Baxter, K., Rabiee, P., Curtis, L., Wilde, A., Arksey, H. and Forder, J., Social Policy Research Unit.

Home Care Re-ablement Services: Investigating the longer-term impacts (prospective longitudinal study), 2010
Glendinning, C., Jones, K., Baxter, K., Rabiee, P., Curtis, L., Wilde, A., Arksey, H. and Forder, J., Social Policy Research Unit.

Home care re-ablement - optimum organisation of services. Keynote.
Rabiee, P., Adult Social Care Transformation: Seizing the Opportunity! Making Research Count Regional Conference for Adult Services, York, 3 February 2010.

Organising home care re-ablement services for maximum user benefit
Rabiee, P., Community Care Live 2010, London, 18 May 2010.

The organisation and delivery of home care re-ablement services - factors that promote successful outcomes for service users. Keynote
Rabiee, P., What Works: Putting Research into Practice - Reablement, Institute for Research and Innovation in Social Services Workshop, Edinburgh, 30 April 2010.

The organisation and content of home care re-ablement services, 2010
Rabiee, P. and Glendinning, C., Research Works, 2010-01, Social Policy Research Unit.

2009

The organisation and delivery of home care reablement services
Glendinning, C., Community Care 'Webinar', London, 12 November 2009.

The Short-term Outcomes and Costs of Home Care Re-ablement Services: Interim report, 2009
Jones, K., Baxter, K., Curtis, L., Arksey, H., Forder, J., Glendinning, C. and Rabiee, P., Social Policy Research Unit.

The Organisation and Content of Home Care Re-ablement Services: Interim report, 2009
Rabiee, P., Glendinning, C., Arksey, H., Baxter, K., Jones, K., Forder, J. and Curtis, L., Social Policy Research Unit.

Media coverage

The Guardian http://www.guardian.co.uk/society/2011/jan/12/reablement-costs-wipe-out-savings

University of York http://www.york.ac.uk/news-and-events/news/2011/research/home-care/

Impact

Improving Value for Money in Adult Social Care, Audit Commission (2011). This reablement research is quoted on pages 17-18.

Reablement: a cost-effective route to better outcomes, Social Care Institute for Excellence (2011). Both the interim and the final report are referenced throughout.

Reablement: a key role for occupational therapists, Social Care Institute for Excellence and the College of Occupational Therapists (2011), At a glance, no. 46. The final report and Health and Social Care in the Community article are referenced throughout.

If you require further information about the project, please contact Caroline Glendinning