1. Reablement Seminar Tate Gallery Liverpool 10 January 2008

2. 2 Home Care Reablement – From ‘Specialist’ to ‘Mainstream’ Services a Jane Dabrowska Service Manager Older and Disabled People’s Services, Melton and Market Harborough

3. 3 H omecare A ssessment & R eablement T eams Council Profile: 610.000 population – 15.7% over 65, 1.8% over 85 (2001 census) Rural area, 6 market towns, 6 District Councils 4 PCTs now down to 1

4. 4 Background: The Home Care Market in 1999:- Mixed Economy - 25% in-house Generic Provision Purchaser/Provider Split Task/time specific commissioning H omecare A ssessment & R eablement T eams

5. 5 Triggers for Change: Promoting Independence Grant Rehabilitation Agenda Best Value Review H omecare A ssessment & R eablement T eams

6. 6 Home Care Reablement Team: Pilot project begun in 1999 ‘New’ Team in one area of the County ‘New’ look ‘New’ way of working H omecare A ssessment & R eablement T eams

7. 7 What was different? Short term Time spent to fit service user’s needs Not ‘doing to or for’ - doing with Working towards set goals Adjusting care plan Contributing to first review H omecare A ssessment & R eablement T eams

8. 8 De Montfort University Evaluation HARTMATCHED GROUP Average Care Package at Start 8 hrs/wk5.6 hrs/wk Discontinued at 1 st Review 62%5% Decreased at 1 st Review 26%13% Increased at 1 st Review 2%11% Maintained unchanged at 1 st Review 10%71%

9. 9 After the Evaluation…. Pilot never stopped…. rolled out Some changes made to original design:- –Staff trained by OT on assessing for minor aids and adaptations, –Home Care Managers carry out reviews, –Entrance extended to all newly assessed (or re-assessed following significant change) service users unless clear indication that reablement could not benefit, –Home Care Managers commission any on-going care packages to independent sector via broker. H omecare A ssessment & R eablement T eams

10. 10 Implementation: All teams across the county have been restructured to ‘specialist’ areas of work:- –HART (37%) –Dementia Teams (45%) –Child Care Teams (14%) –Awaiting Transfer (4%) (April 2007) Ongoing success of HART due to………. H omecare A ssessment & R eablement T eams

11. 11 OUTCOMES General 2001/22006/7 Average hours commissioned/week 28,80036,577 Households 3,9004,393 Average Hours/household 7.48.3 H omecare A ssessment & R eablement T eams Currently: 13% of activity in-house

12. 12 OUTCOMES HART 2005/62006/7 Number of Cases 18362,216 No Further Services 913 (49.7)1,102 (49.7) On-going need Start – Finish hrs 6.61 – 5.16.37 – 5.3 Total % Reduction in Hrs/week 41.6%42.3% H omecare A ssessment & R eablement T eams

13. 13 Financial Benefits: In 2006/7, Taking account of the cost of HART, average break-even point is approx. 26.3 weeks Reduction/week - £85,000 H omecare A ssessment & R eablement T eams

14. 14 And finally……..Top Tips:- Trusting relationship between commissioners and providers Pro-active management of staff to work in ‘new’ way Clear, consistent message to service users Eliminate delays/bottle necks Effective communication with all stakeholders H omecare A ssessment & R eablement T eams

15. 15 For further information, contact jdabrowska@leics.gov.uk 01664 503900 H omecare A ssessment & R eablement T eams