More on reablement at Community Care Live
The biggest and best social work event is back on 21-22 May in London, with a session on making reablement work among its many highlights.
Zero-hours contracts and unpaid travel time are likely to be the wrong approach to managing reablement staff engaged in helping people regain independence, says a guide published by the Social Care Institute for Excellence.
Councils should be prepared to invest up-front in reablement so that staff – whether in-house or in commissioned services – can receive training, supervision, paid travel time and set-contracted hours to help ensure effective services that will deliver savings by reducing people’s needs for care.
The guide for commissioners, social workers, managers and care staff, Maximising the potential of reablement, is based on existing research and practice evidence on reablement, typically an intensive period of support for people to regain daily living skills following a hospital episode, a deterioration in health or the onset of disability.
It suggested councils use outcomes-based commissioning so that providers receive extra payments if they help service users to recover independence and can time care visits flexibly in line with people’s needs and progress. This is in contrast to the much-criticised approach to commissioning home care, in which providers are paid according to time and appointments are commissioned in fixed, and often short, slots.
The latter approach has fed through into service users receiving little continuity of care worker and rushed visits, and employment conditions in which home care staff are not paid for travel time and employed on zero-hour contracts, in which they are not guaranteed work.
The guide said zero-hours contracts were likely to be inappropriate because they would not incentivise staff to reduce people’s support needs as this would reduce their own earnings. It advised commissioners and providers to ensure staff had set-hours contracts instead, and said they should also be paid for travel time and time off for training.
It said provider managers needed to ensure staff received regular training and supervision that covered the social model of disability, a “thorough grasp” of tools to agree, monitor and record outcomes for service users and support to develop a “reabling” ethos.
This involves knowing when to do things for a person and knowing when to step back and encourage them to do things for themselves, which would be a challenge for staff with a long history of working in home care, and for those working with service users who had previously received home care. It also said managers needed to promote continuity of care staff for service users, as the short duration of reablement meant trust and rapport had to be developed quickly.
The guide also includes advice on the skills mix for reablement teams including that they should have access to occupational therapists, though not necessarily as team members.