Reablement services must become more focused on helping people re-engage with their community rather than simply supporting them to regain independence at home if they are to deliver significant cost savings.
That was the message from a report produced today by think-tank Demos, which calls for reablement services to be reshaped to improve their impact, particularly in reducing hospital admissions.
Reablement tends to refer to a six-week package of support delivered to people following a crisis or discharge from hospital, designed to help them regain independence and reduce demand for care.
However, Demos said that while reablement reduced social care costs moderately over the longer-term it was less effective at reducing health costs and preventing hospital readmissions. It suggested this could be linked to shortcomings in the current approach to reablement, including the withdrawal of support after six weeks and a “narrow focus on home care tasks” rather than helping people regain independence in their communities.
It said helping people to reconnect with social networks and pursue hobbies was vital to improving well-being and reducing the risk of hospital readmissions.
To achieve this, it urged commissioners to engage housing associations in the running of reablement services. Housing associations “excel in encouraging their tenants’ community engagement”, said the report, and are ideally placed to support care providers in building independence among users and help them “regain their social networks”.
Government funding for the NHS to spend on reablement will rise to £300m a year by 2014-15, while much of the £1bn a year due to transfer from the NHS to local authorities up to 2015 is also likely to be spent on reablement.
“Government faith in reablement is well founded, it helps with delayed discharge and reduces people’s reliance on social care, so everyone wins,” said Claudia Wood, head of public services and welfare at Demos.
“But that doesn’t mean it can’t be improved. Commissioners need to consider whether more can be achieved with the government’s reablement funds, and this includes looking again at how it is delivered, and who delivers it.”
The findings echo those of a report by consultancies Ambrey Association and Helen Sanderson Associates last year that found reablement was insufficiently personalised and remains a service that is largely “done to” the service user.
The Demos report was funded by housing and care provider Midland Heart Care and Support. Its director for care and support, Chris Munday, said: “We need a broader focus than simply home care – it is time for a much more holistic approach that will help people to integrate back into their communities and ultimately support them to lead the lives they choose with confidence and independence”.
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