RELATED CHAPTER

Initial Response and Reablement

This chapter was introduced in May 2016.

1. Introduction

Reablement is part of a continuum of support services, all of which have the long term independence and well being of people at their heart. All services must aim to prevent, reduce or delay the development of need.

There is not a single, agreed definition of reablement, but the Care Services Efficiency Programme (DH 2007) stated that reablement consists of ‘Services for people with poor physical or mental health to help them accommodate their illness by learning or re-learning the skills necessary for daily living.’ This distinguishes reablement from other services by placing an emphasis on learning or relearning skills as opposed to providing support to someone during a period of recovery.

2. Policy Statement

Reablement will be offered to people who meet the criteria for such a service, free of charge for up to six weeks. It is important to identify those who qualify for the service prior to commencement. Support offered to people who do not meet the eligibility criteria for reablement will attract a charge from the outset.

3. Differences and Similarities with other Services

Reablement has many similarities with home care, but one of the biggest differences is in the culture and ethos of reablement services which are focused on improving someone’s health, wellbeing, confidence and independence to help them regain the ability to live as independently as possible. With reablement, the aim is to help the person regain skills and abilities to maintain their independence, rather than simply to ensure that the defined task has been completed to a high standard and to the person’s satisfaction. Everyone involved in reablement services needs to be supporting and motivating people to achieve these changes, every time they work with them.

4. Differences and Similarities with Intermediate Care

Intermediate care’ describes a range of services which support people in the transition from hospital to home or prevent the need for admission to hospital or to long term residential care, by providing alternative support for a limited period of time. Intermediate care patients have a defined clinical need, and intermediate care services are clinician led. In contrast, people using a reablement service have a social care need and adopt a social model of support.

Reablement can be helpful to people who have been through a period of intermediate care. However, it may also be offered to those who have not been in hospital, and are not at high risk of admission to hospital or a care home, but who need support to help them learn or relearn skills following a crisis. Many people who would not be eligible for intermediate care may be able to access reablement.

5. Essential Elements which should be present in all Support Services

All services should be outcome focused; the overall goal is to help people maximise their independence and wellbeing. This means that the level of support offered may reduce as outcomes are achieved and individual resilience grown.

All services should adopt a very personalised approach; the kinds of support given are tailored to the individual user’s specific goals and needs.

Assessment of need should be regarded as something that is dynamic not static. This approach means that you cannot decide a user’s care or support package on the basis of a single, one off assessment, instead you need to accept that someone’s needs and abilities will change over time and respond accordingly.

All support services should build on what people currently can do, and support them to regain skills to increase their confidence and independence.

Assessment and support planning should explore the use of appropriate equipment and / or assistive technology, and understand how to use it.

6. Essential Elements which define Reablement

Reablement:

  • actively helps people to do things for themselves, rather than doing things to or doing things for people;
  • involves setting and working towards specific goals agreed between the service user and the Reablement Team;
  • assumes that something should change by the end of the reablement intervention; you are working towards positive change;
  • aims to reduce or minimise the need for ongoing support after the period of reablement;
  • is time limited; the maximum time that the user can receive reablement support is decided at the start. For most people, this will be six weeks or less.

7. Eligibility Criteria for Reablement Services

The following are eligibility criteria for reablement services:

  • The person has a need for support which meets the national eligibility criteria for social care support;
  • The need for support arises from a crisis such as an accident or illness which leads to a temporary impairment;
  • The assessment supports a reasonable belief that following reablement, the person will regain full independence.