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

SPRU research team

• Hilary Arksey
• Kate Baxter
• Parvaneh Rabiee
• Caroline Glendinning
• Alison Wilde
  
  

External collaborators

• Julien Forder, Personal Social Service Research Unit (Kent)
• Karen Jones, Personal Social Service Research Unit (Kent)
• Lesley Curtis, Personal Social Service Research Unit (Kent)

Project summary

Background

Adult social care services were increasingly developing specialist home care reablement 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 reablement 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 reablement
• identify factors affecting the level and duration of benefits for users of home care reablement services (e.g. features of the service, types of services used subsequently)
• describe the content and costs of home care reablement 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 reablement services.

Design and methods

The study followed users of home care reablement services in four different local authorities with established home care reablement 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 reablement services. Data on the unit costs of home care reablement services were collected and calculated for the first time. The study included an investigation of the organisation and delivery of home care reablement teams through interviews with managers; focus groups with front-line staff; and observations of reablement interventions. Small subsamples of reablement service users and carers were interviewed in depth about their expectations and experiences of the service.

Findings

Home care reablement 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 reablement intervention. Reablement had positive impacts on users’ health-related quality of life and social care outcomes; the probability that reablement 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 reablement services.