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

Individual budgets sit at the heart of government policy for improving choice and control for people needing social care support. Individual budgets bring together a number of different funding streams and offer a transparent way of allocating resources to individuals. There are 13 pilot areas for individual budgets. Evaluating these pilot projects is fundamental to a future decision by government about whether this approach will be rolled out more widely.

Related links

Publications and presentations from the project are available from the York Research Database.

This research sits within our Evaluation: interventions research theme. Read about our research themes.

Download a copy of the Full Report, Executive Summary and Research Works Summary.

SPRU research team

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 re-ablement 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 re-ablement 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 re-ablement
  • identify factors affecting the level and duration of benefits for users of home care re-ablement services (e.g. features of the service, types of services used subsequently)
  • describe the content and costs of home care re-ablement 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 re-ablement services.

Design and methods

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

Findings

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

Duration

April 2008 - December 2010

Related links

Publications and presentations from the project are available from the York Research Database.

This research sits within our Evaluation: interventions research theme. Read about our research themes.

Download a copy of the Full Report, Executive Summary and Research Works Summary.