Embedding Outcomes in Homecare Re-ablement for Older People in North Lanarkshire

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This project aims to investigate the potential for and most effective means of implementing evidence (formal research studies, practitioner wisdom and user and carer perspectives) about outcomes in the context of home care re-ablement. While there has been some attempt to consider outcomes in homecare more broadly (Sawyer, 2005), progress remains patchy. There is also a need to develop outcomes in re-ablement services, which are being promoted throughout the U.K (CSED, 2007). Re-ablement has been recognized as achieving significant savings for local authorities; however initial costs of re-ablement appear to negate long-term savings (PSSRU, 2010). Embedding an outcomes approach within re-ablement may assist in providing effective home care services within a context of diminishing resources and an ageing population.Emerging evidence of outcomes approaches show that they are both person-centred and enabling and can be implemented without additional resources (Miller, 2010). Evidence from re-ablement is largely positive, suggesting that home care re-ablement can reduce commissioned hours of home care, and offer sustained benefits to service users by increasing their skills and ability to live independently, (MacIntyre and Stewart, 2011). However, (Slasburg, 2009) suggests that establishing a re-ablement culture for all rather than a specific service for some will ensure benefits to all rather than to a small minority of hand picked service users. This project will build on an established knowledge exchange initiative in Scotland, Talking Points (Scottish Government, 2009). It will work directly with a partner local authority, North Lanarkshire Council, to investigate how an outcomes-based approach to assessment has been embedded within two home care re-ablement teams. The project will enable existing evidence on both outcomes and re-ablement to be mapped across current practice in North Lanarkshire and this iterative process will facilitate knowledge exchange. Guidance and associated tools will be produced for the local authority as well as digital stories for broader dissemination and training purposes. It is expected that the key messages from this knowledge exchange process will have applicability for other home care services who are working to embed outcomes in re-ablement across the U.K. and internationally. In addition, if funding is secured, this project will be the first stage in the development of the exploration of a re-ablement approach being introduced throughout home care services both within the council and in the contracted private sector services. Key stages of the project are summarised below.Stage 1 will establish key messages from the literature as they relate to outcomes and re-ablement. In addition a small number of strategic staff within the local authority and other providers will be interviewed to establish a baseline for current practice.Stage 2 will test out via focus groups the relevance and applicability of the key messages identified in stage 1 with practitioners and managers across two re-ablement teams in North LanarkshireStage 3 will synthesise the messages from research, the practice experience and potential challenges to implementation via an Expert Group comprising; relevant practitioners, researchers and external advisors including Partnership4Change. Stage 4 - Detailed guidance on the optimum model of practice, including relevant tools to ensure outcomes are embedded in the re-ablement model in North Lanarkshire will be produced.Stage 5 - guidance and tools disseminated via a 2nd focus group to consider any challenges concerns from the practitioners.Stage 6 - second Expert Group meeting to finalise the model to be developed within North Lanarkshire. A further output of this event will be detailed guidance for disseminationStage 7 - implement model across North LanarkshireStage 8 - dissemination of project outcomes across Scotland via IRISS.