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

该项目旨在调查实施证据(正式的研究研究、从业者的智慧以及用户和照顾者的观点)的可能性和最有效的手段，以了解家庭护理重新启用的背景下的结果。虽然已经有一些尝试更广泛地考虑家庭护理的结果(Sawyer，2005)，但进展仍然参差不齐。还需要在重建服务方面取得成果，这项服务正在全英国推广(CSED，2007)。重新启用已被公认为为地方当局实现了大量节省；然而，重新启用的初始成本似乎否定了长期节省(PSSRU，2010年)。在能力重建中嵌入结果方法可能有助于在资源减少和人口老龄化的背景下提供有效的家庭护理服务。越来越多的证据表明，结果方法既是以人为本的，也是有利的，无需额外资源即可实施(Miller，2010)。重新启用的证据在很大程度上是积极的，表明重新启用家庭护理可以减少委托家庭护理的时间，并通过提高服务用户的技能和独立生活的能力为他们提供持续的好处(MacIntyre和Stewart，2011)。然而，(Slasburg，2009)建议，为所有人而不是为某些人建立一种特定的服务，将确保惠及所有人，而不是少数亲手挑选的服务用户。该项目将建立在苏格兰既定的知识交流倡议--Talk Points(苏格兰政府，2009年)的基础上。它将直接与合作伙伴地方当局北拉纳克郡议会合作，调查两个家庭护理重建团队如何嵌入基于结果的评估方法。该项目将使关于结果和重新能力的现有证据能够在北拉纳克郡的现行做法中绘制地图，这一迭代过程将促进知识交流。将为地方当局制作指南和相关工具，并为更广泛的传播和培训目的制作数字故事。预计这一知识交流过程中的关键信息将适用于其他家庭护理服务，这些服务正在努力将成果嵌入整个英国和国际社会的重建工作中。此外，如果获得资金，这个项目将是探索重建方法的第一阶段，该方法正在整个家庭护理服务中引入，包括在理事会内和在签订合同的私营部门服务中。项目的关键阶段总结如下。阶段1将从文献中建立与结果和重新启用相关的关键信息。此外，还将与地方当局和其他供应商的少数战略工作人员进行面谈，以建立当前做法的基线。第二阶段将通过重点小组与北兰开夏两个重建团队的从业者和管理人员测试阶段1中确定的关键信息的相关性和适用性第三阶段将通过一个专家组综合研究、实践经验和实施中的潜在挑战，专家组成员包括相关从业者、研究人员和包括Partnership 4Change在内的外部顾问。阶段4-关于最佳实践模式的详细指导，包括确保将结果嵌入北拉纳克郡重建模式的相关工具。阶段5-通过第二个焦点小组传播指导和工具，以考虑从业者的任何挑战关切。阶段6-第二次专家组会议，以最终确定将在北拉纳克郡开发的模式。这次活动的另一项成果将是关于传播的详细指导意见阶段7--在整个北拉纳克郡实施模式--阶段8--通过IRIS在整个苏格兰传播项目成果。

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.