WIREDGOV

Housing providers should bid for reablement contracts - Opportunities for at-home recuperation being missed

Clinical commissioners should look again both at how reablement services are delivered – and who delivers them – as they take responsibility for these schemes from local authorities, says a new report by Demos.

The report comes in response to significant government investment in ‘reablement’ services, support services designed to speed discharge from hospital and reduce the need for ongoing care and support.

The Government has chosen to not only honour the previous government’s commitment of £70m for reablement services but to add a further £162m from Department of Health efficiency savings. The Department of Health’s most recent estimate stated that delayed hospital discharges cost the NHS around £170 million a year (or around £500,000 for every day of the year) and account for 1.7 million lost bed days annually.

Reablement is seen as the key to this, speeding discharge and reducing the reliance on ongoing care.  But the Demos report stresses a need for greater scrutiny over the scheme’s ability to reduce readmissions to hospital, as this remains an overlooked but critical element of the cost savings reablement might achieve.

Weaknesses in the current reablement system – including a narrow focus on home care tasks, a ‘cliff edge’ of support at the end of the intervention, and a lack of personalisation – could explain why reablement has limited impact on readmissions.

But social landlords, who excel in encouraging their customers’ community engagement and who can create a more gradual reduction in support, could be the key to improving the current reablement offer.

The report The Home Cure calls for reablement teams to partner with social housing to help them deliver more holistic reablement services, but also encourages housing with care providers to bid for reablement contracts themselves, ending the local authority monopoly on reablement services, and creating a more diverse market for reablement services.. 

Claudia Wood, Head of Public Services and Welfare at Demos said:

“Government faith in reablement is well founded – it helps with delayed discharge and reduces people’s reliance on social care, so everyone wins. But that doesn’t mean it can’t be improved – commissioners need to consider whether more can be achieved with the government’s reablement funds, and this includes looking again at how it is delivered, and who delivers it.”

Chris Munday, Executive Director, Midland Heart Care and Support said:

“The research shows the hugely important role that housing and care has in supporting reablement services.  The prospect of combining the best of housing and health together to develop new and innovative ways of working is truly exciting. 

“We need a broader focus than simply home care - it is time for a much more holistic approach that will help people to integrate back into their communities and ultimately support them to lead the lives they choose with confidence and independence.”

ENDS.

NOTES TO EDITORS

Twenty one per cent of people over 65 and 24 per cent of people aged 75+ live in social housing

Research for Age UK suggested that of the 2 million older people with care needs in England, 800,000 receive no formal support, current government austerity measures could push this figure above 1 million by 2020.

Today there are 2,000 registered social housing providers, making them the main providers of affordable and social housing in the UK.  Housing associations provide 2.5 million homes for 5 million people.

Case studies:

Maud is 82 and lives alone. After admission to hospital  with a serious illness she received reablement services  (as it currently stands) for around 6 weeks following discharge.

Maud would have like the support to continue longer than 6 weeks.  She thought the current reablement package was inflexible and did not help her with as many tasks as she would have liked.

She also felt it should have been more personalised, to reestablish her independence.

The service was also too home based and lacked a reconnection with the wider community.

Roger, a 70 year old widower, spent 3 months in hospital after he was knocked down at a traffic light by a motor bike. He was discharged into supportive housing with a social care reablement package lasting 5 weeks.

Overall, Roger was positive about the reablement care he received, however, like Maud, he would have liked it to have lasted longer. He suffered several falls after the withdrawal of care and needed a wheelchair but felt he could not ask as the support he was receiving had ended.

The scheme is commission by Bedford Council social services through a central government grant. Up to 60 people stay in the scheme every year, for an average of four weeks at a cost of £68 per day, result in an estimated cost saving, of £5,656 per person compared with continued hospital stays and readmission. The annual scheme costs £140,000 per year of which the housing association contributes £15,000. Source: ‘Bedford Borough Draft Health and Wellbeing Strategy’

The Home Cure by Claudia Wood and Jo Salter is available to download for free from www.demos.co.uk/publications/thehomecure

This report is funded by Midland Heart Care and Support, one of the largest housing, care and regeneration providers in the country with nearly 32,000 homes.

For further information about Midland Heart contact: 

Amanda Govani, Midland Heart: 0845 850 1020 ext 6157

Amanda.govani@midlandheart.org.uk

Media contact: 

Beatrice Karol Burks

Beatrice.burks@demos.co.uk

020 7367 6325

079 2947 4938