Investigating the longer-term effects of home care re-ablement services (retrospective longitudinal study)

SPRU research team

• Hilary Arksey
  
• Caroline Glendinning

External collaborators

• Liz Newbronner, Acton Shapiro
• Martin Baxter, Acton Shapiro
• Ruth Chamberlain, Acton Shapiro
• Jane Maddision, Acton Shapiro

Project summary

Background

Many local authorities have reconfigured their in-house home help services to provide short-term re-ablement interventions aimed at helping users acquire skills, confidence and equipment for independent living. In some localities these services are aimed specifically at people discharged from hospital; others take all new referrals for social care services. There is some evidence showing significant reductions in needs for home care support following a period of re-ablement. However, there is no evidence on the longer-term duration of such reductions, or on the factors that might lead to subsequent (increases in) service use.

Design and methods

This small study used routinely collected service activity data to examine changes in subsequent use of social care services following a period of home care re-ablement intervention. Four re-ablement services were included: two ‘hospital discharge’ and two ‘intake’ services. Routine data was supplied by each local authority on individuals’ use of social care services for up to two years following home care re-ablement; this data was analysed to provide descriptive statistics documenting the changes in use of social care services up to 24 months following ‘discharge’.

Semi-structured interviews were carried out in each site with the home care reablement service manager and a care manager team leader about:

• the operation of the reablement service
• factors perceived to contribute to the success of the service
• factors perceived to limit the impact and duration of the benefits of the home care reablement service
• knowledge of other services used on ‘discharge’ from home care reablement>
• knowledge of the factors affecting resumption or increase in social care service use after home care reablement.

Information from the interviews was used to inform the statistical analyses and also to identify factors that may need to be taken into account in designing a larger study.

Findings

The analysis suggested that re-ablement could bring immediate, but relatively short-term, benefits for some users; but could delay needs for home care support for others for a year or more. Interviews identified some of the factors likely to affect the magnitude and duration of any benefits observed from home care re-ablement. However, without a comparison group it was impossible to ascertain whether any improvements in outcomes and reductions in use of social care services might have occurred anyway; the need for further, comparative research was acknowledged. There was an in-depth follow-on study to this project, please see details at: Home care re-ablement services - investigating the longer-term impacts (prospective longitudinal study).