East Midland Reablement Evaluation Tool EMRET A PROGRAMME OF WORK RE ITS VIABILITY
EMRET - Background n Participants at an East Midland CSED workshop in September 2009, agreed to try and develop across the region a consensus on what would be the core requirements of an assessment tool. The intention would be to apply a common set of measures alongside the core requirements in a pre and post assessment of reablement, and then to use this information to evaluate the impact and effectiveness of an authority’s reablement service.
EMRET Methodology: The programme tracked the changes required to enable two different local authorities to introduce a common system of measuring their reablement/enablement services. To enable us to compare the outcomes and the use of services over the period of the programme and to identify those features that appear to contribute to optimum outcomes for the service users. n Our differences were a challenge not a barrier. n What was conceived became a reality
EMRET + = ? Sleeping Babies or Re-Enablement Giants
Context n n n n Lincolnshire is a large shire authority, it provides Home Support services through both In House and Independent Sector provision. FAC’s Moderate + Introduced Reablement in April 2009, provides currently on average 2, 500 hours per week across the county. (11 Months into Roll Out) Target for 2010 -2011 total 4, 500 hours per week Close working relationship with Intermediate Care Teams but not integrated Provides a service for up to six weeks. Charged for service ? n n n Derby City Council is unitary authority, and is a significant provider of direct home care services The current FACS level has been moderate since 2007, previously it was low Have been providing an enablement service since 2008 Is integrated with Hospital Home Care Teams. Provides a service for up to six weeks. Not charged until after 4 weeks
EMRET n n n Establish the principle that we are able to begin to measure like for like. Across the region Viability of the use of a common assessment tool Activities of Daily Living Scores ADL’s Look at a reduction in the number and range of assessments: OT’s, Barthel, Protocol etc The practical application of such an approach Better understanding of what are the most cost effective interventions in a reenablement service.
EMRET Some of the issues to be addressed were: n Common Principles n Different Processes n Data collection n Changes in practice
EMRET Common principles and features in service provided: n n Helping people ‘to do’ rather than ‘doing to or for’ people Outcome focused with defined maximum duration Assessment for ongoing care packages not a oneoff assessment based on an initial and a final. EMRET Tool has informed the development of each authorities Daily Records Information
Derby’s Yellow enablement folder n Why do we use it n Who is it for n Main sections
Sections of the folder n n n n Enablement Plan/Activities to Daily Living Daily Record Needs Assessment Medication Risk Assessments Application for Home Care Service Direct Payments Info /Quality Questionnaire/Service User Guide
EMRET BASIC & INSTRUMENTAL ADL’S COVERED n n n Ability to undertake personal care needs Ability to undertake practical activities to sustain their lifestyle Ability get around indoors Ability to use WC/toilet Ability to eat and drink Ability to get around outdoors.
EMRET INSTRUMENTAL ADL’S Other ADL’s are dealt with but not included in the joint evaluation tool: n Health n Use of Technology n Managing Risk n Safety procedures and emergency responses. n Areas relevant to a persons situation LD; PD; Mental Health. Work, parental resp.
EMRET n n DEVELOPMENTS FOR THE FUTURE Improve the evidence on the performance of two authorities in the delivery of a recovery - re-enablement service. To identify the areas of home care re-enablement for looking at developing and improving the service. Areas identified through ADL’s (e. g. improved independence, lower dependence, quality of life, mental wellbeing). To identify any impact on and savings in the use of social care and other services, that can be set against the costs of re-enablement services. Better description of the content and impact of a home care re-enablement service.
Information to date on ADL’s
Information to date on ADL’s
Post Enablement Impact on Maintenance Packages
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