Research into the Longer-Term Effects of Homecare Re-ablement Services
June to October 2007

Evidence from the few homecare re-ablement services which have been evaluated suggested that there are significant reductions in the use of homecare services following ‘discharge’ from a re-ablement service, compared with assessed levels of need on ‘entry’ to the service.  However, there was no evidence on the longer-term duration of such reductions, or on the factors that might lead to subsequent (increases in) service use.  To begin to address this gap in the evidence, the Care Service Efficiency Delivery Programme (CSED) commissioned the Social Policy Research Unit at the University of York and Acton Shapiro to conduct a very focused and rapid study into the longer-term impact of re-ablement.
 
The study had three main aims:
  • To examine changes over time in the subsequent use of social care services following a period of homecare re-ablement, using routine service data from a number of Councils with Adult Social Services Responsibilities (CASSRs)
  • To identify factors that may affect subsequent use of social care services following a period of homecare re-ablement in the selected CASSRs
  • To consider what a larger evaluation of homecare re-ablement services might most usefully encompass and identify issues that may need to be taken into account in designing such a study. 

The study team selected four CASSRs with re-ablement services (two ‘intake’ services and two ‘discharge support’ services) which had been established for at least four years.  In each site we:

  • obtained routine quantitative data for clients who had an episode of homecare re-ablement in 2004-5, including the level of social care services they subsequently used over the following two years (i.e. 2005/06 and 2006/07)
  • carried out interviews with the re-ablement service manager and at least one care management team manager. 

A profile of the ‘population’ of re-ablement service users in each area, including a breakdown of age, gender and ethnicity, and an examination of the service users’ pattern of service use was prepared.  Four main strands of analysis were then undertaken with the aim of gaining some insight into the overall impact of re-ablement and the duration or sustainability of that impact.  These were:

  • Profile of re-ablement service users
  • Time from re-ablement to first episode of homecare
  • Change in homecare usage after re-ablement
  • Intensity of homecare usage after re-ablement.

The findings from the work were published on the CSED website and were sent to every CASSR in the country. We also presented them at several conferences and published a number of articles in both professional and academic journals.  Download a copy of the report here.