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By Deborah Rozansky, Social Care Institute for Excellence (SCIE)
Reablement services play a critical role in maintaining people’s independence and quality of life. Most frequently used to support people’s recovery after a hospital stay, reablement can also be preventive, reducing the need for hospital admissions or long-term residential care.
However, our research has shown that reablement is misunderstood, potentially preventing people from fully benefiting from it. Inconsistent staff training, varying levels of family support and limited access to appropriate services and equipment also play a role.
Last year, we published evidence-based and practical recommendations for reablement commissioners and providers, developed by researchers from the University of York, to tackle these barriers and ensure more people receive the high-quality support they need and deserve.
Boosting staff training and morale
A significant barrier the researchers identified relates to the training of reablement staff, who include assessors, support workers and, in some cases, occupational therapists or physiotherapists.
Reablement is not just about assisting with daily tasks, but also involves understanding what motivates each individual and tailoring support accordingly, to achieve the person’s goals.
To do this well, staff need comprehensive training in the core principles of reablement – specifically promoting independence, motivational interviewing and working within multi-disciplinary teams.
Proper investment is needed for staff training to achieve the culture of care that supports reablement. Regular check-ins and open communication channels that help staff problem-solve, share best practice and build confidence are also important.
Another significant barrier to success is low staff morale. While some sources of low morale are beyond the control of managers, there are steps services can take. These include involving staff in review processes, acknowledging their expertise in supervision meetings and keeping them updated on service performance, thereby helping them feel supported and valued, which in turn can lead to better outcomes for those receiving care.
Setting goals
When staff fail to involve individuals in setting their own goals, or when goals are unrealistic or too vague, their engagement with the reablement process suffers.
A two-step approach to assessment and personal goal-setting can help individuals feel more engaged in the process.
The initial assessment should introduce broad goals that align with the core principles of reablement, such as improving mobility or rebuilding confidence in daily tasks. A follow-up assessment should then refine these into more focused, personalised objectives that reflect the individual’s specific needs and priorities – being able to make a cup of tea or climb the stairs, for example.
Progress should be documented clearly – ideally being displayed in the home where individuals and their families can see it – and reviews should be structured around it to ensure goals remain meaningful and individuals stay motivated.
Engaging families
Lack of family support is another significant barrier. Family members may not always fully understand their role in the reablement process or may be reluctant to support it due to safety concerns around increasing independence.
First and foremost, staff should have open conversations with families to address any concerns, clarify relatives’ roles and ensure they feel confident in supporting the reablement process.
Involving them directly – encouraging them to celebrate progress and reinforce goals, for example – can make a real difference, where it is appropriate to do so.
If safety is a key concern, staff can also provide reassurance by signposting family members to fall alarms and other digital tools that offer extra security and peace of mind.
The right equipment
Sometimes, the smallest adjustments make the biggest impact. Something as simple as adapted cutlery can produce immediate results, boosting motivation.
Conversely, lack of access to appropriate equipment can hinder progress and therefore knock an individual’s confidence, discouraging engagement in the reablement process.
Occupational therapists (OTs) are often responsible for assessing and recommending equipment that supports a person’s independence. However, the availability of OT support can vary.
Given this, reablement services must equip non-OT qualified staff – who often have limited knowledge of the options available – with the information they need, to empower them to identify and provide the right equipment in a timely manner.
Resources such as the NHS’s ‘Care services, equipment and care homes’ and Scope’s ‘How to get disability equipment and assistive technology’ can be invaluable. Services could also consider providing staff with a small budget to purchase non-prescribed equipment.
Promoting companionship and connections
For many people, visits from reablement staff aren’t just about practical support – they also provide much-needed companionship.
With reablement services often limited to six weeks, the prospect of losing support can sometimes lead to individuals disengaging from the process.
To prevent this, reablement services should assess individuals’ community networks early on and ensure they have opportunities to reconnect with activities and relationships that enhance their wellbeing.
Involving family members, friends and community contacts can also be invaluable in ensuring loss of companionship doesn’t impact motivation and engagement.
An increasingly vital service
As our population continues to age and care needs become more complex, the role of reablement services in supporting individuals to restore their independence, maintain their wellbeing and enhance their quality of life will becomes increasingly vital.
It’s essential, therefore, that we continuously refine reablement practices and seek opportunities to improve outcomes at every stage.
The work already done by practitioners, researchers and organisations like SCIE provides a strong foundation; now, we must focus on translating this knowledge into practical, everyday actions.
Deborah Rozansky is director of policy, research and information at SCIE
