Agenda item

The Council’s Provider Services Manager drew attention to the following points when taking the Panel through the Agenda Report and Presentation:

·       Reablement was defined as a short term (up to six weeks) goal-focussed intervention, providing support and confidence to enable an individual to recover or maintain physical functions, such as mobility or walking support, in their own home or care home.  The support may come from Occupational Therapy or Physiotherapy and it did not replace the need for social work nor appropriate assessment

·       The Council’s Community Reablement Pathway, suitable for all adults aged 18+ regardless of additional needs, was due to commence in April 2020, however, due to the COVID-19 pandemic, delivery was put on hold with the hope that the 7 day running service would now commence in late October 2020.  Since April, Staff had been utilised in other work areas, such as supporting patients who were discharged home from hospital

·       Referrals would be made via operational teams, such as the hospital based Onward Care Team, with individuals allocated a professional who would be the key contact throughout the whole process, including assessment, review and any handover in relation to long term social work or further provider intervention.  The Pathway was available to all residents, including self-funders, and could be used as a hospital or care home admission avoidance opportunity.  Prisoners from the two County prisons were also eligible for referral

·       It was envisaged that appropriate ongoing rehabilitation support would be identified early, after Care Act assessments had taken place and financial assessments undertaken, which would move away from the traditional ‘Time and Task’ support available

·       Residents were instrumental in developing and agreeing their own reablement plan, with Staff working with all health and social care partners to ensure that the desired outcomes were embedded in any future provision, ultimately aiming to reduce demand on hospitals and care homes.

In the ensuing discussion, the following key points were made:

·       A Member asked how people would be referred into the Community Reablement Pathway and it was clarified that if the individual was in a hospital setting, the Onward Care Team would always take the ‘Home First’ approach.  If an individual was at home, referrals could come through a social worker as part of the 3 conversation model of care

·       When asked how confident Officers were that there was sufficient resource to commence the service in late October, given that Staff were redeployed on COVID-19 duties, it was reported that based on current modelling, no issues were foreseen

·       Referring to the Agenda, which highlighted a number of benefits including a saving of £1.5m, a Member queried how this would be achieved.  It was clarified that the figure included cost avoidance measures, such as lower demand long term for domiciliary care and care home placements, the deletion of surplus posts and organisational restructure.  The Senior Social Work Lead added that nationally, other Local Authorities had seen the effectiveness of reablement, resulting in less long term support

·       Given the uncertainty surrounding any long term health issues arising from COVID-19, a Member asked whether Officers had any concerns going forward.  It was difficult to predict, however, the Panel noted that the hospital discharge process had changed and during the initial response stage, planned surgery did not take place, therefore the number of people supported was much lower.  In the longer term, it was feasible that patients recovering from COVID-19 could have some mobility issues due to breathing difficulties arising from the pandemic

·       In response to a question as to whether self-funders (those with savings in excess of £23,250) would have to fund the six week reablement support, it was clarified that it was free to all, as the benefit to the Council would likely occur either in the short or long term.  However, if a resident was a self-funder in a care home, then the care home fees would continue to be due.

The Engagement Officer from Healthwatch Worcestershire was invited to comment on the discussion and made some observations:

·       Whether the system as a whole had the capacity to support the Community Reablement Pathway, not just within the six week programme, but longer term in areas such as numbers of therapists and the expected demand on home adaptations for example

·       Recognised the need for a whole system approach, however, it would require a new way of thinking to ensure that there was consistency not just within the six weeks but also with any after care

·       Queried the level of awareness of the service and offered the services of Healthwatch in promoting the intervention.

In response, the Council’s Provider Services Manager acknowledged the points raised and recognised the requirement for promotion whilst balancing that with keeping the service from being overwhelmed.

The Panel Chairman thanked everyone present for a helpful discussion and requested an update at an appropriate time in the future.