Commissioning intentions as at March 2018
The council and its partners have no immediate intention to go to market for reablement services in Staffordshire and the current preference is to work with the NHS and Local Authority’s wholly-owned home care service, Nexxus Care, to provide the service. However, we will continue to monitor and review arrangements for the provision of reablement services to ensure an adequate supply of good quality care. Where this cannot be assured, we will consider making alternative arrangements as necessary.
Introduction to services
Staffordshire Council commissions short term community reablement care to reduce, delay or prevent reliance on more intensive and long-term services by meeting agreed outcomes, improving independence and quality of life for individuals.
We define reablement as a particular type of intermediate care, which has a strong focus on helping an individual to regain skills, confidence and capabilities they have lost through poor health, disability, entering the care system following a crisis or having spent a considerable time in hospital or residential care. In particular this may be through the use of therapy and/or minor adaptations/ assistive technologies. Reablement services in Staffordshire are funded through the Better Care Fund and are free at the point of delivery for up to 6 weeks, (dependent on need as many people are re-abled in a shorter time).
The reablement service is one of a range of integrated prevention and discharge to assess services commissioned by the local NHS and/or Staffordshire County Council that are focused on:
- supporting people to remain as independent as possible in their own homes;
- preventing unnecessary admissions into hospital;
- enabling timely discharges to reduce lengths of hospital stay;
- avoiding unnecessary placements into longer term care.
Demand for services
The reablement service will accept people from all client groups including older people, mental health, physical disabilities, and learning disabilities, subject to the person having reablement potential.
We fund a fixed capacity reablement service. Where the service capacity has been exceeded, we look to use capacity from an alternative integrated prevention or discharge to assess service. Where demand exceeds the combined capacity of these, services will not be available and individuals will be offered an assessment for social care needs. People who are eligible for publicly funded care and support will have a subsequent review of needs within six weeks to establish whether the person will benefit from a reablement service.
Between 2016 and 2019 an average of 4740 people per annum received a reablement service.
Services we commission
As part of a strategic decision to deliver an integrated service with the NHS, the Council has commissioned the Midlands Partnership NHS Foundation Trust to deliver a reablement service under a service level agreement in place until 2020. However, to address ongoing capacity issues, in 2018 the Council’s wholly-owned home care service, Nexxus Care, was also directed to provide community reablement services. Through this approach both providers are offering community reablement, including step-up, step-down and maintenance-transition, from the NHS hospital trusts based in the county. We also utilise some step-down provision and pathways linked to hospitals in the Greater Birmingham area.
Outcomes from our reablement services compare well against the West Midlands Region and England. For the year 2017/18, 91% of older people (aged 65 and over) who were discharged from hospital into reablement services were still at home after 91 days. This is better than the West Midlands average of 80% and the England average of 83%.
We are working in partnership with all Staffordshire Clinical Commissioning Groups to implement and improve a discharge to assess model across the County which will determine what support people should receive based on their needs and service availability and make sure it is in place which means that people will have a more integrated service.
Further information is available in a printable PDF.
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