One Housing – Reablement – integrating NHS, telecare, care and housing
“The reablement service at Roseberry Mansions embodies the aims of One Housing: we’re delivering better, more integrated and person-centred services, which also support the delivery of sustainable health and social care.
Telecare plays a significant role in helping us to get people out of hospital and back to the right home environment for them.”
Kevin Beirne, Group Director of Housing Care & Support, One Housing
The current operating environment across the social care and wider health economy is under increasing strain due to levels of presentations at A&E departments rising, as well as delayed discharge from hospitals placing growing pressure on bed availability and limiting patients’ recovery as they remain in hospital settings beyond the optimum time. Budgetary restraints within the health sector and Local Government has exacerbated the pressures further.
Reablement services support people to regain abilities and confidence that may have been reduced or lost through illness or disability, reducing ongoing care needs through sustaining independent living. How can including telecare in reablement services help to find the right balance between managing risks and enabling independence, improving patients’ recovery and delivering clinically safe services at a reduced cost?
Roseberry Mansions Reablement Service is a ten-unit service which provides intensive short term support and therapies to enable people who have been hospitalised to return home or to other appropriate long term accommodation.
The service is based within a purpose built extra care scheme in the heart of the Kings Cross regeneration area in London.
An onsite multi-disciplinary team (MDT) works collaboratively to provide a comprehensive reablement service to people for up to six weeks. The main aims of the service are to:
- Improve the quality of people’s lives by enabling and re-skilling them to be able to return home or to other appropriate accommodation in a sustainable way
- Facilitate earlier hospital discharge and avoid unnecessary or repetitive hospital admissions
- Prevent or delay the need for long term residential or nursing care placements
- Deliver significant NHS and adult social care savings
- 41 customers in 10-month period provided a real saving of £288,695 to NHS
- Forecast NHS saving £1.7m over five years
- Adult Social Care saving of £214,500 per person over five years
- Facilitates earlier discharge and avoids repetitive hospital admissions
- Integrates social care, housing and health
- Real alternative to acute hospital stay
- Reduces care home placement
- Delivers better health outcomes
One Housing and Camden Adult Social Care collaborated to gather quantitative and qualitative data throughout the first ten months of the service provision up to August 2014. 41 patients were assessed, including 33 who had left the service and 8 active users. Average length of stay was 41 days, just under the 6 week allocation.
As a result of the service:
- 72% of people returned home, or to other appropriate accommodation such as sheltered or extra care services
- 28% of those who returned home did so with a reduced care package
The service contributes to relieving the NHS’s bed-blocking problem by enabling patients to be discharged to an appropriate and constructive programme earlier than would have been otherwise possible. As well as the clear advantages for the NHS, the reablement service gives real quality back to customers’ lives by relieving negative anxieties and rebuilding skills and abilities for independent living.
The service also gives adult social care and other relevant agencies more time to carry out further assessments, for instance for aids and adaptations, that would otherwise be impossible before the customer returned home. This means the most informed and appropriate long term solution for the health and wellbeing of the customer can be determined and unnecessary hospital readmissions can be avoided.
The savings that Roseberry Mansions Reablement Service can deliver for both the social care budget and the NHS is difficult to effectively quantify due to a lack of a like-for-like comparator. However, the cohort involved in the evaluation of the service over a ten month period provided the NHS a saving of £288,695 alone, which extrapolates to a forecast saving of £1.7 million over five years. This does not take in to consideration efficiencies of the onsite team, the aversion of repeated hospital admissions, NHS discharge fees or other potential savings or efficiencies.
Therefore, it is reasonable to assume that the savings to the NHS would be considerably higher.
The cost benefits to adult social care of customers returning to their homes in a sustainable manner instead of a move to long term nursing care equates to £214,500 per person over five years. Importantly, the service provides a valuable and effective alternative to residential and care placements which are in such short supply, and supports people in the place they want to be.
Our Connected Care solutions have been designed to support a wide range of people, including older people, people at risk of falls, people with limited mobility, people with learning disabilities, people with dementia and people with conditions such as epilepsy