Hertfordshire County Council strengthened its reablement approach by creating a dedicated Enablement Team, using OT-led triage and targeted interventions to help people regain independence and reduce reliance on long-term care.
Overview
Hertfordshire County Council had previously sought to embed a reablement ethos in care provision by placing occupational therapists (OTs) within generic teams, largely managed by social work qualified managers. This approach had delivered limited progress, and the expected benefits did not fully materialise. The Council therefore decided to take a new approach, creating a dedicated Enablement Team.
Action
In the Enablement Team, OTs triage reablement referrals and identify people who would benefit from OT input that may not have been picked up through Care Act assessment routes. This prevention and enablement focused model was reinforced by OT leadership at senior level, including a redesigned “front door” to Adult Care Services and investment in additional OT and assistant roles within this service.
Building on this foundation, Hertfordshire County Council launched the Connect and Prevent Development Programme to strengthen prevention, maximise independence and support the long-term sustainability of adult social care. The programme aims to reduce reliance on long-term commissioned care by ensuring people receive timely, strengths-based interventions that help them regain skills, confidence and independence, while making best use of workforce capacity and resources. One of its five workstreams, Effective Enablement, focuses on increasing throughput, improving the effectiveness of reablement interventions and creating sustainable service capacity to meet growing demand. As part of this work, an Enablement App is being trialled to improve visibility of goals and progress, speed up reviews and support timely step-downs.
Outcomes
In the first year (2017-18) the Enablement Team saved £800,000 or 40,490 home care hours, in addition to savings related to people returning home from short stay residential beds.
Early monitoring from the Connect and Prevent Enablement App trial indicates quicker review and decision-making, earlier reduction or cessation of care where appropriate, and more timely escalation to mainstream services when reablement is not suitable. Positive outcomes have been achieved through targeted OT and OT Assistant intervention, demonstrating the value of early, proportionate support. These emerging outcomes indicate that the approach has real potential to further strengthen independence, improve service efficiency and contribute to a more responsive and sustainable model of prevention-focused adult social care.
Peer to Contact
Laura Owers, Principal Occupational Therapist and Head of Adult Care Services Learning and Development, Hertfordshire County Council Adult Care Services: [email protected].