Reablement

Occupational therapists are the only AHP working in significant numbers in social service organisations

Disabled service users are supported to access and remain in their own homes. Occupational therapists work with them to adapt their environment in order that they can carry out their chosen activities safely in their own homes thus reducing the need for complex and costly care packages or admission to residential care (DH 2008).
 
Occupational therapists deal with between 35-45% of local authority referrals and yet only make up 2% of the workforce (DH 2008). This in itself shows considerable throughput. Occupational therapists in social care promote enablement and personalisation and assist disabled people by:

• assessing, providing and securing funding for equipment and adaptations to remove environmental barriers in the home (DH 2008)
• providing home safety checks (DH 2008)
• reviewing care packages (COT 2008)
• assessing and problem solving manual handling situations (DH 2008)
• delivering reablement services

 
Realising the potential’ (COT/ADSS 2003) outlined the core skills of occupational therapists and stated that occupational therapists within social care services are in a ‘unique position…to respond to individual needs through rehabilitation programmes which focus on improving people’s abilities and assisting in engaging in the wider community through purposeful activities or leisure or vocational rehabilitation’.
 

Cost benefits of occupational therapy

Occupational therapists who have review care packages have produced substantial savings. In 50% of cases reviewed, the care package was removed. In the remainder of cases the care package was significantly reduced (Riverside Community Health care NHS Trust 1998). One authority where occupational therapists reviewed 85 service users’ care packages; savings equaled £170,000. Through this process occupational therapists have also met service user goals and encouraged greater engagement with the local community.
 
A study that explored the relationship between provision of equipment and reduction on care package costs and residential care found that over an eight week period; cost savings to care packages through provision of equipment were over £60,000 (Hill. S (2007).
 
Housing adaptations reduce the need for daily visits and reduce or remove costs for home care (savings range from £1,200 to £29,000 a year) (Heywood et al.2007).
 
Through providing additional moving and handling equipment; occupational therapists have reduced the need for two carers to assist with personal care needs. In Somerset, of the 125 services users who were assessed; 37% (46) of them are now only assisted by one carer (instead of two), with savings of £270,000 achieved. Average initial investment in equipment £763 per service user. (Somerset Council report on reduction of double handling as reported in OTN April 2010).
 
It is estimated that just one year’s delay in providing an adaptation to an older person costs up to £4,000 in extra home care costs (Care and Repair England 2010).
 
Postponing entry into residential care by just one year through adapting peoples home saves £28,080 per person (Laing and Buisson,2008)
 
Norfolk County Councils reablement scheme led by occupational therapists found that care hours were reduced for those going on to longer term care by 90% (Allen K 2010). 
 
Download Occupational Therapists Contribute to Reablement and Positive Outcomes for Service Users of Social Care
 
References
Allen K et al (2010) 'The billion dollar question': embedding prevention in older people's services - 10 ‘high impact’ changes. A paper from Health Services Management Centre, University of Birmingham.
 
College of Occupational Therapists (2008) Position Statement: The value of occupational therapy and its contribution to adult social service users and their carers, COT, London
 
Department of Health. (2008) Occupational Therapy in Adult Social Care in England: Sustaining a high quality workforce for the future
 
Heywood F and Turner L (2007) Better outcomes, lower costs: Implications for health and social care budgets of investment in housing adaptations, improvements and equipment: a review of the evidence. London: Her Majesty's Stationery Office
 
Somerset County Council (2009) project carried out by OTs investigated the prospect to substitute equipment for domiciliary carers assisting services users in their home (there were 2 carers assisting 1 service user). Held at COT Riverside Community Health Care NHS Trust (1998) The Victoria Project: community occupational therapy rehabilitation service: research findings and recommendations. London: Riverside Community Health Care NHS Trust.