Reable-M

Selecting reablement models that best support people leaving hospital after an unplanned admission (Reable-M)

In England, policies to improve hospital discharge processes have been introduced to reduce high hospital occupancy and delays to people returning home from hospital. Reablement can help people transition home and resume their usual activities after a hospital stay for illness or injury. Models of reablement can differ considerably in scope - from an exclusive focus on basic activities of daily living to addressing a range of everyday and social participation activities. These models can feature different types of staffing - ranging from multidisciplinary teams to teams wholly staffed by support workers. However, there are widespread differences in models of reablement provision and more robust evidence on the outcomes of these different models of provision is needed.

Introduction

The REABLE-M Project seeks to develop an evidence base on the effectiveness of these different reablement models.

Reablement has been around for over a decade, but we are unsure how well it works. We do not know if it works better for some people than others and why, or if the length of time people have support makes a difference. We also do not know much about the type of training that reablement workers get and whether this makes a difference to the experiences and outcomes of the people they are working with.

We want to find out which models of reablement help people the most when they leave hospital.

Helping people to leave hospital and get back to their daily lives is an important goal for health and social care services. ‘Reablement’ has been part of the mix of back-to-home services for a while now, but we still don’t know as much as we’d like about why it works and for whom, and what kind of training is available for staff and the impact of that on people using reablement services. So in this study we’ll be looking at which types, or models, of reablement are best able to help people leave hospital, by talking to a range of people using and providing reablement services, and to community organisations supporting people leaving hospital.

Aims

The study will evaluate which model or models of reablement are associated with better outcomes for people leaving acute hospital.

Methods

The REABLE-M study uses a mixed-methods approach which first involves a feasibility study where we will conduct research in 5 council areas to test a questionnaire on outcomes for participants and their carers, and explore whether councils are able to provide social care data to link to questionnaire data, and examine what are helps people to participate in the research.

Following that, we will delve into the models and experiences of reablement through two qualitative studies in the 5 areas:

• Looking at how reablement teams in the 5 sites are organised and what models are being used,
• Looking at experiences of reablement from different perspectives – people currently using reablement and their carers, community advocacy organisations representing groups of people who are most likely to use reablement, and groups who may have difficulties accessing or engaging with reablement.

This part of the study will run over 16 months.

If feasible, we will then proceed with a large-scale survey in 8 areas (5 previously and 3 newly recruited sites). We will survey people using different models of reablement collecting outcome measures from participants and linking these with care records data. We will investigate the effectiveness and cost-effectiveness of the four models of reablement using a large dataset of outcomes collected from reablement users, linked to administrative care records from the areas.

The whole study will run over 36 months in total.

Further project information

Dates: March 2024 - Febuary 2027

Funder: NIHR

Princpal investagtor: Catherine Henderson

Research team:

Contact: