REABLEMENT FEATURE
At the beginning of this year , in the UK ’ s third lockdown , a new service was launched within Norfolk County Council , called Norfolk First Support . It is part of a first response team that provides a period of support and reablement for people in their own homes for up to six weeks .
Prior to occupational therapy input the service consisted of reablement liaison co-ordinators who organise the provision of care , reablement practitioners who would assess the level of support required , and reablement support workers who carried out this support in individuals ’ homes .
A pilot study conducted in South Norfolk identified that the implementation of occupational therapists within Norfolk First Support helped : the identification of reablement goals ; increased problem solving ; prevention of ongoing care packages ; reduction of ongoing therapy referrals to health and social care ; and greater service user outcomes .
As a result of the pilot study , the new Norfolk First Support occupational therapy service has been implemented county wide . The main aims of the service are : to support the reablement practitioners to develop reablement plans ; identify reablement goals in coalition with service users , with the larger aim of preventing , reducing and delaying ( Care Act 2014 ) the need for ongoing support ; and maximising independence .
The Norfolk First Support occupational therapy team has an assessment form that uses the Morriston Occupational Therapy Outcome Measure ( MOTOM ) ( 1994 and 2004 ). The MOTOM aims to identify a change in the service user ’ s ability ( James and Coor 2004 ).
This is a working document , allowing the therapist to fully understand the service user , including their strengths , what they find meaningful and the current challenges that are preventing them from being independent .
This then generates collaborative goal setting , ensuring these are in the SMART formula ( specific , measurable , attainable , realistic and timely ) ( Doran et al 1981 ).
This holistic assessment form also applies a pre- and a postintervention rating , allowing the service user to see the marked changes in their occupational performance . Various occupational therapy interventions can then be employed , such as education , installation of equipment , activity analysis , grading , environmental modifications , motivational interviewing , moving and handling techniques and ongoing referrals to teams such as assistive technology .
So far , feedback from both service users , their friends and family members have highlighted the usefulness of the service .
One person commented : ‘ Bea is an exceptionally professional occupational therapist , she was completely honest and reliable for us . Without her exceptional dedication and knowledge we would not be in the position we are in today … the equipment that she has supplied has made both our lives a lot less stressful and enabled both of us to move forward .’
Another said : ‘ I would like to thank you for your many visits and suggestions as to how I could improve my health and get more mobile . It was always helpful to talk about the various pieces of equipment that were available and to decide which would be best . All in all , I have nothing but praise for all your help .’
The reablement practitioners and support workers within Norfolk First Support have also found that the introduction of occupational therapists within their team has enabled quicker responses for their service users , with one stating : ‘ I feel having you on board will be an enhancement to the great Norfolk First Support service .’
Another fed back : ‘ This has been great for me , as usually we refer the service user to the occupational therapy team never to hear anymore , due to being on different systems .’
Equally , feedback from members of the occupational therapy team have also described this reablement process as highly rewarding and have found that we have been able to develop practice as occupational therapists that has led to increased job satisfaction within the team .
Although starting a new service within a global pandemic has not been without its challenges , the team has found the use of technology such as Microsoft Teams invaluable . In fact , this technology has allowed the team to be able to communicate daily with a ‘ virtual office ’ and due to working in different localities this has promoted communication when this may not have been possible pre-pandemic .
Equally , virtual working has allowed the team more opportunities to attend training and continue professional development .
Reablement is not a new concept , however research shows that it is not always clearly defined and equally the parameters of reablement can change depending on location ( Clotworthy et al , 2021 ).
This is an exciting and key area that occupational therapists can get involved in , due to the natural skillset that the profession obtains . We know from practice guidelines and recent research that this is a growing area of importance for many reasons , including the potential cost savings that the service provides .
In addition , this service reflects Norfolk County Council ’ s living well philosophy , which is the vision to support people to be independent , resilient and well . Not only does this benefit funding and the structural organisation of services , but this reablement service can also have a profound impact on quality of life for service users .
References
James S and Coor S ( 2004 ) The Morriston Occupational Therapy Outcome Measure ( MOTOM ): Measuring What Matters . British Journal of Occupational Therapy [ online ] 67 ( 5 ) 210-216 [ accessed 15 June 2021 ] Available from : https :// doi . org / 10.1177 / 030802260406700504
Doran G , Miller A and Cunningham J ( 1981 ) There ’ s a S . M . A . R . T way to write management goals and objectives . Management Review . 70 , 35-36 .
Clotworthy A , Kusumastuti S and Westendorp RGJ ( 2021 ) Reablement through time and space : a scoping review of how the concept of ‘ reablement ’ for older people has been defined and operationalised . BMC Geriatrics [ online ] 21 ( 61 ) 1-16 [ accessed 1 June 2021 ] Available from : https :// doi . org / 10.1186 / s12877-020-01958-1
Sophie Tooke , reablement occupational therapist , Norfolk First Support , Norfolk County Council , email : sophie . tooke @ norfolk . gov . uk
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