Integrated Service: Rehabilitation and Reablement Consultation
Frequently Asked Questions
- What are rehabilitation and reablementservices about?
Rehabilitation is a treatment a person undergoes to recover from injury, illness or disease to help them regain as much independence as is possible. It can be about learning to walk again, using the stairs and staying active. Reablement is about helping someone regain daily living skills and the ability to better manage any ongoing illness or long-term health condition after an acute period of ill health. For instance, it can be about re-learning how to cook, taking care of oneself, having confidence to go out and to manage own medication.
- What is the Better Care Plan?
The Southampton Better Care Plan was developed by Southampton City Council and Southampton City Clinical Commissioning Group (CCG) as a part of the Better Care Fund – a government programme encouraging local authorities and health services to join up their work. Its aim is to deliver a seamless and integrated service to everyone. It has a strong focus on prevention and early intervention, and putting individuals at the centre of decisions about their care.
- Is this not about cutting back on services and saving money?
No. This preferred Option is about cutting out inefficiencies and duplication, so that the amount of money we have allocated for rehabilitation and reablement in the city will stay the same, but invested differently, to ensure that we focus on keeping people as independent as possible within their own homes and communities. Some small savings are possible, but all monies associated with rehabilitation and reablement will be reinvested on community-based provision.
- Why does the council have to be careful with its budget?
The money we get from the central government has been significantly reduced and will continue to be reduced in future years. Prices and demand for some of our services - especially the more expensive services for vulnerable older and young people - are increasing. This means that we have less money to meet higher demand, and we need to use our resources differently to make sure that everyone gets the help they need.
- Why don’t you just improve the hospital discharge and keep the Brownhill House services open?
This action would not achieve all the outcomes we want for clients/patients and would not meet our commitments in the Southampton Better Care Plan. We want to make sure that people have an improved experience of services across the whole health and social care system, and have the best opportunity to achieve their outcomes.
- What plans have you put in place for people who use Brownhill House regularly?
Southampton City Council work with over 50 residential care providers who are able to accommodate around 90 placements on a daily basis, including emergencies. Brownhill House has a small number of regular users, and the current system can offer suitable alternatives, so that people’s care is unaffected.
The people who use the Day Services will continue to use Brownhill House until Southampton Care Association and the City Council identify a suitable alternative building.
7 What alternatives are available for people in need of rehabilitation and reablement services, and respite care?
Rehabilitation and reablement staff will be able to provide more support to people in their own homes. We have a new Domiciliary Care Contract with a wide range of Providers, and this again will enable support to be provided in people’s own homes.
Voluntary and Community Sector organisations will be working closely with health, social care and Providers to help give additional support to people before, during and after a hospital stay to aid their rehabilitation and reablement. We have, and will be increasing our resources of Extra Care Housing in the city. Our staff who work in Supported Housing will continue to work closely with colleagues across health and social care to help people stay independent for as long as possible in their homes. People will also have an option to use residential care based in their local community for a short-term stay.
8Will there be any impact on jobs?
If a decision is made to implement our preferred Option, this would lead to a reduction of potentially 41 Full Time Equivalent (FTE) postsat Brownhill House. However staff from SCC, Solent NHS Trust, University Hospital Service and Southampton City Clinical Commissioning Group are working together to identify opportunities for redeployment to minimise the risk of staff redundancies.
9What will happen to the day centre operating from Brownhill House?
The day centre will continue as usual. We are currently working on identifying another building it can operate from. This service’s budget will stay the same.
10How are you going to try to reduce the impact of the proposals?
The council understands that there will be a number of people across the city that will be affected by these proposals. An initial Equality and Safety Impact Assessment (ESIA) has been carried outfor the preferred Option to fully assess the impact of the proposed changes. The ESIA is available here: The City Council will take all reasonable steps tominimise any impact identified so far, and to also minimise any further new impacts identified during the course of this consultation.
11Have you made a decision already?
No. We are consulting on the preferred Option. We will give careful consideration to all viable proposals resulting from this consultation and we will look at the ways these could be taken forward.
12When would any agreed changes be implemented?
A decision on the final way forward will be made by Cabinet in early 2016, takinginto account the results of this consultation and the Equality Impact and Safety Assessment.
13Why has the take-up of Beds at Brownhill House been so low?
There are several potential reasons.
The general complexity of patients staying in hospital has increased, therefore people that are discharged but needing rehabilitation services are more likely to have health needs as well. Brownhill House is not staffed to provide health care.
The range of equipment available to support people at home with rehabilitation or reablement needs is improving all the time, so more people can be supported at home.
An increasing range of respite services are available and people are exercising their choice and preference.
The lower take up may not have been identified earlier as beds have also been used to provide support for other situations e.g. hospital “black alert” when additional beds are required quickly.
14Why not just improve the admission criteria for Brownhill House and include medical support in the services?
Brownhill House is registered with the Care Quality Commission (CQC) as a residential Care Home, and not as a Nursing Home able to offer health care. In addition, the building is not an accessible environment and not suitable for the disability equipment to support a range of health needs as well.
15How will the money that is released from Brownhill House be used?
To support the delivery of Rehabilitation and Reablement services in a different way, focussing on the individual in their community. The proposal seeks to substantially increase the level of home based reablement, flexible extra care housing, and the range of residential and nursing home choices.
16What is the consultation focused on?
We are consulting on changing how and where the health, care and support services associated with a stay in hospital (before and after) are provided. These services are often called rehabilitation and reablement services.
17Are there plans to cut respite care provision?
There are no plans for cutting replacement (respite) care provision as part of these proposals.Even if Cabinet decides that Brownhill House is no longer required for bed-based reablement care then the respite provision currently provided would be secured from suitable alternatives.A Review of Respite Services across the city is being undertaken.
18Are there plans to cut care posts?
Although there may be a reduction in the number of council care posts, no one will be forced to take redundancy as there is adequate capacity in the local NHS and social care system to offer staff options for redeployment.
19Why is a service review required for this Rehabilitation and Reablement?
We know that the current city wide service provision is not efficient and effective and so we need to make better use of our resources (staff and money). For example we presently have separate teams for Rehabilitation and Reablement across a range of different locations, and some services have high demand and others are underused. We want to improve people’s experience of care and the outcomes they achieve through transforming the way our care is provided.
20What do the proposals cover?
The proposals outline a new service that puts the patient’s needs first and creates a unified and streamlined service which focuses underused resources on supporting more people to receive the care they require in their own homes. At the core of the proposals is the principle that people are best supported to regain or maintain their independence within their own home or place of residence, as opposed to a hospital environment.
We will be updating the Frequently Asked Questions pages throughout the consultation. If you feel that your question is not listed here or if you would like to see the latest version of this document, please visit the consultation website:
Glossary:
Respite careis a way of giving carers a break, by providing short-term support to the person with care needs in their own home, or in a residential setting like Brownhill House.
Domiciliary Careis care provided in your own home by paid care workers.
Supported Housingis Sheltered Housing, or retirement housing, where people receive help to manage day-to day while living in their own home.
Extra Care Housing is an option if living alone at home is difficult, but people do not wish to go to residential care. It means they still have their own home, either rented or owned, but with personal care and domestic help readily available.