Enablement & Intermediate Care Services

Care at Home Services work closely with the NHS and Social Services to provide homecare support following illness, injury or a period in hospital.

Enablement

Also known as Reablement, the aim of this service is to provide a progressive schedule of care to improve the confidence and regain the personal independence of the patient.  Care at Home Services offers this service from any of its locations in East Sussex and Kent.

Rather than just providing care, our specialist staff encourages the service user to do more things for themselves for the duration of the period of care.  This normally involves a tapered care process starting with a higher level of support in the first 1-2 weeks, reducing to a minimum level of support in the final week. In many cases the service user may opt to stop having care if they feel it is no longer necessary, thereby reducing the burden of cost to the funder.

We can do this by explaining the enablement process and discussing and agreeing the personalised care plan with the service user and setting basic outcomes which demonstrate progress towards full independence.  A weekly review is undertaken with the service user with a Care at Home Supervisor to monitor the outcomes and amend the following week’s care plan to a lower level, either by reducing the number of visits or reducing the duration of the visit.

The enablement care service often covers therapeutic support such as gentle exercise routines or support with treatments recommended by the Occupational Therapist or GP.  It may also include monitoring nutrition, medication, fluid intake, temperature, blood pressure, application of topical creams, massage etc. in support of the healthcare team. Our staff will work with the healthcare team to be trained on the procedures for these tasks.

Where progress is not meeting outcome expectations, a review will normally be held with the care manager to re-assess the service user to modify the care and support package for intermediate care, continuing care or ongoing local authority funded homecare.

After the first 1-2 weeks, enablement support generally becomes more flexible and is not normally based on rigid visit times unless there is a medical need e.g. diabetes.

Intermediate Care

Intermediate Care differs considerably from enablement in that it is not assumed there will be progressive improvements in independence for the duration of the care period. The personalised care plan would not normally have specific outcome objectives apart from those set in the universal assessment agreed by the hospital. Intermediate Care normally works on a fixed programme of support for the duration at specific times and with less flexibility than enablement.

Service users who have previously received ongoing domiciliary care prior to hospital admission and are very likely to require ongoing care at the end of the 4-6 week period, would not normally be considered for an enablement programme. Steps would be taken to start planning for a follow-on domiciliary care package 2 weeks before the end of the intermediate care programme.

The intermediate care service often covers therapeutic support such as gentle exercise routines or support with treatments recommended by the Occupational Therapist or GP.  It may also include monitoring nutrition, medication, fluid intake, pulse, temperature, blood pressure, application of topical creams, massage etc. in support of the healthcare team. Our staff would work with the healthcare team to be trained on the procedures for these tasks.

Rapid Response

Whichever approach is selected by the care manager, Care at Home Services can provide enablement support or intermediate care on a rapid response basis. Subject to availability, experienced care staff with risk assessment training can start on the care package at short notice, subject to a full care plan assessment being carried out within 24 hours of the start time.

If the service user has no family members living locally or anyone who can attend to their needs when they return home from hospital, arrangements can be made by the care staff to ensure that there are some basic food items available at home. Care staff can do shopping as part of the support programme.

Private Services

These services can also be provided privately to patients returning home from private hospital treatment and may also be claimed on private health insurance.