Improving lives for people with sight loss 1 Visual impairment rehabilitation in the context of...

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Improving lives for people with sight loss

Visual impairment rehabilitation in the context of personalisation

and the core offer

Jenny Pearce – CEO, Vista

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What the session will cover

Background – Local authority survey 2010 Reablement as an early intervention Rehabilitation within personalisation

framework & as part of core offer Prioritising need in the context of Putting

People First The way forward for rehabilitation.

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Survey of local authorities

How was visual impairment rehabilitation viewed within personalisation framework? Lack of clarity Inconsistent interpretation Lack of understanding of the specialist role of

VI rehabilitation Inflexible interpretation of reablement as a

standard 6 week model.

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Findings

Rehabilitation often viewed as standard 6 week model, & personal budget if required. Results: money not spent on early interventions longer term needs not addressed adequately more expensive over time more disabling approach – does not enable

inclusion and independence.

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Early intervention and prevention

Support to recover from the effects of illness Help to manage a long term condition,

including help to safely maintain home and garden

Training to get a job or return to work; support to start taking exercise.

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Transformation agenda - reminder

Universal services Early intervention and

prevention Choice and control Social capital

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Reablement

A specific form of early intervention Active process of helping an individual to

regain skills, confidence and independence, following a change in circumstances, or specific period of illness or injury

Usually provided as time-limited, intensive programmes of intervention and may involve use of specialist equipment or technology

Major preventative role.

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Rehabilitation…

…within the personalisation framework Is rehabilitation a kind of reablement or

something completely different? Does it matter? Why?

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Rehabilitation…

…as part of the Core Offer Rehabilitation is a long-term process borne

out of a long-term condition: emotional support daily living skills mobility training communication.

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The difference…

Rehabilitation involves longer term intervention – and possibly recurrent intervention over time

but … Early intervention and prevention are

fundamental characteristics – rehabilitation needs to be essential part of any primary response to sight loss.

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Does it matter?

Of course it does! Longer term intervention is needed to enable :

confidence building mobility training learning new communication techniques etc

A time limited 6 week package is likely to fail to deliver and thus to fail the person with sight loss.

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Different perspective on reablement

Reablement should be viewed as an umbrella term for a range of interventions that meet the broad criteria – intensive, time limited but not time prescribed interventions that help an individual to regain skills, confidence and independence, following a change in circumstances, or specific period of illness or injury.

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Rehabilitation under a reablement umbrella

Flexibility around time frames A form of early intervention and prevention Essential and central part of the

personalisation framework for people with sight loss

Its essential value as part of the core offer must be proactively defended.

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Policy context…

‘Prioritising need in the context of Putting People First: A whole system approach to eligibility for social care’

Guidance on Eligibility Criteria for Adult Social Care, England 2010

Local authorities exhorted to focus on outcomes and invest in early intervention and prevention, rather than just ratcheting up the bar of eligibility criteria

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Policy context…

“councils should consider the needs of their wider population and put into place support strategies to reduce the number of people entering the social care system in the first place. Before proceeding to determine eligible needs, councils should consider whether an individual might benefit from a short period of re-ablement or intermediate care to increase what they are able to do for themselves before an assessment of longer-term need is undertaken”.

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Policy context…

“The most effective community support systems will be ones in which all citizens can expect some level of support and those with the greatest needs can access additional help”.

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Eligibility needs in the context of the environment

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Levels of need identified

Presenting needs Eligible needs.

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The ‘Putting People First’ approach

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The way forward for rehabilitation

Rehabilitation clarified as a distinct reablement intervention – stressing the difference but always remembering the umbrella! (time limited but not time prescribed)

Clear targets for measurable outcomes - evidence of the effectiveness of rehabilitative interventions

Rehabilitation recognised as an essential intervention – early intervention and prevention.

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Maximise the opportunity

Evidence based practice Responses to specialist needs, eg dementia,

dual sensory loss Technological advances – computers,

assistive technology A valued qualification Excellent standards of practice.

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And …

The UK Vision Strategy highlights the importance of rehabilitation as essential part of the eye care pathway

Rehabilitation clearly rooted within personalisation framework as part of the Core Offer.

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Visual impairment rehabilitation in the context of personalisation

A great opportunity for effective early intervention

Part of the range of reablement approaches

but not… Restricted by a ‘one size fits all’ approach.

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Contacts

Jenny Pearce, Vista (Visionary representative)

[email protected]

Simon Labbett, SCA Rehabilitation Workers Consultative [email protected]

Carl Freeman, Guide [email protected]

Improving lives for people with sight loss 1 Visual impairment rehabilitation in the context of...

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