Reablement

Background: SCARF (Status, Certainty, Autonomy, Relatedness and Fairness) is a neuroscience model based on reward and threat that has been used in a number of areas, such as coaching and group facilitation including practice development, performance management and leadership development. Aim: The aim of this article is to understand readiness for transformation in the workplace by considering the impact of a new philosophy of care called 'reablement' on behaviour change in health services staff, using a modified SCARF questionnaire. Methods: The quantitative survey was nested in a larger health services project to introduce the philosophy of reablement to 166 staff members of a regional community care organisation. The data collection instrument was modified to combine the five SCARF domains into statements related to reablement. Data were collected from participants at six timepoints before and after project staff training. Results: The results show that for each SCARF domain, staff responses remain relatively stable. Results indicate a consistently positive response to the philosophy of reablement, reflecting a high level of comfort and engagement with the change-management process. Conclusion: Evaluating reflection and change over time using SCARF can support training and other methods of change management in the context of a community care organisation. Further development is needed with different groups, and different change-management projects within health services. Implications for practice: • The SCARF model can be applied to organisational change in health and community care with benefits for clients, staff, stakeholders and the organisation as a whole • This model has previously been used to improve organisational communication and collaboration but this article suggests it also has a positive impact on overall change management, with a particular focus on understanding the factors related to behaviour in health and community care

Reablement is described as a person-centred, goal-directed intervention with a view to regain, maintain or improve the independence of older clients. Although evidence to support the use of reablement as a multidisciplinary, home-based intervention for community-dwelling older adults is increasing, there is limited knowledge about what it means for care staff who provide client-based services. This study, which was nested in a larger program evaluation, used a descriptive qualitative approach to explore direct care staff and care coordinator experiences of translating a reable-ment training program into practice for older people in a regional Australian community. Two months after the training program four focus groups were conducted with 13 care coordinators to assimilate staff experiences with development of care plans, systems, processes and practices of reablement. In addition, four direct care staff took part in individual interviews, which centred on eliciting their experience using the reablement approach with clients. Results from the care coordinator focus groups and the direct care staff interviews highlight the importance of reablement staff training and the involvement of staff in the development and delivery of a reablement approach to client-centred care. A number of organisational and client-centred challenges such as communication, functional partnerships, staff education and resourcing are also uncovered in this research into the development of a reablement-focused care service in a regional setting. Overall there is support for the dominating discourse around healthy ageing and the policy approach of ageing in place to support wellness. K E Y W O R D S care coordinator, direct care worker, experience, health service research, independence, reablement, regional, social care