Using ICECAP capability measures to assess Adult Social Care service users’ wellbeing: a reablement services case study

Despite the 2014 Care Act's duty to improve wellbeing, it remains poorly conceptualised and operationalised in adult social care (ASC). ASC services lack experience and skills to routinely collect and analyse quality-of-life outcome data.

This poses a challenge considering the imperative that they move away from decision-making based on activity, cost, or capacity, toward an outcome-orientated approach. Reablement services support older people at home to regain independence.

Current variation in the delivery of local services, and widespread delays in access having detrimental consequences for hospital capacity, suggest opportunities for Reablement services to improve efficiency and user wellbeing.

Accordingly, Reablement is the case-study ASC service for this project to pilot the application of the ICECAP capability measures to promote the wellbeing of service-users.

Research question: What is the potential for ICECAP Capability measures to operationalise assessment of Adult Social Care Service-users' wellbeing? A Reablement services case study.

Aims and objectives: Develop methods for collecting ICECAP and other relevant service-user data at up to four Reablement service pilots.

Develop outcome-orientated analysis at the pilot sites to inform decision-making to improve service provision, drawing on co-production activities.

Produce an implementation framework for commissioners and service providers to support the collection and analysis of ICECAP and other data across ASC Reablement services.

Methods: Each stage of this project will be undertaken with the involvement of User and Public Involvement (UPI) representatives, including service users and carers from a Reablement service, and public contributors from NIHR ARC West.

Work package (WP) 1: Recruit up to four Reablement service pilots representing varied delivery models, and with UPI members and Reablement staff, develop and implement methods for staff to collect ICECAP, cost and user data at start and end of service, and 6-months post.

WP2: Undertake comparative analysis of users' wellbeing and service costs across the pilots using regression models, with a focus on 'vulnerable' users with low baseline ICECAP scores. Use co-production methods to develop further local analysis to inform local decision-making.

WP3: Apply constant comparative methods to analyse semi-structured interviews with a sample of service users, Reablement staff and commissioners to understand the value ICECAP-informed analysis to inform decision-making.

WP4: Coproduce implementation guidance for local authorities wishing to implement ICECAP data collection and analysis in Reablement services. Key milestones for delivery: Complete pilot site recruitment by month nine. Commence data collection by month six for first pilot site. Finalise data collection by month 26 for fourth pilot site.

Complete quantitative analysis by month 29. Complete qualitative analysis by month 32. Completion and thesis submission by month 36.

Anticipated impact: Services will benefit from a database of information on service users experience of quality-of-life, improving understanding and operationalisation in practice and to improve decision-making. National guidance supporting implementation of this approach to quality-of-life evaluation.

Empowering decision-makers to consider value for money when evaluating service provision. Dissemination: Implementation guidance disseminated through professional and academic networks. Workshops for relevant ASC audience. Conference presentations and journal articles to a wide audience.