The Australian Government’s Better Ageing – Promoting Independent Living (PIL) budget measure allocated $29.2 million over two years to trial a number of reablement initiatives. The measure supported Regional Assessment Services (RAS) and Commonwealth Home Support Programme (CHSP) providers to deliver services that promote greater client independence - with the aim of reducing or delaying the need for more complex aged care support services.

The measure comprised a trial of a reablement model and a range of national complementary support strategies. The evaluation included:

• Assessment of the implementation, appropriateness, effectiveness and cost-effectiveness of the PIL reablement trial and of the national PIL complementary support strategies for the broader aged care sector.
• Consultations with stakeholders to obtain expert advice and feedback on the implementation, ongoing delivery and outcomes of the PIL reablement trial.

The Department appointed AHA to evaluate the PIL measure because of our extensive track record of evaluating programs in the aged care sector, and our ability to engage sensitively with people from diverse, vulnerable or ‘hard-to-reach’ population groups. Our two-year evaluation was completed in December 2020, and the final report is available on the Department’s website.

Our evaluation findings include:

• The trial model focused on active assessment, increased reablement opportunities and client follow-up – which is a substantial shift away from the traditional model of assessment. Despite the scale of this shift, the trial model was successfully embedded within the 5 RAS organisations that participated in the trial, and all saw considerable benefit from this new approach.
• Compared with the traditional model, the trial model is substantially better at identifying opportunities for client reablement. Rates of clients undergoing reablement increased from 13% at the commencement of the trial to 30% at the end of the trial – a significant achievement within 12 months.
• The trial demonstrated that active assessment is more appropriate, more effective at identifying reablement opportunities and is cost-neutral, compared with the traditional approach.

These findings are consistent with the 2021 Royal Commission into Aged Care Quality and Safety, which emphasised the importance of wellness and reablement (W&R) in aged care.

The following briefly describes:

• Wellness and Reablement (W&R) approaches to delivering aged care services
• The Commonwealth Home Support Program (CHSP).

WELLNESS AND REABLEMENT (W&R) APPROACHES TO DELIVERING AGED CARE SERVICES

As Australia’s population ages, the number and proportion of people needing care are increasing. Overall spending on aged care in Australia is forecast to grow to $22.1 billion in 2021–22.

The 2017 Legislated Review into Aged Care recommended that government and providers work together to strengthen W&R approaches when delivering aged care services.

Wellness is a broad approach that aims to promote independence by building on a client’s strengths and capability. Like wellness, reablement aims to promote a client’s independence, specifically through time-limited interventions that are targeted towards regaining confidence and the capacity to resume daily activities such as shopping.

Emerging evidence indicates that investment in W&R can slow the rate of functional decline in older people and reduce their dependence on longer-term and more costly services. Our evaluation provides evidence and insight to support the Department’s implementation of reablement approaches in aged care.

THE COMMONWEALTH HOME SUPPORT PROGRAM (CHSP)

The CHSP provides entry-level support services for frail, older people aged 65 years and older (or 50 years and older for Aboriginal and Torres Strait Islander people) who need assistance to keep living independently at home and in their community.

CHSP is underpinned by a ‘wellness approach’, which is about building on older people’s strengths, capacity and goals to help them remain independent and to live safely at home.

The Australian Government provides approximately $2.5 billion annually to 1,600 providers to deliver CHSP services to over 800,000 Australians.

CHSP services include domestic assistance, transport, home maintenance and modifications, meals, personal care, allied health and therapy, aids and equipment. Regional Assessment Services assess potential clients/carers’ eligibility to access CHSP services.

The key objective of CHSP services is to enable clients to remain living independently at home and in their community for as long as they can and wish to do so.