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Dudley Council
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Living independently service/reablement

Sometimes you may require short term support to help you regain your independence. Our free, short term service is here to help adults to regain or maximise their independence to enable them to continue to live at home.

You might contact us yourself or on behalf of a friend or family member who may be finding it hard to cope at home.

Our team is made up of social workers, occupational therapists, nurses, physiotherapists and rehabilitation workers.

You might need our support because you:

  • are returning home after a period in hospital or residential care
  • have new physical disabilities
  • are recovering from a period of illness
  • need some support to remain living in your home
  • want to regain daily living skills and confidence to live independently

Residential intermediate care

This is a placement within a 24-hour care setting and is generally for people who have experienced a crisis at home which has resulted in them needing further support following a hospital admission, or to avoid a hospital admission. 

The length of stay is determined by the individual needs and the aim is to offer a reablement service based on those needs.

An assessment will be completed by the Dudley Integrated Health Care Team to determine if this service is suitable for that individual prior to admission. 

There is no charge for this service.

Coming to an end of a stay in hospital

If you need further support at home following a stay in hospital, before discharge and whilst you are still in hospital, patients and/or carers should ask the ward staff to contact the Access Team.

You will then be referred to the hospital social work team who will work closely with the Dudley Group of Hospitals, patients and/or their carers offering support, advice, and guidance.

The team will assess your needs and either provide you with the appropriate advice and information or refer you to the appropriate discharge pathway dependent on current care and support needs. 

  • Pathway 1 is a discharge home with a package of care in place
  • Pathway 3 is a discharge to assess bed within a residential or nursing home to assess your ongoing care needs

If you require further rehabilitation in a bedded facility, you will be referred to the Integrated Care Board, who assess for these beds; these are referred to as Pathway 2.

Living Independently

This is information that outlines the short-term intermediate care or reablement service that is available from Dudley Council.

What is Living Independently?

Living Independently is a free service, available for up to six weeks, for adults who need help regaining or maximising their independence to enable them to continue living in their own homes. The service is also sometimes known as reablement, rehabilitation, or intermediate care at home.

Reablement is an intensive service using a ‘doing with’ approach, which involves supporting you to do things for yourself. Reablement workers stand back to encourage and allow you the time to complete a task on your own. This may involve being shown a different way to carry out the task to achieve independence.

The service can help you to regain your independence, perhaps following a period of illness, or to maximise it if you are struggling with living independently at home. You might need support from the service because you:

  • are returning home after a period in hospital or residential care
  • have new physical disabilities
  • are recovering from a period of illness
  • need some support to remain living in your home
  • want to regain daily living skills and the confidence to live independently

The Living Independently team is made up of social workers, occupational therapists, physiotherapists, assistant care coordinators and rehabilitation support workers. You will be contacted by a member of the team to complete an assessment of your needs. From this, together we will develop a care plan which will aim to help you become independent. The plan will be tailored to your needs, your abilities, and goals that we will agree with you – exactly what you want to achieve from the service.

Who can use the service?

The service is for adults aged 18 and over who live in Dudley Borough and who are felt to be at risk of losing their independence.

A needs assessment for the service will take place to decide if you are eligible for it. If you do not qualify for support from the Living Independently service, then we can still provide you with information and advice about preventative and community-based services that can help you stay independent and prevent your situation from worsening.

How long will the service be provided for?

The service provides short term intensive support, lasting up to a maximum of six weeks. Generally, the length that the service is provided for depends upon individual needs. You will be encouraged to set regular goals and review your progress along the way, with the support of our staff. Often people regain their independence within a few short weeks, and we will work with you and family members or carers to achieve your goals as soon as is practically possible.

What kind of support will be provided?

For some people it could be encouraging with personal care or to prepare meals, while others may need help to get out of the house and get involved in social activities. Some people may benefit from having telecare home alarms installed in their home, adaptations to their home, or other assistive technology to support in living independently as possible, while others may find occupational therapy or physiotherapy useful. Whatever your needs our staff will work with you to design a service that works best for you.

We offer a flexible service to suit your needs, the aim being to help you to regain your confidence and independence, to enable you to do things for yourself again.

Is the service available in a residential setting?

We offer a linked service in our residential homes for people who have experienced a crisis at home which has resulted them needing further support. This could be following a hospital admission or to avoid the person being admitted into hospital. 

An assessment of need will be completed prior to admission into this service. 

The aim of this service is to offer a reablement service based on the individual’s needs, therefore the length of stay is determined by the needs of the individual.  Here we will assist you to return to living safely in your home. There is no charge for this service.

What happens at the end of the service?

At the end of the service, your needs will be reviewed and hopefully you will have regained your confidence to live independently at home. Our aim is that the intensive short-term support provided will result in you being able to continue living independently. Most people who have used the service are able to regain their independence.

If you still have some longer-term care and support needs after the service has ended, then we will arrange for a reassessment by another team. Following this, your long-term support will be planned and put into place. This will include a financial assessment to work out if we can make a contribution to the cost of your support. If this is the case you will be allocated a personal budget which you can spend as you choose, to meet your agreed long term care needs.

Further information

For further information please contact our access to adult social care helpline:

Telephone 0300 555 0055 (Monday to Friday - 9am to 5pm)

An emergency duty team is available on 0300 555 8574 at all other times



Post: Brierley Hill Health & Social Care Centre Venture Way, Brierley Hill, DY5 1RU

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