Balancing Independence and Ongoing Support in Acquired Brain Injury Reablement
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In acquired brain injury reablement, independence is sometimes misunderstood as complete self-sufficiency. In reality, many people with ABI require ongoing, proportionate support to sustain independence safely. Commissioners and inspectors expect providers to balance independence with safeguarding rather than pursuing unrealistic withdrawal of support.
This article examines how ABI services can balance independence and ongoing support. It should be read alongside Positive Risk-Taking & Risk Enablement and Workforce, Skill Mix & Practice Competence.
Redefining independence in ABI
Independence often involves supported decision-making rather than doing everything alone.
Commissioner and inspector expectations
Expectation 1: Proportionate support. Commissioners expect support to reflect individual need, not arbitrary targets.
Expectation 2: Safeguarding assurance. Inspectors expect independence to be balanced with risk management.
Operational example 1: Flexible support levels
A provider adjusted staffing levels based on confidence and risk rather than rigid schedules.
Supporting independence with safety nets
Contingency planning is essential.
Operational example 2: Independence with escalation plans
Individuals were supported to act independently with clear escalation routes if needed.
Reviewing the balance over time
The balance between independence and support must be revisited regularly.
Operational example 3: Graduated independence reviews
Support was increased or reduced following structured independence reviews.
Evidencing balanced practice
Providers should evidence:
- Flexible support models
- Risk-aware independence planning
- Clear review and escalation processes
Why balance underpins sustainable reablement
Balanced support enables independence without compromising safety or dignity.
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- ⚡ 48-Hour Tender Triage
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