Adaptations
What is an adaptation?
- The purpose of an adaptation is to modify disabling environments in order to restore or enable independent living, privacy, confidence and dignity for individuals and their families. In practical terms this involves a physical, structural modification to a disabled resident’s home such as the removal of a bath and the provision of a level access shower or the installation of a stairlift.
Statutory Duties
2. The principal legislation for Social Care is the Chronically Sick & Disabled Person’s Act 1970. This places a duty on social services authorities to arrange practical assistance in the home and any works of adaptation or the provision of additional facilities designed to secure greater safety, comfort or convenience.
3. This has a far-reaching impact on adaptations as it means social services authorities have a duty to ensure that the assistance required by disabled people is secured. This includes where the help needed goes beyond what is available through a Disabled Facilities Grant (DFG). In these circumstances Social Care may award a Top-up grant to enable the work to proceed.
4. Since 1990, local housing authorities have been under a statutory duty to provide grant aid to disabled people (subject to a test of the applicant's resources) for a range of adaptations to their homes. This grant aid is given in the form of a Disabled Facilities Grants, as prescribed by the Housing Grants, Construction and Regeneration Act 1996.
5. The duty to provide grant aid extends to the tenants of Registered Social Landlord (RSL) properties. As part of the transfer agreement, Erimus Housing must fund the first £500K of any adaptations required to their stock each financial year before directing their tenants to apply for a DFG. All other RSLs are asked if they can fund the cost of the required adaptation before a DFG is progressed. The Government proposes to give RSLs greater responsibility in this regard in future legislation.
Role of Occupational Therapists (OTs)
6. Occupational Therapists have a thorough understanding of disabling conditions and how a disability impacts on a person's everyday living. An OT visits a client in their home to gain an understanding of how the property either helps or hinders everyday living. They will observe the activities that the service user finds difficult, so the exact nature of the difficulty can be identified.
7. If the difficulties identified cannot be resolved by an alternative way of undertaking the activity or the use of equipment designed to overcome that specific problem then an adaptation will be recommended. The OT then sends a referral to the Staying Put Agency that details the recommended provision (such as the installation of a level access shower) and the relative urgency of the case.
8. As an outcome of a best practice review that encouraged joint working, a small team of OTs are based in the Housing Service and work closely alongside the Staying Put Agency to provide an integrated adaptations service.
Role of the Staying Put Agency (SPA)
9. Local authorities have been encouraged by Government (through its agency, Foundations) to set up arms-length Home Improvement Agencies (HIAs) to provide support and assistance to enable disabled residents to adapt and improve their homes. Middlesbrough’s Housing Service set up an in-house HIA in 1990, the Staying Put Agency, which has recently been awarded the Foundation’s Quality Mark for excellent customer service.
10. Upon the receipt of a recommendation from the OT the SPA offer the service user a comprehensive agency service through the complex DFG application process. The SPA will complete all of the necessary paperwork (including application forms, financial information, architect’s drawings, planning permission etc.) on the applicant’s behalf, seek estimates for the work required, monitor the progress of the work on site and arrange payment to the builder when the work is completed to the satisfaction of both the Technical Officer and the service user.
11. The Staying Put Agency also provides a link to other complementary services such as benefit checks, a handyperson scheme and various energy efficiency projects.
Role of the Housing Service
12. The Housing Service has the statutory duty to provide DFGs as described in paragraph 4. Upon receipt of a DFG application from the SPA the Housing Service must ensure that the submission constitutes a valid application as prescribed by legislation. An application must be formally approved or refused within 6 months of receipt by the Housing Service.
13.The Housing Service also has a wider role to promote social inclusion. It is vitally important to ensure that new housing development meets the needs of people with physical disabilities so as to enable this group to exercise housing choice. There may be alternative housing options available that the client has not considered through work with partners such as RSLs or via the use of incentive schemes to assist people to move to more suitable accommodation.
Funding Issues
14. The Government gives an annual allocation of Specified Capital Grant (SCG) to support the authority’s expenditure on DFG. The SCG allocation constitutes 60% of the Council’s budget for DFG. The remaining 40% must be match funded from the Council’s own capital resources. The Housing Service has traditionally utilised Single Housing Investment Pot (SHIP) resources as a source for the required match funding. SHIP resources are accessed on a sub-regional basis via the development of sub-regional housing strategies and are allocated by the North east Housing Board
15. It has been announced that the regional SCG award will increase by approximately 15% in 2008/09. In order to maximise the draw-down of these resources the Council must increase its match funding. It seems likely that the Council’s SHIP resources will be reduced for the period 2007-10 as funding has been re-distributed at a national level to support affordable housing programmes. As a consequence alternative match funding may need to be sought. The actual allocations will be known in late January, early February, which makes alignment with the Council’s capital and revenue budget planning processes problematic.
16. Historically the demand for DFGs has exceeded the available financial resources. As a consequence the provision of adaptations has been subject to lengthy delays, as cases have had to be carried forward to the next financial year once the annual budget has been exhausted.
17. The number of staff required to deliver the DFG programme is dependent upon the actual capital allocations. In 2007/08 the Council received an increased DFG allocation and were able to appoint additional staff after the award of Resource Led Performance Management revenue funding. Staffing resources for 2008/09 will be considered once the actual allocations are known.
Performance
18. The increased budget for 2007/08 has enabled a greater number of cases to be delivered and as a consequence has had a positive effect on the waiting times for service users. OTs have reported a reduction in waiting times for an initial assessment from 29 weeks to 4 weeks since the appointment of the additional staff. The Staying Put Agency can also demonstrate that the average time from referral to grant approval has reduced from 35 weeks in 2006/07 to 27 weeks in 2007/08 with further improvement anticipated over the remainder of the financial year.
Andrew Carr
Housing Assistance Team Leader
Tel: 01642 729148
7th January 2008