Local authorities and third-sector organisations in South Staffordshire have come together to provide housing aids and adaptations to help people live independently at home. Streamlining applications, assessments and provision has resulted in a reduction in costs of 40 per cent and huge cuts in waiting times.
Key learnings for other councils
Factors for success include:
- collaborative working to agree funding levels and processes
- the appointment of an in-house occupational therapist (OT)
- applicants know who to speak to at every stage and are involved at all stages in the planning process.
The proportion of people aged over 65 in South Staffordshire is set to rise to nearly 20 per cent by 2012. The incidence of stroke and heart disease is rising across residents in social housing. The need for aids and adaptations to enable people to remain living independently in their homes is therefore rising too.
Depression is commonplace among older people. Inability to perform tasks of everyday life, such as bathing and showering, is cited as one of the causes. Not having a safe physical environment in the home can itself be the cause of accidents and ill health. There is evidence that ‘low level interventions', such as minor housing adaptations, can save hospital bed days and improve health (DH, 2008).
Who was involved?
The ‘Project Independent Living (PIL)' partnership involves:
- South Staffordshire District Council (the housing authority)
- Staffordshire County Council (the social services authority)
- South Staffordshire Housing Association (SSHA)
- Property Care (aids and adaptations contractor).
The partnership has reduced delays and misunderstandings in providing a service to residents of South Staffordshire. It has recently won an award from the National Housing Federation.
The problem and how it was tackled
Formerly, people who need adaptations to their home must go through an assessment process with social services. Their applications must then be approved and tested by the local authority. Finally the adaptations are usually fitted by their landlord or their agents.
This process could take up to two years, during which everyday life can be difficult for a disabled or older person. To add to the frustration, often several agencies would be involved. Applicants did not always know at what stage in the system they were or whom they should be asking for information.
To reduce waiting times, SSHA talked to residents and looked at the number of agencies involved. They investigated the way resources were used and allocated and the process used for allocation.
SSHA found that delays were occurring when, for both funding and medical reasons, applicants needed an assessment by an occupational therapist (OT) before work could start.
SSHA approached South Staffordshire Council with the proposal that the district council and the housing association jointly fund adaptations. Also that, wherever possible, the housing association should be the first and only point of call for applicants.
Following agreement to the proposal, SSHA commissioned an OT. As doing assessments for major adaptations, the OT advised their customer services staff in assessing for minor aids.
The OT also advises on environmental issues as well as internal property adaptations. Broken paving slabs, steps and uneven surfaces, are made good at the earliest opportunity and dropped paving is installed. This is making it easier for young mothers with strollers as well as for people of all ages with mobility or sight difficulties.
While some adaptations must be tenant specific, allowing for their height and particular needs, others are universal, like ramps or level access. SSHA has now built a pool of housing stock with adaptations already built in to help people with mobility and other problems.
This housing with universal adaptations can be used by older people with mobility issues or younger families with pushchairs. They are also suitable for those who have mobility difficulties following illness or a sports or other kind of injury. Where a property does not lend itself to adaptations, residents on the housing waiting list can be advised of where there is a vacancy that may suit their needs.
The initiative generated a large number of Disabled Facilities Grant (DFG) applications over a short period. This put pressure on local authority administration and budgets.
Outcomes and impact
The formal DFG application procedure was cumbersome and time consuming. Completing individual application forms, means testing, administering and approving applications, inspecting work and paying individual invoices often took a great deal of time.
Disabled Facilities Grant (DFG) funding has been streamlined by using a standard specification and plan. The housing association was given a general permission to start works as soon as possible, whether or not the DFG application had been received and approved by the local authority.
The partnership with the local authorities and with Property Care has reduced average costs for major adaptations from £7,000 to £4,200, a 40 per cent reduction.
Project Independent Living (PIL) means that:
- the wait for minor adaptations have been cut from 12 months to seven days: major adaptations are now usually completed within three months rather than two years
- there is now no waiting list for minor adaptations
- applicants know who to speak to at every stage and are involved at all stages in the planning process
- the overall increase in adapted stock has reduced the ongoing demand and tenants now have a greater chance of being moved into an adapted home should they need one in the future
- customer satisfaction ratings are now 100 per cent for major adaptations and 98 per cent for minor aids.
Since it started in 2005, PIL has helped more than 1,000 people to live independently in their own homes. It has also provided the community with a stock of adapted homes for the future.
Mrs Edna Lawton had lived in a home owned by SSHA for many years. At 94, she had become frail and gave up using the bath to wash because she felt unsafe. She then had to strip-wash at the sink, which took her over half-an-hour every day. Soon after an assessment with an occupational therapist, a walk-in shower for fitted for Mrs Lawton, making her life much easier. Throughout the process she had clear information about who was responsible for the work and how they could be contacted to minimise the stress and disruption to her everyday life.
This initiative has reduced waiting times, improved customers' quality of life, and reduced bureaucracy. However, South Staffordshire Council and SSHA believe that the process could be improved further. They are currently working on proposals including the use by SSHA of the ‘i-dapt' web planning tool. This will enable tenants to be more involved in the planning of their applications as well as further streamlining the process.
References and further information
Housing and health: building for the future: BMA (2006)
Making a strategic shift towards prevention and early intervention: key messages for decision makers: Department of Health (DH, 2008)
How low-level housing-related services contribute to the DH preventive agenda, Foundations, Home Improvement Agencies: Skidmore, Clare (undated)
Grant Mitchell, Housing Strategy and Regeneration Manager
South Staffordshire District Council
Email: [email protected]
Chris Mantle, Senior Environmental Health Officer
South Staffordshire District Council
Email: [email protected]