CELG(4)-07-13 - Paper 2

Communities, Equality and Local Government Committee

Inquiry into Home Adaptations

Response from : Welsh Heads of Environmental Health, Housing Technical Panel

Introduction

The Housing Technical Panel is an expert panel of managers who work in local authorities and are responsible for private sector housing issues.  (Enforcement, renewal, adaptations, energy efficiency etc).  The Housing Technical Panel involves all twenty two local authorities.

The Housing Technical Panel is well regarded as a source of expertise and has been identified as a body to assist in the development of a number of new national initiatives by Welsh Government such as its “House to Homes” scheme and licensing of the private rented sector.

A key aspect of the group is the promotion of best practice and service improvement. A number of Technical Panel members will be responsible for developing and running adaptation services across tenure within their local authorities.  We are therefore of the view that our evidence will be critical to this inquiry.

General

The Housing Technical Panel is of the view that the provision of adaptations is of paramount importance in terms securing independence, keeping older people in their own home as opposed to expensive residential care as well as facilitating hospital discharge.

The delivery of adaptations is a critical part of local authority housing strategies.  We are of the view that maintaining this local delivery is essential.  In addition the delivery of adaptations to the private sector involves a significant proportion of the households in Wales (82%).  The delivery of adaptations compliment social care services and homelessness services.  In the main the provision of adaptations also compliments general home improvement services offered by local authorities through its Private Sector Housing Renewal Policies.

The Housing Technical Panel is of the view that local authorities provide a “one stop shop” for adaptation/home improvement services through their private sector housing teams.  In many cases, particularly where local authorities have retained their own housing stock they will also deliver adaptations to council tenants.

Whilst the focus from a local authority perspective will be the delivery of adaptations to private sector and council homes it is hoped that the enquiry will look at Physical Adaptations delivered by Registered Social Landlords.

Why are there still significant variations in the time it takes to deliver aids and adaptations funded by Disabled Facilities Grants (DFG’s)?

It is worth mentioning that the question relates only to DFG’s, it makes no mention of any service disparity in relation to adaptations provided for Council tenants or Physical Adaptations Grants (PAG) for tenants of Housing Associations.  These areas should also come in for scrutiny as part of the Inquiry.

There is an assumption that that reference is being made to National Performance Indicator in relation to the delivery of DFGs. The performance data in relation to this P.I shows a steady improvement in the delivery time for DFGs with the average time being reduced from 545 days in 2005/06 to 326 days in 2011/12, an improvement of 40% over 6 years.  It is also clear that the level of consistency between authorities has improved.

Members of the Housing Technical Panel assisted in the development of this performance indicator and from the above information it is clear that it has helped to improve delivery times.  However based on our experience it remains a very basic indicator as to the quality the services being delivered.  A number of local authorities have considered the value of adaptations delivered in terms of health improvement maintaining independence and overall satisfaction of the client.

It is important to remember the performance indicator is an average and in terms of delivery.  In many cases the time it takes to complete a DFG is dictated by client choice i.e. when they want the work done and by which builder.  Whilst local authorities can influence this to a certain degree it will delay things.  Below is an example provided by one local authority of how the time taken to deliver a DFG is split between the local authority and the client?

A significant part of the time can be taken up by the client (choosing a builder, deciding when the work starts and is completed).

Local authorities have constantly reviewed their processes to improve the time taken and quality of service from its own perspective and that of the client.  This was highlighted in the Equality of Opportunity Committee Report in 2009 and the CEL Transform Report for Welsh Assembly Government “Review of progress in implementing recommendations on the provision of Adaptations Services in Wales” 2010.

Clearly there will be some degree of inconsistency across Wales given the differences in need, health, population, geography, labour markets, organizational structures, processes and financial pressures.

Local Authorities were, however, involved in bringing together best practice and assisting the WLGA in producing “Housing Adaptations for Disabled Persons – A Good Practice Guide.”  Likewise, the Wales Heads of Environmental Health Housing Technical Panel who have representation from all Welsh Local Authorities have also been active in ensuring that good practice and standards within the delivery of adaptations is available for all to share.

Whether sufficient progress has been made on implementing recommendations from the Equality of Opportunities Committee’s 2009 report on home adaptations.

Most of the recommendations are targeted at the Welsh Assembly Government.  A more appropriate question maybe should be around what support have the Welsh Government could provide to improve the delivery of adaptations in Wales.

Local Authorities were involved in bringing together best practice and assisting the WLGA in producing “Housing Adaptations for Disabled Persons – A Good Practice Guide.”  Likewise, the Wales Heads of Environmental Health Housing Technical Panel been active in ensuring that good practice and standards within the delivery of adaptations is available for all to share.

Our view is that services in local authorities have evolved and improved since the Welsh Assembly Governments Review of Adaptation Services by Chris Jones in 2005.Housing Technical Panel members report a range of initiatives including:

· A single point of contact, or reference point for advice and assistance has been developed which links to OT staff with housing

· Fast track systems for priority cases

· Targets for delivery of key stages

· Use of specialist staff to carry out home visits to help access the service and help find builders and agents

· The introduction of better sign-posting involving the development of a  Registered Builders Scheme

·   The provision of agency services via  co location with Care & Repair

·   The use of self-assessment questionnaires particularly in terms of minor adaptations

· Integrated working arrangements for OTs across Health Social Care & housing.

· Better use of Council owned stock including incentives to move vacant already adapted properties.

· Recycling of stair lifts

· Use of complementary services such as loans, small grant and handy person schemes.

What impact reduced resources for housing are likely to have on the provision of home adaptations?

It is evident there is inequity in terms of funding and how performance is measured. In 2010/11 housing association tenants who make up less than 10% of households in Wales had access to £8.5m of funding for large scale adaptations via the Welsh Government Physical Adaptation grant (PAGs) scheme.  In contrast owner occupiers and private tenants who make up 82% of households in Wales had access to just over £35m for Disabled Facilities Grants through Local Authorities.

Having sufficient capital resources will dictate the number of people local authorities offer grants to.  Whilst DFGs are mandatory other forms assistance may not be available because of local financial pressures.  Repair issues are often evident within the home environment and it is difficult to proceed with an adaptation because the property may need repairs.

There has been some discussion on the removing the current means test provision because it causes delays.  This is not the case and in most cases the process is quick and straight forward.  Removing the means test would put enormous pressure on local authority capital resources and deflect from supporting the most vulnerable.

A further issue relates to the level of staffing resources available to local authorities. Revenue resources are also under immense pressure within local authorities which if reduced will impact on delivery times and the quality of service.  A particular issue relates to the time taken to undertake an assessment of need.  This is a particular requirement in most cases and is invaluable to ensure the correct packages of measures are specified.  The time taken to undertake an assessment is often the most significant delay in the process.  We are of the view that dedicated Occupational Therapists are required within adaptation and private sector local authority teams.

It is clear that the provision of adaptation services protect other budgets such as health and in view of the pressure from a growing elderly population it is our view there would be value in deflecting more resources to local authorities.

Is the Welsh Government effectively monitoring the provision of adaptation services?

The only monitoring evident appears relates to the performance indicator.  It is our view that there is a role for Welsh Government in exploring the value of adaptations services in Wales via some form of Health Impact Assessment.  We are aware of the work being undertaken by Swansea University on the value of improvements to social housing.  We are of the view that a similar study would support the view that more resources are required by adaptation services.

What more needs to be done to improve home adaptation services in Wales?

Members of the Housing Technical Panel are committed to continuous service improvement in terms of adaptation services.  Further improvements to systems and process need to be developed through perhaps a systems thinking approach.  The Housing Technical Panel would welcome any support the Welsh Government could provide with regard to this.

Inevitably there will be a limit to how effective service improvement and process re-engineering can be.  With a growing elderly population and an increased demand sufficient capital resources to offer grants and revenue resources to support delivery teams will be critical.  The Welsh Government need to ensure there is sufficient resources available to local authorities and it is properly targeted.