Cynulliad Cenedlaethol Cymru The National Assembly for Wales Y Pwyllgor Cymunedau, Cydraddoldeb a Llywodraeth Leol The Communities, Equality and Local Government Committee
Dydd Mercher, 21 Mawrth 2013 Thursday, 21 March 2013
Cynnwys Contents Cyflwyniad, Ymddiheuriadau a Dirprwyon Introductions, Apologies and Substitutions Ymchwiliad i Addasiadau yn y Cartref—Sesiwn Dystiolaeth 11 Inquiry into Home Adaptations—Evidence Session 11 Ymchwiliad i Addasiadau yn y Cartref—Sesiwn Dystiolaeth 12 Inquiry into Home Adaptation—Evidence Session 12 Ymchwiliad i Addasiadau yn y Cartref—Sesiwn Dystiolaeth 13 Inquiry into Home Adaptation—Evidence Session 13 Cynnig o dan Reol Sefydlog Rhif 17.42 i Benderfynu Gwahardd y Cyhoedd o’r Cyfarfod Motion under Standing Order No. 17.42 to Resolve to Exclude the Public from the Meeting
Cofnodir y trafodion yn yr iaith y llefarwyd hwy ynddi yn y pwyllgor. Yn ogystal, cynhwysir trawsgrifiad o’r cyfieithu ar y pryd. The proceedings are reported in the language in which they were spoken in the committee. In addition, a transcription of the simultaneous interpretation is included.
Aelodau’r pwyllgor yn bresennol Committee members in attendance
Mohammad Asghar	Ceidwadwyr Cymreig (yn dirprwyo ar ran Janet Finch-Saunders) Welsh Conservatives (substitute for Janet Finch-Saunders)
Peter Black	Democratiaid Rhyddfrydol Cymru Welsh Liberal Democrats
Mike Hedges	Llafur Labour
Mark Isherwood	Ceidwadwyr Cymreig Welsh Conservatives
Ann Jones	Llafur (Cadeirydd y Pwyllgor) Labour (Committee Chair)
Gwyn R. Price	Llafur Labour
Rhodri Glyn Thomas	Plaid Cymru The Party of Wales
Joyce Watson	Llafur Labour
Lindsay Whittle	Plaid Cymru The Party of Wales
Eraill yn bresennol Others in attendance
Naomi Alleyne	Cyfarwyddwr Cydraddoldeb a Chyfiawnder Cymdeithasol, Cymdeithas Llywodraeth Leol Cymru  Director of Equalities and Social Justice, Welsh Local Government Association
Jennie Bibbings	Rheolwr Polisi, Shelter Cymru Policy Officer, Shelter Cymru
Sue Finch	Swyddog Polisi Tai, Cymdeithas Llywodraeth Leol Cymru  Housing Policy Officer, Welsh Local Government Association
Ivor Jones	Rheolwr Gwelliannau Tai, Cyngor Bwrdeistref Sirol Conwy Housing Improvements Manager, Conwy County Borough Council
Steve Kidwell	Prif Swyddog Adnewyddu Tai, Opsiynau Tai a Chymorth Gofal Cymunedol, Cyngor Bwrdeistref Sirol Castell-nedd Port Talbot Principal Officer, Housing Renewal, Housing Options and Community Care Support, Neath Port Talbot County Borough Council
Gill Pratlett	Cyd-bennaeth y Gwasanaeth Integreiddio a Gwelliannau (Gwasanaethau Oedolion), Cyngor Bwrdeistref Sirol Torfaen. Joint Head of Service Integration and Improvement (Adults Services), Torfaen County Borough Council
Jim Stobbart	Rheolwr Gwasanaeth Cwsmeriaid (Tai’r Sector Preifat), Cyngor Sir Penfro  Customer Services Manager (Private Sector Housing), Pembrokeshire County Council
Kenyon Williams	Cyngor Bwrdeistref Sirol Caerffili a Phanel Technegol Tai, Cymdeithas Llywodraeth Leol Cymru Caerphilly County Borough Council and Housing Technical Panel, Welsh Local Government Association
Swyddogion Cynulliad Cenedlaethol Cymru yn bresennol National Assembly for Wales officials in attendance
Sarah Bartlett	Dirprwy Glerc Deputy Clerk
Marc Wyn Jones	Clerc Clerk
Dechreuodd y cyfarfod am 9.30 a.m. The meeting began at 9.30 a.m.
Cyflwyniad, Ymddiheuriadau a Dirprwyon Introductions, Apologies and Substitutions
[1] Ann Jones: Good morning, everyone. Welcome to the Communities, Equality and Local Government Committee. I will start with the usual housekeeping rules. I ask Members around the table to check that they have switched off their mobile phones and pagers, because they affect the translation and broadcasting equipment. We operate bilingually, and headphones are available—translation from Welsh to English is on channel 1, and if you need amplification of the floor language, that is available on channel 0. We are not expecting a fire drill, so if we hear the alarm, we will take instructions from the ushers, who will direct us to the assembly point, or you can follow me, which is what I normally say—follow me, as I will be one of the first out of the building. As this is a formal meeting, we do not need to touch the microphones; they are operated from the booth behind me, where there are men beavering around—I do not think that we have any women behind the screen today—to make sure that the microphones come on. So, thank you very much for that.
[2] We have had apologies from Ken Skates, but there is no substitution, and we have had apologies from Janet Finch-Saunders; Mohammad Asghar has kindly agreed to substitute for Janet. Thank you very much for that, Mohammad, and welcome. Do Members need to declare any interests that they have not already declared during this inquiry? I see that they do not.
9.32 a.m.
Ymchwiliad i Addasiadau yn y Cartref—Sesiwn Dystiolaeth 11 Inquiry into Home Adaptations—Evidence Session 11
[3] Ann Jones: We now continue our inquiry into home adaptations. We have representatives from four local authorities. Could I ask you to introduce yourselves for the record, and then we can move straight to some questions? We have quite a lot of questions and a short amount of time to get into them. Would you like to start, Gill?
[4] Ms Pratlett: I am Gill Pratlett, joint head of service integration and improvement in adult services in Torfaen County Borough Council.
[5] Mr Kidwell: I am Steve Kidwell, principal officer, housing renewal, housing options and community care support for Neath Port Talbot County Borough Council.
[6] Mr Jones: I am Ivor Jones, housing improvements manager for Conwy County Borough Council.
[7] Mr Stobbart: I am Jim Stobbart, customer services manager, private sector housing for Pembrokeshire County Council.
[8] Ann Jones: Thank you very much for coming today. I will start by providing some context. For Members who have been here for some considerable time, this is the third inquiry into home adaptations. We hope that this will be the last one that we need. We are going to try to get it right. The last inquiry was held in 2009 by the Committee on Equality of Opportunity. Prior to that, an inquiry was held in 2005. Have any of you seen home adaptations services being improved in recent years? Have the recommendations that were made in those reports been adopted and carried out?
[9] Mr Jones: I can say, on behalf of Conwy County Borough Council, that we have actually had our own review as well as looking at Chris Jones’s review and the other reviews. I think that there is a big reduction in Conwy, from 1,045 days down to 160 days currently. A lot of good practice has been taken from all of these different reviews.
[10] Mr Stobbart: I would echo that from Pembrokeshire. We have seen a change for the good. In terms of the performance indicator, when it first came out and we analysed where we were, we were well in excess of 1,000 days. When we looked at individual cases, we found that some cases had been sitting there for several years. That forced us to look into the systems to find out where the bottlenecks were. We have done quite a bit of work with the Wales Audit Office on the system itself, the process and how we could refine that. A lot of that work has been done. We are now down to a more acceptable level, in terms of the league table. Even if it is an acceptable level, of course, 330 days is still quite a long time for someone to wait for an adaptation to be delivered to them. We deal with the grants system rather than an agency provision arrangement, so, at present, the indicator has forced us into looking at the timescale. We have dealt with the timescale, but one of the issues that fall out of that is a double-edged sword, in that it affects the customer. When we looked at the overall figures, we found, for example, that of the 1,011 days or so that we were taking in 2006, 500-odd of those days were down to the customer part of the process.
[11] Ann Jones: In what way was that?
[12] Mr Stobbart: They had to employ contractors and get work done. They had to employ an agent and submit a grant application and so on, once the technical assessment process had been done. There were some customer activities that took quite a bit of time, and we allowed them to take that time. Since then, as we have moved towards a more improved position, we have ensured that the customer is given a certain amount of time to do what they are required to do and no more. That has an impact on the customer, obviously, and we have to look at that to see whether our systems need more refinement.
[13] Ms Pratlett: In Torfaen, picking up on the observation that the experience may have been disjointed where you have a number of different elements, we have brought the surveyors and the occupational therapists together under one roof and one line management. That has worked well, so they now go out together. When you look at the pathway, sometimes you can see that a lot of the tasks can be done in parallel. When we looked at the process mapping before, it was almost a case of ‘That bit’s done and then it goes to X’. It was almost segregated, but now we have the right members of staff under one roof working together, and that has certainly made a difference.
[14] Mr Kidwell: There have been a lot of local improvements, but, fundamentally, we are still talking about areas that have different demographics, different pressures and different levels of demand, which has an effect on the overall process. Unfortunately, we have tended to concentrate on the need to get the time down for the indicator and the league table that surrounds the indicator. The pressures on individual managers come from that rather than concentrating on getting it right for the customer at the first time and responding in an appropriate manner so that things do not get worse for that person. We need to look further into individual systems and understand what is going on in the system. I do not know whether that is taking place at the moment.
[15] Ann Jones: During the course of this inquiry, we have heard that people find it difficult to access the services in the first instance, so have any of you improved it or made it easier for people to access your services, or have you used best practice from another authority?
[16] Mr Jones: In Conwy, we have a single point of contact, namely the customer care officer in social services, so that has improved the contact side. Leaflets and websites have been prepared, so that has improved quite a lot. However, speaking from personal experience, my mother has been quite ill lately, and I have visited some of the hospitals, and a lot more work is required there to signpost people from hospitals to the service. That is an area that we would like to move on and improve as well.
[17] Ann Jones: Do any of you have anything that you want to add to that?
[18] Mr Kidwell: We have certainly made improvements. We had a systems review of the process in about 2009. In terms of the indicator, we are just looking at figures in which we have not been well placed for quite a long time. It was going to be a slow-burner and, since then, the authority has recognised that. Over the last three years and coming up to this year, there have been significant improvements. However, we now understand that the process is more complex than what is reflected by the indicator, and we have to act on all of the pieces in it. In doing that, we think that the service delivery has improved considerably for the individuals in terms of what they would want, we have reduced waiting list numbers, and we have made significant savings while the process gets better. So, it is achievable; it is just about understanding what is going on in your systems.
[19] Ms Pratlett: Yes, we have leaflets, as do all the authorities, but we have also invested in training for customer care, to make sure that the right information is given when somebody first picks up the phone. We have also managed to get some invest-to-save money to look at employing OTs, and professional people on the front line, so that they can have the right response, and see whether that is the right road for them in that first conversation, rather than two or three months into a process.
[20] Mr Stobbart: In Pembrokeshire, we have set up a first point of contact, which is the contact centre itself. In that process, individuals go through a telephone contact questionnaire with experienced officers who then determine in which direction that particular customer ought to be referred. We have tried to improve that, because we understand that a number of people would not be able to go through that lengthy process on the telephone with an officer. I have customer services assistants in my team who are able to go out to visit people and help them to fill in those contact questionnaires wherever necessary. That is an improvement in access to the service.
[21] Ann Jones: Mark, you have a supplementary question.
[22] Mark Isherwood: I have just a quick one for Mr Jones, if I may. Good morning. Several witnesses have referred to good practice in Conwy during our inquiry. How have you managed down the delays initiated by customers referred to by Mr Stobbart?
[23] Mr Jones: What we have done is that we have visiting support officers going out, assisting clients to fill in a form and hand-holding them through the process. That has been very important within Conwy because there is quite a long prescribed form to complete, and with the support of the officers visiting the clients, they fill in the form and are helped through the process. That has been a big improvement within Conwy, and obviously we then get it right the first time with the application.
[24] Joyce Watson: I am pleased to hear that, when people contact you, you are all working towards making that easier. My question is about the step before that. How do people know in the first place that they are entitled to help?
[25] Mr Kidwell: When we did the review of process, it was interesting to find out that most people were coming asking for help, not asking for adaptations. That was quite an important moment for us. It led to the design of a new purpose for the service from the customer’s perspective, and that was getting the right help as opposed to adaptations. What we have found is that a lot of the experts—the social workers, health workers and nurses, the occupational therapists and physiotherapists who are involved—were already involved long before us. People were already asking for help. We looked at the whole process over a period of about the previous five years and found that, every time somebody came in for a disabled facilities grant, that person had been to social services, on average, two and a half times already. So, in answer to your question, they were already in there: they were not asking for a DFG, but they were asking for help. They did not necessarily know what they needed. What we needed to do was to make DFGs a responsive service, so that the social workers and the professional healthcare people could use DFGs as a solution and reduce the use of high-cost care. They do not do that and, understandably, they need to make an immediate decision. If a DFG is on a waiting list somewhere, it cannot be part of the solution. As a result, we tend to end up being the last resort, not at the front end.
[26] Peter Black: I would like to revisit the question that the Chair asked, particularly in relation to Torfaen, because you are part of this project that is integrating health and social care in Torfaen, so I would have expected that you would have a clearer pathway into adaptation as a result. I was wondering how the Gwent ageing project is helping you in terms of making sure that the right people get the right adaptations in good time.
[27] Ms Pratlett: The Gwent frailty project, if you were not aware, is a multi-agency project looking at short-term intervention around enablement. What we have is that pathway from the members of the community resource team in frailty straight into our disabled persons’ team. From the therapist doing the assessment within the community resource team, when they are first out there, we would not expect any duplication of assessments. Those assessments go straight into the team, and they are then worked on by surveyors. So, there is no passing on and duplication—it works from the outset of the community resource team’s intervention.
9.45 a.m.
[28] Peter Black: So, the biggest impact is on eliminating duplication, rather than on improved signposting.
[29] Ms Pratlett: It is about improved signposting, because the community resource team does not just consist of local authority social care and housing staff; it also works with the third sector and health professionals. So, we are getting the message out a lot further, so that we can hopefully get those referrals in a lot quicker. I think that that is a point that you made about how we are getting the message out. We are trying to involve as many front-line professionals as possible, such as the district nursing service, because the district nursing service, for example, will be visiting a number of people who may not be known to the local authority. So, as I say, we are trying to get that message out, but avoiding duplication.
[30] Peter Black: Has that had any noticeable impact on the demand for adaptations and your ability to fulfil that demand?
[31] Ms Pratlett: We have not seen a significant increase in demand, but it is early days as far as the community resource team is concerned. It is something that we are tracking regarding the origin of the referral, so it will be something that we will keep an eye on. As far any response is concerned, we have found that some of the referrals from the community resource team are taking longer. Those clients are not necessarily at their optimum level of independence, so the assessment can take a bit longer because you are working with that client to enable them to get to a point when it is the best time to assess them. That assessment could be in the two months during that person’s recovery period.
[32] Peter Black: Okay, thank you. This is a question to all four of you. The Welsh Government has said that it will do a review of adaptations—it promised that in the housing White Paper—which presumably follows Chris Jones’s review published in 2005. What would you like to see coming out of that review?
[33] Mr Kidwell: I would like to see a common purpose in this. As far as each individual is concerned, I would like to see services that are entirely designed by what the customer requires. If we are listening closely enough to them, we will find that people are not necessarily asking for adaptations. They appear in the service in all sorts of ways, whether through GPs, hospitals or as a consequence of making a decision as to whether to stay at home or to go into residential care. If we listen a little closer, and if the Welsh Government could help us to come up with a clear defined purpose for all the services, then I think that we will understand better what is going on.
[34] Peter Black: How does that translate into practical reform? Are you talking about the sort of frailty project that you have in Gwent?
[35] Mr Kidwell: I think that that is part of it. Neath Port Talbot is about to introduce a similar model with a community resource team and a front-end input that involves disabled facilities, assisted technology and all the things that you would want at the front end. An important part of the systems review that we did was about understanding that if we had to design something for an individual, we needed to know what their problems were and to make sure that what we were designing was appropriate. We had to get it right the first time. To do that, you needed to clearly know what mattered to those individuals. It should not be driven by how much money we have or how long we are going to take; it is about what is appropriate for those individuals. The most important thing is the steps that are of value to them. If you do that, it is cheaper, and they do not come back.
[36] Ann Jones: Does anyone else have anything to add to that?
[37] Ms Pratlett: It is about the monitoring and the evaluation, and if the steer could move away from counting the days, as has been mentioned, and towards more of an outcome-based framework and how that could be built in.
[38] Ann Jones: Does anybody else wish to come in? Mr Jones?
[39] Mr Jones: I would like to add that it is consistent across all tenures. It is very important for all, not only local authority clients and those of registered social landlords; that fact is quite important. My colleagues mentioned results-based outcomes as well as performance indicators, and those are important as well. Perhaps there is a need to simplify means testing; that is quite an important area to look at. I think that the main thing is to look at good practice around the whole of Wales; there are good bits in lots of authorities and if we could bring it all back in together, that would be an important task to carry out, I think.
[40] Ann Jones: Thank you very much. We are going to try to make some progress. Joyce?
[41] Joyce Watson: Talking about putting it all together, do you think that there is effective corporate leadership and accountability on adaptations within local authorities?
[42] Mr Jones: I can say, on Conwy’s behalf, that I think that there has been for a quite a long time. There has been a push to improve the delivery of service. It has been recognised that we were taking too much time to deliver it. There is a lot of support financially and corporately to improve service delivery within Conwy.
[43] Ms Pratlett: I would echo that in Torfaen. You can always talk about how much capital is available, but we have always had corporate support and corporate scrutiny. We have had significant scrutiny around our performance, and supporting vulnerable people in terms of enablement in their own homes is one of the corporate priorities, so, yes, we have the support and the scrutiny.
[44] Mr Kidwell: As far as Neath Port Talbot is concerned, it is a battle that we have won over recent years. Members and corporate directors are very keen to support the commitment to a higher level of funding—£3 million per year over the next few years, which will get us to a point where we will be responsive in terms of DFGs on a day-to-day basis.
[45] Mr Stobbart: Corporate leadership and the general approach to this particular service area improved dramatically when the performance indicator itself came out. Prior to that, there was a situation where the private sector housing and public sector housing approach to adaptations was quite diverse and they were brought together in a housing and health department. Subsequent to that, when the performance indicator evolved, we moved into a social care and housing framework and, over that period of time, significant improvements were made. There is a lot more corporate buy-in to this particular process and a lot more support for both occupational therapy and disabled facilities grants inspectors et cetera. From Pembrokeshire’s point of view, the situation has improved dramatically, probably in the last 10 years.
[46] Joyce Watson: Good; I am glad to hear it. In your view, does the complexity and bureaucracy of the adaptation system contribute to delays? If you want to highlight other reasons for delays, please feel free to do so.
[47] Mr Stobbart: Undoubtedly, that is the case. The complexity and bureaucracy do contribute to delays, and particularly the resources test itself. When I look at the figures for the last two or three years, I see that we had a situation last year where, of 145 DFG applications, 130 were means tested. Prior to that, a lot of people who had inquired about the system had dropped out, and we are looking into that in some depth at the moment. However, we feel that a lot of people are entering this service at an age when they simply do not wish to reveal what their personal financial circumstances are, so they abandon the system before they even get started. Of those who get into the system, as I say, of 140 cases, 130 were means tested. Out of those, eight made a contribution, and that contribution overall was about 4% of the spend on the works that were executed. That has only occurred subsequent to us amending policy where we have increased the number of people who would have to go through the resources test. Prior to that, in previous years, the percentage of contributions raised against the amount of money spent was around 0.5%. When you consider the complexity of the resources test and the number of officers who are involved in that, and the time taken to do it, it is one of those areas in the system that is bureaucratic, complex and creates delay.
[48] Joyce Watson: Are you telling me that part of the way that you reduced your figures was by raising the threshold?
[49] Mr Stobbart: Yes, we had a situation where, when we were fast-tracking small works grants, we applied a resources test, but once we got to a point where we considered that the applicant could not afford the full cost of the works, we just simply approved the grant and they were not expected to contribute. In our renewal policy review, we brought them back in to the standard test of resources process. That has marginally increased the amount of income contribution, but not dramatically so.
[50] Joyce Watson: Thank you.
[51] Ms Pratlett: I would like to add, Chair, that it is not just about the complexity of a process, but about the complexity of the individuals. However much you streamline a process, individual lives and the nature of vulnerable people’s support are complex, so, although you are able to support a person through the journey, family dynamics and ill health will always extend that journey. So, it is not just about a process, but also about the individual.
[52] Joyce Watson: Do you all use occupational therapists for straightforward assessments?
[53] Mr Kidwell: Yes.
[54] Ms Pratlett: Yes. Occupational therapists and occupational therapist assistants.
[55] Mr Stobbart: I use OTs and OTAs. I have an OT in the team who deals specifically with more complex issues, but I also have customer service assistants, who are trusted assessors and who carry out low-grade assessments, for example, bathing assessments and that sort of thing.
[56] Mr Jones: In Conwy, we have an intake before the straightforward adaptations in order to release time for senior OTs and the other OTs to concentrate on more difficult cases. So, we have a team that will take on the simple bathroom adaptations and fast-track those through the process. That has been proven to be quite beneficial.
[57] Mr Kidwell: We have a similar process in Neath Port Talbot. We need to make sure that the people who design the work are a very close part of this and we aim for the visits to be carried out jointly with surveyors, so that the design is addressed and the questions that need to be asked are answered at that one visit with an occupational therapist and the surveyor so that the adaptation can be done as soon as possible.
[58] Joyce Watson: Do you all agree that means testing is contributing to the bureaucracy in the system, if there is bureaucracy in the system?
[59] Mr Kidwell: To illustrate that from a bureaucracy point of view, I am sure that the means testing is doing so, but as my colleague said, it is a very small part overall in terms of what it delivers. We identified 291 potential steps for someone who is coming through the system on a DFG from the first point of contact to completion when we analysed this. I cannot speak for my colleagues, but we have been involved in this for many years and there are comparable situations everywhere out there. Understanding what was going on in the system, we were able to reduce those to between 20 and 30 steps. If you can take the complexity out, clearly it makes things much quicker, without having to try to make it quicker.
[60] Ms Pratlett: Could I add one point? What has helped is the good relationships with and the money available to organisations such as Care and Repair, so that we just fast-track any works under £1,000 straight to Care and Repair under its rapid response scheme or under its care and safety process. There are some good examples, where you can sort out a process and where things do not have to be a barrier.
[61] Mr Jones: Could I just add to that? Again, I am not an expert on means testing, but an area that should be considered is that outgoings are not looked at as part of the means testing as well as incomes, especially in terms of the younger families—they have mortgages, student loans and all sorts of loans that are not taken into consideration. Clients also feel that the means testing method only proves that they are ineligible, as opposed to trying to assist them through the process.
10.00 a.m.
[62] Ann Jones: Do any of you, or any of your councils, provide help to self-funders for adaptations? What help is available to self-funders?
[63] Mr Kidwell: Yes.
[64] Ann Jones: You do?
[65] Mr Kidwell: Irrespective of the circumstances. So, the means test is carried out, and if people need to do it, what we want to make sure is that—
[66] Ann Jones: No. If people know that they are not going to get the DFG and come to you as a self-funder, what help is available? Park the DFG—what help is available from your authorities?
[67] Mr Kidwell: We will offer them help with the service, we will offer to support them and make sure that it is right and appropriate.
[68] Ann Jones: Support them how?
[69] Mr Kidwell: We will help them with the design and with securing an appropriate contractor. We know what the alternative is; for example, people looking for stairlifts—a fairly simple item—buy them off eBay, and they end up stuck halfway up the stairs on the stairlift. So, we want them to have something appropriate. We will help them; we accept that they are vulnerable. That is the sort of service we need to provide.
[70] Ann Jones: Do you all provide that sort of help?
[71] Ms Pratlett: We commission Care and Repair.
[72] Mr Stobbart: We have an agreement with Care and Repair and it provides that service for us.
[73] Mr Jones: Care and Repair provides that service for us as well.
[74] Ann Jones: Okay. Thank you very much. Sorry, I am butting in all the time.
[75] Mark Isherwood: What would be the benefits, or disbenefits, if a single adaptation system was introduced across tenure and across Wales?
[76] Mr Jones: I think that you would have a consistent approach. Skills would hopefully improve as well. There is a lot of expertise in the OT service that could link in with housing. You could have a one-stop shop so that clients could focus on a certain area. The current system is complicated with all different sorts of funding options. That would simplify the process.
[77] Ms Pratlett: There could also be a potential for value for money if you had a wider sector looking at procurement or re-tendering.
[78] Mr Stobbart: I echo most of that, but I question whether we might find some difficulties in the private rented sector, because there are short-hold tenancies of six months. It is about having a level playing field with DFGs and accessibility to them, particularly if people require expensive adaptations to a property. The risk to their tenancy is two months’ notice from a private sector landlord. There are issues around the private rented sector that we will have to consider fairly carefully.
[79] Mr Kidwell: The ability to work on a consistent basis across Wales is there. We are all still dealing with the same groups of people with the same sorts of requirements. There are things that have been built into the bureaucracy have changed in different ways over the years, but the intention is still to head in the same direction. What it needs is the same process for all of us.
[80] Peter Black: How would a single adaptation system work when you have so many different budgets and different providers of homes? There are housing associations and stock transfer associations, which all have different ways of providing adaptations. There is council housing, where it still exists, within a ring-fenced housing revenue account, and then there is the private sector. How would you make that work as a single system? Does anybody have any ideas?
[81] Ms Pratlett: With support from the Welsh Government. [Laughter.]
[82] Mr Kidwell: I feel that it has to come back to the recognition of trying to deliver what the customer wants. That will lead us in designing the service. At the moment, the services are so bureaucratic. There is so much waste in the process. If that waste can be identified and removed, we will end up with something fairly simple. We would still need an occupational therapist to assess and we are still talking about the same groups of people. In Neath Port Talbot, 93% of our cases are for people over the age of 50. So, at the moment, we are designing a cradle-to-grave service, when in fact we should be designing a service based on age-related mobility as opposed to disability. I am sure that that is the same across Wales. If we understand it a bit better, then we can certainly get something more consistent.
[83] Peter Black: So, you are looking at a simplified system that may be common to all tenures but may be administrated by the relevant budget holders separately.
[84] Mr Kidwell: Yes.
[85] Mark Isherwood: With reference to the private rented sector, could there be a role for accreditation with this, as a further carrot and stick?
[86] Mr Stobbart: Most certainly, and we are likely to see a little bit more emphasis on accreditation in the housing Act that we expect in 2015. The private sector will certainly be a topic that is outlined clearly in that piece of legislation. Accreditation will probably creep up the priority scale.
[87] Mark Isherwood: Thank you. We have heard from successive witnesses about the need for integrated working between health, social services and across the housing sectors, which you have just alluded to. We have also heard that this varies significantly across Wales. What are your views on that? How can that variation be addressed so that good practice is not just shared but applied?
[88] Ms Pratlett: We successfully launched a forum in Torfaen across health and social care, not just based on adaptations, but on housing solutions as well. It is chaired and supported by the chief executive of Aneurin Bevan Local Health Board, so it has the full support of all organisations. That has brought huge benefits for clients who may be, at the moment, the most complex out-of-area clients due to their complex medical needs, but having those discussions with housing, maybe through adaptations or the different housing options, has enabled them to come back to the borough. That work is just starting, but has huge potential to go a lot further.
[89] Mr Kidwell: The position in Neath Port Talbot of housing within social services has helped this process. The community resource service and intake model, which is in an integrated service with health, has moved forward with the benefit of the knowledge of housing support. That is only just about to start, so we hope to see the benefits at the front end of DFGs.
[90] Mr Jones: Again, it is quite important to bring it all back together within occupational therapy. Housing renewal teams are working closely together with the RSLs. We are developing a property matching service with the RSLs to try to match clients with more suitable properties. There are many benefits from bringing things back into a single team and joint working, and a tenure-blind process would possibly be very beneficial.
[91] Mark Isherwood: I have sat in your office watching a strategy emerge as you were talking with your OT colleagues. Also, you have done some work—and maybe the others have as well—on reaching out to the transfer associations, on which quite a lot of concern has been raised.
[92] Mr Jones: Cartrefi Conwy was set up quite a few years ago, and before stock transfer, our team did all the design works for the adaptations. We have carried on with that process for the new housing associations, because they have accepted and realised that we have the expertise within housing renewals and that there are close links with the OTs in Conwy. They have recognised that, and we have carried on with that process for the last four or five years. There are other RSLs in Conwy that are quite keen to come back to us to see whether we can also offer that service to them for the more complicated design works; they can see that a single unit tends to deliver and has the expertise.
[93] Ann Jones: We need to move on, Mark.
[94] Mark Isherwood: I will ask my final question on this section. Should the rapid response adaptations programme become available to social housing tenants?
[95] Mr Stobbart: I am not inclined to agree with that point. The position there is that, within Pembrokeshire, we have a response programme in the public sector, through our building maintenance team, which tends to mirror the work that is done by rapid response in the private sector in carrying out urgent repair. I cannot see the benefits of moving the rapid response programme into the public sector.
[96] Mark Isherwood: Are there any other views?
[97] Mr Kidwell: I tend to think that rapid response on a mandatory basis already exists as DFGs, although we may not want to go through the whole means-test process with that. Often, we find that if you do small works on an adaptations basis, somebody will be back in six or 12 months. That does not mean that you have something that is gold-plated and is a major investment from the outset, but it is clear from the evidence that rapid response, initially, might lead to a more costly response shortly afterwards. We probably need to do a bit more analysis of that before understanding whether rapid response does what it is intended to do.
[98] Ms Pratlett: I agree. I would want a bit more information on rapid response. I would not be opposed to it, as long as the funding mechanisms follow that, otherwise, it gets quite complex.
[99] Mark Isherwood: Moving on to the next section, how can the adaptations system become more focused on the needs of disabled people and achieving ongoing positive outcomes?
[100] Ms Pratlett: Sorry; I did not catch the end of that.
[101] Mark Isherwood: How can the system become more focused on disabled people and on longer-term, positive outcomes?
[102] Ms Pratlett: By changing some of the monitoring arrangements—
[103] Ann Jones: We will be moving on to monitoring in a minute.
[104] Ms Pratlett: Yes. I think that we are focused on—
[105] Mr Kidwell: Coming back to the point I made a few minutes ago, understanding that it is not necessarily about disability is important, and understanding that a very high percentage of cases are age-related mobility. We are really asking whether we want to provide a relatively low-cost solution, as opposed to high-cost, formal care solutions. There is no doubt that adaptations are a low-cost solution and the evidence exists to support that. There is no doubt that it also delays people going into residential care, which is another high-cost solution. So, we really need to understand what people are asking for. I am not sure whether we do.
[106] Mr Jones: Outcomes are very important for us, in concentrating on customer feedback and engagement with customers. We should also be looking at 12-month follow-on surveys and asking, when the adaptations are complete, whether they have met the customers’ needs in the long term. We are looking at introducing the follow-on surveys in Conwy.
[107] Mr Stobbart: I mentioned earlier that, at the end of the day, it is the review of the adaptation, after it has been provided, that is what is needed in order to inform the general process. We do customer feedback and we have a customer forum. We get feedback in that helps us to deal with some of the issues that arise over the processes we adopt.
[108] Mark Isherwood: If I hear you correctly, you are all saying that it is work in progress, but the need is recognised. We heard earlier about best practice and good practice. You referred to fora where colleagues from different councils get together and discuss that, but to what extent is that actually being implemented effectively when people go back to their own patches?
[109] Mr Stobbart: There is a set of good practice guides delivered through benchmarking, which occurred some years ago, and we have adopted a great deal of the advice that was provided in Pembrokeshire. We generally have feedback from all quarters within the service; from the College of Occupational Therapists, the regional groups that we meet and renewal officers, and so on. All of that joint networking, as it were, provides us with ideas to inform and improve the service. Certainly, the good practice feeds through those sorts of agendas.
[110] Ms Pratlett: I agree. This is one of the areas that I focus on—performance management—as head of service. We have an action plan in place and part of that clearly documents what best practice exists, and how we are going to implement parts of the process that we have imported from other local authorities. It is not about reinventing the wheel; it is about speaking to colleagues, and it does happen. However, one size does not fit all; what works in one authority does not necessarily work in another, but it is about making sure that you have followed that through and looked at it rather than discounted it.
10.15 a.m.
[111] Mr Kidwell: Having completed the systems review in Neath Port Talbot, we have been visited by most authorities in Wales and a number in England, and there have been a lot of presentations to the Welsh Local Government Association and the Welsh Government and a lot of organisational raids. So, it is happening out there, and there is a lot of discussion taking place about DFGs. It would be interesting to see, having done that, how many people have made changes as a result.
[112] Mark Isherwood: We have had positive evidence about Neath Port Talbot previously.
[113] Mohammad Asghar: Are people who need adaptations, their families and carers given sufficient information about the adaptation system? This is for any one of you.
[114] Ms Pratlett: We have already dealt with that first point of access, but we have trained some OT assistants to go out and have that face-to-face contact with the families right at the beginning, so if there are any questions, they can be answered. I do not think that it is about a leaflet at that stage, but about responding to individual questions. So, a lot of information is given, but it has to be through face-to-face contact. I am confident that we are doing that.
[115] Mohammad Asghar: I know that Neath Port Talbot County Borough Council is delivering a new system and that improvement is going on, but it still seems like some other authorities are not using and learning from this DFG process. The average time for delivering a DFG in Neath Port Talbot is still 531 days. You talked about best practice, but authorities are not using each other’s best practice, so how can it be achieved in the best possible way?
[116] Mr Kidwell: I agree. We would readily accept that, going back a few years ago, the position was particularly poor. I recollect that we were at 700 days in 2009-10. However, we accepted the fact that in completely redesigning the system, making huge root-and-branch changes to the way that we handle things, it would take a few years to make the improvement. There has been a steady improvement each year. If we are looking at this simply on the basis of the indicator—and, as we said, perhaps that is not the best way—I anticipate that this year we will see it at around 230 days. However, again, looking at demand, in Neath Port Talbot, we have the highest level of long-term limiting illness cases in Wales and we have the highest number of informal carers in the UK, which are indicative of an enormous demand. So, we are trying to manage that, but, in saying that, the authority has committed itself to high levels of expenditure. We are getting there, step by step; there are major changes, which are being reflected in the numbers.
[117] Ann Jones: Does anybody else have something to add? Do not feel that you have to if there is no ready answer.
[118] Mr Jones: As regards the point of contact and informing families and clients how to access services, lots of leaflets and websites have been prepared. In Conwy, we have carried out lots of roadshows and attended agricultural shows to promote the service, but there is an area there that we still need to look at in education; that has been acknowledged.
[119] Ann Jones: We will move on to performance monitoring.
[120] Rhodri Glyn Thomas: Yng nghyd-destun monitro perfformiad ar hyd a lled Cymru, rydych wedi cyfeirio’r bore yma at y dangosydd perfformiad ac wedi cwestiynu ei werth o ran monitro perfformiad. A oes modd cael fframwaith monitro perfformiad cyson drwy Gymru? Rydych wedi awgrymu hefyd na fyddai cael un system, o reidrwydd, yn addas i bob awdurdod.		Rhodri Glyn Thomas: In the context of performance monitoring throughout Wales, you have referred this morning to the performance indicator and you have questioned its value as a means of monitoring performance. Would it be possible to have one performance monitoring framework across Wales? You have also suggested that a single system would not necessarily be appropriate for all authorities.
[121] Mr Jones: We mentioned that the performance indicators are not everything. Outcomes are very important and we should focus on those as well, because you can deliver a very quick service very poorly. So, it is very important to look at the outcomes and what the benefits of the investment in DFGs are, and to measure them. That is an important area to look at.
[122] Mr Kidwell: The indicator tells us very little. It tells us just the average time; it does not tell us whether that is a good or bad average time. Are 50 days good? Are 200 days good? We do not know; we are just trying to be better than everybody else in terms of the league table. There are better ways of measuring and of understanding whether or not our systems are capable of delivering what the client is asking for.
[123] Ms Pratlett: I would like to see that mixture of qualitative and quantitative measurement, as my colleagues have said. I am not saying that there should be different measures for different areas, but, time and again, we have seen inconsistency of application where different authorities interpret the PI as regards when they start the clock ticking. So, there needs to be some clarification on that. I would prefer to look at an outcomes-based framework like the one in Supporting People. It is very much about asking, ‘What does that mean to the customer? Has it made any difference?’ It may have been done quickly, but it may be of poor quality and it may not have made any difference at all. That is where we need to focus.
[124] Mr Stobbart: We have to accept as well that there are different ways of delivering DFGs in individual authorities across Wales. Some authorities have full agency services where they will provide the full service from the date of first contact right through to commissioning the works and executing the works, whereas in Pembrokeshire, for example, we use the grant system and the applicant is expected to deal with part of that process. So, there is some disparity there, and if you were in control of the whole thing, you could move a lot faster, hopefully.
[125] Rhodri Glyn Thomas: Ymddengys felly eich bod yn gytûn bod y dangosydd perfformiad presennol yn annigonol, oherwydd dim ond mesur nifer y dyddiau mae’n cymryd i ddarparu’r gwasanaeth a wna ac nid oes cysondeb o ran lle mae’r dangosydd perfformiad yn dechrau mesur, felly mae anghysondebau yn hynny o beth. A fyddai dangosydd perfformiad mwy cynhwysfawr yn werthfawr, neu ai mater i bob awdurdod yw ceisio gwella systemau yn fewnol ac nad oes gwerth mewn cymhariaeth ledled Cymru?		Rhodri Glyn Thomas: It appears, therefore, that you all agree that the current performance indicator is inadequate, because it measures only the number of days that it takes to provide the service and there is no consistency as to where that indicator starts measuring, so there are inconsistencies in that regard. Would a more comprehensive performance indicator be valuable, or are you saying that it is a matter for every authority to try to improve systems internally and that there is no value in making comparisons across Wales?
[126] Ms Pratlett: In Torfaen, when we look at the indicator as it is—how long it takes to deliver the grants—I do not think that the average tells us anything. What is useful is breaking that journey down to the constituent parts of what needs to be done to deliver that grant so that you know where the blockages are. Most local authorities do that internally anyway as part of improving their performance, because they want to see—whether you call it systems thinking or whatever—where the blockages are. So, that is done internally anyway. In Torfaen, it ranges from 74 days to over 1,000 days, so when you look at the average, it does not mean anything. It is about having that local intelligence to improve the service, so I do not know what benefit doing it on a national level would bring.
[127] Mr Kidwell: The end-to-end time is an important period. Understanding when somebody first comes in and when they leave the system is extremely important, but, in the middle of that, a great deal will happen. Much closer analysis of what is happening there enables you to adjust your system and take out the things that are not of any value and put in things that are of value. A simple line across the page tells us nothing, but it leads to poor behaviour because it leads to a league-table situation in which people are under pressure to become better.
[128] Mr Stobbart: Again, the journey that Pembrokeshire has been on has been exactly the same. We have been able, through that performance indicator, I suppose, to disaggregate parts of the system and find out where the blockages are, and we have sought to improve in those areas to try to improve our performance overall. Again, I would echo what has been said here: a single line showing the average for Pembrokeshire is probably no good to anyone. I can identify cases within the list that have been sitting there for some considerable time for various reasons, and others that have been in one day and gone out the next.
[129] Mr Jones: Personally, I feel that performance indicators are very important, and especially the client experience from start to finish. It is a very important measure to look at. Again, it is about breaking those timescales down into the various stages for service improvement. That is a very important area to look at, as well as focusing on outcomes and looking at the end outcome for the client. It is very important to link it with the PIs.
[130] Ann Jones: Joyce, you have a brief supplementary question.
[131] Joyce Watson: I am confused, which might not be a great surprise. I want to understand the difference between using a grant system, and that possibly causing delays, and not using a grant system. I suppose that, because Pembrokeshire has said that, very often, it is the client who holds things up because they have to get the agent, I need to know—through you, Chair. If you do not feel that you can give us a detailed explanation on that now, I am quite happy to accept a note on it, but I do not think that we can move forward in our discussion and our findings unless we understand the difference between those two systems.
[132] Mr Stobbart: I suppose that, as I was the one who raised it, I ought to come back on that. The issue with an authority that runs a full agency system is that it will provide the architectural service. It will provide the assessment, the architectural service, and it will employ the contractor and supervise them to deliver the final adaptation. With a grants regime, we will do an assessment, we will do a technical assessment at the property, and then we will invite the individual to apply for a grant. The decision rests with them as to how long they take to make that application. Similarly, when they have applied for the grant, we take it through a process and approve it, and currently we approve grants within five weeks of the date of application, which is a fairly reasonable average time. Then the customer has to go and appoint their contractor and get the work done, so there is a major difference between the two systems; a major difference.
[133] Joyce Watson: Absolutely.
[134] Mr Jones: I think personally that it is very important to have an all-in design team linking with the OT service, because it all adds up for vulnerable clients and their families as a massive task. They are already in a lot of difficulty, so to expect them to take on that role is asking far too much. In Conwy it has been beneficial to bring a team together with the OT service, housing renewals and social services and look at it as a one-stop shop.
[135] Mr Stobbart: In mitigation, I can say that Pembrokeshire uses Care and Repair to assist in that role, guiding people through the system. Also, we pay agents a reasonable fee to take them right through that process as well. Of course, when dealing with the private sector, it is difficult to keep control of it on a day-to-day basis.
[136] Mr Kidwell: I would say that, at the outcome of the review, we understood what was happening in this. We removed all the barriers to people having help in terms of design. The people who are going out will be the same people who do the design and monitor the work through to the finish and appoint the contractor.
[137] Joyce Watson: [Inaudible.]—that was not happening.
[138] Mr Kidwell: It was a barrier. It was something that did not need to be in the system, and it did not help people. People were asking for help, and so you give them the help.
[139] Ms Pratlett: That is what we apply in Torfaen as well.
[140] Ann Jones: Lindsay, you have been patiently waiting.
[141] Lindsay Whittle: That is okay. Good morning. Your evidence is certainly consistent with other witnesses. Performance indicators certainly need a bit of a revamp, to say the least, because they should be measuring success, and I do not think, from what I am hearing, that they are. How can the outcomes and impact of the adaptations be monitored more effectively in your opinion and experience?
10.30 a.m.
[142] Mr Jones: What we currently do is carry out customer satisfaction surveys at the end of the job. We measure the client’s perception of the service by the housing renewals, and they see the occupational therapist throughout the process. We ask in a questionnaire about outcomes and what benefit the adaptation has and we do an analysis of all the data, which has been very beneficial to us in measuring service delivery.
[143] Ms Pratlett: We do the same questionnaire at the end of that intervention. We have also extended the ongoing review, where we have social work and ongoing care involvement, to measure the impact that that has had on the individual’s quality of life and the amount of care that they now need.
[144] Mr Kidwell: There are a whole range of other things to measure. We might measure how many times the client comes back after we have done the work. If they come back six months later, there has to be some question as to whether it was the right work in the first place. Do they come back in a year later? Do they get homecare in the same year? Do they go into residential care? You can measure these things and they tell you a lot more about the system.
[145] We also measure whether they get the help that they need, and whether it was what they were expecting, and whether it made a difference in terms of what they can do, and what their family and carers can do. We continue to measure the start-to-end process, because it is crucial, but it is split up into various different sections. If we understand that there may be a blockage somewhere, we will take the measuring down to much more detail—we will measure how much work a contractor has, what the outcomes of that work have been and how long we have taken over different elements of it. The last part is to ask the customer one question, namely to grade us from one to 10, 10 being the highest, and to ask, if it is not 10, why not? I suppose that that runs into two questions if it is not 10, but the aim is to find out what the problem was for the customer in that process and how we can put it right and move forward.
[146] Lindsay Whittle: That is really interesting. Should any new indicators allow each stage of the adaptations to be assessed, therefore? You seem to be suggesting that they should. What about the longer term monitoring of adaptations for someone who is 55 years of age, say, which enable them to live longer in their own home, as to whether the adaptations are suitable when they are 75 years of age? Is there any longer term monitoring of adaptations, and do you think that there should be?
[147] Mr Kidwell: From the point of view of the development into integrated services, the recognition of better intake models and more collective expertise at the front end from a systems point of view, we are putting in experts at the front. So, by putting people together more evidence will be available, which will have an effect on DFGs. DFGs are among the solutions along with formal care, so they all need to be seen in the round. We need to be measuring all of them to see what impact they have on each other.
[148] Ann Jones: We will move on to funding, and questions from Gwyn.
[149] Gwyn R. Price: Good morning to you all. Could better use be made of existing adaptations, for example through recycling equipment such as stairlifts and developing accessible adaptation housing registers across the piece?
[150] Mr Stobbart: We have developed an adapted housing register in Pembrokeshire, and we work closely with Pembrokeshire Housing, with which we have a joint housing register. We try to match disabled tenants with appropriate housing wherever appropriate. One of the biggest obstacles we face is people who simply do not want to leave the property that they live in, and it is very difficult for us to force anyone down the road—perhaps ‘force’ is the wrong word; what I mean is that we cannot coerce people in that direction. However, wherever possible, we try to match relevant cases to appropriate housing. That works well. We have a housing officer/occupational therapist panel that meets regularly and looks at individual cases to ensure that that option is at least determined at the front end of the system before we start to embark on the route of expensive adaptation to public sector property.
[151] Mr Jones: I think that the property matching service is very important, especially given the pressures on local authority funding. We have a property matching service in Conwy. We have an officer doing that role currently, linking with the registered social landlords, and a register of adapted properties. Going back over the last three years or so, we have saved in excess of £400,000 by moving more people to adapted properties as opposed to doing adaptations. We recycle a lot of stairlifts; we have set up a north Wales contract for that, so a lot of our stairlifts are recycled, as well as through floor lifts and hoists, which is proving very beneficial and is leading to big savings.
[152] Mr Kidwell: I agree with my colleagues. However, while the housing register works for social housing, on a private basis, it is an entirely different kettle of fish—it is very difficult to manage. We have had a register for a number of years, but I have yet to see anybody move.
[153] Ms Pratlett: You have to take into account the different geography of areas. Certainly, in rural locations, people could be moved out of their support network, which has a significant impact. So, you have to weigh that up, which we do.
[154] With regard to recycling, in Torfaen, we have started to use a lot more temporary portable ramps and things such as that so that we can recycle them as people’s mobility changes. All local authorities are looking at the recycling element in particular. I see the benefits of the property register and the matching, but you have to look at the social elements and networks as well.
[155] Gwyn R. Price: Do you have a register in Torfaen?
[156] Ms Pratlett: We started doing some work with RSLs around a register. We do not have a fully developed register at the moment.
[157] Gwyn R. Price: Do you have best practice across the piece? You said that you have a register, and you may think that could be a rural issue, and does not apply to you. However, as a matter of best practice, do you think that the register is a good thing?
[158] Ms Pratlett: I do, particularly where clients have complex needs and given the amount of money that is needed to adapt those properties. You need to get that throughput, for want of a better word, and get the best properties for the best value.
[159] Mike Hedges: I have two questions. The first is whether you think that regional collaboration offers any opportunities to make savings or improve the service. Secondly, and perhaps this is more difficult, you are in competition with a whole range of other things for capital expenditure. As you know, your revenue support grant is made up of a calculation of how much should be spent, or how much is in the system that is then hypothecated for disabled facilities grants. Do your authorities spend more or less than is calculated, or exactly the same amount, or do you not know?
[160] Mr Kidwell: I would not be able to say so; not as far as I am concerned. The only thing that I would say is that there is a strong commitment to that. On the hypothecation argument, the authority supported unhypothecation a number of years ago, so I do not know whether we can go back and say something different now.
[161] Mike Hedges: I did not make my point. Although the money comes out unhypothecated, the calculation of how much capital you have is fitted in there. It might say, ‘Neath Port Talbot—£4 million for DFG, £5 million for education’. That is how it is calculated in the standard spending assessment that goes into the revenue support grant. So, you can then check back against the book to see whether you are spending more or less than that.
[162] Mr Kidwell: It is not something that I am aware of in terms of looking at that. The question for me, always, is: how do you know that is enough? I know how many people are coming in, and what part does that play in the calculation of how much money that we get, whether in the amount of money that the authority gets or the calculation for the authority?
[163] Mr Stobbart: We have a statutory duty to deal with mandatory applications. It is about demand, and, at the end of the day, I have never found in Pembrokeshire, for example, that the budget for the mandatory disabled facilities grant has been stretched by the demand. We have managed to meet the demand year on year, although we have had some slight hiccups in the public sector in terms of the level of spending within the housing revenue account. However, we have always managed to deal with the demand with which we have been faced. So, the local authority, in itself, is complying with its duty in that respect.
[164] Ms Pratlett: We have £1.1 million allocated to us in Torfaen. As we are a small authority, I think that that shows the corporate support. However, I have to say that, going back two years, in about November or December, we ran out of money. That impacts on the time that it takes, but it is not just about allocating more money. Through the work that we have done around procurement and e-tendering, we are now able to process more applications for less money while still keeping the quality. I know, certainly from working with Care and Repair, that we have managed to almost clear the waiting list. Yes, I had to put in another £70,000, I think, from revenue to support that, but we know that, going in to 1 April, it is a fresh start—we do not have a big waiting list. It is not just about more money, but about better use of the money that we have.
[165] Mohammad Asghar: The witness from Torfaen said that there is a lack of knowledge in the adaptations sector and in the housing sector. Is that just in Torfaen, or right across Wales?
[166] Ms Pratlett: I think that it is a lack of knowledge among the public. We are doing a lot more work with RSLs. We have not fully got there with the housing register, but the work that we have done internally, bringing the different elements together, has been really positive. Going back two or three years, there was poor communication between the OTs and the surveyors, and poor communication then going back to the customer, which was confusing for customers. Those are the bits that make a difference to the customer—they do not want two people who do not know what they are talking about, or who are not talking to each other.
[167] Ann Jones: Thank you, all, for coming to give evidence. We will send you copies of the transcript to check for accuracy, and we will send you a copy of our report when we have finally decided on our recommendations. Thank you all for coming today. We will now have a break until 10.50 a.m.
Gohiriwyd y cyfarfod rhwng 10.42 a.m. a 10.52 a.m. The meeting adjourned between 10.42 a.m. and 10.52 a.m.
[168] Ann Jones: Welcome back to the Communities, Equality and Local Government Committee. If you switched your mobile phone on during that brief break, please make sure that you switch it back off.
Ymchwiliad i Addasiadau yn y Cartref—Sesiwn Dystiolaeth 12 Inquiry into Home Adaptation—Evidence Session 12
[169] Ann Jones: It is a pleasure to welcome the Welsh Local Government Association to give us some evidence. Will the three of you introduce yourselves for the record? Then, we will go straight to questions, because we have quite a few questions to go through. Will you start, Naomi?
[170] Ms Alleyne: I am Naomi Alleyne, director of equalities and social justice.
[171] Ms Finch: I am Sue Finch, housing policy officer for WLGA.
[172] Mr Williams: I am Kenyon Williams, private sector housing manager at Caerphilly County Borough Council.
[173] Ann Jones: Thank you. Naomi will know—I do not know about the other two witnesses—that this is the third inquiry into home adaptations. The last one was done by the Committee on Equality of Opportunity, and there was a set of recommendations in 2009. I want to ask you this today: how have local authority adaptation services improved in recent years?
[174] Ms Finch: As we explained in our written evidence, the figures for waiting times, which are recorded through the performance indicators, speak for themselves. They have continued to decline significantly since 2005-06 and since the last inquiry. We carried out a survey of authorities in preparation for this inquiry and came up with a huge range of improvements that authorities have made since the 2009 report. It is in our written evidence, but, essentially, it relates to more co-ordinated teamwork with regard to responses to customer requests for help, better procurement and more regional work to share good practice. The list goes on as to what actions local authorities have taken, largely, in an effort to improve services, irrespective of what the committee report said. It was a direction of travel that authorities were taking anyway.
[175] Mr Williams: That has been happening since 2005. After the 2009 set of recommendations came out, we all got together, as a working party, with our colleagues in Welsh Government and looked at the efforts of local authorities in addressing the recommendations of previous reports and took it on from there.
[176] Ann Jones: We have just had some local authority representatives giving evidence, and it is clear that there is not a common system among local authorities in terms of how they operate. Does that contribute to the way in which the delivery times for DFGs are so massively different in every local authority? Are there two local authorities that have the same waiting times?
[177] Mr Williams: I would not know.
[178] Ann Jones: Okay.
[179] Mr Williams: Having said that, the manner in which adaptations are processed will vary from authority to authority. I am extremely lucky in Caerphilly; I am fortunate to work within a unified housing department that looks after the private and public sectors. We have a dedicated adaptations team and a one-stop shop for adaptations, dedicated occupational therapists within the housing team, and extremely good working relationships with our OT colleagues and social services. For example, when we are dealing with adaptations, we deal with them cross tenure. We do them for council house tenants, because we are a stock-retention authority, and we deal with them for those who go through the DFG system. The same occupational therapists go to either client, apply the same set of criteria and come up with the same recommendations. The person in the council house will get his adaptation done in 190 days and the person who is going through the DFG process will get theirs done in 320 days. That is nothing to do with the team. The team does the same amount of work on both, but the process for the DFG is substantially more bureaucratic. The manner in which local authorities tackle that will vary. In Caerphilly, for example—I am sorry; I will keep referring to Caerphilly, but I know that I am here with the WLGA—we have a full-blown agency service, whereby no-one has to fill in an application form or do any of the means testing; it is all done for them. Not everybody has that luxury, but there is a disparity of service across Wales, and we are striving to share our best practice and encourage others to be consistent in upgrading their service provision.
[180] Peter Black: We have referred to the number of reviews that we have had and the Welsh Government, in its housing White Paper, said that it is going to carry out a further review of adaptations. Are there any particular recommendations that you would like to see coming out of that review that you think would improve the process across Wales?
[181] Ms Finch: It is ripe for review. We welcome the White Paper proposal to review. Returning to the concept of a waiting time, it is very misleading to think of it as a waiting time, because it is a failing of the performance indicator in that it measures different things in different authorities. The interpretation of the PI is different in different authorities. So, it is very difficult to use that as a way of comparing authorities. An important part of the review would be a revision of that PI. What we are measuring is process; the number of days that it takes to go through a process. Part of that will be waiting for the builder to be available and part of it will be waiting to go through the planning. So, it is measuring a process, and not measuring satisfaction with the outcome. We should be aiming for a PI that measures outcomes and there are many different ways of achieving the outcome of adapting someone’s home. DFGs are one way of doing that; in fact, it is a minority approach, because it is largely used for large-scale adaptations. There is a huge amount of traffic on minor adaptations, or rapid response, which might take a matter of days and that remains unrecorded in the PI. So, a PI that looks at outcomes and all the ways in which we deliver those outcomes would give us a better sense of what is going on in Wales: where there needs to be further improvement and where there is some good practice.
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[182] The other important part of review is about ensuring that the provision that we make is tenure blind. There is no doubt—I am sure that you have heard evidence from other organisations—that your ability to access an adaptation will differ depending on which sector of the housing market you live in. For instance, RSL tenants have access to both DFGs and physical adaptation grants. In fact, the physical adaptation grant is a much larger pot per head than the DFG pot. People in the private rented sector have relatively little access because of the issues around being able to guarantee their security in that accommodation for a period of five years, which is specified in the regulations. I think that we need to look at making sure that the provision is much more tenure-blind than it currently is. There are some easy ways of doing that, but I would not pretend that it will be an easy job overall because there will be some quite difficult bits of that job. However, it is very welcome.
[183] Ms Alleyne: We very much welcome the opportunity provided by the review to input into that. Having read some of the evidence provided, I think that there is quite a lot within the evidence that should help to form the terms of reference of that review. Sue has picked up on some of the detail, but I think that there is quite a bit of consistency around some of the issues and concerns that agencies think that the review should address in that way. So, I think that it does give us an opportunity to take a lot of the recommendations and to look at current practice and at what we can do collectively to improve that moving forward.
[184] Joyce Watson: Do different parts of local authorities—housing and social services and health, for example—work together on this particular issue? I have heard from Caerphilly, so I do not need that repeated, but I am asking about others.
[185] Mr Williams: I would like to think that what happens in Caerphilly is mirrored by the majority of other local authorities.
[186] Joyce Watson: Is it?
[187] Mr Williams: I think that it is. It is certainly getting better.
[188] Ms Alleyne: Particularly over the last few years, it has arisen as a corporate issue. It is seen as something that is not just a housing function; it is something that delivers priorities and objectives that other departments across the authority have, particularly around things like independent living and ensuring that disabled children have quality of life. There has been an increasing profile, which has led to people understanding the benefits gained by other departments through undertaking effective DFGs. I think that that is reflected in the discussions that we have with our Cabinet members, who are often responsible for housing and social services. There have been some changes around the integration of that, which means that there is a more joined-up approach to tackling those issues. The priority that has been given to this has increased over the last few years.
[189] Mr Williams: That is also helpful at a local level, when we have the annual capital bun fight, as it were; because it is such a corporate priority, resources for disabled facilities grants are always put at the top of the list. So, that budget is the first one that is put in place. We never have any argument about that corporately. Cabinet members for social services and housing are totally supportive of that. I think that you will find that that is the picture in most places.
[190] Ann Jones: Do you have any evidence, as the local government association, that what Mr Williams is saying about Caerphilly actually is the same across local authorities? I would not be so bold, Mr Williams, as to say that every local authority does it. I have some real worries about some of the local authorities.
[191] Ms Alleyne: I do not think that we have the evidence across the 22 local authorities, but that has certainly been the discussion during our discussions with our cabinet members along with our heads of housing. That is not from each of the 22 local authorities, but there is certainly that commitment around the corporates. It is those who contribute at that meeting, so I could not tell you that it is across the 22 local authorities.
[192] Joyce Watson: You have said that you think that that is the case, you have talked about some of the reasons for delays in the adaptations system and how they could be reduced, and we have heard this morning that one size does not fit all. Would you like to explain to us why one system will not fit all, or do you think that one system could fit all?
[193] Mr Williams: I will have to give that a bit of thought. In principle, one system could fit all; in practice, it would be extremely difficult. Capital funding restrictions would be difficult. Ultimately, a disabled person in an RSL property, a council house, a stock transfer home, the private rented sector or an owner-occupier should have exactly the same access to whatever service anybody else should have.
[194] Ms Finch: We would support the idea of one system applying to everyone, which links it up with this idea that the system should be tenure-blind. Wherever you live, you should have the same opportunity to benefit from adaptations. I think that it is inevitable, within organisations, that processes are sometimes slightly different, but the system should effectively be the same. However, I can understand why some authorities—probably most of them, in fact—have a fast-track process; if someone is terminally ill or someone is coming out of hospital, you need to be able to deal with that in a different way.
[195] Joyce Watson: That would be in the system, would it not?
[196] Ms Finch: Yes. If you have someone who merely needs a grab rail by the bath, it would be sensible to have a system where you put that in place very quickly, rather than putting people in the same queue. Essentially, the system should be the same, but it should allow you to identify how you can meet needs most effectively within that similar system.
[197] Joyce Watson: If I remember the figures correctly, you said that it would be 160 days against 390 days for a DFG, depending on whether you were in private or public sector housing—
[198] Mr Williams: The figures that I quoted? They were not quite—
[199] Joyce Watson: Yes. I think that those were the figures.
[200] Mr Williams: I was trying to make the point that it is far easier to deliver an adaptation outside the DFG system.
[201] Joyce Watson: Outside; okay.
[202] Mark Isherwood: Therefore, to what extent would a single adaptation system create a more level playing field for private tenants, social tenants and owner-occupiers?
[203] Mr Williams: The DFG process—as you will have heard over and again—is just bureaucratic in the extreme. There is an argument that certain people should pay towards adaptations and that if you are an owner-occupier with substantial savings, there is no need for the public purse to pick up the tab for it. We have heard the debate about the means test, for example. There are people who fall foul of the means test, and there are other people who do very well by it. You can end up going through a means test and come out with a nil contribution and still have £20,000 or £30,000 in savings. Likewise, we get telephone calls—and I had one the other day from someone who had nearly £70,000 in savings—asking whether they could get a disabled facilities grant. So, there is a degree, I think, where we have to say—as sympathetic as we are to the needs of disabled individuals—that some people need to make a contribution towards it, and that will vary from sector to sector.
[204] Mark Isherwood: In your evidence, you call for more focus on the outcomes for disabled people. Therefore, across Wales and across the unitary authorities, how and to what extent is the current system meeting the needs of disabled people and achieving positive outcomes? Is that being quantified in any way?
[205] Ms Finch: Clearly, the outcomes are very positive in terms of cost savings, quality of life and so on. It is just that the PI does not record that. The PI merely records the time that a process takes from the beginning to an end. So, it gives you no insight into what is working well and what the differences in outcome might be for different authorities or processes.
[206] Mr Williams: I can sit here and wax lyrical about the way in which I deliver adaptations in Caerphilly, but we are not particularly good at going back in a year later to see what a difference that adaptation has made and talking to the individual concerned. There is probably a piece of work to be done there in respect of the actual effectiveness of what has been done.
[207] Mark Isherwood: That very much reflects the response that we had from the previous witnesses. Therefore, to what extent would customer satisfaction feedback assist this process, or does it assist in certain parts of Wales already?
[208] Mr Williams: I cannot believe that any authority does not undertake customer satisfaction mechanisms. We do it. I would say that our customer satisfaction in Caerphilly is in excess of 95%.
[209] Mark Isherwood: Does that include quality of life?
[210] Mr Williams: Yes. I say ‘quality of life’, but the problem with the customer satisfaction survey is that it is done fairly quickly after the adaptation is done. Really, it should be done a bit later than that. You cannot really measure quality of life at that particular point in time.
[211] Mohammad Asghar: What improvements should be made to the information that is made available to disabled people, their carers and families about housing adaptations? I think that Naomi should answer this question.
[212] Ms Alleyne: Awareness of DFGs or adaptations is already made available via a number of sources, such as websites, newsletters, or individual referrals, but just by feeding into some other work that is ongoing, it is very difficult sometimes to ensure that the advice, information and assistance are there, because the application forms can be quite complex and lengthy, to say the least. It is important, and it is a key issue for us generally, to ensure that advice and information are available in lots of different formats at lots of different times. It is something that we are continuing to improve more generally, not only in relation to adaptations, but on a whole range of other issues. There have been a couple of reviews and we fed into the review that the office of the Commissioner for Older People in Wales undertook last year about advice and information on a range of subjects, and there are a number of lessons to be learned from that in terms of moving forward. It is about making sure that people have the information available to them at the time when they need it in order to make that decision. So, it is about making sure that our colleagues, not just in local government, but across health and other agencies, are aware of that and can provide the information to people as they need it.
[213] Mohammad Asghar: Thank you for that, but your own paper says that the system is
[214] ‘complex and in some respects inequitable’.
[215] Those are your words. So, we heard Mr Williams saying that they have a one-stop shop and 95% achievement in Caerphilly, but how about the other areas in Wales? Are they learning from them? What are you doing about it?
[216] Mr Williams: There are several best practice guides that have been published on this issue. I sit on the housing technical panel, and I know that you have taken evidence from it as well. Very few of our agendas for discussion do not include adaptations and best practice, so there is a mechanism to do that. We have done seminars in the past as well, to try to spread it around. Coming back to what Naomi was saying about the availability of information for people, I think that it is there: it is there on websites, and in publications that local authorities send out every quarter. They know exactly where they have to go to get information. What is important as well is that clients are helped through the process. I took the opportunity of bringing an application form with me and, as you see, it is 28 pages long. It beggars belief for me that sometimes we simply send out an application form that is 28 pages long and ask elderly people to come back with two estimates from builders, certificates of future occupation, and so on—I think that service should be provided for them. We do it in Caerphilly, and I know that an awful lot of local authorities are already doing it, and others are moving in that direction. It is so important for the client experience.
[217] Ms Alleyne: One other thing in terms of reports, I do not think that I can sit here and talk about what is happening across the 22 authorities, but the social services Bill, moving forward, will look to put a duty on local authorities around advice, information and wellbeing, so there will be opportunities. This will be an important aspect of ensuring that people’s wellbeing is being catered for. So, if it is not there across the 22 now, the social services Bill will obviously ensure that it is there in the future.
[218] Ann Jones: If an in-house agency is the best practice—and I think there are some differences across the 22 authorities—why is that not spread as best practice? What does the WLGA do to make sure that that best practice is worked on with those local authorities that still do not have an in-house agency?
[219] Mr Williams: The predominant discussions about adaptations and in-house agencies are those of the housing technical panel, and that covers all 22 local authorities in Wales. When I say that people need to be hand-held through this process, it does not necessarily have to be the local authority that does it, but someone within that local authority area has to do it. You find that certain Care and Repair agencies are very good at it. Someone has to do it. All 22 local authority areas should have someone in place, be they Care and Repair agencies or the authorities themselves, to handle what is a very difficult process.
[220] Ann Jones: What support is there for self-funders—people who will not apply for the DFG because they know that it is means-tested? So, what support is there across—
[221] Mr Williams: May I stop you there for a minute? First of all, I would always encourage people, even those who need to make a contribution, to apply for a disabled facilities grant. The reason for that is, say, for example, someone is means-tested and their contribution is to be £5,000 but the cost of the adaptation work is less than that—so, to all intents and purposes, they will have to pay for the adaptation in full themselves—they should still be given a disabled facilities grant approval for nil because if, at any time during the next 10 years, there is a need for them to come back for another adaptation, that initial contribution will be deducted. Okay?
[222] Ann Jones: So, why is that not best practice across all 22 authorities?
[223] Mr Williams: That is not best practice; that is statute. Those are the rules of the test-of-resources legislation.
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[224] Ann Jones: All right, then; there are some local authorities that do not do that, but never mind. There we go.
[225] Peter Black: They do not tell people.
[226] Ann Jones: There you go. If you are saying that it is statute—
[227] Mr Williams: It is.
[228] Ann Jones:—and it does not happen in some local authority areas, then I can feel a recommendation coming.
[229] Mr Williams: I think that it probably does happen if somebody comes back a second time. Perhaps it does not happen in that people are not told about it in the first place.
[230] Ann Jones: Yes. There are a lot of things people are not told about when they are self-funders, but that is another issue, is it not?
[231] Mr Williams: Again, with self-funding, if they cannot afford it, we will lend the money.
[232] Ann Jones: Oh, right. Okay.
[233] Mr Williams: Yes, we do property appreciation loans. There are all manner of opportunities out there.
[234] Ann Jones: Thanks. Sorry; I jumped in on somebody’s question there.
[235] Mark Isherwood: In its written evidence, Neath Port Talbot told us that it had shared its good practice on DFGs across Wales, but that
[236] ‘there still does not seem to have been any significant move by other authorities to use the learning within their own DFG processes.’
[237] To what extent could be WLGA move on from sharing to implementing, and then to monitoring?
[238] Ms Alleyne: Through the cabinet network that we provide, I think that Neath has been there in the past to give a presentation and to answer questions around the process on what it has done and what it has changed. I think that some of the other evidence demonstrates that people have learned from different parts of it but may not have replicated the whole system or the whole-scale changes that Neath had put in place. I think that it is down to local discretion as to how they run their systems and how they feel some of the changes—or what they hear from elsewhere—will fit within the current system, if you like. So, reading some of the evidence from Torfaen and Pembrokeshire, bits have been learned, so they have looked at the processes that Neath and others have done.
[239] An issue that we, more generally, want to pick up is the sharing of best practice. In some instances, we do not need to reinvent the wheel; there are good processes that are ongoing, and I am not sure what else we can do, apart from making sure that people are aware of the good practice. Very often, it is not just a presentation; if someone is not in attendance, those details are then sent out. The people who provide the presentations are more than happy to sit with authorities and talk them through the process. So, I think that the opportunity is there. People have just looked at their own processes and have made some amendments, but they may not have adopted whole-scale what Neath has done in that way.
[240] Mr Williams: The regional collaboration agenda is helping. Certainly in north Wales and in Gwent, we have working groups on adaptations, and we are talking about this sort of thing. So, the best practice is certainly being shared within regions.
[241] Mark Isherwood: Is it being implemented?
[242] Mr Williams: Yes.
[243] Ann Jones: Joyce, do you want to come in on this?
[244] Joyce Watson: Yes. Local authorities quite clearly need to know about best practice. Does every single member on a local authority get information about best practice, just to avoid, for example, a leading group perhaps not wanting to implement it or to inform the opposition of the best practice? How do you share that with your members?
[245] Ms Finch: We have a website, as all organisations do. We have a section that deals with adaptations, and our good practice advice is on there, with links to other organisations that have developed similar good practice advice. So, the information is publicly available to anyone who wants to locate it.
[246] Ms Alleyne: More recently, we have started establishing networks of scrutiny chairs—that is, those who would scrutinise that performance within an authority. At the beginning of this year, we had a full day’s seminar for the chairs of housing scrutiny committees. The idea is that we can provide some of those examples, Joyce, to those that will then scrutinise cabinet members in the ruling administrations. So, that information about practice is shared more broadly to enable them to be informed about those opportunities, to pick that up and to question that internally with the authority as well.
[247] Joyce Watson: Would all authorities allow their chairs to go to those days—in your opinion?
[248] Ms Alleyne: I think that part of the difficulty at the moment is that some authorities, because of the costs, have had to bear down—
[249] Joyce Watson: So, the answer is ‘no’, then.
[250] Ms Alleyne: Well, it is not as simple as ‘no’, because it is not about ‘allowing’. We try to hold it in mid Wales, and we have looked at the opportunity to have networks in south Wales and in north Wales, to cut down on the travelling, but we are obviously making sure that, after the meetings, all the presentations that have been provided, are sent out to all members that were invited to those meetings. So, it is not just the people who have attended that will see the presentations; they are more broadly shared with anyone who could not attend. However, I am not aware of any scrutiny chairs who have said that they cannot attend. As I said, this was the first meeting, but the feedback was that they found it really useful, and it is something that we want to continue to do in moving forward.
[251] Ann Jones: We will move on to performance monitoring.
[252] Rhodri Glyn Thomas: Rydych yn cyfeirio yn eich tystiolaeth—ac rydych wedi cyfeirio ato y bore yma—at y ffaith bod y dangosydd perfformiad yn annigonol i fesur gwerth y gwaith. Rydych wedi sôn am asesu boddhad y cwsmer a’r angen i fynd yn ôl yn ddiweddarach i weld i ba raddau mae’r addasiadau wedi gwneud gwahaniaeth i ansawdd bywyd y cwsmer. A oes modd creu fframwaith monitro perfformiad sydd yn gyson drwy Gymru i gyd er mwyn cael asesiad llawn o sut mae’r ddarpariaeth hon yn cael ei chyflenwi ym mhob awdurdod lleol?		Rhodri Glyn Thomas: You refer in your evidence—and you referred to it again this morning—to the fact that the performance indicator is inadequate in measuring the value of the work. You mentioned assessing customer satisfaction and the need to return to look at the extent to which the adaptations have made a difference to the customer’s quality of life. Is there a way of creating a performance monitoring framework that is consistent across Wales in order to have a full assessment of how this provision is delivered in each local authority?
[253] Ms Finch: It would be following the direction of travel that is already being set by other policy areas, such as social services and Supporting People services, which are all developing outcomes frameworks to look less at process and more at what the outcome for the client or the customer is. I do not see any reason why that is not achievable within this policy area as well.
[254] Rhodri Glyn Thomas: Beth felly fyddai’r criteria ar gyfer y math hwn o fframwaith i fonitro perfformiad? Pa fath o ddangosydd perfformiad fyddai angen ei greu er mwyn sicrhau bod y darlun yn un cyson?		Rhodri Glyn Thomas: So, what would be the criteria for this type of performance monitoring framework? What type of performance indicator would be required to ensure that there was a consistent picture?
[255] Ms Finch: The Supporting People outcomes framework, in a similar way to the variety of people accessing disabled facilities grant, deals with a huge variety of needs. The outcomes framework is based on an assessment by the customer of how much their life has improved or how much more independent they have become. So, it is very much based on the perspective of the user of that service, rather than on any external definition of what the outcomes might be. I can imagine that different people will have different views on how good a measure that would be.
[256] Ms Alleyne: That framework was developed with input from practitioners across sectors, namely local authorities and providers. It took about nine months to a year and a lot of discussion to try to make those as focused in the right way as possible. It is probably something that we could do collectively to move that forward and across a lot of the concerns that some other agencies and departments would have as well.
[257] Ann Jones: We will move on to funding. Gwyn?
[258] Gwyn R. Price: Good morning. What are your views on the current funding arrangements for DFGs, where it is for local authorities to allocate resources from their general capital resources? As a little follow-up, what is your view on whether funding for DFGs should be hypothecated?
[259] Ms Alleyne: Our view as the WLGA is that it is much better for funding to be unhypothecated because it can then be allocated according to priority. Some of the discussions and feedback that we have had from local authorities has been around making sure that the benefits of DFGs are understood across the authority, so that it is seen not just as an allocation for housing and that the benefits are seen as being taken into account. Some of those processes will differ from authority to authority. Kenyon has a bit more detail, not just from Caerphilly’s perspective, but from the discussions held by the housing technical panel.
[260] Mr Williams: The most important thing is that it is a mandatory grant, and should remain so. As long as it is a mandatory grant, local authorities will discharge their obligations in resourcing it adequately. There will never be enough money, let us be totally honest. We are an ageing society that is getting older by the minute, so the demands will become greater. I am not too sure how hypothecation would work—how the funding would be allocated, who would have what and, more importantly, where the money would come from. Would the money come from another housing pot that is already under pressure?
[261] Peter Black: Given that it is a mandatory grant, how do you ensure that you do not overspend?
[262] Mr Williams: We budget for it properly.
[263] Peter Black: So, you ensure that you estimate the demand for the grant each year, and you ensure that you have the money for that. Do you ever face a situation where you receive more applications than for which you have money?
[264] Mr Williams: I am sure that there are local authorities that struggle. I cannot keep banging on about Caerphilly; I am not here to do that. However, this is resourced properly by us, and it is resourced properly by most other local authorities. It is getting more difficult; you sit in a capital strategy meeting with colleagues from the education and social services departments, and it is getting more and more difficult.
[265] Peter Black: It has been suggested that some local authorities will operate a waiting list for the grant—an unofficial waiting list—before it becomes mandatory. Has that happened in some local authorities, in your experience?
[266] Mr Williams: I would hope not.
[267] Ms Finch: I have never heard of an authority that has done that.
[268] Mr Williams: There is a mechanism within the statutory framework for local authorities to delay the payment of the grant anyway, so there should not really be a need for that to happen.
[269] Ms Finch: The inevitable increase in demand and rising pressure on budgets are prompting authorities to look at different, more effective and efficient ways of delivering services; for instance, regional procurement has been an approach that has been used to drive down the cost of stairlifts or walk-in showers. There has also been a shift to move provision to minor adaptations grants, and to increase the ceiling for those grants, so that you can do the work more quickly and through a slightly different process. Authorities are managing that in different ways, largely by trying to drive down the costs as demand increases.
[270] Gwyn R. Price: What are your feelings on whether or not the means test is a necessary part of the process? Is it just added bureaucracy that has little or no effect?
[271] Mr Williams: My personal opinion is that the means test should remain, but that it should be simplified. It takes an awful long time to get information from individuals; a lot of individuals simply will not give you the information in the first place. The problem with scrapping the means test, in my opinion, is that a lot of people who can legitimately afford to pay for an adaptation would otherwise have it done for nothing.
[272] Secondly, if you scrap the means test, coming back to what we have just discussed with regard to capital, the pressures on local authorities would go through the roof. I know that there is an argument that, at the moment, those who are asked to pay a contribution represent 5% of all of the DFGs that are made, but the minute you scrap the means test, you will have all manner of extra numbers coming through your door and placing demands on the service.
[273] Gwyn R. Price: Is it fair to say that you think that the bureaucracy that goes with this should be scrapped?
[274] Mr Williams: I think that the disabled facilities grant should remain in this kind of form, but that it should be simplified. If we can simplify things around the means test, the need for estimates and stuff like that, we can make a difference.
[275] Gwyn R. Price: As you were saying, we should ensure that people apply for the grant, even if they do not get it, because they may come back in future years to their advantage; that was a good point, Chair.
[276] Ann Jones: It was a good point. We may have to write to some local authorities and find out why they do not do that. I have a couple in mind—or one, at least.
[277] Mike Hedges: You say that hypothecation would mean that money is taken away from other places, but that is not the case. I do not actually believe in hypothecation, but all you would have to do is take the rate support grant that you get, which is calculated with so many DFGs as part of it anyway, and compare how local authorities are spending against that. Do you know how many local authorities are spending more than the DFG-calculated portion of their rate support grant, and how many are spending less? If you do not, are there any means of finding that out?
[278] Ms Finch: One of the important things to recognise is that the element of the RSG that is allocated for this area encompasses renewal as a whole rather than DFGs alone. There is a proportion that is formula-driven that is for the whole of renewal; it encompasses grants to individual owners, renewal areas, DFGs and so on. Our last calculation showed that something like 60% of that element of the RSG is going on DFGs as an overall average. However, there is no specific amount in the RSG for DFGs.
11.30 a.m.
[279] Mike Hedges: So, the support group—which, I assume, is still going—has not gone down to that level. It used to do so.
[280] Ms Finch: I can see that there is an area of confusion. This is where it gets very technical, but one of the proxies in the formula for deciding how much of the RSG is for renewal for each authority is the number of DFGs granted in that authority area. It is possible to assume that, therefore, that bit of the RSG is for DFG solely; but, in fact, it is for renewal. Therefore, it is erroneous to judge authorities as to whether they have spent that on their DFGs, because it is for the whole of their renewal area activities.
[281] Mike Hedges: Thank you for that. Perhaps we need to get some more information on how the DFG function works from the Welsh Government or from the WLGA.
[282] First, a number of things could be recycled, so is enough done on recycling? Secondly—and this is something that I find to be really strange—you have purpose-built bungalows for disabled people that can only be used for disabled people within local authorities, and then you have houses and flats that have been massively adapted, with between £30,000 and £50,000-worth of adaptations having been spent on them, but when the person for whom they were adapted leaves, those properties go back on to general offer by RSLs and local authorities. Is there a case for having an adapted housing register to include those homes that have been adapted as well as those that are purpose-built?
[283] Ms Finch: Yes. There is an obvious direction for authorities to move in. Many of them already do that. In some authorities, there is a formalised, accessible housing register, and in others, it is a case of identifying which properties in the stock of that authority or that RSL have been adapted. So, when they come up as vacancies, they are then earmarked to be allocated to people who are in need of adapted properties. Most authorities will have some mechanism for doing that with their own stock, but there is an issue in terms of private stock, where authorities are not in control of the way that a property is disposed of after someone has left.
[284] Mike Hedges: I was only talking about housing owned by councils or registered social landlords. Obviously, you cannot do anything about private landlords or owner-occupiers, but there might be a premium that they could charge for an adapted property, although that would be up to the market—there is nothing that we can do about that.
[285] Mr Williams: Generally speaking, most local authorities have an accessible housing register in place now; they have been put in place since 2009. You cannot always let an adapted property to a disabled person. There are huge demands on local authorities to return voids to occupation as quickly as possible. It is a case of being sensible about it, is it not? If you heavily adapt a property, that should be there for the needs of a disabled individual. Having said that, the needs of disabled individuals greatly vary.
[286] Ms Alleyne: We would accept that improvements have been made, but there are still improvements to be made in that area. Something that had not hit me until I read the Shelter evidence, I think, is what the bedroom tax will impact on going forward. That is something that we would need to specifically pick up on. While discretionary housing payments could be used to enable people to stay in their homes, perhaps that may not be used full time, on an ongoing basis, year in, year out. So, we need to look at how the bedroom tax impacts on people.
[287] Mike Hedges: Particularly when you build a bedroom downstairs and they have an extra bed, which, theoretically, they do not need but end up being charged for it.
[288] Mr Williams: You mentioned recycling. I presume that you meant stairlift recycling and that sort of thing.
[289] Mike Hedges: Yes.
[290] Mr Williams: Again, I would have thought that all local authorities do that. We even take them off private sector residents. We ask them to sign a form, and when they have had their use out of it, we take it back into stock to use it in social housing. We cannot always use them, particularly if they are between two and four years old.
[291] Mohammad Asghar: When you maintain these lifts, baths and other equipment for disabled people, how much does it cost the council for sub-contractors to maintain those when they come to knock on doors, rather than perform regular maintenance when needed? There must be a huge amount of waste there. Some people came to me saying that someone had knocked on their door saying, ‘You need the equipment serviced’, when there was no need for it. The council knew nothing about it. So, with something like that, how much of your money goes to these sub-contractors?
[292] Mr Williams: Sorry to keep banging on about Caerphilly—
[293] Mohammad Asghar: I am not talking about Caerphilly; I am talking about the whole of Wales. I know that you have painted a glossy picture, with your 90-odd per cent satisfaction rate, but I am talking about the whole of Wales.
[294] Mr Williams: Seriously, I would have thought that all local authorities annually negotiate a maintenance contract.
[295] Mohammad Asghar: My question is—[Inaudible.]. What is your stance on that? It is a serious amount.
[296] Ms Finch: I would be very surprised if all authorities did not have some form of contract for maintenance, because it makes absolute sense. I know that one authority carried its own insurance for breakdown instead of paying a premium to an insurance company for that, but that is a different matter. I would have thought that maintenance was something that regional groups should be looking at.
[297] Mohammad Asghar: I think that you better to look at this as a whole thing, because a great amount of public funding is being drained in that way.
[298] Mr Williams: Are you talking about social housing?
[299] Mohammad Asghar: Yes.
[300] Mr Williams: I find that strange. I would have thought that most authorities would have an annual maintenance contract negotiated.
[301] Ann Jones: There is another issue that self-funders who want to try to access maintenance often find that their local authority’s maintenance contract for its social housing is a lot dearer than what they can go out to find themselves. You talk about procurement. I wonder how local authorities procure to the best advantage.
[302] Ms Finch: Procurement by authorities follows a very formulaic process in that they are obliged to get best value in the broader sense of the term. That would be the process that they would follow in procuring maintenance services.
[303] Ann Jones: Thank you for that. Does anyone else have more questions? I see that there are none. Thank you for coming in and for your evidence. We will send you a copy of the transcript to check for accuracy—Naomi knows this because she has been here several times—and a copy of the report when we have produced it. Thank you to all three of you for coming today.
[304] Ms Alleyne: Chair, I just want to say that if there is anything in our evidence that you feel that you need more detail on, please contact us.
[305] Ann Jones: Thank you. That is helpful.
11.37 a.m.
Ymchwiliad i Addasiadau yn y Cartref—Sesiwn Dystiolaeth 13 Inquiry into Home Adaptation—Evidence Session 13
[306] Ann Jones: We now move on to take our evidence from Shelter Cymru. Thank you, Jennie, for coming in; it is nice to have you here. Jennie Bibbings is the policy officer for Shelter Cymru. Thank you for your written evidence. I will start off with some questions, if that is all right. This is our third inquiry into home adaptations; some of us have sat on all three. What are the difficulties that still face disabled people when they try to obtain adaptations?
[307] Ms Bibbings: We see the difficulties that people face in the casework that our clients come to us with every day. I want to focus on those impacts, because there are grave human impacts, which also carry economic costs. That is well documented. Research shows that the longer someone has to wait for an adaptation, the earlier they are admitted into residential care—I think that the figure is four years earlier. We also see the mental health impacts, which is something that comes across clearly, because our clients who are waiting a long time for adaptations have to make do in circumstances that are often very undignified. We have clients who are unable to wash themselves or who have to strip wash, because they are unable to have a bath or shower, and, sometimes, we have clients who are unable to go to the toilet without assistance. People have to live with these sorts of things for months on end and it has a negative impact on their mental health. There are also impacts on friends and family, because many of our clients rely on informal networks of carers, such as neighbours, friends and family who have to come in to help them with basic care needs, which would not be necessary if they had an adaptation fitted in an appropriate and timely way. So, there are wider impacts there. There are still issues around our clients experiencing stress and difficulty in accessing the list. There are also concerns about the means test and confusion about the different funding streams. There is a lot of bureaucracy that people have to negotiate. Specifically, there are a lot of problems in the private rented sector that I want to focus on in my evidence to you today.
[308] I also want to raise the fact that there are a lot of people who never make it onto the list in the first place. There is a dark figure of negative impacts on people, for whom a wait of a year or two just is not viable in their situation. A recent case study was brought to my attention in relation to a client of ours from south Wales who is a wheelchair user in social housing—in accessible housing. She had a ramp leading up to the front door, but there was a lip on the front door, so she could not get into the property. When the allocation was made, she was mostly using crutches and only needed the wheelchair on bad days, but as time went on, her condition deteriorated and she found herself using a wheelchair pretty much full time. At that point, she could not get in or out of her house without assistance, so she had to move in with her sister. She went to apply for an adaptation and the waiting time was such that it was not viable for her, because she would have had to have stayed with her sister for that length of time. The local authority advised her to give up her tenancy and move in with her sister and apply for a DFG at her sister’s house. That was not acceptable to our client, because she would be giving up a secure tenancy in favour of becoming a lodger at her sister’s house, with practically no rights of tenure whatsoever. So, the only option available to her was to give up her tenancy and apply as homeless. Think about the vast cost of that, when all she needed was a simple adaptation to help her to get over the lip of her front door.
[309] So, we see a lot of people who never make it onto the list in the first place and the longer that adaptation waiting times are, the greater that dark figure is that is not captured by performance indicators or traditional monitoring. We see a lot of difficulties. There is a strange phenomenon that when you are on a waiting list, waiting for that work to be carried out, it can lead to a stagnation of your living conditions. To illustrate that, we had a recent case with a client in west Wales who had been on the waiting list for adaptations for two years. His partner worked some distance away from where they lived and she had to do a 30-mile round trip every day to go to work. So, that was quite an expense for them and they wanted to move closer to her place of work. They found a house with which to exchange; it was a like-for-like exchange, but the local authority refused the nomination for him, because the property that they wanted to move to was not adapted, although the property that he was living in was not adapted either. The local authority told him that if he went ahead with the exchange, he would be put right back to the bottom of the waiting list. So, he would have another two-year wait and he would have to wait for an OT to come to do another assessment, which meant that it would be six months before he even got onto the list. At that point, he contacted Shelter Cymru and we negotiated with the local authority and, luckily, he was able to go ahead with the exchange and he did not lose his place on the list. However, that was after our intervention.
[310] So, there are a lot of negative problems that people still face and there is a cost to all of that. We know, in theory, that there are costs to all of that—to the NHS and so forth—but if we understood what that figure was, we would see that managing the situation, and dealing with the fallout of managing the situation in the way that we do, needs to be much more of a priority. It costs us a lot more than it needs to just to manage the long waiting lists, which creates work in itself—there are high drop-out rates and people’s circumstances change. If we could only circumvent that and get back to delivering things in the way that people needed when they needed them, it would be a much more efficient service overall.
[311] Peter Black: I want to take some time to look at the consequences of the examples that you have given. It seems to me that some of those clients have been getting some very bad advice, particularly in your first example, in terms of fast-track adaptations and the use of Care and Repair, which could have sorted that one out. So, I am just wondering whether you think that that is typical across Wales—that that sort of poor advice is available to people seeking adaptations.
11.45 a.m.
[312] Ms Bibbings: We do see this. It is a feature of our casework. All that I can say is that it is a danger. It may be poor advice. It may not be provision as it should be, but, at the same time, it is up to people then to have the wherewithal to seek advocacy and come to someone like Shelter Cymru and find out what the situation is really like. Yes, it is a factor.
[313] Peter Black: The Chair has already referred to the fact that this is the third review and that the Welsh Government also carried out a review in 2005 through Chris Jones. The Welsh Government has now stated in its housing White Paper that it will review adaptations again. Is there anything specific that you would like to see coming out of that review that will improve the situation for applicants around Wales?
[314] Ms Bibbings: From our perspective, we would like the review to perhaps take a few steps further back than previous reviews and to look in a very fundamental way at the way that adaptations are delivered. With regard to questions about the spread of good practice and why good practice has not spread, we have been saying this for a long time and there have been many attempts to spread good practice that have not been effective. So, I think that we have to take a further step back and ask ourselves why the current system is incapable of adopting what is known to be good practice, why we persist in having these arguments about the level of funding priority, and whether we can deliver it in a whole new way. Having spoken to some of my colleagues in disabled advocacy groups, I have found that there is a lot of interest in having a single entry point for adaptations across tenure, which is something that would really simplify things for people at the front end.
[315] I also think that the review should make involving service users a focus and that it should be grounded in what people actually want from adaptations. I think that the review should look at the actual cost implications. It is not the most straightforward methodology in the world, but it can be done. There are methodologies out there where you can look at the cost impacts of long waiting lists on services such as the NHS, and you can also look at it in terms of what it will cost local authorities themselves to run DFGs in the way that they do. The systems thinking work that was carried out in Neath Port Talbot found that there was this 33% drop-out rate on the list, because the waiting list was so long that people were dying or going into residential care, people’s needs were changing and people were dropping out because of concerns about the means test, and all of that work is a waste. I think that the review should look in a fundamental way at what it actually costs public services in Wales to manage this the way that we do. As things are at the moment, with a very localised structure, you have local decisions about funding priority and it is very difficult to make those arguments time and time again. It would be much easier and more straightforward if it was delivered centrally.
[316] Joyce Watson: You have already answered a lot of questions, so I will not ask all of those again. However, I am interested to know, as is the committee, whether people are being denied adaptations because of the area that they happen to live in.
[317] Ms Bibbings: There are inconsistencies across tenure and across local authority areas. In terms of the private rented sector we did some work looking at the distribution of DFGs in the private rented sector in Wales. We found that there were a lot of inconsistencies. Some local authorities were granting quite a lot of DFGs for the private rented sector and some were granting none. In fact, eight local authorities, which, collectively, account for 30% of the population in Wales, granted no DFGs at all last year. It is highly unlikely that 30% of the population of Wales has no disabled people in the private rented sector that have an adaptations need. There are, potentially, arguments around why those figures are the way that they are in terms of allocations policies, because some local allocations policies may prioritise disabled people more highly than others, but all of them will prioritise disabled people to a certain extent, so I do not think that it can account for the rather extreme levels of inconsistencies that you see in last year’s figures. For us, it is a great problem, and it will become more of a problem with welfare reform, because it is likely that we will see more and more disabled people who have adaptation needs who will have no choice but to find housing in the private rented sector in future.
[318] Joyce Watson: Do you think that the bureaucracy of the adaptations system, particularly the means test for the DFGs, is a major problem?
[319] Ms Bibbings: It is certainly bureaucratic and it certainly puts a lot of people off applying in the first place—we know that. It is also delivered in different ways in different local authorities, which can be a problem. We had a case recently of a young couple in north Wales who needed a downstairs bathroom, and they applied for a DFG, but were turned down on the basis of their income. However, the calculation only took account of notional income; it did not take account of their actual outgoings, which were a lot higher than the notional figures. So, they were turned down for a DFG and were basically told, ‘You have to find £10,000,’ which they were completely unable to do. Had they been in a different local authority area, they might well have had a different decision on that.
[320] The question about the means test, however, is difficult. It certainly needs reviewing, and we do not like means testing as a rule in Shelter Cymru. It is bureaucratic, but the overwhelming priority has to be meeting people’s needs and meeting the needs of people on a low income who cannot afford it anywhere else. So if, on a practical level, removing the means test will mean much longer waiting periods, we have to think about that very carefully, but there is a need to review this.
[321] Peter Black: Did you say that local authorities determine the means test differently, so you might get different outcomes in different authorities?
[322] Ms Bibbings: Yes, that is right.
[323] Peter Black: Is there no statutory process that they have to follow on that?
[324] Ms Bibbings: No, there are different processes.
[325] Ann Jones: I see. Okay, thanks very much. Mark is next.
[326] Mark Isherwood: Today, and in your written evidence, you have highlighted concern over adopting good practice and best practice. Why do you believe that good practice and best practice have been adopted in some areas, but not in others?
[327] Ms Bibbings: It is a capacity issue. If you look at DFGs in particular, you will see that some authorities have only two or three occupational therapists working for them and it is very difficult for small teams to make fundamental changes to the way that they work, particularly when they are running to catch up all the time. To a certain extent, a lot of authorities have got bogged down in the backlog of dealing with the long waiting lists.
[328] DFGs are an example of a service that is very process led and, as such, they are well suited to the systems approach, because it is all about identifying customer need and meeting that need with as few steps as possible—in theory, anyway. The Neath Port Talbot work was useful, because it identified how this could be done in a practical way, and it was all about reducing the number of steps. It had 291 steps in the process at the outset of the study, which was reduced to 34 or something by the end. A lot of it was about common-sense measures, and about making sure that, when an OT visited, a grants administrator and a contractor visited at the same time, so that everybody could be there and work out what needed to be done, rather than having all this to-ing and fro-ing and the inevitable Chinese whispers effect that happens where the solution ends up meeting people’s needs ever more inaccurately. So, it is a clear example of good practice and yet it has not been adopted. It is a capacity issue at this point. We know how to do it; it just cannot be done.
[329] I do not want to bash Neath Port Talbot, because I think that it is good that it did that piece of work, but its waiting times are still unacceptably long, and we have got to a situation where local authorities are routinely exceeding statutory waiting times. The Welsh Government should not ignore the significance of that. These are statutory maximum waiting times, and they are being routinely exceeded. That is a very strong argument, together with looking at the severity of the human impacts of those waiting times, to intervene in a very assertive way.
[330] Mark Isherwood: How could corporate governance in local authorities be improved to address the points you highlight? Is there a role for the Welsh Government at a central level in driving that?
[331] Ms Bibbings: Our inclination in Shelter Cymru is to argue for a single, tenure-blind system for administering adaptations across Wales. That would be our preference. It would be the simplest way. There is no need for it to be divided among 22 authorities. The local differences can be exaggerated—the uniqueness of local territories and responding to those needs. The needs of disabled people do not necessarily vary that much. You just need to understand on an individual level what those needs are, and so there is no need for that to be delivered at a local level. So we would argue in favour of a single entry point, which would be so much simpler for people to negotiate rather than the plethora of funding streams and entry points that there is at the moment.
[332] Mark Isherwood: Does that need a change of leadership?
[333] Ms Bibbings: I am not qualified to say that, I do not think. [Laughter.]
[334] Mark Isherwood: I am not talking about individuals—I am talking about the leadership culture. Far be it from me to blame individuals. [Laughter.]
[335] Ms Bibbings: This has not had as great a priority as it should. If you look at the White Paper commitments, yes, to have an accessible housing register covering all of Wales, that is great. We have been talking about that, and it has been recommended previously. With the onset of welfare reform, we need those accessible housing registers now. It would have been wonderful had we had them in place because a lot of Wales still is not covered by accessible housing registers, and there is nothing for the private rented sector at all, which is something that I would like to go on to talk about. So, from our perspective, the level of priority has been perhaps not as high as it should have been, and ought to be, given the economic impacts and the impacts of welfare reform to come.
[336] Mark Isherwood: Based on Shelter’s case work experience, how do you believe that positive outcomes for disabled people can be better achieved?
[337] Ms Bibbings: From the point of view of our casework, it would be just to listen to people better. Quite often we advocate on behalf of people. I will give you another example. A client of ours from south Wales needed adaptations carried out to her house—she was an owner-occupier and she needed a walk-in shower and a stairlift. The local authority was pretty quick in providing the stairlift, but it did not want to provide the walk-in shower. It said that all she needed was a seat for the bath. We were advocating for her, saying that her needs were more severe than that, and she needed to have a walk-in shower. We felt at the time that it was a funding issue, and that the authority did not want to spend the money. It put the seat in and it was not suitable for her needs, so what we had to do was gather additional medical evidence and present it to the authority. Finally, it conceded that she needed a walk-in shower, so she eventually got one, but it was after a lot of to-ing and fro-ing and really the authority could have saved the expense of putting the seat in the first place if it had just listened to what our client wanted. So, from our point of view, we see evidence of people’s views not being listened to, and work not necessarily being carried out in an appropriate way—and the work is not necessarily of a very high quality, either. We would place the views of people and measures of customer satisfaction much higher.
[338] Mohammad Asghar: Jennie, you have answered my question already. My theme is: how can the adaptation service be improved? Are disabled people, their families and carers given sufficient information about the adaptation system?
[339] Ms Bibbings: There are good examples out there of leaflets and so on and services where information is presented in an accessible way. Yes, we do occasionally have examples in our casework where people are advised in less than satisfactory ways. The problem with information is that the system itself is so complicated for people to negotiate the information itself ends up being complicated. If we had a simplified, ideally tenure-blind, system for people to apply to, it would be so much easier to communicate that to people. Really, it is not in the interests of service users that there should be all these different funding streams, depending on the size of your adaptation, what tenure you happen to be living under, or where you live in Wales. It is not in people’s interests. That regime has grown up around the needs of institutions, you know? I think that it would be so much easier to communicate with people if the information itself was simple.
12.00 p.m.
[340] Mohammad Asghar: What type of general questions does your organisation receive from the public?
[341] Ms Bibbings: I had a look through our e-mail queries. We do not get an awful lot of queries looking for information about adaptations. We tend to see people more at crisis point—that is, where their tenure is being threatened or they have been turned down for a DFG; something like that. That is when we would generally come into contact with people.
[342] Mohammad Asghar: Do you think that there are some areas to be improved upon?
[343] Ms Bibbings: Did you mean in terms of information?
[344] Mohammad Asghar: Yes.
[345] Ms Bibbings: Clearly, there are, because we hear about front-line staff not always giving advice to our clients that is consistent with what we believe is in our clients’ best interest and what our clients believe is in their best interest. So, there is an issue there about raising awareness among front-line staff and ensuring a certain quality and consistency of advice. It would also be very beneficial if there could be more direct and active engagement with disabled groups and older people’s groups locally, so that people could find out generally what is available, and also so that service providers could get that feedback, because that two-way exchange information is all very useful data for helping you to improve your service.
[346] Rhodri Glyn Thomas: O ran y fframwaith monitro perfformiad, a ydych yn credu bod y dangosydd perfformiad yn gwneud asesiad llawn o’r modd y mae’r gwaith wedi cael ei gyflawni a pha wahaniaeth mae hynny wedi ei wneud i ansawdd bywyd pobl?		Rhodri Glyn Thomas: With regard to the performance monitoring framework, do you believe that the performance indicator assesses fully the way in which the work has been carried out and what difference that has made to people’s quality of life?
[347] Ms Bibbings: The way that performance is monitored at the moment is skewed towards just getting the work carried out. No data are collected on quality, or on customer satisfaction. This is an area where there is potential for so much more meaningful data collection. There is the whole issue of monitoring numbers on waiting lists. Now, waiting list numbers are not part of the data collection, but that would illustrate the pressure on local authorities, and it would also illustrate the severity of the problem that people in that area are facing. However, it is really important that data collection looks at the quality and the suitability of the work carried out, because it is not always that good, looking at our data collection.
[348] There should be a much greater emphasis on customer satisfaction data. A lot of authorities—probably most—do collect customer satisfaction data, all according to their different, non-comparable methods. There is a fundamental methodological flaw in the way that a lot of authorities do this, however, and it is that they always ask for the information at the point when the work has just been carried out. This is a bit of a bugbear of mine, because, usually, when people have just had the work carried out, they are so pleased that they have had it carried out that they just go, ‘Excellent, excellent, excellent’, and of course, it all looks great, but they have not had a chance to live with that adaptation and really understand how well the work was carried out and how much it contributes to their quality of life. So, I would really like to see a rigorous, comparable method of measuring customer satisfaction that goes back to them six months to a year down the line and looks at what difference that work has made to their lives.
[349] The other point that I would like to make is that we need to see that across all of social housing. It should not be just for DFGs; it needs to be housing associations as well, so that we can understand how well people are being served across Wales.
[350] Gwyn R. Price: What benefits, if any, would there be from streamlining the different funding streams for adaptations into one tenure-blind system?
[351] Ms Bibbings: There would be greater equality and fairness for people. In terms of the percentage of people who need DFGs, as opposed to physical adaptations grants, there is unequal provision at the moment. One tenure-blind system would be wonderful, to create that simplicity and equality for people. I do not think that it is acceptable that people should be more or less likely to be able to access the adaptations that they need to have a fundamental quality of life. These are very fundamental and important things to people, and a very simple outlay in many cases. I do not think that it is acceptable that people should have differential access and likelihood of getting that help, depending on where they happen to live or what tenure they happen to be in.
[352] Gwyn R. Price: Could funding from health budgets be more effectively used to support adaptation programmes?
[353] Ms Bibbings: In theory, yes, absolutely—we would be really pleased to see money from health coming to make this service more effective for people. There is a real need for a piece of work that could demonstrate clearly to the NHS the potential savings that there could be for its budgets. There are methodologies out there that could do that—there is the Carmarthenshire study, which looked at the impact of the Welsh housing quality standard on healthcare services. That is a really nice methodology, which could easily be used to make that argument, because it is difficult to make the argument to health that it should spend money outside its area. We would be very pleased to see that, as it would inevitably create savings for health budgets.
[354] Mike Hedges: You would nominally make savings to the health budget, but the problem is that there are huge demands on the health budget. If you prevented the damage that leads to hip replacements, and no hip replacements took place in Wales, you might say ‘We’ve now saved the health budget £100 million, £70 million or whatever’, but would not the problem be that the same amount of money would be spent by the health service on different things?
[355] Ms Bibbings: That is the counter-argument, is it not? However, if you are looking at a net reduction in accidents, for example, as a result of a set of interventions, that is a net reduction in health expenditure as well. I agree that these are very difficult arguments to make to health, and perhaps the Welsh Government, in its overarching role, should be the appropriate body to make these decisions.
[356] Mike Hedges: I think that you said earlier that better use should be made of adapted and accessible housing registers. Is that correct?
[357] Ms Bibbings: Yes, absolutely. Many parts of Wales are not covered by accessible housing registers. I would also like to make the point that we have clients who have a lot of difficulty in accessing the private rented sector. There are a lot of issues around private landlords not being willing to have adaptations carried out. We have had clients who have had possession proceedings in response to requests to have work carried out. There is probably a need for awareness-raising among private landlords about disability in general, because there is perhaps a little prejudice among some. However, the overarching problem, and one that could potentially be solved quite easily by the Welsh Government, is about landlords not being willing to narrow their market—if they have an adaptation carried out and the tenant moves on, who are they going to get to rent it next? If we had an accessible housing register for the private rented sector, it would solve that problem at a stroke.
[358] The Welsh Government is developing the landlord licensing scheme, which means that every privately rented property in Wales is going to have to be registered. So, we are going to have that information as part of that scheme. A simple adjunct to that scheme would be to have an accessible housing register, or, alternatively, something along the lines of a social lettings agency for the private rented sector. With the pressures of welfare reform and the bedroom tax creating an awful lot of churn in social housing, a lot of people will not be able to get the one-bedroomed and two-bedroomed properties that they need in social housing, and they are going to have to find them themselves in the private rented sector. This is going to become more of an issue in Wales in years to come. An AHR in the private rented sector would, therefore, be very beneficial.
[359] Ann Jones: Do Members have any other questions? I see that you do not. I thank you for coming, Jennie. [Interruption.] Sorry—do you have a question, Mark?
[360] Mark Isherwood: What engagement have you had with organisations like the National Landlords Association, given that it gave evidence to our predecessor committee for an inquiry into the private rented sector two and a half years ago that addressed virtually every point that you have just made? It also made an open approach to local authorities in Wales in March 2011 to start putting in place social letting agencies, proper accreditation schemes and a refocus on the PRS as an option of choice for local authorities that would, otherwise, have a shortage of social housing for long waiting lists of applicants.
[361] Ms Bibbings: That is very interesting, because I was not aware that the National Landlords Association had made that approach. I will definitely take that up with Lee Cecil.
[362] Mark Isherwood: He is also doing some very interesting work beyond that on how to lever in more ethical funding to address social need.
[363] Ms Bibbings: Excellent; I will have a chat with Lee. Thank you.
[364] Ann Jones: On that note, we will finish. Thank you very much for coming in and giving your evidence today, Jennie. We will send you a copy of the transcript to check for accuracy.
12.11 p.m.
Cynnig o dan Reol Sefydlog Rhif 17.429 i Benderfynu Gwahardd y Cyhoedd o’r Cyfarfod Motion under Standing Order No. 17.42 to Resolve to Exclude the Public from the Meeting
[365] Ann Jones: I move that:
the committee resolves to exclude the public from the remainder of the meeting in accordance with Standing Order No. 17.42(ix).
[366] I see that the committee is in agreement.
Derbyniwyd y cynnig. Motion agreed.
Daeth rhan gyhoeddus y cyfarfod i ben am 12.11 p.m. The public part of the meeting ended at 12.11 p.m.