Equipment and adaptations: guidance on provision
Guidance outlining the responsibilities of NHS Scotland, Local Authorities, Integration Authorities, and their Housing and Education partners for the provision of equipment and adaptations, with the aim of supporting partnerships, across Scotland, to deliver a more equitable and accessible service.
Core Values and Principles
People must be able to access support at the point they feel they need it, including for advice and signposting. Fair and consistent access to suitable assessments should be available on a non-discriminating, tenure neutral and human rights basis.
Assessment should be focused on individual outcomes and enablement, have service users and unpaid carers listened to, have a say, be respected and responded to, and be reliable. As stated in the Equality Act, there should be no discrimination on the grounds of:
- gender reassignment
- marriage and civil partnership
- pregnancy and maternity
- religion or belief
Health boards and local authorities have responsibilities under equality legislation for ensuring that discrimination does not occur, and for promoting equity of opportunity. Equity recognises that each person has different circumstances and allocates the exact resource and opportunities needed to reach an equal outcome. The focus should be on proactively seeking to improve access and experience for all, but especially those at greatest risk of disadvantage and inequality.
People needing equipment and adaptations, and their unpaid carers and family, need to understand clearly their right to an assessment and the assessment process; what needs can be met by health and social care services, and other agencies such as Housing, Education, and Prisons, as well as any costs involved. They should receive advice and information to enable them to participate in informed decisions about the outcomes they wish to achieve. Any decisions made, and the reasons behind them, should be transparent from the outset for service users, unpaid carers, family, and staff.
The Carers (Scotland) Act 2016 puts in place a system of carers' rights designed to listen to carers; improve consistency of support; and prevent problems – helping sustain caring relationships and protect carers' health and wellbeing – set out in our Carers' Charter. This includes each carer's right to an Adult Carer Support Plan or Young Carer Statement (sections 2 and 3 of the Carers' charter) to identify what is important to them and their needs for support. Carers also have rights to have their views taken into account in assessing the needs of the person they care for (section 5c of the Carers' charter). Every area must also have a local carer strategy and carer information and advice service.
Although the term 'unpaid carer' is used throughout this document, as highlighted in Missing out: the identification challenge a report from Carers UK It is important to recognise that not everyone will identify as an unpaid carer.
Some may prefer to identify as family members or friends and may choose to reject the label of unpaid carer. As one carer shared, 'I am his wife, I cannot stand being called his carer'.
When assessing for equipment and adaptations, there should be clear evidence that outcomes for the service user, and also the unpaid carer have been addressed in the care plan, and an updated adult carer support plan (or young carer statement). This also applies to the transition from children services to adult services.
There should be no discrimination in the provision of equipment and adaptations based on where a person lives, this is of particular importance for people living in care homes.
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