Equipment and adaptations: guidance on provision - executive summary

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.

Adaptations and Housing Solutions

The timely provision of adaptations can make a significant difference to the outcomes for an individual in relation to where they can live and the level of independence they have within their daily environment.

However, adaptations to a person's home, should be seen as one of a number of possible solutions available, and it may be that housing support, or re-housing would be a better option for long term needs.

It is vital that we help service users consider their long-term housing needs at an early stage, and proactively support them to identify solutions that could minimise the need for more extensive adaptations, and disruption, in the future.

In addition, in the wake of The Independent Review of Adult Social Care, there is a renewed interest in fundamentally improving the processes and infrastructure which deliver services, to offer greater emphasis on preventative and anticipatory responses, and removing barriers in the systems.

This context offers an opportunity to revisit the work previously carried out by the independent Adaptations Working Group (AWG), (and the subsequent Adapting for Change programme), which reported in Dec 2012, with recommendations which are still very relevant but, have as yet, with the exception of some work around the Housing Solutions programme, have not been taken forward.

There is now an impetus within our partnerships, to address the outstanding issues, with the need to bring all relevant housing, and health & social care stakeholders together to create service models which remove the barriers to provision, and offer a genuine person-centred, 'tenure neutral' approach, for people living in our communities.

One of the ways of addressing inequities in the system, would be to remove the need for owner occupiers to apply for grant and instead provide 100% funding, where the need for an appropriate adaptation has been agreed.

To address these types of issues and help partners jointly manage budgets in a more strategic and planned way, partners should jointly identify the most effective mechanisms to utilise financial resources collectively, including consideration of pooled budgets under joint governance arrangements which include a wide range of relevant stakeholders across housing (all tenures), health and social care.

Work also requires to focus on the need for cohesive local housing plans, aligned to housing allocation policies, which promote the provision of barrier-free housing and early intervention strategies.

The 'Housing Solutions' change programme been developed as an output from the AfC programme, and offers a framework for service improvement which would help drive forward the range of required changes identified in the section above.

This approach offers a practical and effective way of encouraging wider responsibility across our housing, health, social care & 3rd sector services, for the identification and discussion of housing needs and solutions with people in our communities who need advice and support.

Training modules have also been developed to support the change programme, and encourage a multi-partnership integrated approach to identifying and assessing for local solutions.

In addition, an example Partnership Joint Protocol for Housing Solutions & Adaptations has been developed as a good practice tool to help partners embark on their strategic improvement work and some partnerships in Scotland have already utilised this to help them work with a wider range of stakeholders with the aim of taking forward service improvement.

Key Actions

  • A national Adapting for Change Action Plan should be devised to compliment other policy work, and assist partnerships to drive forward the changes recommended from the original Adapting for Change report by the Adaptations Working Group.
  • To assist with the practical implementation of the Adapting for Change recommendations, partnerships should implement Housing Solutions change programmes which assist all relevant partners to develop local Protocols, and deliver training programmes, which effectively promote:
    • Early intervention with full exploration of rehousing opportunities;
    • Better planning for the delivery of barrier-free housing and an inclusive design/living approach;
    • Robust joint governance, which provides a clear strategic direction and supports priority setting;
    • Joint finance arrangements which help streamline service improvements (e.g. pooled budgets)
    • Equity in the system, applying a 'tenure neutral' approach;
    • To address barriers in the system, removing the requirement for grant assistance for owner occupiers and providing 100% funding for the assessed adaptations;
    • Removing the need for occupational therapists to provide an assessment for standard adaptations in housing association properties e.g. shower provision; and encouraging 'direct access' arrangements.
    • Maximising procurement and recycling benefits to help deliver efficiencies.



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