Community equipment and housing adaptations: draft guidance

Purpose of the Guidance

This guidance covers the responsibilities of NHS Scotland and Local Authorities (Health & Social Care Partnerships, and their Housing and Education partners) for the provision of equipment and adaptations, and replaces all previous guidance on this issue. This updated guidance is issued with immediate effect.

The guidance outlines the responsibilities of all relevant agencies, with the aim of supporting partnerships, across Scotland, to deliver a more equitable and accessible approach to the provision of equipment and adaptations.

The overall aims of the guidance are to:

• Remove barriers in the systems promoting seamless pathways which are consistent and equitable across the country;
• Ensure services evidence that the service user, and unpaid carer, are at the centre of provision.
• Enable choice and control for service users and unpaid carers as partners in the process of assessment and support planning.
• Focus service provision on supporting the achievement of successful outcomes for the individual, and where relevant, their unpaid carer.
• Promote a consistent approach to the assessment for, and provision of, equipment and adaptations, which promotes prevention and early intervention, and supports self-management.
• Ensure that service users and unpaid carers have access to up to date and relevant information on equipment and adaptations.
• Promote good practice and effective partnership working in relation to equipment and adaptation provision.

Defining equipment and adaptations

The timely provision of equipment and adaptations, supports the health, housing, social care and educational needs of a broad range of children and adults, and can help reduce risk, and support independence and control. They support those with short and longer term needs, and assist those with physical, or learning disabilities, mental health needs including dementia, and individuals who require support with communication, including Alternative and Augmented Communication (AAC) users. Many older people do not see themselves as disabled, but may be frail, or have difficulty with everyday tasks, and also benefit from these services.

Equipment

Equipment can be defined as any item or product system, whether acquired commercially off the shelf, modified or customised that is used to increase the functional capabilities of individuals. Community equipment can include, but is not limited to:

• Equipment to support people with more significant health needs to be nursed or cared for, such as profiling electric community beds, pressure relief mattresses, and a range of moving and handling equipment.
• Equipment to support daily living tasks, or make caring for the individual safer and easier such as shower chairs and stools, bath lifts, raised toilet seats & frames, grab rails, and mobility aids.
• Technology enabled care products such as flood detectors, falls monitors, smoke detectors and movement sensors. These are often linked to a call centre, triggering a response when activated, and provided as part of a service.
• Children's equipment to support every day functions, including their education.
• Ancillary equipment for people with sensory impairments, such as flashing doorbells, low-vision optical aids, text-phones and assistive listening devices.
• Wheelchairs for short-term loans.
• Environmental control equipment.
• Communication aids (including AAC) – to assist children and adults who have difficulty with speech. Equipment includes aids to writing and reading as well as speech.

Note: It does not include any medical devices or anything that is invasive to the body (e.g. PEG feeding equipment).

Adaptations

The purpose of an adaptation is to modify an environment in order to restore or enable independent living, privacy, confidence and dignity for individuals and their families. As defined by The Public Bodies (Joint Working) (Scotland) Act 2014, the form of the adaptation can be wide ranging and is not restricted to defined types. Rather, the emphasis is on the intended goal, to maximise independence and ensure people are supported to live safely in their own home.

Adaptations can improve confidence, skills and mobility and reduce symptoms. They can form part of a range of options available to people experiencing a disabling environment. This could include, but is not limited to:

• Adaptations to a bathroom, e.g. replacing a bath with a walk in shower;
• Improvements to support access into, and around the home e.g. widening of a door frame to allow wheelchair access and external access improvements;
• Adaptations and equipment which provide safety features for people with autism, signage & tonal contrast for people living with dementia etc.;
• Fitting lower work surfaces in the kitchen;
• Installation of a stairlift or through floor lift.