Home refits: Wales leads the way on rapid response home adaptations
With our high proportion of vulnerable old people who are often challenged to stay in their own homes sustainably this is a really interesting example of good practice worth replicating more widely. The story tells us….
After a bad fall at home, Linda Jones spent three weeks in hospital. Fearing she might fall again, the discharge coordinator at the Royal Gwent hospital in Newport arranged for an assessment of her house. Within 48 hours she had a handrail in the hallway and grab rails in the downstairs toilet.
While there is nothing odd in making minor home adaptations to prevent falls – the single biggest cause of hospital admissions of older people – the speed of this intervention is unusual. All too often, applications for even the simplest practical aids are held up for months in the mistaken belief they require approval by an occupational therapist.
A survey last year by the Equality and Human Rights Commission found the average wait for an adaptation was 22 weeks – eight weeks for a decision, then 14 for installation – with some local councils taking more than a year.
New guidance aims to tackle the problem. Adaptations Without Delay, commissioned by the Royal College of Occupational Therapists (RCOT) and drawn up by the Housing Learning and Improvement Network, sets out a decision-making framework to grade different types of adaptations and advise when they can be authorised and installed without going through the full process.
“Adaptations play a crucial role in prevention and need to be delivered in a timely manner,” says Karin Bishop, RCOT director of professional operations. “We need a radically different approach to address the delays.”
The guidance praises the approach of Care & Repair Cymru, which supports 13 Welsh care and repair agencies that carry out adaptations and operate a rapid-response service authorised to undertake minor works costing up to £350 and grant-funded without a means test.
More money is available for adaptations than ever before. With ministers now recognising their value in helping keep older and disabled people out of hospital and residential care, funding for disabled facilities grants, which pay for adaptations, has risen by 8% in England in 2019-20, to £505m. The aim is to make 85,000 grants this year, more than twice the number five years ago.