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091027_Disabled Facilities Grants_Occupational Therapy

Maidstone Borough Council

Regeneration and Sustainable Communities Overview and Scrutiny Committee

Tuesday 27 October 2009

Disabled Facilities Grants Review �The Role of Occupational Therapy

Report of: Overview and Scrutiny Officer

1.�� Introduction

1.1�� At the meeting of the Regeneration and Sustainable Communities Overview and Scrutiny Committee on 30 June 2009, Members agreed to carry out a review of disabled facilities grants.� The relevant extract from the minutes of the meeting is as follows:

�The Committee agreed that clearance of contaminated land would be its major review of this year.� It was noted that there were a number of sensitive issues with regard to this matter, and the Legal Team had been asked for advice on this.� A smaller review would also be carried out with regard to disabled facilities grants.�

1.2�� It was agreed, in consultation with the Chairman, to delay the Committee�s in-depth review of contaminated land to November 2009 as changes to the contaminated land strategy were being made and it was agreed prudent to await the outcome of this.�

1.3�� At its meeting on 25 August 2009, the Committee interviewed the Private Sector Housing Manager, Stuart White with regard to its review of Disabled Facilities Grants (DFGs).� The Committee agreed that the review should focus on: the distribution of DFGs to Registered Social Landlords, home owners and private sector tenants; what happened to adaptations funded by DFGs after installation; the impact of Choice Based Lettings; and whether all aids and adaptations were appropriate and necessary.�

1.4 The Committee interviewed the Group Director of Operations, Ms Jillie Smithies, and the Property Services Manager, Ms Eileen Parrott, from Maidstone Housing Trust (MHT) and Councillor Beerling, a Council nominee on Maidstone Housing Trust�s Board of Directors, at its meeting on 29 September 2009. �The draft minutes from this meeting can be found at Agenda Item 7.�

1.5 At its meeting on 29 September 2009 the Committee agreed that it would be useful to interview a representative from the Kent County Council Occupational Therapy Service as part of its review. �Ms Sue Stower, Kent County Council�s Head of Service for the Maidstone and Malling Locality will therefore be in attendance at the meeting to be interviewed by the Committee.

1.6 The scoping document for this review is attached at Appendix A.

2.�� Occupational Therapy

2.1�� The Occupational Therapy (OT) Service assesses residents� needs for special equipment or adaptations to their home if they have difficulty with daily living tasks due to a physical disability or frailty.� The Occupational Therapist or rehabilitation co-ordinator will then provide advice on possible solutions to meet the needs of the resident.

2.2�� Possible resolutions may include, for example, the provision of bathing equipment or the installation of a stair rail that gives the resident safer access in their home and a greater degree of independence.

2.3�� The OT Service provides:

� Assessments for grants available through district or borough councils to help with the cost of major adaptations to disabled peoples' homes;

� Assessments for equipment and minor adaptations to enable people to live safely and independently;

� Short periods of rehabilitation at recuperative care centres for older people who need to practice daily living skills; and

� Information and advice for disabled people and their carers about sources of help.

2.4�� In order for a resident to qualify for an assessment by the OT service, the disability must be significantly affecting the person�s ability to carry out at least one of the following essential daily activities:

1. Accessing essential facilities within the home;

2. Using the toilet;

3. Getting in and out of a bed or chair;

4. Preparing hot drinks and essential food;

5. Maintaining personal hygiene; and

6. Getting in and out of the home.

2.5�� Equipment is provided by the OT Service, free of charge, by either KCC�s stores or a joint council and NHS store. Residents are encouraged to let them know if they no longer need the equipment so that they may collect it.� Basic items of equipment which are in stock will usually be delivered within seven working days. Non-stock items of equipment which have to be ordered or which may need to be manufactured specially will take longer to provide.� All provided equipment remains the property of Kent County Council or the NHS and will be maintained as required and replaced if necessary.

2.6�� Minor adaptations include the following:

� Fitting stair rails;

� Fitting grab rails;

� Adapting steps; and

� Raising the height of beds and chairs.

These are usually carried out by KCC�s own technicians and there is usually no charge for this service. Residents living in rented properties may need to pay a small charge to their landlord if the work is carried out by the landlord's own technicians.

2.7�� If the problems experienced by the resident cannot be resolved by the provision of equipment or minor adaptations, the OT may need to look at having major adaptations made to the property. Major adaptations can include the following:

� Changing the layout of rooms;

� Changing the use of rooms; and

� Extending the property if the available space within it is not adequate.

DFGs available from District Councils are means tested and may help with the cost of major adaptations.

2.8�� Applications for these grants require the support of an occupational therapist. The work must be approved before it is undertaken, and the grant cannot be paid after the work has been carried out.

3.�� Disabled Facilities Grants

3.1�� Disabled Facilities Grants are a mandatory entitlement administered by local housing authorities to help fund the provision of adaptations to enable disabled people to live as comfortably and independently as possible in their homes. �A grant is paid when the council considers that changes are necessary to meet disabled persons� needs, and that the work is reasonable and practical.

3.2�� A grant can be used for adaptations to give better freedom of movement into and around the home and/or to provide essential facilities within it.� Acceptable types of work for disabled people include:

� Widening doors and installing ramps;

� Providing or improving access to rooms and facilities - for example, by installing a stair lift or providing a downstairs bathroom;

� Improving or providing a heating system;

� Adapting heating or lighting controls to make them easier to use; and

� Improving access to and movement around the home to enable disabled people to care for another person who lives in the property, such as a child.

An occupational therapist looks at the claimant�s circumstances and will recommend the type of adaptation(s) needed.�

3.3�� The work must be considered "reasonable and practicable" bearing in mind the layout and condition of the property, and is assessed by an officer of Maidstone Borough Council.� Maidstone Borough Council must also be satisfied that the works required are "necessary and appropriate" to meet the needs of the disabled occupant and to establish this will consult with the Social Services Department of Kent County Council through their Occupational Therapy Bureau.

3.4�� A further requirement is that the disabled person must live in the property for a reasonable period after the grant has been given.

3.5�� The amount of grant paid is usually based on a financial assessment - a 'means test' - of the applicant�s average weekly income in relation to their outgoings. However, there is no means testing for families with disabled children under 19.� Depending on the outcome of this assessment the amount of financial assistance offered can vary from 0 to 100 per cent of the cost.

3.6�� The maximum amount of grant that an English council is required to pay is �30,000 per application less any assessed contribution from the claimant. If the cost of the eligible works is more, the council can use discretionary powers to increase the amount.

3.7�� The following Disabled Facilities Grant Allocations have been received by Maidstone Borough Council from Communities and Local Government since 2006:

�� 2006/07�� 210,000

2007/08 �� 237,000

2008/09�� 270,000

2009/10�� 405,000

3.8�� Kent County Council also has separate funding to help vulnerable people to have �a better quality of life by providing housing related support services�.� This is provided through Kent County Council�s Supporting People programme.� The programme helps pay for the services that allow people to live independently in the community.

4.�� Recommendation

4.1�� Sue Stower, Kent County Council�s Head of Service for the Maidstone and Malling Locality, will be in attendance at the Committee�s meeting on the 27 October 2009 to discuss: her views on DFGs; KCC�s involvement with DFGs; how customers� needs are assessed; whether all adaptations are necessary; and what other aids and adaptations are available through KCC.

4.2�� Members are recommended to consider the statements of Ms Stower and ask questions with regard to the Disabled Facilities Grants Review as they feel appropriate. Areas of questioning could include, but are not limited to:

� Best Practice;

� The role of OT in the provision of Disabled Facility Grants;

� Waiting times to receive assessments for Disabled Facilities Grants and how assessments are prioritised;

� Number of Occupational Therapists in Maidstone assessing residents� needs for Disabled Facilities Grants;

� The appropriateness and need of aids and adaptations made to properties;

� How residents are assessed for Disabled Facilities Grants;

� The relationship between OT, Maidstone Borough Council and Landlords in providing Disabled Facilities Grants;

� What other assistance is offered to residents by Kent County Council;

� The responsibility of Registered Social Landlords with regard to making aids and adaptations;

� Does KCC provide aids and adaptations to all residents from the Equipment Store, including to Registered Social Landlords;

� What are your views with regard to awarding Disabled Facilities Grants on un-occupied properties, given that it may provide a suitable and cost effective alternative to adapting an occupied property?

� How residents find out about the provision of Disabled Facilities Grants.