Introduction

In 2019 the Disabled Facilities Grant (DFG) will be 30 years old. Originally, it was one of several housing grants available to fund repairs, improvements and adaptations. All the other grants have now gone, and the DFG is part of the Better Care Fund; a pooled budget seeking to integrate health, social care and, through the DFG, housing services. 

This Review looks at how the DFG currently operates and makes evidenced based and practical recommendations for how it should change in the future. The aim is to (1) support more people of all ages to live in suitable housing so they can stay independent for longer; and (2) make the case for more joined up action across housing, health and social care. 

Home is central to everyone’s lives, but is particularly important for disabled and older people, as it is where they spend most of their time. Increasing numbers are living alone, especially in later life. Ability to get in and out of the home, move around inside, access the bathroom, receive friends, cook and go to bed has a significant effect on people’s dignity, autonomy and wellbeing.  

The majority of disabled people are living in ordinary housing but only 7% of homes in England have basic accessibility features such as downstairs toilets and level access. Three quarters of deaths relating to falls happen in the home, and falls represent 10-25% of ambulance call-outs to older adults. Once admitted in an emergency, older people use more bed days than other people (65%) and falls often precipitate a move into residential care. 

The DFG is often seen as simply providing level access showers, stair lifts and ramps. This review proposes a fresh approach that is all-encompassing and creates a home environment that enables disabled people to live a full life. Districts and counties, housing and social care, occupational therapists and grants officers will need to work together to establish person-centred services that meet a disabled person’s needs in a more preventative, holistic and timely way.