Joining it up - operationally

Existing DFG systems are usually a two-part process, starting with an assessment by social care services and then a grant application to housing. For customers this can mean a long and difficult journey involving delay and frustration.

HEART - The Home Environment Assessment & Response Team in Warwickshire

The new integrated service was originally set-up as a pilot in one of the districts, but it is now operating county-wide. Staff have been seconded from district and county authorities into two teams, one operating in the south and one in the north of the county, each with a similar structure.

Staff seconded from Districts and County

The process is now 22 steps rather than 220, with the number dropping out reduced from 35% to just 3%. A single access point means enquiries and referrals come directly into the service and can be routed to staff with the right skills. Time from first enquiry to completion has reduced significantly and benchmarking shows faster completion times than comparable authorities.

 

There is a growing number of integrated teams that do things differently. They bring together occupational therapists and housing staff into a single team; they have one point of contact throughout the process and they provide equipment, minor adaptations, telecare, housing options and support to move as well as the major adaptations funded by the DFG.

It’s not just about structures and systems, there’s a need for better guidance on what provision is necessary and appropriate and a more collaborative approach to decision making. A set of guiding principles for assessment should be adopted.

Nine guiding principles for installing adaptations

•         Need to retain (or restore) dignity

•         Need to have values recognised

•         Need for relief from pain, discomfort and danger

•         Need to minimise barriers to independence

•         Need for some element of choice

•         Need for good communication as part of giving choice

•         Need for light

•         Needs of children: to provide for growth and change; need for space

•         Needs of other family members and of the family as a whole

 

When you’re working hard to meet the demand for adaptations it is difficult to commit time to redesigning how services are delivered. This requires transformation funding and using just 1% of the DFG budget will make a significant difference to help integrate services across the country.

Recommendations:

  • Integrated teams are essential in all areas to simplify and speed up customer journeys.
  • Better analysis of local need to develop preventative strategies and determine levels of revenue and capital funding.
  • Single point of access with ‘good conversations’ at the start and people routed down appropriate pathways.
  • Regulatory Reform Order (RRO) policies have been developed in around half of local authorities and need to be adopted in all areas to provide more flexible use of the grant.
  • New decision-making tools to help staff collaborate more effectively and use of 3D design and design centres to communicate better with customers.
  • Better partnerships with health and care to ensure that ways of ‘Making Every Contact Count’ work more effectively so people are referred earlier, not at crisis point.
  • Transformation funding equivalent to 1% of the DFG budget to enable change to happen across the country.