Run a HIA

Mission Statement

A home improvement agency will aim:

“To enable those in need of support to maintain their independence in their chosen home for the foreseeable future. This includes older people, people on low incomes, disabled people and other vulnerable groups in the private sector.” 

This outcome would normally be achieved by supporting people throughout the repair, adaptation or improvement process, so that the individual is able to remain in their own home in a warm, safe and secure environment. This could also include the direct provision of repair and maintenance services, preventative initiatives, and providing advice on accessing appropriate, including private, finance. Where the existing home is no longer sustainable, information and advice on options for moving on to more suitable accommodation can be provided.

An agency will be committed to ensuring that clients have as much dignity, independence, choice and control over their own lives as possible. Clients will receive appropriate advice and information to allow them to make informed decisions and access appropriate services.

Access Criteria

An agency service will typically be aimed at vulnerable groups, such as those residents:

• Aged 65 or over
• Registered disabled or described as disabled
• On a means tested social security benefit
• On a low income

Assistance may be available to other “vulnerable” residents at the discretion of the Agency Manager.

Access to the Service

Clients will typically access the service directly or via a referral from a local health or social care professional.

Direct access may be made by phone and email, or in person.

Agency team

The generic roles of agency team members are detailed below. The actual role played by each member of the team may incorporate one or more of these functions depending upon the skills of the person and ultimately the needs of the client.

Agency Manager

The Agency Manager shapes the delivery and development of the service and is responsible for quality and quality improvement. The manager will be involved with all aspects of service delivery and provide backup and support to the rest of the team.

Caseworker

The key member of the team is the Caseworker, who will make most of the initial visits to potential clients, and be responsible for advising, counselling, and to a lesser extent, monitoring the work.

The Caseworker can also give advice and information to older people who are considering moving to alternative, more suitable accommodation. Support is also available for people seeking to take out a loan to improve or adapt their current home.

Technical Officer

The main role of a Technical Officer is to provide technical advice on all building repair, improvement and adaptation work. In most cases, the Technical Officer will prepare drawings and specifications. They will seek out contractors and recommend the one considered most suitable, usually based upon cost. They will monitor the work and advise when payment should be made.

Handyperson

The Handyperson does small DIY-type jobs around the home. The type of work ranges from repairs to a leaking tap to mending a garden fence.

Administration Officer

The Administration Officer provides administrative support to the whole team and will also deal with the majority of enquiries from potential clients. As the main user of the case management system they are the bedrock of a well organised service.

Liaison with other agencies

Good relations with other agencies – professional, commercial, statutory and voluntary – are essential in the Agency service is to be productive. Other agencies must be made aware not only of the role filled by the HIA, but also of the role expected of them.

Social Services

Social Workers and Occupational Therapists are a good source of referrals, but can also help to provide complementary services.

Solicitors

If the client is to take up a mortgage, they will need a solicitor and may not have one, or may want a new one. It is perfectly proper, if the client seeks advice, to put forward the names of one or two solicitors that are known to deal with matters expeditiously but will not charge the earth. The client must choose and appoint a solicitor themselves.

Citizens Advice Bureau

The CAB receive many enquiries from older people and can be a useful source of referral. In turn, they can help with clients whom we cannot help.

Independent Financial Advisors

Finance is an emotive and complex subject, and financial advice is best left to people who are qualified to provide it. However, there is a difference between providing and advice and information. Giving information on the options available is an integral part of the Agency service, but should stop short of recommending or endorsing any particular product.

The Police

The Police take referrals for older people who have a fear of crime, as well as providing leads for people who have been burgled.

The Fire Service

The Fire Service take referrals for fitting free smoke alarms.

Age UK

Free advice and assistance with all matters related to older people, and a good source of publicity through the Senior Citizens’ Forum.

Trading Standards

Trading Standards often run a Trader Register – a list of reputable local tradesmen. The HIA can use the list as a source of information and also receive referrals from the call centre.

Most people, despite age or disability, prefer to remain living in their own homes for as long as possible. However, a person’s home sometimes becomes unsuited to their needs because it has fallen into disrepair or because the occupier gains a disability. Unfortunately, organising the necessary repairs or adaptations to unsuitable homes can often be a complex and distressing experience for older and disabled people. Support is required in order that such people can live in satisfactory conditions.

A Home Improvement Agency can help people face these problems by offering the level of support required by vulnerable occupiers to organise the financial and practical details from start to finish. The kind of work that a Home Improvement Agency can help people carry out ranges from small repairs to major renovations or adaptation of a property, often costing tens of thousands of pounds. Tasks range from fitting new locks to doors and windows, to installing a new downstairs bathroom.

Assessing the Needs of Clients

To be able to advise on the most appropriate option for a particular client, the Agency must do its best to appreciate the client’s circumstances in relation to their home environment and to sympathise with their wishes.

The following factors in particular should be taken into account:

• Health and general well-being
• Ability to manage in existing accommodation
• Income and savings
• General condition of the property, its current value, the cost of remedying defects and making necessary adaptations and improvements
• Social support available from carers, family, friends, neighbours and other statutory and voluntary sources
• The client’s own wishes.

When making any assessments of an individual it is important to use the “social model of disability”. This social model identifies the barriers that disabled people face in their everyday lives that prevent their full inclusion. The barriers may be due to such things as physical and environmental factors, attitudes, discrimination and stereotyping, or even the way society is organised. The model does not focus on a disabled person’s impairment or condition but addresses their needs as an individual.

It may take a lot of time, patience and effort to find the right solution and help the client make a decision. Clients should never be bullied or rushed into a decision, particularly if they have been bereaved or suffered serious illnesses.

Contact Assessment

Enquiries

An enquiry can originate from another agency, a family member, older or disabled people themselves, or a third party, during which that person asks whether a service is available. This request for information may be made by direct approach, telephone conversation, e-mail, letter or through an interpreter or other “friend”. A Contact Assessment form will be completed to gather the information necessary to assess the enquiry.

Enquiries from other agencies will generally be made through the Standard Assessment Procedure, in the form of a completed Contact Assessment.

An enquiry does not in itself become a referral unless there is reason to believe that a service should be provided. All requests for Disabled Facilities Grant made by an OT will automatically be deemed to be a referral.

Consultation

Consultation is where an enquiry is made and a discussion follows which seeks to establish the basis of concern. This discussion may take place at the time of the enquiry or at a later date and may be informed by additional information from a record or given by another party. A consultation should lead to a decision as to whether or not a referral is made.

Referrals

A referral can be thought of as a formal bridge building exercise between a client and the Agency. This implies that a professional judgement has to be made, taking account of the information available from the enquiry and/or consultation, and the current criteria for the provision of a service.

The outcome of a referral will be that the client will be visited and a full assessment carried out.

The First Visit

The first visit to a client’s home is probably the most important step in the while process.

As soon as possible after receiving an enquiry or referral (but within 4 weeks), the caseworker should make an appointment to visit the client in their home. An appointment may be made by telephone, but where the client has not made the referral directly all first visits should be confirmed in writing and include the following information:

• The name and contact number of the caseworker
• The date and approximate time of the appointment
• Any financial or other information that it may be useful to have at hand
• That it may be useful to have a friend or relative present

A visit must be made even if the client has visited the office and outlined their requirements. Much more can be learnt about the client’s detailed circumstances, physically and financially, in their own home where not only are they more relaxed but the caseworker can see for themselves. It is in any case rare for clients to appreciate just how much can be done to improve their quality of life and general comfort. Direct assessment in the home of the client’s mobility is especially important.

Proof of identity

All Agency employees must carry an identity card with a photograph, which must be shown to the client on arrival. It is advisable to show it on each and every visit to get clients into the habit of asking for proof of identity of each and every visitor.

Outline the Home Improvement Agency Service

The caseworker should first outline the services provided by the Home Improvement Agency by reference to the Client Handbook. For us to offer a service, it is important that the Client knows what we can and can’t do. In particular the Client must sign to confirm that they:

• Can initiate a review of their case at any time.
• Know the procedure for terminating the current service.
• Are aware of our confidentiality, privacy and freedom of information policies.
• Know how to access information held about themselves.
• Have received a copy of the Client’s Handbook.

Client Assessment Tool

The Specialist Assessment Tool is designed to gather not only basic information for the sake of monitoring, but also the client’s personal details which is essential if advice is to be informed. It should be used as an aid to structuring the conversation, rather than being a formal question and answer session.

It may not always be appropriate to gather, at the first visit, all the information needed to complete the Assessment Tool; in particular the health information if an Occupational Therapist has already carried out an assessment.

Listen to the Client

The caseworker should listen carefully to the client’s account of their problems, weaving into the conversation prompting questions to be able to complete the Assessment Tool. Encourage the client to talk through their average day in the home to gain a deeper understanding of their needs. Any comments that may affect the way in which the service is delivered or the works that are required should also be recorded in the case notes.

During the conversation, hearing or other sensory problems may be observed. This should be noted on the Assessment Tool.

Ask the client about their preferred forms of communication, e.g. written documents may be misunderstood or misinterpreted.

Inspect the Property

The client should be invited to show the caseworker around the house, and to point out defects that need remedying and any improvements they are seeking. It is important that the client accompanies the caseworker to allow an assessment to be made, with reference to all aspects of the house, of the client’s mobility and general ability to cope. If the client is unwilling or unable to accompany the caseworker, this should be noted in the assessment.

It is important to look not only at issues of disrepair, but also the general condition. Ingrained dirt, soiled carpets and uncared for gardens can indicate problems with managing the household.

Outline Further Action

After the tour, the caseworker should summarise the discussion, draw up a preliminary “shopping list” of what needs doing (the Support Plan), and decide with the client what action is to be taken, by whom and approximately when. The Plan should include wider support needs that may be met by other agencies.

Discuss with the client whether the suggested works will meet their expectations, and the implications to their lifestyle when having different types of work carried out.

Where a client expresses an interest in moving, or there are limited options for remaining in the current property, the case should be referred on to the Housing Options Officer. Advice is available on the options for moving and the factors to consider.

The Home Safety Advisor can visit where the client may need any of the following:

• Advice and practical guidance on maintaining their home to prevent problems in the future.
• A risk assessment where the client is over 65 and may be at risk of falling.
• A risk assessment where the client may be at risk from fire.
• Practical help with minor repairs around the home.

In some cases the Agency will not be able to offer the types of assistance needed. In such circumstances the Client should, with their permission, be referred or signposted to other service providers. The information should be confirmed in writing, including an explanation of why the Agency is unable to assist further. See Contacts Directory.

It is always the Client’s choice as to which services they want to receive.

Confirm in Writing

Any decisions made must be explained to the client. The Support Plan should be completed in duplicate with a copy given to the Client. Client’s can also request a copy of the completed Assessment Tool.

With the client’s permission a copy of the Support Plan may be sent to the referrer where applicable.

Imparting Information

Caseworkers will have to assess at an early stage how much information the client is able to assimilate and how quickly. It is better to make two shorter visits than to risk confusion in one over-long visit. In general, visits should last no more than one hour: research suggests that even younger people find it hard to absorb information properly over a longer period.

Finance is a crucial, sensitive issue, and it is not always appropriate to question the client about finance on the first visit. On the other hand (and this can be almost frightening) clients seem to trust any visitor completely from the moment they set foot in the house.

Initially the idea of taking out a loan or equity release product can prove a stumbling block for some clients. Talk of financial products should not be glib and clients must not be rushed into accepting the idea. Indeed they should be encouraged to think the matter over and to discuss the question with friends, relatives and advisors.

Carers

Carers are people who look after a relative or friend who need support because of age, physical or learning disability or illness, including mental illness. The 2001 Census showed that there are 5.2 million people providing informal care in England and Wales, one in ten of the population.

Where a Client relies upon the support of a carer, the carer should be involved in the decision making process wherever possible – assuming of course that the Client consents.

Relatives

If the client has supportive relatives, with agreement they should be involved as soon as possible. Ideally (and this can save time where a grant may not be available) supportive relatives or close friends should be present at the first and all subsequent meetings. They will be able to help the client make considered decisions, and may have a direct interest as potential legatees. Once aware of the options available through the HIA, they may even be prepared to take on the organisation of the subsequent repairs and improvements, leaving the HIA free to help those who have no such helpful friends or relatives.

Where the client keeps in touch with relatives or friends at a distance, they should be encouraged to keep them in the picture, and may be given copies of letters to send to them. Only with the client’s express permission may the caseworker write to the directly.

Levels of Support

Clients will require varying degrees of support, some total from start to finish, others very little. The HIA must attempt to ensure that the support offered is pitched at the right level. To give too much assistance is a waste of time and money. To give too little risks letting the client down.

Some clients will only want preliminary information for the moment that may or may not be of value at a later date. Others seek only financial advice and having been shown, for example, how to secure a comprehensive interest-only loan, are perfectly capable of proceeding with little or no further help.

Others need all the help that the HIA can offer, and at every turn.

Reviews and changes

The client can initiate reviews or changes to their Support Plan at any time. However, if any changes result in additional expenditure, the consequences must be agreed with the client prior to proceeding.

Any requests for change or changing needs must be given proper consideration. A client’s situation can and will change and it is more important to provide an appropriate outcome than to stick to the original plan.

A request for change may not just be to the works being carried out, but over the timing or choice of contractor.

Compliments, Complaints and Consultation

If the Client is dissatisfied with us for any reason, or has a suggestion about how we could do things differently, they should be encouraged to let us know. Any compliments should also be encouraged so we can learn what works, as well as what doesn’t. Suggestion cards should be given out as a matter of course

Any informal comments about the service provided should be recorded as a case note for potential service improvements.

Most complaints will be of a relatively minor nature and made directly to the Caseworker or Technical Officer. Such issues can usually be resolved fairly easily and will not need any further attention. If the Client is still dissatisfied the complaint should be referred to the Agency Services Manager. 

A “Complaints, Comments, Compliments” leaflet will be provided in every welcome pack, and Clients should be encouraged to use it where they feel that they haven’t received the level of service that they expected. Complaints rarely reflect poorly upon an individual Officer, but highlight areas where the Agency needs to improve.

An agency should aim to have a positive, proactive safety culture. This involves all employees, from casual staff to directors and members:

• being clear about their health and safety responsibilities
• providing services in a manner that protects the health and safety of the users
• working with partners and other agencies to promote good standards of health and safety

To put this policy into practice an agency should give its employees, as far as is reasonably practicable:

• A safe and healthy workplace
• The knowledge and supervision they need to work safely
• Safe work equipment and safe ways of working
• Safe means for using, handling, storing and moving anything at work
• Adequate welfare facilities
• Access to occupational health support

The law requires all employees, wherever they work, to do certain things. That means you must take personal responsibility to:

• Take care of your own health and safety and that of anyone else who is affected by your work
• Co-operate in the interests of health and safety
• Take good care of anything provided for the purposes of health and safety
• Report accidents, incidents, “near misses” and anything we think is dangerous – actively look for opportunities to improve health and safety

Personal Safety – Lone Working

Visiting clients in their own homes is an essential part of  an agency service. In these situations you can often feel, and actually are, at greater risk than if you were working with a colleague, principally because:

• if you are known to be on your own a potential assailant can see you as an easier target.
• if you have an accident, are attacked or encounter any other difficulty help may not be readily to hand.

A clearly understood booking out, calling in and reporting back procedure for employees working away from base is essential. Everybody has a responsibility to see that the procedure is followed. An employee who refuses to follow the agreed procedure should not go out. The Agency Manager will ensure that the system is monitored and regularly discussed within the team.

Typical signing in and out procedure

• Worker to record date and time of visit, and client’s name and address in their electronic diary – which is available to view by the rest of the team.
• Worker to record an estimated time of return on white board – where the visit is to a potentially risky property, the details should be written in red ink.
• If more than half an hour has passed from estimated time of return, the Worker should contact the team to confirm safety and give a revised time of return.
• If more than half an hour has passed from estimated time of return, a nominated member of staff should make efforts to contact the Worker to confirm safety and obtain a revised time of return.
• If it is known in advance that a visit will not be completed before the normal end of the working day, a manager should be informed and arrangements for reporting in agreed if required.
• If a visit looks to continue past 5pm, the Worker should contact the office before 5pm to confirm safety and to set up arrangements for further checks if required. This may be contacting a member of staff at base or manager on completion of visit / safe return home.
• At approximately 4.45pm the nominated member of staff begin to contact all workers on visits to check safety. This is recorded in a daily log.
• If a Worker calls in and mentions a “red file” – this is an emergency code to signal that they are in danger. The Police should be called immediately to respond.

Lone Workers

Before commencing any lone working, the following checklist should be actioned and completed:

• Attend a personal safety course
• Carry a first aid kit suitable for treating minor injuries
• Be aware of current risk assessments
• Job shadow an experienced officer
• Check the corporate risk register

An Agency is committed to involving and empowering clients and using their experiences to improve services. Clients’ experiences are central to the improvement method.

What is meant by Empowerment?

The table below shows a useful model for distinguishing between consultation, participation and empowerment:

A client’s involvement can range from decisions about one’s own individual service to involvement in collective decisions about service commissioning and running. The scale of participation runs from level 1 to 5:

1. Passive involvement (being a recipient of services), 
2. More active involvement (being involved in one’s own assessment and care plan), 
3. Passive participation (being informed about what services are proposing), 
4. More active participation (client representatives on advisory group contributing to decisions), 
5. Empowerment (with users active in the running of the Agency.) 

The aim is for informed, supported clients to be as involved as possible in all aspects of their service and, where possible, to contribute actively to the running and improvement of services for others.

How does this relate to service improvement?

All service improvement programmes are based on the importance and centrality of Client experiences. This is seen in:

• Using actual Client experiences to identify outcomes, map service pathways and identify improvements
• Focusing process mapping on the Client to enable a whole system approach to improvement of service pathways and Client outcomes
• Enabling informed choice by improving information to Clients, carers and other agencies
• Involving Clients in evaluating services; in training staff, and in developing services.

Practical ways Clients and carers will be involved in the Agency include:

• Membership of the advisory group
• Systematically using Client experiences to identify issues for change
• Client involvement in their own assessment
• Taking a ‘whole person’ and ‘whole system’ approach so that assessments cover a wide range of issues of concern to Clients and are not limited by service boundaries
• Ensuring that older and disabled people’s views are central to assessment and support planning
• Empowering Clients to be actively involved in the programme. 
• Revising forms and letters to make them more understandable
• Spreading the word about the Agency. Some older or disabled people may act as ’ambassadors’ for the Agency and help to explain the work to ‘hard to reach’ groups

Client Participation

There are many good reasons to involve clients. These include:

• To give people a real say in the services we offer and the way we provide them;
• To better tailor our services to meet people’s individual needs;
• To make sure we provide quality services that are friendly, fair, and useful;
• To make sure our services support people’s dignity and independence;

Client participation is about talking and listening to our clients and involving them as partners in the decisions that affect their lives. 

Examples include:

• Involving clients in decisions about their own housing needs and how these are to be met. 
• Asking clients for their views on the usefulness and friendliness of our public information. 
• Inviting clients to take part in service planning groups
• Creating user forums where people can have their say about the services we offer. 

Clients have a right to have their say, to enjoy choice and control, and to share in decision making about their services. 

At the same time there are limits to this right and we must be open and honest about these. For example, elected members of the Council are also involved in decision making and have the ultimate authority in policy making. 

We have legal duties and responsibilities that we must carry out. Also, we may sometimes need to make decisions that may go against the views of clients. If this happens, we will clearly explain our actions as well as people’s right to appeal or to make a complaint.

Having set out some of these limits to user participation, we are committed to making sure that service users are at the centre of all that we do and the way we do it.

How much participation?

Participation can range from clients being involved in decisions about their own services to taking part in the management, planning and development of services for the community.

For some clients, receiving information about services is enough. Other clients will look to be more actively involved, wanting to give their views and expecting to take part in local decision-making. Some people may want to take part in both their own services and in the management, planning and development of services for the community. 

Clients must be given the equal opportunity to participate to a level and a degree that suits them.

Accurate, simple, up-to-date records are essential if the day-to-day operation is to be efficient, and the service monitored and evaluated consistently.

Case Files

Responsibility for files

Once a case has been allocated to a member of the team, the responsibility for the maintenance of data and information on paper and electronic systems lies with that person. The tasks of recording may well be delegated to others, but this does not remove the responsibility for the accuracy, relevance and adequacy of the stored information.

The responsibility to act as Data Controller under the Data Protection Act lies with the Business Manager. 

Maintaining files

The Administration Officer will ensure that the Contact Assessment details are entered onto the appropriate database.

It is important that information is assessed before being added to the file, on a need to keep basis.

Opening a casework file

A paper-based Casework Files will be opened if the Client meets the Access Criteria. The responsibility for the opening of these files lies with the Administration Officer. 

Security of files

Paper files are to be kept in a locked filing cabinet outside of office hours and must not be left unattended during the working day.

Missing files are to be treated as an emergency situation and every effort made to recover them. The fact that a file is missing is to be reported to the Agency Services Manager without delay.

Access to files

Access to files may be requested by the person to whom the file relates. This requires the files to be managed by the data controller for the team. The data controller will operate according to the procedure set out in the “Access to Personal Service Records” policy.

Case Notes

All case notes should be entered onto the file flysheet  for each case. Notes should be entered in chronological order, and include the date entered and the initials of the person making the entry. If unsure whether to make a note, consider whether a colleague would need the information if you were to win the lottery and move to Barbados.

Monitoring

Where any monitoring information is to be passed to an outside body, no names or addresses may be included unless this has been explained to clients and their express permission obtained.

Individual clients should only be identified by a reference number.

Freedom of Information

The Freedom of Information Act It is intended to promote a culture of openness and accountability amongst public sector bodies by providing people with rights of access to the information held by them. It is expected that these rights will facilitate better public understanding of how public authorities carry out their duties, why they make the decision they do and how they spend public money.

It means that people have a right to know whether the Council holds particular information, and what that information is.  It covers all information held by the Council, except information held on behalf of someone else, and all information held on our behalf by someone else.  This means policies, guidance notes, minutes and agendas for meetings (but not meetings about a person eg case notes), internal reports, statistical information, Post-It notes, notes of telephone calls, emails, the contents of your filing cabinet, databases, spreadsheets, letters – everything