The Social Value of aids and adaptations

A report commissioned by Foundations Independent Living Trust sets out the social value of home adaptations.

This research explores the stories of the people helped by Home Improvement Agencies to find, fund, and use adaptations to their homes. Enabling them to stay in the homes they love, in the areas and near to the people they know is hugely valuable at human level. However it is all the more essential when accessible properties are not being constructed quickly enough to meet the needs of a growing older and disabled population, nor is it economically sensible to construct afresh when needs can be met at lower cost in the houses which are already built and occupied.

Those stories show five key needs being met, time and time again. Through these we see families, couples and individuals maintaining their independence and mobility, finding new solutions for everyday living that make tasks around the house simpler and less of a burden. In some cases we can see significant changes in life course: a downward spiral of incapacity turned around, or a debilitating accident, otherwise just a matter of time before it happened, now avoided.

Those changes, little or great, are experienced by people at five levels. They are given knowledge and information about how to adapt their homes, and their ways of living, to make them more comfortable and suited to their needs. They are guided to the financial assistance necessary to fund the adaptations, or are helped to find cost-effective solutions if they are not eligible for grant support. They see improvements in mobility, wider physical health and wellbeing. These all have a significant effect on independence and self-respect, and enable people to maintain greater degrees of purpose and identity. Last but not least, they find themselves less fearful, less isolated, and feel safer.

The financial benefits emerge from our exploration of blended case studies presented as four personas with their individual storylines. Even with an evaluation of just some of the cost benefits, and a restriction of the evaluation period to one over which outcomes can be reasonably predicted, cost benefits are felt which all show strong improvements. Some of these are enjoyed by the person themselves, but many fall to the public services that support them should their needs escalate.

Whichever way you look at it, home adaptations bring real value.

Their stories

Rachel’s story

Arthur’s story

The role of the HIA is central to the success of an adaptation

We have identified that the two key points of interaction that a HIA has with customers fall into Before and After installation.

1. Before: empowering the customer with their full knowledge of the solutions to their needs. Many times this has been an adaptation of which the customer was not aware or had previously discounted due to a belief that it would negatively impact the aesthetic of their home, cost too much or be too disruptive to put in. HIA case workers are able to show them that this is often not the case and persuade them of the benefit that they will receive. Many customers are reluctant to make adaptations due to the perceived costs of purchasing and installing them. The HIAs extensive knowledge and experience means that they are able to help the customer apply for and secure funding for some, if not all, of the cost.

2. After: as has been mentioned in this report – in identifying the impact of adaptions, we have assumed that the customer is able to use their adaptation to its fully in order to benefit from it. This assumption is made because, through our conversations with Foundations, HIAs and other sector stakeholders, we have observed that HIAs’ and OTs’ relationships with their customers extend to supporting them once an adaptation is installed and provide training where needed. From this relationship, customers have a reliable and trusted advisor to whom they can turn if they have any further needs that emerge over time.

The cost of adaptations in relation to the value of the impact

The range of outcomes and minimum financial effects achieved in the four illustrative personas span a considerable range, as shown in the table below. They are all, however, strikingly positive from a financial perspective and show that appropriate home adaptations, well used, are not just life-changing in a human sense.

Period illustrated Cost with home adaptation Cost without home adaptation Ratio of illustrative costs
Rachel 4 yrs £972 £141,484 146x
Mohamed and Nazia 20 yrs £321,617 £1,644,869 5x
Arthur 8 yrs £131,243 £230,030 1.75x
Shirley and Tony 13 yrs £7,649 £312,753 41x

Our research indicates that the cost of a particular adaptation does not necessarily correlate to the amount of impact that can be achieved from it, or indeed the cost saving as a result. Largely this is because it is so dependent upon the person who will receive the adaptation and their situation. The contrasting illustrations for the personas of Rachel and Arthur are testament to this.

Essential to Rachel’s wellbeing is the ability to socialise with friends and family. A cheap set of adaptations avoid extremely costly events in Rachel’s later life. Rachel’s way of life is very different to Arthur’s, who is resolute and enjoys his own company. Aside from his dialysis he does not need any other adaptations to improve his wellbeing, if it were not for his health condition he would not interact with the HIA at all and would therefore generates very little saving.

As such, we believe that the approach of the HIA must be to place the individual at the centre of their work. Each person is different in how they want to live their life and therefore place differing emphasis to certain elements. What is important to the individual must be the primary motivator for the HIA and how they seek to maintain, or increase, the individual’s ability to do those things.