Agenda Item No 6
The Vale of Glamorgan Council
Scrutiny Committee (Corporate Resources): 15th October, 2014
Report of the Director of Social Services
Disabled Facilities Grants and the Contribution of Occupational Therapy Assessments
Purpose of the Report
1. To advise Members of the contribution made by Occupational Therapists to the Disabled Facilities Grant (DFG) process.
2. To provide Members with information about steps taken and planned to improve timeliness.
1. That the process and performance for delivering Disabilities Facilities Grants be noted.
Reason for the Recommendation
1. That the Scrutiny Committee can exercise effective oversight of a key Council service.
3. The Council has made it a corporate priority to improve the time taken to deliver a Disabled Facilities Grant (DFG), from the initial point of contact when clients requested an adaptation through to the delivery of the works. Officer time and financial resources have been invested in the service.
4. A strategic group has provided oversight of the improvement programme across Housing, Public Protection and Adult Services. This has delivered a significant year-on-year reduction in the overall number of days taken to deliver a DFG, the national indicator used to judge local authority performance. The overall waiting time in 2013/14 was just over a quarter of what it had been in 2008/9. However, the comparative position against other local authorities has not improved during this time. Consequently, all aspects of the process must continue to be reviewed and measures taken to improve the position.
5. On 15th July 2013, Cabinet decided that a detailed update on DFG progress should be brought before it on a quarterly basis (C1415).
6. A further report was presented to Cabinet on 24th March 2014, outlining DFG performance for quarters 2 and 3 of 2013- 2014. The overall DFG performance was within the local targets set. However, the report set out two children’s DFG case examples that illustrated substantial waiting times for allocating the case to an Occupational Therapist (OT) and where the timescales for delivery exceeded 700 days.
7. The Scrutiny Committee (Corporate Resources) on 24th June 2014 requested that the Head of Adult Services and Locality Manager submit a further report to it setting out the Occupational Therapist assessment process and the length of time expected to undertake an assessment.
Relevant Issues and Options
8. At the beginning of August, there were no children on the waiting list for DFG assessment by an OT. This has been achieved as part of the overall plan for reducing waiting times. All potential DFG cases are now managed through a designated waiting list that focuses entirely on requests for a DFG assessment. When demand is high for OT services within Social Services, which could result in a delay, the OT employed through Public Protection will accept these cases as a priority.
9. For both children and adult cases, the DFG process involves a functional assessment by an OT. This assessment takes into account the service user’s medical condition, physical abilities and the probable future progression of their condition. The OT asks the service user to complete tasks that demonstrate how they are managing with daily living activities, such as using stairs, bathing and meal preparation.
10. The OT has a duty of care to ensure that the recommendations made will be safe and suitable for the applicant. This may require further discussion and / or a demonstration of equipment / adaptations and can be time consuming, particularly when the applicant wants an adaptation or appliance which the OT knows is unsuitable. A process of negotiation is often required with all relevant parties to ensure that a safe and suitable adaptation is provided. To secure accurate information about the service user, the OT will need to contact other health or social care professionals to get further advice before recommendations can be made. This will also take time, especially if other services then have to review or re-assess the applicant.
11. One recurring example of where a delay may occur due to applicant’s expectations is when a request is made for a walk-in bath. To an OT with previous experience and knowledge of the baths available, a walk-in bath is rarely the most suitable provision following assessment of the applicant’s physical ability and prognosis. This usually requires further investigation and contact with Health professionals to identify a suitable alternative. In addition, negotiation with the applicant about more suitable adaptation options will need to take place and this may include arranging visits to look at previously completed schemes. Appendix 1 contains two case examples, one of which highlights the negotiation process with the applicant and a further multi-disciplinary assessment.
12. In order to inform decisions about how further reductions in the waiting time for DFGs can be achieved, a business process re-engineering review is to be undertaken in October 2014. Initially, this will focus on the Occupational Therapy part of the process.
Resource Implications (Financial and Employment)
13. There are no direct resource implications as a result of this report.
14. There is an identified capital budget for the approval and payment of Disabled Facilities Grants. Public Protection and Adult Services have identified revenue budgets to deliver the service.
15. The Occupational Therapist role in recommending adaptations assists in ensuring that the most suitable adaptation is provided for current as well as long-term need. It also avoids unnecessary expenditure where adaptations do not suit the needs of the applicant.
Sustainability and Climate Change Implications
16. The provision of improvements to property will meet current sustainability criteria in terms of building and adaptation methods. The provision of adaptations to allow independent living can also reduce the need for community care packages and promote sustainable communities.
Legal Implications (to Include Human Rights Implications)
17. In meeting their responsibilities under the Housing Act 1985, Housing Authorities are required by the Chronically Sick and Disabled Persons Act 1970 (CSDP) to have specific regard to the special needs of chronically sick and disabled persons.
18. Social Services have duties and powers under a range of legislation including the CSDP Act 1970, to assist in carrying out adaptation work or the provision of additional facilities. For Children in Need, the Children Act 1989 requires Local Authorities to provide services which may include accommodation.
Crime and Disorder Implications
19. There are no specific crime and disorder implications as a result of this report.
Equal Opportunities Implications (to include Welsh Language issues)
20. There are no specific equal opportunities implications as a result of this report.
21. Corporate outcome: Citizens of the Vale of Glamorgan are fit, healthy and have equality of outcomes and, through appropriate support and safeguards, the most vulnerable members of our community maximise their life opportunities.
Policy Framework and Budget
22. This report is in accordance with the Council's Policy Framework and Budget.
Consultation (including Ward Member Consultation)
23. This report is not ward specific and, as a result, no consultation with Members has taken place.
Relevant Scrutiny Committee
24. Social Care and Health
25. Housing and Public Protection
26. Corporate Resources
Cabinet Meeting 24th March 2014 report of the Cabinet Member for Housing, Building Maintenance and Community Safety - Disabled Facilities Grant Performance 2013 - 2014 Quarter 2 and 3.
Lance Carver, Head of Adult Services and Locality Manager
Corporate Management Team
Operational Manager, Legal Services
Team Manager, Occupational Therapy Team
Philip Evans, Director of Social Services