The vital lifeline of home improvement agencies

For the last 25 years district councils across the country have been helping people with disabilities to make adaptations to their homes. Thousands of people have been awarded Disabled Facilities Grants (DFGs) to pay for level access showers, ramps, stairlifts and the like, which means they have been able to remain living in their own homes.

This year marks the silver jubilee of the DFG, and it still ‘does what it says on the tin’: offers grants to fund facilities to help people with disabilities.

In most areas home improvement agencies (HIAs) help people to apply for a DFG by working with occupational therapists to design the adaptations and then arranging for contractors to carry out the works – taking the stress out of the process and assuring a fit for purpose solution.

Premature moves

Foundations – the national body for HIAs in England – has undertaken new research into the benefits of DFGs. By making a Freedom of Information request to all social care authorities in England, we have discovered a direct link between adaptations funded by a DFG and preventing premature moves into residential care.

For people who have had to move into residential care, those who had previously received a DFG on average moved just before their 80th birthday and stayed there for two years. Those people who hadn’t applied for a DFG moved when they were 76 and stayed in residential care for another six years.

”One of the requirements for this fund is the adoption of service users’ NHS number to link health records with social care data”

With a residential care place costing around £29,000 per year, compared to an average DFG costing less than £7,000 as a one-off, this highlights the major impact that adaptations have for social care budgets. With over £1.4bn spent on DFGs over the last five years, it could also go some way to explaining why the number of care home beds reduced for the first time ever in 2014.

Measuring impact

From 2015 the DFG pot forms part of the Better Care Fund; the funding pot shared between social care and clinical commissioning groups aimed at promoting integration and prevention. One of the requirements for this fund is the adoption of service users’ NHS number to link health records with social care data. Unfortunately this does not currently extend to housing information which means that many of the authorities we surveyed could not yet fully measure the impact of DFGs.

This could be crucial for future plans as some funding allocations will be based upon decreasing the number of people admitted into residential care.

However, this could be the tip of the iceberg. If the NHS number is used when recording a wider range of housing interventions – like making a home warmer, or removing safety hazards – commissioners will be able to monitor the true impact on social care and health systems and make evidence based decisions on such preventative services.

These are just the sort of services that HIAs are expert in delivering. For instance, many HIAs provide handyperson services that could quickly and cheaply make the small modifications to a person’s home that currently delays discharge from hospital. Our agency of the year, Manchester Care and Repair, is a great example of how this works in practice.

Independence and wellbeing

It expanded its services to include a seven-day-a-week hospital discharge service that supported 1,450 patients during a one-year pilot in 2014 commissioned by North Manchester CCG and Manchester City Council. It has since been extended with exclusive support from the CCG so that patients aged 60 and over being discharged from North Manchester General Hospital receive an assessment to gauge what’s needed to support their recovery and ongoing independence and wellbeing.

It’s also important to note that in many areas, HIAs are the only housing service that work across tenures. Whether a patient or service user is a tenant, home owner, or even a lodger, HIAs can help. When housing associations only manage 10% of houses in England, it’s important that services can deliver the type of universal approach offered by the NHS.

Paul Smith is director of Foundations, the national body for home improvement agencies and handyperson services. www.foundations.uk.com