A guide to the process of adapting the homes of people with disabilities from initial request to completion
In most districts of Norfolk there are two main statutory agencies involved in the process of providing adaptations to your home. They are the District Council and Norfolk County Council Social Services Department. However, in areas where the District Council transferred its housing stock you will have to consider the Housing Association and possibly the agent acting on behalf of the Housing Association.
The District Council or Housing Association: The Housing Department or Housing Association provides and maintains ‘social housing’, including adaptations for tenants with a disability.
The Environmental Health Department is responsible for the administration of the Disabled Facilities Grant for Adaptations to housing in private ownership. Occupational Therapists presently employed by Social Services are the link between Social Services, Environmental Health and the Housing Departments/ Housing Associations. These Departments are responsible for adapting properties to meet the needs of people with disabilities.
The person is disabled if:
Norfolk County Council’s Social Services Department does operate a prioritising system for all referrals to the Occupational Therapy Department. We first visit people who are considered to be in most urgent need. That is to say people with conditions which leave them at the highest risk of injury or harm. Our recommendations made to the Environmental Health Department for Disabled Facilities Grants reflect this policy, so that we all work to the same standards.
Early intervention required because:
a) Client at very high risk and cannot remain at home safely.
b) Carer is at risk.
c) Client has no access to essential facilities ie
d) Client cannot be discharged from hospital safely.
a) Moving and handling issues, ie person unable to be transferred without suitable equipment and/or adaptation.
b) Major difficulty or inability to use stairs where this provides access to the only toilet and sleeping facilities (where bed cannot be brought downstairs and commode used as temporary measure).
The situation is putting significant pressure on client, family or carers. In all likelihood if action is not taken, physical or emotional breakdown or loss of independence will result.
a) Knowledge that the client has rapidly deteriorating condition or limited life expectancy indicates that a high risk situation likely to deteriorate, eg MND, some cases of MS, cancer.
b) Request from Housing Department requesting advice or suitability of property for disabled client on Housing transfer list being offered immediate accommodation.
c) Client has terminal illness, is managing but having difficulty with stairs to reach WC.
d) Client is unable to manage stairs, and using bed and commode in only family living room.
e) Disabled single parent unable to prepare meals for self and family without alterations to kitchen, so significant risk of losing role in family.
f) Client who is having great difficulty toileting themselves because of inability to get up from lavatory seat where provision of toilet equipment and rails would make them independent (this would only be the case if there were no one to obtain the equipment from the Red Cross).
g) Where client’s mobility is such that they cannot access the property without adaptations being undertaken.
h) Where a child has a development delay in toileting and the additional WC has been identified as a possible solution, which will aid a toilet training programme.
Intervention is needed to maintain or provide reasonable level of independence. There is no immediate threat to health and safety.
a) Client having significant difficulty with Activities of Daily Living and requires advice on intervention to improve or maintain the existing level of independence and quality of life.
b) Client has significant difficulty with stairs, and WC is upstairs.
c) Client has a progressive neurological condition and is helped by formal or informal carer with washing and WC use. Could be independent with accessible facilities.
d) Accessible facilities are needed for a disabled child to maximise independence and assist parents to continue to provide care safely.
e) Bathing is always given low priority unless there is a genuine medical condition requiring daily baths (eg colostomy, skin ulcers etc).
f) Request is received for provision of ceiling track hoist to replace mobile hoist to reduce time on carers or make client independent.
g) Housing needs assessment requested - no suitable property yet identified.
Client is able to remain independent and can manage most daily living activities with difficulty using existing/alternative methods. It may be likely that higher priority needs will arise in the longer term.
To ameliorate a current low level of risk which will escalate in times as a consequence of either a progressive disability or one of, which becomes more profound with age. The client has lived with the problem for a very long time and has now heard of a possible solution.
a) Client feels apprehensive about using bath because of physical problems. Now feels they would be confident with bathing equipment.
b) Wheelchair user lives with able-bodied spouse requesting adaptations to cupboards in kitchen.
c) Having difficulty using front door step, but could be safely independent with hand rails.
A wide range of adaptations are available from the comparatively simple such as concrete ramps, over bath showers and stair lifts, to the more complex, such as level access showers, through floor lifts and ground floor extensions to provide bedrooms and bathrooms.
These are only examples of what is available. The Occupational Therapist and members of the Housing Authority (or their agent) or Environmental Health Department, in consultation with you, will advise on the most appropriate adaptation to meet your needs.
Simple adaptations, such as handrails and small timber ramps will be undertaken by the Equipment and Adaptations Service at the request of the Occupational Therapist
Funding for Adaptations depends upon the type of works needed and who owns the property.
Time standards have been set out between Housing Authorities, Environmental Health and Social Services for
Some services will not be able to meet the time standards at present, because of resourcing problems.
The time standards will vary depending upon which category the referral falls into. Categories 1-3 will normally be mandatory under Disabled Facilities Grant legislation. Category 4 may not be mandatory, but could possibly be funded by a Care and Repair Grant. Environmental Health Departments will give you details of this service and the eligibility criteria.
You need to make a referral, or if you prefer, you many ask someone else to do it on your behalf. Contact the Customer Services Team on 0344 800 8020
During the first visit, the Occupational Therapist will carry out a detailed Occupational Therapy Assessment to determine what course of action would most suits your needs. You will be asked for details of your condition and how it affects your everyday life. You may be asked to show the Occupational Therapist around your home and to demonstrate the difficulties that you are having. It may be necessary for the Occupational Therapist to consult with Health Professionals involved with your care, which will not be done without your permission.
The views of you and your carers will be considered and will contribute to the decisions made.
The Occupational Therapist will check who owns the property. There are different types of assistance, depending on whether you own or rent your home.
You will be advised of the process for the adaptations system depending upon the type of housing that you live in.
1. Do not start work until authorised in writing by the Grants Officer or the Agent of the Housing Association
2. The Grants Officer or Agent of the Housing Association must check the completed work against the schedule.
3. Completed work must be to a reasonable standard before payment of the grant money.
4. You are responsible for the contractor and the work undertaken.
The process will be very similar to that for Council Housing and privately owned properties. Some Housing Associations set aside a sum of money for adaptations to properties and will arrange for adaptations to be done following an assessment of need and recommendation from the Occupational Therapist. Some Housing Associations will use the Disabled Facilities Grant to fund all or some of the adaptations, in which case they may pay your assessed contribution.
There are many Housing Associations in Norfolk and it is advisable to check with your own particular Housing Association as to how they assist with adaptations to their properties for tenants with a disability.