Recent reports have highlighted the huge challenges we face in both catering for the housing needs of vulnerable people and relieving the pressure on acute hospital services.
This month the public accounts committee warned 1.5 million hospital admissions could have been avoided in 2016-17 if health and care services worked together more effectively.
In May a report commissioned by the Equalities and Human Rights Council highlighted the shortage of suitable housing for disabled people. It called on local authorities to improve the way they assess housing demand and offer accessible housing to their communities.
The two are inextricably linked: by ensuring vulnerable people have adaptable housing coupled with appropriate community based support we can help to tackle the cycle of unnecessary hospital admissions.
In my role at Foundations, I’m responsible for improving practice and delivery around disabled facilities grants (DFGs) in England, the main source of local government funding for housing adaptations.
Government funding for DFGs has increased substantially and in the space of five years will have more than doubled to approximately £550m a year in 2019-20, reflecting the key role it has in enabling independent living and reducing both care needs and hospital admissions. It contributes to the prevention and early intervention agenda and the integration of health, housing and social care.
With the increase in funding, the Government is keen for more people in need to benefit from DFG funded interventions. But it’s aware of the often-significant disparity and variation of DFG delivery across local authority areas and is keen to see greater harmonisation and higher standards in delivery.
In terms of customer experience, depending upon which local authority area you live, their DFG application process can be impacted by a number of factors. These include assessment, local interpretation of what is necessary and appropriate, technical delivery of an appropriate scheme, and procurement of contractors.
These variables tend to impact on timescales, where the time from point of assessed need to practical completion of the adaptation can vary from eight weeks to two years! The complexity of particular adaptations – especially those for children – tends to extend delivery times.
But it is clear that greater focus on rationalising the stages from assessment to the point of having contractors on the ground can deliver significant benefits, not only to the customer but arguably to local social care and health services.
That’s because it will reduce the time a customer spends ‘at risk’ while waiting for their adaptation to be delivered.
As part of its remit around DFG transformation, Foundations has adopted a multi-aspect strategy to help local authorities improve their delivery systems. The first has been awareness raising, principally via a series of regional DFG Champions roadshows in which everybody with an interest in DFG is invited to share best practice and figure out ways of improving the system in a constructive, non-judgemental manner.
These events have been a great success in highlighting the inherent flexibilities of DFG by utilising the powers of the Regulatory Reform Order (RRO) and by promoting the notion that DFG should be considered just one tool in a whole-system approach for delivering home-centred interventions.
Another aspect is quality assurance, whereby best practice is embedded within local delivery mechanisms in order to reduce the likelihood of a postcode lottery occurring. This quality assurance is delivered using a number of tools. They include the HIA Quality Mark, in which a home improvement agency’s policies and procedures are subjected to critical review with suggestions being made to rationalise and improve them.
However, not all DFGs are processed via HIAs. Foundations has therefore been consulting on the development of a DFG specific Quality Mark which can be deployed in every local authority and focuses on 10 aspects of DFG delivery. This can be supported by use of the Foundations DFG analytics system, which allows local authorities to compare and contrast their own DFG delivery performance against other comparable local authorities.
Significantly, Foundations has also been working with Advice Services Alliance to make the Quality Mark assessment a stepping stone to the Advice Quality Standard (AQS) – a robust and respected tool used to improve the performance of Citizens Advice Bureaux and other organisations.
Greater emphasis on delivering robust and safe advice services is vital. Not only does this align with the requirements of the Care Act, but it will also help to remove some of the myths that have propagated at local level concerning grants such as DFG.
Robust advice services perform a vital role in facilitating better multi-agency hand-offs and also allow professionals to get a greater understanding of customer needs, thereby arriving at better solutions.
Finally, in order to strengthen the final stage in the customer’s DFG experience – the stage in which contractors are actually working in their home – Foundations offers TrustMark support. TrustMark is the only safe-trader scheme with Government-endorsed standards. Contractors who hold TrustMark accreditation operate at the forefront of consumer protection, but also have robust procedures in place to offer protection should anything go wrong.
Providing local authorities with support to rationalise their DFG processes and realise the flexibilities allowed under RRO, combined with targeted quality assurance tools, can transform the DFG experience for customers, and help unlock savings in terms of time, resources and money.
Roy McNally is development manager at Foundations, the national body for home improvement agencies.