The recent State of Caring 2016 report from Carers UK was a stark reminder of the impending crisis England faces.
The charity warned how a ‘perfect storm of squeezed public services and financial pressures is pushing carers to the brink’ with more than half expecting their quality of life to get worse this year.
There’s a growing body of evidence to show that home adaptations – and more flexible use of Disabled Facilities Grants (DFGs) – could play a significant role in relieving some of the pressure carers are now under. It forms the basis of Foundations’ submission to the Government’s consultation on a new national Strategy for Carers.
Research published by Foundations last year found adaptations can delay entry into residential care by four years but only leads to a small reduction in domiciliary care hours. Indeed, only 17% of applicants for a Disabled Facilities Grant are also in receipt of state funded domiciliary care. This led us to surmise that informal carers must significantly benefit from the provision of home adaptations.
This line of thought is backed up by new research from Australia which shows a significant reduction in the number of care hours following the installation of home adaptations.
The study found adaptations to assist with bathing and showering led to a 63% reduction in informal care-giving hours. It was a similar story with adaptations to help with toileting, which reduced care by 47%, and those to assist a person to move around the house (41%).
This suggests they may be at least as beneficial for carers as they are for the person with the disability – and in turn prevent or delay admissions into residential care.
And the good news for those on lower incomes is the Government has increased the funding local authorities have at their disposal to award means-tested DFGs to pay for adaptations. By 2019-20 that pot will have risen to £500m – enough to fund around 85,000 home adaptations that year.
This offers a huge opportunity to support both disabled people and their carers. But it will only be truly realised if local authorities make use of DFGs in a more flexible way.
The legislation governing DFGs in England and Wales is the Housing Grants, Construction and Regeneration Act 1996. This is primarily housing legislation and sits aside from the provisions of the Care Act 2014, which strengthened the rights and recognition of carers in the social care system, including, for the first time giving carers a clear right to receive services.
Section 23 of the 1996 Act sets out the purposes for which a grant must be approved and includes making ‘the dwelling … or the building safe for the disabled occupant and other persons residing with him’. This is often overlooked, but there is some helpful case law to help explain the provision.
In one case involving Calderdale Council, the parents of a boy with autism applied for a DFG to pay for a loft conversion. The boy had subjected his younger brother, with whom he shared a bedroom, to dangerously inappropriate horseplay and to violent interference with his sleep on a regular basis. The local authority turned down the application on the grounds that the danger to the younger brother was not confined to the shared bedroom; so an extra bedroom would not make the dwelling safe for him.
On appeal the judge ruled that any adaptation could not necessarily be expected to make the premises completely safe for the disabled person and other people he lived with. The question was whether it was enough for the works to make the premises safer, or whether there was a safety threshold to get over in order for the works to be deemed ‘necessary and appropriate’.
The judge also held that as long as the safety of the disabled occupant is involved in some way, a grant would not be precluded; there was not a requirement that the principal purpose of the works should be the safety of the disabled person. For example, a fire escape or smoke alarm might benefit several other occupants of a dwelling, and not just the disabled occupant.
From this reasoning it can be argued that works that make the home safer for an informal carer should be considered as part of an application for DFG. It would then be for the local authority to decide whether those works were necessary and appropriate in each case.
Even without this case law, since 2008 local authorities have had significant discretion in how they administer their DFG programmes and can choose to offer grants that directly provide adaptations to support carers.
Our evidence suggests this would be a cost-effective way to both lighten the load on carers and help to prevent people from needing to go into a care home.
Paul Smith is director of Foundations, the national body for home improvement agencies and DFGs.