the highland council fast-track self-referral process for medical adaptations
TRANSCRIPT
The Highland CouncilFast-Track Self-Referral Process
forMedical Adaptations
Session Objective
• Introducing the Highlands
• Why Fast-Track
• What is Fast-Track
• Handyperson Service / Care & Repair Service
• Challenges along the way
Introducing the Highlands
• The Highland covers an area the size of Belgium
• The terrain in parts is isolated, rural and difficult to access
• Clusters of urbanisation
• Strong and supportive communities
Population
• The Highlands has a population of 222,370
• Higher than average, aging population
• Projections for the future are:• Number of retired people will almost
double• The number of people aged 75+ will more
than double
Resources
•Finite number of trained Occupational Therapists
•Close working links with Community Health Teams & NHS partners
Policy
Why Fast-Track
• Occupational Therapist assessment of adaptation need
• Adaptations graded based on their urgency
• A-F Grading
• Desktop Assessments for priority
What is Fast-Track
A model which allows clients to submit a self-assessment application for a range of adaptations that can be installed in the home without the need
for a full medical or Occupational Therapist’s assessment.
Adaptations Process
Two main stages
The assessment – of need and priority for an adaptation
The provision – of the adaptation (the responsibility determined by tenure)
Adaptations Process
Two stages of assessment
Expert Assessment – Usually by an Occupational Therapist
•Considers the clients wider community care needs•Long term needs and ability to remain in their home
Adaptations ProcessAssessment
Self Assessment
•Self Assessment applies where the client does not have more complex needs
•Most carried out without referral to OT for assessment
•Pre-determined criteria
•More efficient and speedy service
Fast-Track ModelSelf Assessment for
Small / Minor Adaptations & Equipment
Level Access Showers
Medical Heating Changes
Fast–Track Criteria
Level Access Shower
Applicants must meet one of the following criteria;Aged 70 or overAlready been assessed for mobility aidsReceive Disability Living AllowanceReceive Attendance Allowance
Fast–Track Criteria
Heating Changes
Applicants must meet one of the following criteria;Aged 70 or overLives alone, under 65 and receives either;
o High Rate of the mobility component of Disability Living Allowance
o Receives Middle or High rate Care Component of Disability Living Allowance
Lives alone, aged 65+ and receives Attendance Allowance
Fast-Track PrioritySelf referral cases fall into a priority category C
Priority Example Timescale
A • Client unable to be discharged from hospital• Client unable to carry out essential activities Critical
Within 48
hours
B • To prevent imminent hospital admission• To prevent serious breakdown in health / home
situation• To meet the needs of a disabled child
SubstantialWithin 15 days
C • Adaptation would be a significant benefit• Adaptation would promote client’s safety or
independence • Adaptation would prevent future crisis in the
home
Moderate
Within 4 weeks
D • Adaptation is not of sufficient priority to be funded – clients are offered advice
N/A N/A
Adaptations ProvisionCouncil Housing
Housing Association
Private Sector Housing
Who has responsibility for adaptation decision / provision?
Council Housing Association
Council
Who funds adaptation? Council - HRA Housing Assoc. Grant
Council – through private sector
grant
Who is responsible for recording / monitoring adaptations?
Council – H&P Service
Housing Association
Council - H&P Service
Who guides / supports person through installation?
Council staff – H&P Services
Housing Assoc. staff
Care & Repair
How are minor adaptations provided?
Council or Handyperson
Housing Assoc. or
Handyperson
Handyperson Service
Who assesses for adaptations (not fast-track)
Occupational Therapist
What priority categories are used? Priority Categories A - C
Fast-Track SafeguardsSafeguards in the Fast-Track system include;
•Clients not accepted for Fast-Track if they are already in the system and awaiting assessment
•Clients with dementia or related illnesses must always be assessed
•All Maintenance Officers (HC), Handypersons and Care & Repair Agents undergo training with OT’s
Handyperson & Care & Repair ServiceHandyperson Service and Care and Repair Service are integral to the Fast-Track scheme being a success.
Often the same organisation delivers both the services
Fast-Track would not work without these agents
Highland agents provide an exemplar model
One agent has been one of the first organisations to recently achieve Care & Repair Accreditation
Handyperson & Care & Repair ServiceOur leaflets are available to download at:
http://www.highland.gov.uk/NR/rdonlyres/2EC867E1-1DB0-45A6-8F94-9CF88907357F/0/handypersonserviceleaflet.pdf
http://www.highland.gov.uk/NR/rdonlyres/95DC80B2-C1EA-488C-940D-F657554836CE/0/schemeofassistanceadaptations.p
ChallengesScottish Governments strategy for the next decade ‘Homes Fit for the 21st Century’ – commitment to simplify arrangements for the public and housing providers to access funding for adaptations.
Greater integration
Reduce waiting lists and manage client expectation
We don’t always get it right!!
Staff Guidance
