What was the issue you were addressing or working on?
To provide a client focused One Stop Shop for a range of services to social and private housing tenants. To be a centre point for design, specification and provision of adaptations and one point of contact for clients, carers and landlords. The provision of a client focused service which endeavours to ensure that the client’s needs are met and adaptation failure is minimised. A central client focused service encourages innovation to provide best value for money whilst maintaining quality. Similarly, clients are offered good advice and guidance on repairs, improvements and adaptations to their homes all of which guards against potential exploitation.
What you did?
A range of initiatives and services were established using the model of a One Stop Shop:
- Providing a client focused one stop shop for major adaptations for clients who have a need no matter what their disability. The service for major adaptations for people with a disability was piloted between 2005 and 2007, and rolled out across the Scottish Borders in 2007. Uniquely, the service has an in-house Occupational Therapist with specialist knowledge on adaptations and the impact of the home environment of disability. The service can provide 3d architectural drawings and specifications for many adaptations therefore reducing the need for an architect. Training was provided to NHS Occupational Therapists which allowed them to refer directly to the service. This assisted in hospital discharge thus helping people have a successful, timely discharge. An in-house OT gives an overview to all adaptations including the appropriateness of the ‘eligibility criteria’ rating so ensuring that clients’ adaptations are actioned in an equitable and timely manner.
- Streamlining the provision of minor adaptations allows a central administrative site from which all requests can be acted upon. Additionally, this approach generates a platform for monitoring requests and answering queries from clients, family, Occupational Therapists and other referrers. The provision of grab rails was de-prioritised allowing self referrals where clients do not wish to go through the local social work departments. The service assumed control of budgets in 2008 since when it has continued to evolve. In 2011 the service accepted responsibility for the provision and administration of major and minor adaptations on behalf of 4 local Registered Social landlords (RSLs) . A Handyman Club for clients was established to provide DIY services on a subscription basis. The Handymen carry out minor task that clients are unable to do, eg fit shelves, change light bulbs, curtains, hand pictures, move items of furniture, change locks. They also carry out safety checks to ensure against trips and falls and fire prevention. The handymen also provide regular contact with clients and will refer to other agencies as appropriate.
- The “Homefast” Falls Prevention Initiative used the “Homefast” screening tool to identify interventions required to assist in the prevention of falls in the home. The required works were taken forward through the Care & Repair Service. The tool was piloted between January and April 2009
- Providing advice and assistance for repairs, improvements and self funded adaptations runs along-side all the other aspects of the Borders Care and Repair service. Borders Care & Repair provides advice and guidance to clients on repairs and improvements that are required. It can arrange contractors and provide project management. Clients wishing to self fund adaptations can receive advice on processes, products and good design. It also provides plans and specifications, arranges estimates from contractors and can project manage the works if required.
What were the outcomes - benefits or otherwise?
The One Stop Shop provides a streamlined service with resulting making provision easier and better provision for clients. They have single point of contact from a client focused service which has their needs at the core. From the professonal assessor perspecive Borders Care and Repair lightens their work load by taking forward necessary adapations thus freeing them to assess/review more clients, waiting list are positively impacted, and direct access for NHS OTs speeds up processes by by-passing time consuming referrasl to social work. Improved value for money is achieved through providing 3d architectural drawings and specifications, keeping up to date with inventions and innovatiions, and timely completion adaptations which are of high quality. In-house OT ensures clients’ needs are considered in the long term.
Providing advice and assistance to clients ensures against bogus workmen and provides good competitive quotes for clients. Clients have peace of mind that they are getting value for money and the improvements they need.
The approach has generated an income for the service from the RSLs which will offset against the SLA revenue costs. It also allows clients to join the Handyman Club where they can receive the Handyman Service for a £24 annual subscription to carry out DIY jobs.
The Handyman service was evaluated on an SROI (social return on investment) basis showing a value in excess of £8 per £1 spent. It speeds up the response to clients to carry out work. Requests are received by fax and e-mailed out to the local Handyman immediately. The Handyman does not have to travel to carry out the work as they are working in the area anyway. Requests tend to be completed within 3 days of receipt. Clients can remain in their own home with small jobs to ensure safety and comfort being done. They also have someone to interact with. The service has a 98% client satisfaction rate.
The introduction of the Home Falls Initiative has reduced the number of falls in the home from 33%(National statistics) to 9% in the 65-80 year old age group and from 50% to 9% for the over 80 year old age group in the pilot cohort. The screening tool information in the pilot was collected and managed manually. Funding has been obtained from the Change Fund to provide hand held equipment and data software which will reduce the burden of data handling and increase capacity. From early indications the costs of equipment upgrades identified through the use of the tool might create a funding challenge, however it is considered that savings are being made through prevention of falls and thus costs associated with care in these situations and thus opportunities to access NHS funding locally.
The service is currently working on a ‘revamp’ of provision of adaptation assessments along with a change fund bid. This will increase the size of the service and move adaptation assessments away from the local authority and over to Care & Repair. It is hoped that this will be running before the winter (2013).
Contacts - to find out more
Tel: 01750 724895