Integrating Adaptation Services

1. Integrating Adaptation Services Derek Hardy, Lead Commissioner

2. Dear Catherine, • I am writing to you on behalf of one of my residents who has contacted me for advice and because I have also had experience of the same lack of transparency recently with a related matter. • Would you be kind enough to look into this matter for me and let me know the relationship and process between Dorset County Council, East Dorset District Council, Acme Home Improvements ltd and ' handicare Ltd' when applying for what I believe to be a Disabled Facility Grant. • I can confirm that neither my resident or myself received a communication directly from either of the local authorities that appeared to be involved in this process. The only letter received was from Acme Home Improvements Ltd, with no detail of how the application had been dealt with, which Council was the decision maker, whether there was an Appeal process and particularly how and by whom had the financial assessment been carried out. • Thank you for your help in this matter and I look forward to your reply with interest. • Best wishes, • Janet • > • >

3. Dorset County Council – two tier authority • Weymouth & Portland • West Dorset • North Dorset • Purbeck • East Dorset • Christchurch • Bournemouth • Poole 3 5 2 6 8 4 7 1

4. Dorset County Council – the issues • Rural county, over half is designated an area of outstanding natural beauty • Public transport is poor in rural areas • Growing older population, many are living alone, potentially more isolated and vulnerable particularly in rural areas

5. Adult and Community Services – Strategic context • Pathways to independence • “to support people to live independently for as long as possible, to reduce demand for health and adult social care and to promote health and wellbeing”

6. Background and drivers for change • Audit commission 2009 criticised Aids and Adaptations • Services • “in some areas it takes too long to make improvements to allow disabled people to live in safe and accessible homes” • Independent review The Housing Consultancy Partnership • Principal recommendation was to move towards a fully integrated service, including pooling of budgets

7. Background • Dorset Integrated Services Project Board • Occupational Therapy Review • Centres for Independent Living (CILS) • Integrated Community Equipment Service • Assistive Technology Review • Information and advice review • Representatives from LAs, Public Health, NHS and Healthwatch invited as a ‘critical friend’

8. Scoping the service • Began by looking at HIA services, Floating Support and ELA • BUT ……. • Project for CILS took a different direction • ICES contract to be re-tendered at the same time • Decision made for two separate services • Physical support • Personal support

9. Scoping the service • Consultation with customers and community • Pathway workshops with stakeholders on ‘as is’ and ‘to be’ • Engagement with other LAs (Wiltshire) • Support from Foundations and THCP • Provider engagement

10. Scoping the service • 2 x HIA contracts • 2 x Telecare contracts • 1 x Independent Living Centre • Major Adaptations Panel (separate budget and process) • Minor Adaptations (separate budget and process) • DFGs (6 district budgets and processes)

11. Scoping the service • ICES – in or out? • Bournemouth and Poole – in or out? • BUT ……Decision made for ICES Pan-Dorset model with potential to integrate in the future

12. Dorset Accessible Homes – what will it provide? • Advice and Information • Alternative Accommodation Options • Assistive technology and telecare • Minor repairs and adaptations • Major Adaptations

13. Dorset Accessible Homes Person identifies difficulty with mobility, personal hygiene and/or daily tasks GP/ community health professional DCC Access Team/ SW or OT Family & Friends General promotion Self referral Targeted promotion Third Sector Agency Hospital POPPS Dorset Accessible Homes Service (replaces initial/non-complex) Social work support RP Aids and Adaptations OT assessment – complex needs Specialist support

14. Dorset Accessible Homes Service – key features • Outcomes focussed • Trusted Assessors • Co-location • Outreach and publicity • Encouraging innovation in service delivery

15. Dorset Accessible Homes Service – the benefits • a seamless, joined-up approach to service delivery between partner agencies; • choice of all options for resolving needs, presented at an early stage; • ability to control implementation of the chosen option where possible; • support to exercise choice where required; • quick delivery once the chosen option is decided; • single point of contact and good feedback about progress

16. Obstacles and lessons learnt • Communication - is the message going as wide as it should? has it been understood? • Cultural change (trusted assessors, pooled budgets) • Understanding partners needs and motivations • Implications of wider change (Better Together, Pathways to Independence, integration with health)

17. Obstacles and lessons learnt • Striking a balance between responding to opportunity and setting deadlines • Time • Something else will always crop up e.g. stair lifts contract

18. Where we are now and next steps • Partnership Agreement • Better Care Fund and DFGs • Registered Provider Protocol • DAHS went live 1st April 2015