Personalised solutions on a universal platform Julia Fitzpatrick

1. Personalised solutions on a universal platform Julia Fitzpatrick

2. Needs, aspirations and supply People with mobility impairments in need of suitable housing Need 199,402 Supply 26,000 Wheelchair users in need of suitable housing Need 36221 Supply 7000 Pensioner households in need of property adaptation Need 66,300

3. How well are we addressing the gap?

5. Audit Scotland 2004 'equipment supply is the single most confused area of community care service provision, with adaptations being particularly complicated'

7. £ Where is the money? • £531 million AHIP in 08/09 • £425 million LA & RSL spend on SHQS • £107 million RSL spend on planned maintenance (not SHQS) • NHS spending 09/10 – £10.8 billion • Social care revenue spend – circa £2.5 billion • £70 million Change Fund

9. “More than a ramp and a handrail” Independence, inclusion, choice, control, citizenship Social & medical models – what’s driving our current systems? Housing, health, social work & community care legislation from 1968; Children’s (Scotland) Act, DDA, Human Rights Act, Equality Act 2010, Self Direct Supported Bill ... Corporate responsibility and whole system thinking vs Hot potato and poor relation

10. ££ and the rest of the lottery • Inconsistency of practice and criteria • Lack of clarity, knowledge or consistency of availability of minor adaptations services for RSL, tenants or owners • Levying charges – rents or service charges, pooled or specifically allocate? • Provision or planning for future replacement • Managing and paying for aftercare - Health & Safety, cost in use – maintenance and servicing

11. Changing the system – Rebalancing power Prevalent resource allocation process; • Assessment of need • Proposal or Plan • 6 Funding routes • Provide • Review

12. The ‘professional gift’ model An underlying system of power: “we know best’, be grateful, don’t expect too much Professionals work out what you need Which, very often, turns out to be what they can offer or afford OTs as gatekeepers; Government holding the purse strings Costly and complex, reactive process Poor relationship between needs and service provision Few all round experts, few independentbrokers working across all systems

13. A universal platform Simple self assessment Person in driving seat Right to independent living Transparent funding entitlement Ease of use Access to independent information and advice Capacity principle

14. Levelling the threshold Remove the current system barriers Biggest demand, relatively low cost Planned replacements and improvements – equipment design and specification, layout, question use and future needs Environmental improvements SAHR – increasing capacity for improving the match Freecycle – web based resource

15. Local and personal • Not once and for all – people’s needs change • Personal & unique needs – one size won’t fit all • Distribution of need and demand – housing quality, house types, allocations policies, age profile. • Availability of alternative accommodation – right type, right place, right time. • Familiarity, caring, social, amenity and professional networks – not just about bricks and mortar.

16. Tools for a better job Acknowledging the problems we have Whole person thinking Working with the health care sector Speaking with one voice Developing the infrastructure Capacity, contribution and community “Inclusion is not about them, it is about us”