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Speedier response to adaptations launched

RCOT publishes report aimed at speeding up process of delivering adaptations to people's homes

Published on 18th June 2019

The Royal College of Occupational therapists has launched a new guide, ‘Adaptations without delay’ in a bid to speed up the process of delivering adaptations to people’s homes.

The guide has been launched to reduce delays in delivery of adaptations and it provides tools that support a proportionate response. The guide contains a decision-making framework that outlines new ways of working that includes the different levels of complexity of a situation and the most appropriate response.

Julia Skelton, Director of Professional Operations at the Royal College of Occupational Therapists said: “Adaptations play a crucial role in prevention and need to be delivered in a timely manner.

“It’s clear that a radically different approach to addressing the delays in the assessment and delivery of adaptations is required. Occupational therapists have a crucial role to play in adaptations – taking a collaborative approach to assessment, design, and delivery that is based on the complexity of the situation rather than the type and cost. The guide should assist all those involved in delivering adaptations to ensure a proportionate response that makes the best use of the skill mix within the workforce for timely delivery," she added.

The report highlights that across the UK, there continue to be delays in the delivery of minor and major adaptations across all housing tenures. In recognition of this continuing issue, in 2017 the Royal College of Occupational Therapy commissioned the Housing Learning and Improvement Network (Housing LIN) to conduct a UK-wide review of Minor adaptations without delay (2006), which was focused on enabling housing associations to provide minor adaptations without the need for an occupational therapy assessment, and to identify whether a new version was required.

The key findings of a review of current practice were:

- There is the need for a more preventative approach to interventions, including adaptations, for older people, disabled children and adults, to maximise health and wellbeing.

- Waiting for a social care assessment is cited as a key factor in contributing to delays in the delivery of adaptations. Legislation pertaining to the funding of major adaptations has been misinterpreted as being dependent on an occupational therapy assessment.

- Current systems for delivering adaptations need to provide person-centred outcomes through a more integrated and collaborative approach to the assessment, design and installation of adaptations.

- In terms of demand for major adaptations, the most common are showers, stairlifts and ramps, often in situations that are simple and straightforward.

- Typically, the need for an adaptation has been defined by the type or cost of the solution, rather than the complexity of the situation.

- It is recognised that there is a large proportion of people who are not eligible for funding for adaptations who could benefit from better information, advice and guidance on how to get adaptations installed.

"From the review findings it was clear that a radically different approach to addressing the delays in the assessment and delivery of adaptations was required," said the report. "This new approach sets out a better way of defining adaptations based on complexity. It focuses on the role of adaptations as a preventative intervention to support person-centred outcomes using an approach that makes the best use of the skills mix within the workforce."

The guide sets out the Adaptations without delay decision-making framework. The framework outlines the person-centred outcomes that can be achieved from having the home adapted. Workforce and operational factors to support integrated and new ways of working are identified. The framework outlines the different levels of complexity of the situation, rather than cost and type of adaptation. The levels of complexity are defined as:

• Universal (simple, low level).

• Targeted (straightforward, moderate).

• Specialist (complex, high risk).

The guide outlines circumstances when occupational therapists need to work closely with those with the technical expertise necessary to establish and develop bespoke adaptations and ensure that the installation is feasible. The guide highlights ways that occupational therapists can add value at a strategic level in the design of services, communication tools, and the provision of training and support for unregulated staff.

The guide is intended to have the following benefits:

• Ensuring a more responsive service to those needing adaptations.

• Reducing demand on occupational therapy services.

• Providing reasoning for key stakeholders about adaptations that do not need an
assessment by an occupational therapist.

• Recognising the expertise of occupational therapists in complex situations where
adaptations are required.

• Being applicable in all four UK nations.

Adaptations without delay 

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