Review calls for overhaul to improve home adaptations

Issue date: 10 December 2018


Housing and health partnership boards should be set up in every area of England to maximise the impact of grants for home adaptations, according to an independent government review.

Similar in structure to local safeguarding children's boards, they would bring together representatives from health, housing and social care to develop local strategies for adaptations and accessible housing.

It is one of a raft of measures outlined in a review of Disabled Facilities Grants (DFGs) commissioned by the Department of Health and Social Care and written by the University of the West of England (UWE Bristol), Foundations, the Building Research Establishment (BRE) and Ferret Information Systems.

The annual DFG budget – worth £0.5 billion this year – has increased substantially in recent years and enables thousands of vulnerable people to adapt their homes and live independently.

Demand for adaptations is outstripping supply and this is set to continue as the population ages. The review examined the operation of the grant and wider delivery of home adaptations to support the independence of disabled people living in their own homes.

It found the delivery of adaptations varies enormously from area to area and there is often a lack of integrated decision making and tracking of impact on those receiving grants.

The report recommends a new Home Independence Transformation Fund, equivalent to one per cent of the DFG budget, be set up to help areas develop more integrated services.

Other key recommendations include:

· Annual increases to the DFG upper limit, currently set at £30,000, in line with inflation

· Including DFG in personal budgets and making spending on adaptations part of the social care cap (if the cap is adopted)

· A further five-year funding programme for DFG before the current programme ends in 2020

· Health & Wellbeing Boards should report separately on DFG funding based on 'the number of people helped to remain independent at home'. They should also review and sign off a single adaptations policy based on local needs

· Renaming DFG as part of a national campaign to raise awareness of the support available

· Replacing the current “confusing mix of methodologies and historical allocations” with a fairer and more transparent funding formula based on local data around the number of people with a disability, income, tenure split and regional building costs

· Introducing a national accreditation scheme for builders and tradespeople carrying out adaptations

· Including a smart home starter kit as part of every DFG application

Sheila Mackintosh, Research Fellow at UWE Bristol and co-author of review, said: “This Review looks at the current way the Disabled Facilities Grant is delivered and how it could be improved to reduce pressures on health and social care. It shows how changes to the home such as providing a shower instead of a bath, installing a stairlift, ramp or rails, or in some cases a downstairs extension, can transform the lives of disabled and older people and enable them to remain independent. But governance needs to be improved, resources distributed fairly and transparently, and services updated to provide faster and more effective solutions in keeping with today's lifestyles.”

Paul Smith, Director of Foundations, the national body for home improvement agencies and DFG, said: “This review sets out a number of practical ways we can improve the delivery of home adaptations and ensure they are tailored to the individual. DFG will be 30 years old next year. In many ways it was ahead of its time – recognising the importance of supporting independence. The preventative approach it embodies is now becoming the norm and we have an opportunity to bring health, housing and social care practitioners closer together to make DFG more effective.”

Helen Garrett, Principal Consultant, BRE Housing and Energy team, said: “This comprehensive review further demonstrates how home adaptations can deliver some government health and social care key policy objectives as well as having the potential to transform the quality of life for those who need them. The impact of inadequate housing upon health and well-being is being increasingly recognized, and the review demonstrates the importance of joint strategic planning and delivery”.

Gareth Morgan, CEO of Ferret Information Systems, said “The review considers the ways in which adaptations, that can transform lives, can be made affordable at a time of great pressures on public spending. Helping people to stay in their homes and live independently in their community brings so many benefits”.

Copies of Disabled Facilities Grant (DGF) and Other Adaptations: External Review can be downloaded here.

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