1. The Highland Council Fast-Track Self-Referral Process for Medical Adaptations

2. Session Objective Introducing the Highlands Why Fast-Track What is Fast-Track Handyperson Service / Care & Repair Service Challenges along the way

3. Introducing the Highlands The Highland covers an area the size of Belgium The terrain in parts is isolated, rural and difficult to access Clusters of urbanisation Strong and supportive communities

4. Population The Highlands has a population of 222,370 Higher than average, aging population Projections for the future are: Number of retired people will almost double The number of people aged 75+ will more than double

5. Resources Finite number of trained Occupational Therapists Close working links with Community Health Teams & NHS partners

6. Policy Adaptations Policy  Eligibility  Type of adaptation  Timescale  Maintenance  Specification  Installation

7. Why Fast-Track Occupational Therapist assessment of adaptation need Adaptations graded based on their urgency A-F Grading Desktop Assessments for priority

8. What is Fast-Track A model which allows clients to submit a self- assessment application for a range of adaptations that can be installed in the home without the need for a full medical or Occupational Therapist’s assessment.

9. Adaptations Process Two main stages The assessment – of need and priority for an adaptation The provision – of the adaptation (the responsibility determined by tenure)

10. Adaptations Process Two stages of assessment Expert Assessment – Usually by an Occupational Therapist Considers the clients wider community care needs Long term needs and ability to remain in their home

11. Adaptations Process Assessment Self Assessment Self Assessment applies where the client does not have more complex needs Most carried out without referral to OT for assessment Pre-determined criteria More efficient and speedy service

12. Fast-Track Model Self Assessment for  Small / Minor Adaptations & Equipment  Level Access Showers  Medical Heating Changes

13. Fast–Track Criteria Level Access Shower Applicants must meet one of the following criteria;  Aged 70 or over  Already been assessed for mobility aids  Receive Disability Living Allowance  Receive Attendance Allowance

14. Fast–Track Criteria Heating Changes Applicants must meet one of the following criteria;  Aged 70 or over  Lives alone, under 65 and receives either; o High Rate of the mobility component of Disability Living Allowance o Receives Middle or High rate Care Component of Disability Living Allowance  Lives alone, aged 65+ and receives Attendance Allowance

15. Fast-Track Priority Self referral cases fall into a priority category C PriorityExampleTimescale A Client unable to be discharged from hospital Client unable to carry out essential activitiesCritical Within 48 hours B To prevent imminent hospital admission To prevent serious breakdown in health / home situation To meet the needs of a disabled child Substantial Within 15 days C Adaptation would be a significant benefit Adaptation would promote client’s safety or independence Adaptation would prevent future crisis in the home Moderate Within 4 weeks D Adaptation is not of sufficient priority to be funded – clients are offered advice N/A

16. Adaptations Provision Council Housing Housing Association Private Sector Housing Who has responsibility for adaptation decision / provision? CouncilHousing Association Council Who funds adaptation?Council - HRAHousing Assoc. Grant Council – through private sector grant Who is responsible for recording / monitoring adaptations? Council – H&P Service Housing Association Council - H&P Service Who guides / supports person through installation? Council staff – H&P Services Housing Assoc. staff Care & Repair How are minor adaptations provided? Council or Handyperson Housing Assoc. or Handyperson Handyperson Service Who assesses for adaptations (not fast-track) Occupational Therapist What priority categories are used?Priority Categories A - C

17. Fast-Track Safeguards Safeguards in the Fast-Track system include; Clients not accepted for Fast-Track if they are already in the system and awaiting assessment Clients with dementia or related illnesses must always be assessed All Maintenance Officers (HC), Handypersons and Care & Repair Agents undergo training with OT’s

18. Handyperson & Care & Repair Service Handyperson Service and Care and Repair Service are integral to the Fast-Track scheme being a success. Often the same organisation delivers both the services Fast-Track would not work without these agents Highland agents provide an exemplar model One agent has been one of the first organisations to recently achieve Care & Repair Accreditation

19. Handyperson & Care & Repair Service Our leaflets are available to download at: http://www.highland.gov.uk/NR/rdonlyres/2EC867E1-1DB0- 45A6-8F94-9CF88907357F/0/handypersonserviceleaflet.pdf http://www.highland.gov.uk/NR/rdonlyres/95DC80B2-C1EA-488C-940D- F657554836CE/0/schemeofassistanceadaptations.p

20. Challenges Scottish Governments strategy for the next decade ‘Homes Fit for the 21 st Century’ – commitment to simplify arrangements for the public and housing providers to access funding for adaptations. Greater integration Reduce waiting lists and manage client expectation We don’t always get it right!!

21. Staff Guidance

22. Contact Details Gail.ward@highland.gov.uk Emma.micklethwaite@highland.gov.uk