the highland council fast-track self-referral process for medical adaptations
TRANSCRIPT
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The Highland CouncilFast-Track Self-Referral Process
forMedical Adaptations
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Session Objective
• Introducing the Highlands
• Why Fast-Track
• What is Fast-Track
• Handyperson Service / Care & Repair Service
• Challenges along the way
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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
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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
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Resources
•Finite number of trained Occupational Therapists
•Close working links with Community Health Teams & NHS partners
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Policy
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Why Fast-Track
• Occupational Therapist assessment of adaptation need
• Adaptations graded based on their urgency
• A-F Grading
• Desktop Assessments for priority
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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.
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Adaptations Process
Two main stages
The assessment – of need and priority for an adaptation
The provision – of the adaptation (the responsibility determined by tenure)
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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
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Adaptations ProcessAssessment
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
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Fast-Track ModelSelf Assessment for
Small / Minor Adaptations & Equipment
Level Access Showers
Medical Heating Changes
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Fast–Track Criteria
Level Access Shower
Applicants must meet one of the following criteria;Aged 70 or overAlready been assessed for mobility aidsReceive Disability Living AllowanceReceive Attendance Allowance
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Fast–Track Criteria
Heating Changes
Applicants must meet one of the following criteria;Aged 70 or overLives 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
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Fast-Track PrioritySelf referral cases fall into a priority category C
Priority Example Timescale
A • Client unable to be discharged from hospital• Client unable to carry out essential activities Critical
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
SubstantialWithin 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 N/A
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Adaptations ProvisionCouncil Housing
Housing Association
Private Sector Housing
Who has responsibility for adaptation decision / provision?
Council Housing Association
Council
Who funds adaptation? Council - HRA Housing 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
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Fast-Track SafeguardsSafeguards 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
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Handyperson & Care & Repair ServiceHandyperson 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
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Handyperson & Care & Repair ServiceOur 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
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ChallengesScottish Governments strategy for the next decade ‘Homes Fit for the 21st 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!!
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Staff Guidance