In social care, the Disabled Facilities Grant (DFG) is often seen as that thing the people in housing do to fit level access showers, ramps and stairlifts. Something with big application forms and long waiting lists.
That may have been the case five years ago but a lot has happened recently that may cause you to think again, writes Paul Smith, director of Foundations, the national body for home improvement agencies.
Crucially, DFG is now part of the Better Care Fund (BCF) – a programme spanning both the NHS and local government which seeks to join-up health and care services, so that people can manage their own health and wellbeing, and live independently in their communities for as long as possible. If you want to keep people living independently at home then it makes complete sense to include the funding that helps to adapt over 50,000 homes every year.
The government has clearly recognised the benefit of home adaptations. The budget has more than doubled in the last five years and now stands at £505m. This was predicated on preventing admissions into residential and nursing care – something that our research shows can be delayed for four years by using DFG appropriately.
And it’s no longer just showers, stairlifts and ramps. Over 85% of local authorities have now published a Housing Assistance Policy, which means they can do much more. For instance, across Worcestershire, they offer a grant which can pay for relatively small modifications around the home that can help someone with a diagnosis of dementia to retain their independence. For a few hundred pounds simple signage, day/night clocks and removing some cupboard doors can mean staying there for several months longer.
Grants are now much more common for other impairments too. Children with autism and challenging behaviours could have a range of modifications made to make their garden a safe place to play – from cushioned flooring to anti-climb rollers on the tops of fences.
One of the key challenges is still how to provide a person-centred response to someone who needs adaptations to their home when different responsibilities (and budgets) span different departments or organisations in two-tier areas. On occasions, more time can be spent on arguing who pays for what than actually getting on with the work. But there is an opportunity to do things differently.
For example, in Warwickshire, they recognised the need to work more collaboratively and set up one joint team to manage all adaptations across the county – whether funded through DFG or by social care. From a grabrail to a bedroom extension on the back of a house, they handle it all, working through the complexities so that it all appears seamless to the service user. Importantly, each service user is assigned a key contact who manages the whole process from start to finish, bringing in other expertise (such as an occupational therapist or building surveyor) as required.
When they started they mapped out a 220-step process and found that 30% of people dropped out along the way. They now have only 22 steps and help 97% to make suitable adaptations to their home.
To promote good practice and share new ways of working we set up DFG Champions – a social movement to challenge the way DFGs have traditionally been delivered. We hold eight regional roadshows every year and have a growing Facebook Group where practitioners discuss tricky cases and how to do things better. We also provide free in-house training and workshops to help local authorities improve their systems, often at the request of social care managers and commissioners.