Agenda item

Presentation on adaptations through Border Care and Repair Service.

4.1       Mr Nile Istephan (Chief Executive) and Mr Michael Patterson (Property Officer) of Eildon Housing gave a presentation on the operation of the Care and Repair Service run by Eildon Housing.  Borders Care and Repair had been set up in late 2004 and opened to the public in January 2005.  The Service was a partnership between Eildon Housing Association and Scottish Borders Council.  Since its inception the Service had been continually developing and in 2010 had started to manage local Registered Social Landlords (RSL) adaptations to housing stock where a client had been identified as needing work on their house to allow them to remain in their home.  This service was also provided to home owners and applied to any type of property.  In 2015 the RSLs had agreed to a joint funding bid to Scottish Government for provision of a Stage 3 Adaptation Service which allowed funding to be spread across the 4 main local RSLs through the one Service.  Care and Repair also provided a Handyperson service.  Services were available for homeowners or tenants over the age of 60 or for disabled owners or tenants of any age.  An Occupational Therapist was employed as part of the Adaptations Service to assess a client for their physical needs within their own home.  Following this assessment, works were arranged and help provided for the client to apply for grant funding for the works (minimum grant award 80%).  Having an Occupational Therapist assigned to the Service allowed a degree of specialism, with the Occupational Therapist working with the team to design and source the most effective aids, which in turn gave a more consistent approach.  Adaptations ranged from level access showers, stair lifts, ramp access to a house, to minor items such as grab rails, banister rails or lever taps.  These latter items could be fitted free and were mainly put in place to prevent falls or accidents. 

4.2       Further details were given about Stage 3 RSL adaptations and the funding of the Service.  Mr Istephan explained that if any of the RSLs had, for example, a replacement bathroom project for houses, the opportunity could be taken to replace traditional bathrooms with wet-floor shower rooms, if properties were more likely to be rented to elderly tenants.  If a tenant moved, then RSLs would look firstly for a new tenant with similar requirements so adaptations were not removed.  Adaptations helped older and disabled people to remain at home, and the aim was to avoid inappropriate admissions to care settings such as hospitals or residential/nursing homes.   The Handyperson Service carried out safety and security work, such as changing light bulbs, installing door chains/viewers and window locks, home safety checks, and arranging for the Fire and Rescue Service to carry out fire safety checks and fit free smoke alarms.  The Service also carried out “comfort” low-level interventions to prevent accidents, such as fitting draught excluders and curtain rails; hanging curtains and pictures; replacing tap washers and unblocking sinks; moving furniture within the house; plus other minor jobs. The Handyperson Service initially worked on 70% direct client arranged tasks, and 30% referral from Social Work or Health Teams, but now 72% of work came via the Social Work and Health Teams. 

4.3       The Handyperson Service cost £36 per annum for individuals for unlimited access, but the membership number had dropped by 12% in the last year.  Although no specific analysis had been carried out, more than one factor was likely to be the cause of the decrease.  The Service was stretched, with work which normally took place within a week of request now taking up to a fortnight.  It was necessary to balance any increase in uptake with service capacity.  The Service was paid for from the Council’s Social Work budget.  It was confirmed that the Borders Ability equipment store was a separate project, with the costs of that paid for jointly by the Council and NHS Borders, although the Care and Repair service could fit items from the Ability Store.  Moving forward, the Care and Repair service had just completed a 12 month pilot allowing Borders residents to refer themselves directly for assessments. A final evaluation had been completed and was available.  This pilot had been supported by the Scottish Government Joint Improvement Team as one of 5 demonstration sites across Scotland.   Examples were given of savings which could be made with an adaptation intervention e.g. the life time cost prior to the installation of a shower for a client would have been £56k: with the adaptation, this cost reduced to £32k , a saving of £24k.  Not only was there a cost saving but there was the additional benefit to the individual of independence and improved quality of life.  Further details were given of the current position with funding, whereby bids had to be made each year for the amount estimated to be needed.  Only 68% of funding requested had been granted.  This meant that by the end of 2015, all funding had been spent and there was an estimated £220k of adaptations on the waiting lists across the 4 RSLs.  Notification of new funding for 2016/17 was not expected to be announced until June 2016.   Two alternate visions were then given for the future of Borders Care and Repair.

4.4       Mr Istephan explained that while the Care and Repair Service was mature and had a certain sophistication about it, there were anxieties that it could do so much more in terms of volume and range of services.  It was a preventative service but it would only be possible to promote it further if it had the capacity to meet demand.  Support was required from the Community Planning Partnership to lobby the Scottish Government about its process for Stage 3 Adaptations funding which did not allow for sufficient forward planning.  Further funding was required to develop the Service and whether this came from the Integrated Care Fund or elsewhere, the important factor was spending money here allowed savings in other budgets later.  While funding had not reduced from Scottish Government, demand was increasing, and the national budget was over-subscribed.  Ms Smith advised members of the Slips, Trips and Falls project within the Fire and Rescue Service and the possibility of that project taking on some of the lower level adaptations.  Mr Istephan confirmed that he had met with Mr Girrity of the Fire and Rescue Service about this and Mr Farries confirmed that a pathway was clearly established with the Fire home safety visits.

DECISION

AGREED:

(a)     to support the Care and Repair Service in its bid to establish a more stable funding process with Scottish Government to allow greater long term planning; and

(b)     that the SBC Communities and Partnership Manager, LSO Farries of the Fire and Rescue Service, and Mr Patterson of the Care and Repair Service take forward the possibility of the Fire and Rescue Service assisting with some minor adaptations as part of their home safety visits and a report be brought back to a future meeting of the Strategic Board in due course.