Agenda item

Context:

To provide an update on the capital budget provided to support disabled facilities grants (DFGs) and Safety at Home (SAHs) grants and the impact on overall service performance and on services provided by Social Care and Health.

Key Issues:

1.         The Council has a statutory duty to provide DFG’s within six months of      receiving a valid application.  Failure to do so lays it open to legal challenge.              It also has discretion to provide SAHs.  Since 2006 a capital budget of           £600,000 has been provided annually to deliver both types of grants. In broad   terms the budget is split into £500,000 to support DFGs and £100,000 to     support SAHs. 

2.         All DFGs are capped at £36,000 and while the majority are in the region of             £4,500, each year a number of large, complex grants are provided to meet         the needs of children with complex disabilities, and increasingly for adults      who are disabled as a result of trauma or degenerative diseases.  It is known             through client feedback that adaptations have a significant impact on the   quality of life of both applicants and carers.  Also, customer satisfaction   scores of 95% are regularly being achieved.

3.         SAHs are intended for smaller works such as handrails, half steps and minor         alterations, often costing less than £250 but which make a dwelling safer for a           disabled resident.  They are often commissioned to facilitate hospital     discharge, or to reduce the risk of falls and injuries which might necessitate      hospitalisation.  Both grants play a key role in facilitating hospital discharge            and preventing admission.

4.         In addition to the impact upon clients who have to wait longer for adaptations         to be carried out, the annual shortage of funds and ever earlier full      commitment (typically in the Autumn) has adverse effects on performance in      respect of DFGs which is a KPI that is monitored closely by Welsh             Government and other stakeholders. 

5.         Alternatives to DFGs and SAHs do exist though none are as attractive as   grant aid. Nevertheless some potential applicants do opt to proceed with the             necessary works at their own cost.  Please see Appendix 1 for other options   available. 

Member Scrutiny:

It was noted that the current allocation of £600,000 is insufficient to meet annual demand and the budget is usually committed before Christmas.  An estimate was provided that the budget is £500,000 short to address the backlog.  At the beginning of January there were 19 applicants waiting for DFG now increased to 44 today, with two months of the financial year to complete.  Up to 70 referrals could be received by the end of the financial year but the demand is unknown.  The majority of adaptations are due to the aging population in terms of wet/shower rooms, stair lifts and ramping but increasingly more complex adaptations to enable release from hospital.

Financial context was provided that the capital programme has been reviewed with consideration given to changing priorities subject to two important principles; it must be self-financing or alternatively must replace something as a bigger priority as resources are scarce.  It was reported that £30,000 has been released from Highways and Access for All budgets to provide a small amount of funding to address quality of life demands.  Otherwise prioritisation of DFGs will have to be decided but it was explained that there is little headroom in the capital programme.  Members were provided with information regarding borrowing.

Following presentation of the report, Members were invited to comment:

It was commented that the authority has an ethos of encouraging independence, but there is insufficient support and is was suggested that the matter should be prioritised. It was queried if the Health Board’s budget could be diverted to DFGs to assist in alleviating bed blocking and make a saving but confirmed that this approach has been raised with the Health Board but declined because of the difference between social and health care.

A member asked if the funding was available, could the remaining demand be reduced.  It was responded that demand is largely unknown to do with the aging population and the unpredictable need for varying levels of adaptation or to move to more suitable accommodation.

A Member questioned the numbers of people in hospital awaiting DFG adaptations to enable their return home.  It was confirmed that numbers were not immediately available but that referrals were made via hospital occupational therapists. 

In response to a question, it was explained that there is collaborative working in the Gwent wide “In One Place” project with Social Care, Registered Social Landlords and local authorities to make joint proposals to develop housing solutions that benefit Health on a higher strategic level.  One such development has been delivered with Monmouthshire Housing (Skenfrith House, Abergavenny) and there is scope for future similar plans.

Members revisited the issue of the difficulties in moving people out of hospital to social housing, and were informed that often Health Services will not release a patient until the necessary work is carried out.   

The speed of completion of works was discussed and it was confirmed that delays are related to the complexity of the work required and lack of funding.  

Recommendations

1.    The Committee considered how the disabled adaptation programme is supporting residents to remain living safely and independently at home and recommended that the identified underspend is used to reduce the backlog of adaptations required.

2.    The Committee recommends to Cabinet an increase in capital funding for disabled adaptation grants in 2017/18 and subsequent years.