The Highland CouncilFast-Track Self-Referral Process

forMedical Adaptations

Session Objective

• Introducing the Highlands

• Why Fast-Track

• What is Fast-Track

• Handyperson Service / Care & Repair Service

• Challenges along the way

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

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

Resources

•Finite number of trained Occupational Therapists

•Close working links with Community Health Teams & NHS partners

Policy

Why Fast-Track

• Occupational Therapist assessment of adaptation need

• Adaptations graded based on their urgency

• A-F Grading

• Desktop Assessments for priority

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.

Adaptations Process

Two main stages

The assessment – of need and priority for an adaptation

The provision – of the adaptation (the responsibility determined by tenure)

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

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

Fast-Track ModelSelf Assessment for

Small / Minor Adaptations & Equipment

Level Access Showers

Medical Heating Changes

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

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

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

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

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

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

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

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!!

Staff Guidance

Contact Details

Gail.ward@highland.gov.uk

Emma.micklethwaite@highland.gov.uk